dental anesthesiology info

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For those of us interested in dental anesthesiology, does anyone have good insight of what the future of this career holds? Are you most likely working in a hospital setting? is there bias against hiring dental vs md anesthesiologist? Still trying to decide whether its the right path for me. thanks for all the help

Originally Posted by jayballer125

For those of us interested in dental anesthesiology, does anyone have good insight of what the future of this career holds? Are you most likely working in a hospital setting? is there bias against hiring dental vs md anesthesiologist? Still trying to decide whether its the right path for me. thanks for all the help

There are only a handful of DAs at hospitals in the whole country...this isn't going to change any time soon. If you want to work in a hospital then go to medical school.

Of course there is a bias between md and dds, all MDs would prefer an MD and many dds are gonna prefer an MD as well. DA is a very uncertain field right now, and no one can argue that. In the early 90s insurance companies almost stopped offering malpractice to DAs and almost wiped out the field.

If you're looking for something certain this is not your field.

Originally Posted by Sublimazing

There are only a handful of DAs at hospitals in the whole country...this isn't going to change any time soon. If you want to work in a hospital then go to medical school.

Of course there is a bias between md and dds, all MDs would prefer an MD and many dds are gonna prefer an MD as well. DA is a very uncertain field right now, and no one can argue that. In the early 90s insurance companies almost stopped offering malpractice to DAs and almost wiped out the field.

If you're looking for something certain this is not your field.

What do you think of the impact of the MD anesthesia world being taken over by CRNAs? The docs will always be needed of courses, but the total doc-hours will be reduced.

I imagine this will spill over and make the MDs go after private practice opportunities outside the hospital. They may target dental offices and efficiently provide care.

I dunno.

I still think a smart and nibble dental anesthesiologist could do quite well in most locations.

Originally Posted by GTFOOMICT

What do you think of the impact of the MD anesthesia world being taken over by CRNAs? The docs will always be needed of courses, but the total doc-hours will be reduced.
I imagine this will spill over and make the MDs go after private practice opportunities outside the hospital. They may target dental offices and efficiently provide care.
I dunno.
I still think a smart and nibble dental anesthesiologist could do quite well in most locations.

No one can make a legitimate guess on any of your questions, as all the issues are still in heavy flux.

DA will be voted on Oct/Nov 2012 by the ADA for an official specialty. Til that goes one way or the other no one can guess with any certainty.

Originally Posted by GTFOOMICT

What do you think of the impact of the MD anesthesia world being taken over by CRNAs? The docs will always be needed of courses, but the total doc-hours will be reduced.

I imagine this will spill over and make the MDs go after private practice opportunities outside the hospital. They may target dental offices and efficiently provide care.

I dunno.

I still think a smart and nibble dental anesthesiologist could do quite well in most locations.

Wouldn't you agree that a CRNA would be in a higher demand to private practice then a DA, likely due to lower fees?

Originally Posted by DrDDSman

Wouldn't you agree that a CRNA would be in a higher demand to private practice then a DA, likely due to lower fees?

It's true the cheapest option is always the best option when it comes to practice management and patient care...I, however, will be avoiding your office

And CRNAs can only operate unsupervised in 16 states...but gambling your entire career on hiring someone that most states in the US don't think can handle their field without supervision seems...short sided

Originally Posted by DavesNotHere

It's true the cheapest option is always the best option when it comes to practice management and patient care...I, however, will be avoiding your office

And CRNAs can only operate unsupervised in 16 states...but gambling your entire career on hiring someone that most states in the US don't think can handle their field without supervision seems...short sided

Heh, I think he just phrased it poorly. The CRNA needs to be supervised in most states, so that doesn't help the general dentist or pediatric dentist they would still need a DA...and the OMFS who could use a CRNA def. might, but kinda misses the point of hiring someone if they're supervising

I'm sure CRNAs work out for a lot of dentists/specialists...but any dentist/specialist who is smart can really benefit from a DA specifically, so those in the know choose DAs. The fact that only 27 a year are coming out and probably half of them go into operative dentistry means DA is a really really small field.

Originally Posted by Sublimazing

There are only a handful of DAs at hospitals in the whole country...this isn't going to change any time soon. If you want to work in a hospital then go to medical school.

Of course there is a bias between md and dds, all MDs would prefer an MD and many dds are gonna prefer an MD as well. DA is a very uncertain field right now, and no one can argue that. In the early 90s insurance companies almost stopped offering malpractice to DAs and almost wiped out the field.

If you're looking for something certain this is not your field.

What did these DA's end up doing? General Practice? Academia? Real estate?

I am unaware of malpractice companies even considering dropping DAs from obtaining insurance coverage. I will have to ask my attendings about this when I start my program. I do believe that since DA programs are now CODA accredited this validates their training. Furthermore, if malpractice companies are considering dropping anesthesia coverage for DAs. I would assume this also threatens OMFS and their model of practice. I, along with the academy of DAs (American Society of Dental Anesthesiologists), fully support OMFS and their dual model of practice (surgeon/anesthesia as one provider). However, I feel it would be difficult to argue that someone with 2-3 years of solely anesthesia training is less qualified to practice deep sedation/general anesthesia than someone who has had 6 months of this training. Once malpractice companies start limiting anesthesia by properly trained dentists there is no way of telling where that stops. As I have mentioned in the past some countries have had anything above local stripped from dentistry. I believe this is one of the biggest reasons to support DA as a specialty this will enable the field of dentistry to have their own "anesthesia specialist" for guidance on anesthesia. I only hope our profession works together to support anesthesia by all qualified dentists; from the OMFS doing deep IV sedation, the pediatric dentist doing oral sedation, the DA during deep/general both intubated/nonintubated, to the general dentist doing mod IV sedation. Our patients deserve this care.

As far as job opportunities/field growth I would encourage anyone who is interested in DA to educated themselves from all view points. This would include externships (I recommend Pitt for this), speaking with private pracite DAs (or even better finding someone who is practicing and shadow him/her), speaking with Oral Surgeons on their views of the field, finding practitioners who use DAs and speaking with them, and finally read as much as you can (the previous DA interview thread has some great links to read). Below are links to two recent articles showing a great interest and demand for office based anesthesia by DAs.

http://www.ncbi.nlm.nih.gov/pubmed/22428968
http://www.ncbi.nlm.nih.gov/pubmed/22428969

I couldn't find PDFs of these articles that are freely available online but just instant messaging and can email you a PDF of each article.

My own personal experience:
I have yet to even began DA residency. Despite this fact, many dentists in many different states have eagerly inquired about my skills as a DA and using them in their office upon completion. I am leaning toward a career in academia with a long-term goal of creating a new DA program (I greatly believe in the field and the benefits it offers to both patients and our overall profession). However, this interest is reassuring.

I hope my post has been helpful.

Originally Posted by DrDDSman

What did these DA's end up doing? General Practice? Academia? Real estate?

They educated the big carriers about what they do and who they were. When you apply for your own practice insurance now, you can see that even TDIC has a category for "dentist anesthesiologist" that was set in place long ago (some 30 years back).

When you offer specialized services, your burden is to educate and inform those professionals around you in what you can offer for their practice and their patients. That's probably the biggest challenge facing residents coming out of programs who wish to practice in areas where dental anesthesiology is an uncommon service. DA residents who are successful tend to be self starters and highly entrepreneurial at the outset, and generally become involved in their surrounding professional communities in order to educate, promote, and advocate for safe anesthesia and sedation practices within dentistry.

Buena Suerte!

-Jimmy

Originally Posted by sucstotherescue

I am unaware of malpractice companies even considering dropping DAs from obtaining insurance coverage. I will have to ask my attendings about this when I start my program. I do believe that since DA programs are now CODA accredited this validates their training. Furthermore, if malpractice companies are considering dropping anesthesia coverage for DAs. I would assume this also threatens OMFS and their model of practice. I, along with the academy of DAs (American Society of Dental Anesthesiologists), fully support OMFS and their dual model of practice (surgeon/anesthesia as one provider). However, I feel it would be difficult to argue that someone with 2-3 years of solely anesthesia training is less qualified to practice deep sedation/general anesthesia than someone who has had 6 months of this training. Once malpractice companies start limiting anesthesia by properly trained dentists there is no way of telling where that stops. As I have mentioned in the past some countries have had anything above local stripped from dentistry. I believe this is one of the biggest reasons to support DA as a specialty this will enable the field of dentistry to have their own "anesthesia specialist" for guidance on anesthesia. I only hope our profession works together to support anesthesia by all qualified dentists; from the OMFS doing deep IV sedation, the pediatric dentist doing oral sedation, the DA during deep/general both intubated/nonintubated, to the general dentist doing mod IV sedation. Our patients deserve this care.

As far as job opportunities/field growth I would encourage anyone who is interested in DA to educated themselves from all view points. This would include externships (I recommend Pitt for this), speaking with private pracite DAs (or even better finding someone who is practicing and shadow him/her), speaking with Oral Surgeons on their views of the field, finding practitioners who use DAs and speaking with them, and finally read as much as you can (the previous DA interview thread has some great links to read). Below are links to two recent articles showing a great interest and demand for office based anesthesia by DAs.

http://www.ncbi.nlm.nih.gov/pubmed/22428968
http://www.ncbi.nlm.nih.gov/pubmed/22428969

I couldn't find PDFs of these articles that are freely available online but just instant messaging and can email you a PDF of each article.

My own personal experience:
I have yet to even began DA residency. Despite this fact, many dentists in many different states have eagerly inquired about my skills as a DA and using them in their office upon completion. I am leaning toward a career in academia with a long-term goal of creating a new DA program (I greatly believe in the field and the benefits it offers to both patients and our overall profession). However, this interest is reassuring.

I hope my post has been helpful.

I'm fairly certain of malpractice insurers threatening to drop DAs within the past 20 years. I have been talking to a dental anesthesiologist from Chicago who told me it was a big to-do for all of them, but the conversation was back in December so I'm fuzzy on the details. The CODA accredidation really means nothing to insurance coverers IMHO.

BUT...as I may have mentioned...in ACA there is a clause that providers operating within the legal scope of their licesnce may not be discriminated against by insurance providers due to Degree/Training. Meaning if your state legally permits you to do something (like deep sedation/GA) then insurance may not decide to selectively cover or have different rates for various providers (dentists, MDs, CRNAs) because of their training/degree

Originally Posted by DrDDSman

What did these DA's end up doing? General Practice? Academia? Real estate?

It was threatened...it didn't happen

DA has been voted upon by the ADA twice in the past...the field has had a very strange history. Look at Indiana...they cancelled their program days before the interviews were held.

If someone were to be accepted to a 2 year program, is there a possibly of a transfer to a 3 year program if a switch partner is involved?

Sent PM