A M E R I C A N D E N T A L A S S O C I A T I O N
Central District Dental Society
|Meeting on May 8th , 2008|
Meeting - "Make it a Date"
Enjoy the MAS exhibits! Come Early!- Head to Toe - an exhibition about five bodily topics: skeletons, organs, the senses, general health and general body facts.
- See a special exhibition featuring over twenty works by 17th through 20th century female illustrators.
-Shop in the Gift Store for unusual and beautiful objects of art and of science too!
- See an exhibition of juried art by high school students in central Georgia.
Dr Ty Ivey discusses changing personel and attitudes at ADA top leadership in Chicago.
|Websites for Snoring & Sleep Apnea Information|
Sleep Review Magazine (Has good page for product links)
Thornton Anterior Positioner
Elastomeric Sleep Appliance, Herbst, Klearway Oral Appliance,
NAPA (Nocturnal Airway Patency Appliance), Snore-Aid, SNOR-X
Quiet Sleep (links to “Snoring Isn’t Sexy”)-Marketing Focus
American Academy of Dental Sleep Medicine (AADSM)
National Sleep Foundation:
Dental Organization for Sleep Apnea (DOSA) - (1 year-old organization)
Extensive list of oral & oral/CPAP combination appliances
(Labs with websites- Glidewell Labs, John’s Dental Lab, Strong Dental Lab, Somnomed,)
|Andrew R. Kious,
Department of Oral Rehabilitation
School of Dentistry AD 3233
Medical College of Georgia
Augusta, Georgia 30912-1260
Dr Ty Ivey's letter to ADA leadership is a response to the letter from the Editor in JADA in March 2008.
N. Tyrus Ivey, DDS
1902 Forsyth Street
Macon, Georgia 31210
March 24, 2008
Dr. Michael Glick, DMD
211 E. Chicago Avenue
Chicago, IL 60611
Dear Dr. Glick,
I read with interest your commentary in the March 2008 edition of JADA, “Lessons Learned – Implications for Workforce Change,” which was co-authored by Dr. O.T. Wendel. I wondered what the giants of our dental past both known and unknown would have thought. These visionaries brought us from the ranks of tradesmen pulling teeth in second floor walk ins to the honored health profession that we and our patients enjoy today. The main question that comes to mind is how much of our scope of practice that these gentlemen fought so hard to build can dentistry give away without reverting to trade status?
The basic premise of your “commentary” seems to be that we must emulate the medical model if we are to deliver oral health care in the 21st century. The commentary raises many questions which are not addressed in the policies of the American Dental Association. If embracing the medical model is so powerful, why is it that most of the grassroots dentists in this country believe and are being led to believe by the leadership of our Association that we have been fortunate in the last twenty years because we have avoided the mistakes that our medical colleagues have made in dealing with scope of practice issues and the loss of the doctor as the primary provider of health care to patients? Weren’t we proudly the only health profession lobbying to be excluded by the Clinton Health Plan in 1993?
While your opening remarks forecast a dramatic increase in demand for dentistry in the next decade, the American Dental Association has been stating to its leadership and councils for the last 10-12 years that we do not have a shortage of dentists in this country. We have stated over and over again that our only problem is a mal distribution of dentists and that we had adequate manpower to meet the needs of the public for the next twenty years. In fact, Dr. Jack Brown speaking for the ADA has emphatically stated that if we did anything to increase the number of dentists in this country, we could do something that could have potentially very negative effects.
The leadership of the ADA has in fact dismissed any suggestion that we train more dentists, but now suddenly we need mid-level providers who are going to provide dentistry. The question must be asked, what difference does it make what you call the person filling your tooth? Dental manpower is dental manpower regardless of the name. Depending on the model, the scope of the midlevel provider is planned to be far reaching to the point of including extractions and restorations. (Of interest to all is the proposed Advanced Dental Hygiene Practitioner legislation in the Minnesota Legislature this year. This model advanced by the American Dental Hygiene Association totally rewrites the educational training program for dentistry.) Strangely, when the Association was preaching that we did not have a manpower shortage, it sat by eight years ago when the U.S. Public Health Service decided to launch an initiative to train high school graduates in 18 months to perform unsupervised dental care in the outer reaches of Alaska. While the Association ignored initial notification that something was going on in Alaska, it is hard to determine how we could not have known. A Google trip to the web sites of the Public Health Service and pages dealing with the Alaska Dental Health Therapist will allow you to document the genesis of this project which is now in full swing in the United States of America and coming soon to a state in the lower 48 near you.
It is very likely that the average dental practitioner will be amused by the comfort that you offer in your editorial on page 234, col. 1. We often see similar statements in advertisements from the insurance industry. You state that these new mid level providers will give patients access to affordable, high quality, comprehensive oral health care. First, these mid level providers will require dentists to supervise their actions. If there are no dentists in these underserved areas what are the plans that will allow the mid level providers to function there? How long can we hide behind the ruse of teleconference oversight before these midlevel providers decide that they should have independent practice? When you call for new state laws to deal with the new “stratified oral health service model” it would appear that we are seeking to emulate the current medical model where the patient is constantly confused by a convoluted treatment program where no one knows who is treating them and for what. The mere statement of “affordable” and “high quality” makes us wonder. On the PPO “opportunities” that I receive in my office the primary qualification that I see that is required of me is my signature on the dotted line and little else. The concern for making the care very affordable is how are the mid lever providers going to make a living if the cost of care is so “affordable?” You do not have to be one of the best read dentists in the country on dental matters to know that Wal-Mart and several of the other chains are preparing to add health care services as a part of their product line. The only way these entrepaneurs can achieve maximum success in dentistry is by the use of mid-level providers. Apparently from the thoughts of your commentary and the thoughts of the leaders of the ADA, we are going to create the midlevel provider just in time for their dental clinics.
My last concern is the call to arms for the Community of Educators to redefine the future of dentistry. The role of dental education historically has been to support the needs of the profession relative to the technology available for the average practitioner. Now we see that you would ask the educators to develop a model that would define the profession rather that the other way around. How can someone who has never had to make a payroll or pay the light bill on the hopes that patients will come, fully understand all of the parameters and requirements of private practice?
And so we repeat again the question, how much of the scope of practice can dentistry give away without reverting to trade status? The insurance industry is not happy paying us for dentistry today, it is doubtful that they will want to pay us much for managing and diagnosing in the future. Before the Educators and the leaders of the Dental Profession give away the jobs of the average general practitioner, a long hard look at the medical past should be weighed against the medico/dental future that you are proposing. It might be a good idea if the average dentist in the street had a clearer picture of the flowery images of his or her job description in the future that are being portrayed in JADA and the ADA News.
Central District Dental Society
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