Advanced dental hygiene practitioner

[airwolfrocks999]

Please disregard this post if it's already been mentioned.

"The ADA sued to block the therapists from performing irreversible procedures such as extractions and fillings, arguing that state law reserved that right to dentists. But a federal law gives the Community Health Aide Certification Board the power to certify the therapists. And in June, the Anchorage Superior Court ruled that this law trumps state dental licensing regulations. Rather than appealing the decision, the ADA settled, paying out $537,500 to the ANTHC."

Excerpt from http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300192

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[gyzeus]

one of the main reason why the ADHP bill has not passed to the senate floor in MN yet is because during the commitee hearing, about 75-100 dental students packed the hearing room to show our opposition to the bill. To protect the integrity of our profession, students and dentists should do the same in Maine and New Hampshire. For the safety of our patients, don't let the DH win so easily.

+1

And if all fails even after this, I guess we're just going to have to push for the fast track Advanced Dental Assistant Program.

 

[gyzeus]

Please disregard this post if it's already been mentioned.

"The ADA sued to block the therapists from performing irreversible procedures such as extractions and fillings, arguing that state law reserved that right to dentists. But a federal law gives the Community Health Aide Certification Board the power to certify the therapists. And in June, the Anchorage Superior Court ruled that this law trumps state dental licensing regulations. Rather than appealing the decision, the ADA settled, paying out $537,500 to the ANTHC."

Excerpt from http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300192

"But for now, the reach of dental therapists is limited. Federal statute restricts them to working through Alaska Native organizations."

And now we should work to at least keep it this way.

 

[gryffindor]

Please disregard this post if it's already been mentioned.

"The ADA sued to block the therapists from performing irreversible procedures such as extractions and fillings, arguing that state law reserved that right to dentists. But a federal law gives the Community Health Aide Certification Board the power to certify the therapists. And in June, the Anchorage Superior Court ruled that this law trumps state dental licensing regulations. Rather than appealing the decision, the ADA settled, paying out $537,500 to the ANTHC."

Excerpt from http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300192

The ADA spent something like $1 million dollars on the first part of your quote where they sued. They got a lot of heat for spending all that money to protect the profession rather than spending it on solving the access problem. Clearly they weren't about to spend another $1 million appealing.

r_u_cool2, thank you to all the dental students who went to the hearing and voiced their opinion on this. Where were the MN dental society reps?

 

[red88m]

You guys have been busy. I kinda stepped away from this debate after I opened the midlevel can of worms, but here's something that perplexes me: why would there be any desire/need for a dental hygienist to have a master's degree? Because my school (Pacific U. in Oregon) has recently opened a dental hygiene program (B.S.) but they're also gearing up for a master's program for those hygienists who want a master's degree. I know next to nothing about this program but since it's housed in the new College of Health Professions along with the pharmacy and PA program my assumption is there will be some kind of a clinical bent (e.g. advance practice hygienist), but that's just my guess.

There are teaching jobs which require a masters in dental hygiene. I saw 2 just the other day- openings for faculty positions in BS programs.

 

[All4ADHP]

I can't help but be amazed at the amount of whining on this blog. YOU chose to go to Dental School and get $400,000 in debt. YOU and other dentists chose not to address the problem of access to care. WE hygienists ARE addressing it and now you want to complain??? I find it completely ridiculous that many of you are complaining that the ADHP only has a 2 year community college degree. I think you need to do your homework before making such an ignorant statement. Licensure for ADHP requires a Master's Degree from an accredited college. We would have never gotten this far had the current DDS's made room in their practices for the MA/no insurance patients. BUT greed got the best of many of you and now the hygienists will step up and do what you should have done a long time ago. I see entirely too many people that do not have dental insurance and can't afford to pay out of pocket for dental procedures. Well, I will be more than happy to help them once I am licensed as an ADHP.

To the one who was worried about the ADHP taking their patients away, now would be a good time to work on your chairside manner.

 

[All4ADHP]

I can't help but be amazed at the amount of whining on this blog. YOU chose to go to Dental School and get $400,000 in debt. YOU and other dentists chose not to address the problem of access to care. WE hygienists ARE addressing it and now you want to complain??? I find it completely ridiculous that many of you are complaining that the ADHP only has a 2 year community college degree. I think you need to do your homework before making such an ignorant statement. Licensure for ADHP requires a Master's Degree from an accredited college. We would have never gotten this far had the current DDS's made room in their practices for the MA/no insurance patients. BUT greed got the best of many of you and now the hygienists will step up and do what you should have done a long time ago. I see entirely too many people that do not have dental insurance and can't afford to pay out of pocket for dental procedures. Well, I will be more than happy to help them once I am licensed as an ADHP.

To the one who was worried about the ADHP taking their patients away, now would be a good time to work on your chairside manner.

 

[armorshell]

I can't help but be amazed at the amount of whining on this blog. YOU chose to go to Dental School and get $400,000 in debt. YOU and other dentists chose not to address the problem of access to care.

If you can't see the relation between the massive debt and the inability to see patients who are classically no to low compensation and incredibly difficult to deal with then I don't really know what to say.

Additionally, it seems that by putting money towards increasing funding to dental schools, or to incentive programs to get DDS's into underserved area's, we could be doing exactly what this bill intends with a much greater effect.

I also think it's ludicrous to think that you're going to be able to get a comparable clinical education to a DDS without spending similarly gross sums on money on your education. The facilities, faculty and patients to build this education aren't going to pay for themselves, you are.

Lastly, while there may be some unique individuals such as yourself out there, a hygienist is no different in the respect that they like money. Everyone does, especially in our society. It's completely unreasonable and unrealistic to expect ADHP's to serve underserved populations more than dentists without a strict, legal requirement for them to do so.

 

[gyzeus]

I can't help but be amazed at the amount of whining on this blog. YOU chose to go to Dental School and get $400,000 in debt. YOU and other dentists chose not to address the problem of access to care. WE hygienists ARE addressing it and now you want to complain??? I find it completely ridiculous that many of you are complaining that the ADHP only has a 2 year community college degree. I think you need to do your homework before making such an ignorant statement. Licensure for ADHP requires a Master's Degree from an accredited college. We would have never gotten this far had the current DDS's made room in their practices for the MA/no insurance patients. BUT greed got the best of many of you and now the hygienists will step up and do what you should have done a long time ago. I see entirely too many people that do not have dental insurance and can't afford to pay out of pocket for dental procedures. Well, I will be more than happy to help them once I am licensed as an ADHP.

To the one who was worried about the ADHP taking their patients away, now would be a good time to work on your chairside manner.

You quacks are not addressing the problem of shortage. You are just trying to fulfill your greeds using the access and shortage problem.

If you think that just anybody can intrude into our profession, we'll show you
how anybody can do likewise to yours.
If competition is what you're asking for, you've got it.
As soon as that bill goes through and we see the quacks near our area, we could get the assistants to take over your jobs and start hiring only them and our fellow associates. We could save huge overheads if we could replace the DHs with well trained DAs. In result, we could keep the prices down, see more patients and start taking more MA/no insurance patients since we would be making huge savings by repalcing the DH to DAs. And as you see those patients walking out of your office to see the dentist and his advance dental assistants with similar prices as yours, you'll know what all this "whining" is about. So we will provide affordable treatments through the cost of your profession.

And guess what? If you don't head out to the rurals after that ADHP, the access problem will go on, and you and I will see that Advance Dental Assitant Program bill just flying through.
If you mess with our profession, we mess with yours.

 

[All4ADHP]

I understand what you mean in regard to little to no compensation and trying to run a dental office. However, since apparently there is no denist shortage in MN, if each office took 10-20 of the little to no insurance patients this problem would not be as great as it is. I understand that they have a much higher no show rate which inturn means lost revenue but many of them are not educated to see how dental health affects them and/or their children. Somehow they need to be reached to give them the education. There are also many that will drive over 200 miles to recieve care as that is the closest clinic that will see them. So as much as there is no dentist shortage in MN, there is a shortage of dentists in MN that will see the little to no insurance patients.

I also understand that my education will cost something. That is yet to be determined. You are right, I would not be able to run a practice on MA and no insurance patients, just as you are not. My hope is that the DDSs in my area will be willing to work WITH the ADHPs to get these people the best care. I can't say that the ADHP answer is but so far the DDSs aren't addressing it. Atleast, we are trying to address it. I feel the best answer to the problem is if the DDSs and RDHs (ADHPs) could work together to fix the problem.

There is room for a midlevel dental provider (just like the PAs and NPs). I don't believe MDs are not able to find work because the PAs and NPs have taken over just as there is room for DDSs and ADHPs. If nothing else, there is room for them in the public health clinics that have been without a DDS for years because they can't afford to pay $75 or more per hour. As an ADHP we would be able to help the public health clinics at a lesser wage. The DDSs won't consider what those clinics are offering.

My problem with many of the people on this blog is that it seems as though many think that if a person doesn't go to "Dental School" they can't be educated. I am an educated person but I prefer the preventative side of dentistry rather than restorative. But I am also tired of trying to find my MA patients somewhere to go and no one will accept them. So I would be willing to do both restorative and preventive dentistry.

 

[aphistis]

I think you need to do your homework before making such an ignorant statement.

But you don't think you need to do your homework before practicing dentistry?

 

[kato999]

BUT greed got the best of many of you and now the hygienists will step up and do what you should have done a long time ago.

Hygienists' greed is genesis of this bill. Some hygenists are not happy doing the procedures they are licensed licensed to do and want to get paid more by expanding their duties to irreversible procedures without putting the time in to becoming a dentist.

Hiding behind the access to care issue when NOWHERE in the bill it states that ADHP's are specificlly going to treat underserved communities is downright deceitful.

 

[12YearOldKid]

I can't help but be amazed at the amount of whining on this blog. YOU chose to go to Dental School and get $400,000 in debt. YOU and other dentists chose not to address the problem of access to care. WE hygienists ARE addressing it and now you want to complain??? I find it completely ridiculous that many of you are complaining that the ADHP only has a 2 year community college degree. I think you need to do your homework before making such an ignorant statement. Licensure for ADHP requires a Master's Degree from an accredited college. We would have never gotten this far had the current DDS's made room in their practices for the MA/no insurance patients. BUT greed got the best of many of you and now the hygienists will step up and do what you should have done a long time ago. I see entirely too many people that do not have dental insurance and can't afford to pay out of pocket for dental procedures. Well, I will be more than happy to help them once I am licensed as an ADHP.




To the one who was worried about the ADHP taking their patients away, now would be a good time to work on your chairside manner.

Actually what is amazing is the amount of arrogance and ingorance found in your post. ALL dentists are greedy? WE are the cause of the access to care problem and only the altruistic DHs can save the day. Does hygiene school have a monopoly on nobility? Give me a friggin break.

 

[All4ADHP]

I never said "all" dentists are greedy if you re-read the post it says "many" but not "all."

 

[futuredds08]

To the one who was worried about the ADHP taking their patients away, now would be a good time to work on your chairside manner.

I think you are underestimating the power of insurance companies in dictating treatment plans to the patient. I can see the result of this being that many patients will go to ADHP's not because they want to, but because it would be all that the insurance companies will pay for. For the most part, I don't think that patient turnover will be due to chairside manner- instead it will be due to the greedy insurance companies- leading to an even greater disparity in the care that patients can receive.

Overall, I think most of the pre-dents on here, who have yet to see a single patient, are more worried that this will not solve a single thing as far as access to quality care is concerned. I would hate to see a world where the middle-class is forced to see midlevel practitioners by their insurance companies while only the wealthy were able to see fully trained dentists (less patients= higher fees= only the wealthy can afford to see DDS/DMD). The only solution I see that would allow both ADHP and DDS/DMD practitioners would be to include a clause saying that ADHP's can ONLY practice in rural/severely underserved areas.

 

[r_u_cool2]

The ADA spent something like $1 million dollars on the first part of your quote where they sued. They got a lot of heat for spending all that money to protect the profession rather than spending it on solving the access problem. Clearly they weren't about to spend another $1 million appealing.

r_u_cool2, thank you to all the dental students who went to the hearing and voiced their opinion on this. Where were the MN dental society reps?

The MDA reps were busy with their own dental access bill in another committee on the same night. Their answer for the ADHP issue was a Community Dental Health Coordinator (CDHC). Unfortunately, this was stripped out of the MDA's bill. The legislatures in MN are determined to pass the ADHP bill in one form or another. Now the U of MN dental school is creating another position called the Dental Therapist (I assume it would be the same as ADHP except anybody can apply, not just DH). So if the ADHP bill were to pass and the U of MN start to teach Dental Therapists, MN will have 2 groups of people pretending to be dentists. Don't let this happen to your state. We just found out about the ADHP thing a couple months ago but the ADHA have been working and lobbying hard behind our back since 2004--without any input of the MDA. The hygienist instructors at my school (some of whom are writers of the bill) said once this bill passes in MN, they will go national.

 

[All4ADHP]

I do think ADHPs have to do their homework prior to doing dentistry--hence the master's program.

 

[OBL1V1ON]

ADHP is dentistry's version of the CRNA, but on a much wider scale.

i dont blame them though...if i wasnt good enough to get into dental school, and i was too lazy to actually become a dentist, id also be trying to manipulate an uniformed legislative body to give me powers i dont deserve.

i mean i can ride a bike.....so i should be able to fly a fighter jet.....right?

 

[gyzeus]

Hiding behind the access to care issue when NOWHERE in the bill it states that ADHP's are specificlly going to treat underserved communities is downright deceitful.

This is exactly what I mean.
To all of you quacks, if you would just go to your group and tell them to add this single statement into the bill, we would all acknowledge your true intentions to serve the underserved communities.

 

[EnamelTuft]

Why the hell do people feel they don't have to take biochem and the other difficult sciences before treating patients. Their arguement is that we won't ever use that stuff. Well, guess what, why can't we skip all grade school and just start training as doctors from the minute we can read and write. To you phonies out there, this is how society works. Organic chemistry is a filtering process. So is the ACT, DAT, MCAT, LSAT's. So if you phonies aren't bright enough to make it, why not just settle for what you're good at, which is by no means doing irreversible procedures. Like I said earlier, should a well trained middle school kid be allowed to treat class II carious lesions if his ability to cut and fill a class II lesion is as good or better than a dentist.

And For the last time, why the hell do hygienists believe that they will be the nice ones who will dedicate their lives to treating the poor, while dentists sleep over greed. Hygienists are just as likely to refuse treating the uninsured/poor patients just as much as dentists.

Because this issue is about about access, then why the "blink" does your proposals don't include anything about only serving in rural/underserved areas? Where are the restrictions? I can't believe how dumb our politicians are, these ADHP's are laughing in their hearts as this bill is being processed. In their minds they are saying "yes, for once i will be compensated just like my dentists." The next step they're going to do is make fun of all us dental students and predents for chosing dental school because there is a backdoor/shortcut to the profession and that is through a master's in hygiene.

And to the dummy who mentioned about having individual schools for individual procedures (endo, perio, etc.): You can only enter those schools after a DDS. I was refering to kids straight out of high school and entering a class II cavity preping institution.

 

[armorshell]

First of all, to all you pre-dent whatevers out there calling the ADHP supporters quacks and phonies, you need to turn that down. You can have a civil discussion, even on the internet, without pointlessly insulting people. You're not adding to the discussion OR to your argument by doing that, you're hurting it. You're seperating us into camps when we should be trying to educate and inform one another. It's flat out ridiculous.

 

[tinman831]

Armorshell is right. There's no need for all the mudslinging. We can have a reasonable conversation without bashing each other's professions.

 

[armorshell]

I understand what you mean in regard to little to no compensation and trying to run a dental office. However, since apparently there is no denist shortage in MN, if each office took 10-20 of the little to no insurance patients this problem would not be as great as it is. I understand that they have a much higher no show rate which inturn means lost revenue but many of them are not educated to see how dental health affects them and/or their children. Somehow they need to be reached to give them the education. There are also many that will drive over 200 miles to recieve care as that is the closest clinic that will see them. So as much as there is no dentist shortage in MN, there is a shortage of dentists in MN that will see the little to no insurance patients.

I still don't see how this means that we need mid level providers. If the dentist/population ratio is fine, it seems plain that we need to concentrate on getting these people into dentists offices, not wasting money creating a new class of mid-level providers with no stipulations on how or where they practice.

I also understand that my education will cost something. That is yet to be determined. You are right, I would not be able to run a practice on MA and no insurance patients, just as you are not. My hope is that the DDSs in my area will be willing to work WITH the ADHPs to get these people the best care. I can't say that the ADHP answer is but so far the DDSs aren't addressing it. Atleast, we are trying to address it. I feel the best answer to the problem is if the DDSs and RDHs (ADHPs) could work together to fix the problem.

This is absolutely unacceptable, and shows clearly that this legislation isn't going to solve any problems, it's just going to create them. You have no more incentive to see underserved patients than any of the dentists you talk so passionately about, and while it's clear that you are an individual motivated towards community care, there's no guarantee that any other ADHP will be.

There is room for a midlevel dental provider (just like the PAs and NPs). I don't believe MDs are not able to find work because the PAs and NPs have taken over just as there is room for DDSs and ADHPs. If nothing else, there is room for them in the public health clinics that have been without a DDS for years because they can't afford to pay $75 or more per hour. As an ADHP we would be able to help the public health clinics at a lesser wage. The DDSs won't consider what those clinics are offering.

What you're not considering is the cost of creating this midlevel provider. With all the money that MN will dump into this program, how many acceptable wages, loan repayment incentives or subsidies could they be paying to DDS's, maintaining the integrity of dental education and increasing care to the underserved for certain.

My problem with many of the people on this blog is that it seems as though many think that if a person doesn't go to "Dental School" they can't be educated. I am an educated person but I prefer the preventative side of dentistry rather than restorative. But I am also tired of trying to find my MA patients somewhere to go and no one will accept them. So I would be willing to do both restorative and preventive dentistry.

Note that many of these people are pre-dents, and don't understand the value, importance or training of hygienists or auxilliary personnel. Also, remember to put yourself in the shoes of the people in question. If someone were suggesting that a dental assistant could take a few courses and perform almost all of the same functions as a hygienist with no restriction, you'd probably be up in arms about it as well.

 

[gyzeus]

http://www.wakingupcosts.net/586

CRNAs think that even their average $130,000 salary isn't enough that they want more. Now they no longer want to be supervised by the physicians but they are asking for just collaboration (electronically or over the phone) with a physician or dentist.
But look what the ADHP is asking for. They saw the CRNAs, and thought why bother to go through this middle stage of supervision when we could just jump straight to collaboration and go into independent practice.

The CRNA program was originally established because of the access problem. But where are most of these CRNAs working now?
And why are they so concerned in passing this bill when they can already practice independently in some rural areas?

 

[rambo2006]

I don't understand how anyone can civically support the ADHP bill the way it was when it was initially presented or even right now. It is obvious that it has so many holes of ambiguity. Although I may disagree with them but I do respect RDH team members of the dental field that support the idea of a midlevel practitioner BUT admit that it is needs a lot of addition and refinement in order to SINCERELY aid the problem of dental access. I see that a lot of dental students are being criticized for being concerned about their loan. Whell if u RDHs and ADHPs want a job, u better hope DDSs don't go bankrupt or move somewhere else. I do despise the arrogant and ignorant RDHs that will stand behind this bill the way it is, believing that is should pass without any change. By the way, drafter of the bill did make it clear that they felt no further changes where necessary, and I find that disturbing. DDSs should be part of this discussion. Our opinion matters. If u works under our license, we have an obligation of making sure you are competent. RDH's are professionals and thus have ethical obligations. They should not want to touch a patient if they believe they are not competent. If RDHs sincerely care about underprivileged patients, then they should NOT accept the bill the way it is. The fact is, the drafters of the bill had very different intentions than the RDHs that are here arguing for the bill. There is some hard core politics going on behind the doors and intentions are far from sincere (this has been confirmed by Dean Loyd, U of M dental school). No one likes making a fool out of themselves, RDHs are NOT less in intelligence than DDS, they are however trained less in the DDS scope and trained on different material. RDHs should be on the front line fighting to make sure that THEIR curriculum is solid, that the accreditation is solid, that where they work (underprivileged areas) makes objective sense. Let's make this discussion objective, attack each other's arguments all u want but not each other. Let dental access be on both of our minds. We all know there is a problem. It is in no ones interest to have a divide between DDSs and RDHs. If we DDSs are not confident in your abilities, we simply won't hire you and you can go work for an HMO that proposed the position and then u can serve underprivileged corporate CEOs. We might need to move away to other states because loan our on our minds haunting us. I briefly spoke with a few MN Senators, and it is clear that this ADHP thing is going to happen, let's try to make the best of it. Let's make it work RIGHT. If change is bound to happen let it happen objectively.

 

[Taurus]

http://www.wakingupcosts.net/586

CRNAs think that even their average $130,000 salary isn't enough that they want more. Now they no longer want to be supervised by the physicians but they are asking for just collaboration (electronically or over the phone) with a physician or dentist.
But look what the ADHP is asking for. They saw the CRNAs, and thought why bother to go through this middle stage of supervision when we could just jump straight to collaboration and go into independent practice.

The CRNA program was originally established because of the access problem. But where are most of these CRNAs working now?
And why are they so concerned in passing this bill when they can already practice independently in some rural areas?

It's worse than you think. The PA bill appears to have died on the floor, after much opposition. However, the CRNA's greed is vast. They have convinced themselves that they are entitled to do pain medicine, which is a medical subspecialty and requires a fellowship. CRNA's have no formal training in pain and the only thing that is close to pain and delivering anesthesia is that both can involve giving injections. CRNA's think that doing 2 weekend seminars in pain techniques qualifies them to do pain. That's like saying I can become a dentist after 2 weekends.

The Louisiana Supreme Court ruled that CRNA's could not simply expand their scope to include pain by changing the language in their bylaws, something which they tried. Then a bill on the Louisiana legislature expanding their scope was blocked. Most recently, a court ruled that pain = medicine. As you can imagine, the CRNA's are whining about it.

Learn the lessons of the NP's and CRNA's. Greed knows no boundaries. The group with the lower qualifications, fewer years of training, and higher risk to patient safety does not care. They want to do what you do and get paid the same. And they won't stop until they get it.

 

[red88m]

Armorshell is right. There's no need for all the mudslinging. We can have a reasonable conversation without bashing each other's professions.

Thank you Tinman and Armorshell. This sort of thing happens far too often on SDN and gives the pre-dents a poor introduction to professionalism.

I'm probably done with this thread since we're just rehashing and bashing now. To sum up my views on the subject as a pre-dental (Human Biology) student and practicing (over 5 years) RDH:

Yes, "hoops" such as biochem, DAT, GRE are necessary to weed out the people who are not smart enough to trust with performing irreversible procedures. (I've already jumped through the biochem and DAT hoops. It's exhausting.)

Something needs to be done about access to care. Our health care system is continuing to evolve to suit changing needs. We all need to make the best of this.

The greed argument could apply to both parties, both RDH and DDS.

I'm sure the ADHP program will be cheaper than dental school, making it attractive to those who don't want to rack up $400K in debt.

I think it's a great idea to put limits on where the ADHP can practice and which insurance he/she accepts.

If training DAs to do DH will lower costs for the public (not solely to give DDS more profits), I'm all for it.

 

[KOM]

What you're not considering is the cost of creating this midlevel provider. With all the money that MN will dump into this program, how many acceptable wages, loan repayment incentives or subsidies could they be paying to DDS's, maintaining the integrity of dental education and increasing care to the underserved for certain.

Also, remember to put yourself in the shoes of the people in question. If someone were suggesting that a dental assistant could take a few courses and perform almost all of the same functions as a hygienist with no restriction, you'd probably be up in arms about it as well.

Thank you. I liked your idea about expanding the NHSC scholarship program. I think probably the biggest issue involving access to care is from a financial perspective. This includes the cost of education and subsequent debt load, govt programs for reimbursement, etc. Rather than poor all this money into a midlevel practitioner program right away, provide greater incentives under programs such as the NHSC. As I understand it, there is great demand for these programs and only what, 1 in 7 people, are even able to get into this program. At least here, people are obligated to practice in rural/underserved areas.

People...in the time it takes you to write some of these posts, you could easily have drafted a strong opposition letter with ALL of these WONDERFUL ideas. Please do so as soon as you can!!!!!

 

[red88m]

Well, I also did 4 yrs of dental school but dropped out of a residency program after halfway completion.

Don't get me wrong; I'm on the same side as dentists, as I am technically one myself.

But really, what more knowledge do you need to perform dental procedures?

Dentistry is 90% hand/eye coordination. The other 10% is diagnosis, in which most pathology are very repetitive and become second-hand nature.

One last thing. I like this whole post by Dr. Airwolfrocks999.

 

[aphistis]

One last thing. I like this whole post by Dr. Airwolfrocks999.

I don't. I don't wish to discredit him as I'm sure he's a perfectly fine person, but keep in mind all his posts come from the perspective of someone who is completely disenfranchised with dentistry and has left the profession entirely. That would color anyone's perceptions pretty significantly.

I happen to disagree with his assessment; I think the psychomotor aspect of dentistry is the *easiest* part. Properly diagnosing and treatment planning a complex patient is much more challenging than any crown prep, and I don't find it boring or repetitive at all. To each his own, and I respect airwolf's opinion, but I disagree with it completely.

 

[airwolfrocks999]

I think the psychomotor aspect of dentistry is the *easiest* part. Properly diagnosing and treatment planning a complex patient is much more challenging than any crown prep, and I don't find it boring or repetitive at all. To each his own, and I respect airwolf's opinion, but I disagree with it completely.

This isn't uncommon. How many times do you recall seeing people not getting it right in pre-clinic labs?

Real patient care just complicates the matter because you have the human element added onto the required minimal dexterity. Even the simplest thing like border-molding isn't all that easy on a real patient while doing it in the gentlest manner.

But diagnosis and treatment planning are something you can always be prepared for. You can always take CE courses and read textbooks on your own.

It's far easier to tell the patient of his/her condition and what the pros options are. But actually doing the treatment is another thing. Diag and treatment planning are done only in the intial visit, while manual procedures are planned for like the next 5 appts ahead. Like I said, manual dexterity accounts for ~90% of dentistry and nearly 100% of mental stress.

And there are no shortcuts to learning hand-skills either. It takes a loooong time to make it close to second-nature.

 

[killbill2]

If dental access is truly a major problem, then just increase class sizes or open up new schools. Increase the number of dentists, not create a new group of providers with lower qualifications and requirements who will later lobby to be your competitors. Doesn't that make more sense?

Recall that back in the late 80's that dental schools such as Northwestern closed because of surplus of dentists. If you allow a dental midlevel group to flourish, then those days of surpluses will come back and all those gains you have made financially will disappear. Dentists need to unite and decide as a group to not simply hire these individuals. If there is no demand, then there won't be many job opportunities for them and fewer people will go ito this field.

You guys need to study how NP's and CRNA's have adversely affected primary care and anesthesiology. Why do dentists on average now make more than a primary care physician? Widespread use of midlevels such as NP's. If there were no midlevels in medicine, the average salary of primary care physicians would be much higher than it is today. What's worse is that NP's and CRNA's claim to be just as good as their physician counterparts and they lobby hard for equal privileges and reimbursements even though they go to school for just 2 years.

Any dentist who doesn't see the parallel between ADHP's and NP's and CRNA's is extremely naive. All of these midlevel groups use the increased access arguments even though they are as likely to work in a rural setting as a regular dentist or physician. Any dentist who hires an ADHP is selling out his/her profession and should be ostracized.

Let me give you guys some perspective. This whole thing is the result of the greed of dentistry. Back in 1980’s when dentistry experienced the problems of over-supply (and consequently of low income), the dental profession drastically reduced the number of people who can become dentists by closing dental schools and reducing class sizes in order to increase the incomes of dentists. The current dentists are reaping the benefits of the action taken 20 years ago. However, that action also resulted in higher fees and very limited access to dentists for poor and some middle income people, which are increasingly becoming a political issue. (A young boy died recently in Maryland because he could not find a dentist who would accept Medicaid.)

If dentistry does not take action to increase the supply of dentists very soon (even if it would mean some reduction in income), the government and the society would want to fix the problems without the consent of dentistry. They will do this in two ways: 1.The government and insurance companies will exert a greater control over how dentistry is practiced and greatly reduce the fees dentists can charge for dental procedures. (This happened in medicine as most of you know. The fee set by Medicare for a cataract surgery which involves cutting the eyeball open and is far more complex and risky than doing a crown or root canal is only $600. How much do you think that they will pay for a crown if they are in control of dentistry?)
2. The proliferation of mid-level practioners would occur as it is happening now. P.A.’s and N.P.’s have reduced the incomes of general physicians greatly, and this will happen to the general dentist.

When these two things happen, it will be the end of the gravy train dentistry has been on for the past 10-15 years.

With the organized dentistry unwilling to take steps to increase the supply of dentists and not understanding the consequences of their (in)action, the future of the dentistry is not so good.

 

[Istr8nthem]

In this very sue-happy culture that we live in, I would be very weary to begin treating patients as a hygienist without supervision of a dentist. Any hygienist performing operative, extractions, etc will be held to the same standards of care as the dental specialists are held. That means those low-income patients that many are hoping to help could very well turn right around and sue for a sub-par procedure. I understand that there will be more education involved in these hygienist's education, but I just can't see how it could possibly compare to the endless hours spent cutting preps in preclinic, clinic and residency and the endless hours studying for pharm, biochem, pathology, etc.

I see first-hand the extreme need that is needed to combat the boundaries of care as I work daily treating medicaid orthodontic patients. On the flip-side, I also am able to see the extreme difficulties that come with treating this population and they include but are not limited to: inability to keep appts, severe sense of entitlement when it comes to appts, procedure types and attention given to them when they themselves pay NOTHING for treatment. I agree these patients need to be seen and the boundaries to care need to be extinguished, however, I just dont see this being the answer as Hygienists will become sick and tired of the same issues that has forced dentists to move away from treating these populations.

 

[aphistis]

This isn't uncommon. How many times do you recall seeing people not getting it right in pre-clinic labs?

Real patient care just complicates the matter because you have the human element added onto the required minimal dexterity. Even the simplest thing like border-molding isn't all that easy on a real patient while doing it in the gentlest manner.

But diagnosis and treatment planning are something you can always be prepared for. You can always take CE courses and read textbooks on your own.

It's far easier to tell the patient of his/her condition and what the pros options are. But actually doing the treatment is another thing. Diag and treatment planning are done only in the intial visit, while manual procedures are planned for like the next 5 appts ahead. Like I said, manual dexterity accounts for ~90% of dentistry and nearly 100% of mental stress.

And there are no shortcuts to learning hand-skills either. It takes a loooong time to make it close to second-nature.

I submit that CE can teach you how to properly border mold much more easily than it can teach you how to design a good RPD for a given clinical scenario.

Some of the reasons for your unhappiness with dentistry are starting to come into focus, but I'm willing to agree to disagree. All the best.

 

[blissdental]

Let me give you guys some perspective. This whole thing is the result of the greed of dentistry. Back in 1980’s when dentistry experienced the problems of over-supply (and consequently of low income), the dental profession drastically reduced the number of people who can become dentists by closing dental schools and reducing class sizes in order to increase the incomes of dentists. The current dentists are reaping the benefits of the action taken 20 years ago. However, that action also resulted in higher fees and very limited access to dentists for poor and some middle income people, which are increasingly becoming a political issue. (A young boy died recently in Maryland because he could not find a dentist who would accept Medicaid.)

If dentistry does not take action to increase the supply of dentists very soon (even if it would mean some reduction in income), the government and the society would want to fix the problems without the consent of dentistry. They will do this in two ways: 1.The government and insurance companies will exert a greater control over how dentistry is practiced and greatly reduce the fees dentists can charge for dental procedures. (This happened in medicine as most of you know. The fee set by Medicare for a cataract surgery which involves cutting the eyeball open and is far more complex and risky than doing a crown or root canal is only $600. How much do you think that they will pay for a crown if they are in control of dentistry?)
2. The proliferation of mid-level practioners would occur as it is happening now. P.A.’s and N.P.’s have reduced the incomes of general physicians greatly, and this will happen to the general dentist.

When these two things happen, it will be the end of the gravy train dentistry has been on for the past 10-15 years.

With the organized dentistry unwilling to take steps to increase the supply of dentists and not understanding the consequences of their (in)action, the future of the dentistry is not so good.

Thanks for sharing your opinion.
But I don't agree with what you term as greed. The private dental schools closed because the market wasn't good and they had a hard time running the schools. Now they are starting to reopen because they think it would be profitable. But what is wrong with a private institution closing or opening according to the market values? You don't pay for them and the goverment doen't either.

And if you check the average dentist to population ratio of other countries and compare that with the US, the US actually has too many dentists. Seriously, go check the numbers. I lived in countries where dentistry is socialized, and even there the prices are high. The reason prices of dentistry in the US is so high is because we live in the US where everything else is expensive. Do you know how much it costs to stay in a 4 star hotel in China? Last year when I went for vacation it cost me $40/night. $40 dollar might seem like nothing in the US but that is alot of money in China (it was like a $240-$280 for them at then) And dental prices would be no different and so is the salary of dental hygienists. Then does this mean that all the US dentists are so mean and greedy since they are asking for these high prices?
Are you a DH? If prices of dental treatments were to go down hugely, your salary would have to go down drastically as well in order for that to work.

I've lived in 3 different countries and it's not just with the US. Where ever money goes follows the people and competition. That's why there is a huge competition for Med school, dental school, and prestigious law schools and business schools. But if you don't guarantee the money the quantities and qualities of the applicants will go down since most of them will now be applying for these midlevel programs. Then these midlevel programs are then going to have upgrade their programs in place of the med and dental schools asking for more time and higher tutition from the students. So eventually it would be the MD program and the DDS/DMD just changing it's name to a different title. Prices of health care could never go down in the US unless the whole country just becomes socialized.
If not, the general qualities of health care is going to go down

 

[primadonna22274]

WRONG, WRONG, WRONG.
Incomes of primary care physicians have not suffered directly because of PAs/NPs. PAs/NPs bring in significant revenue to a practice and so their practice profits, most often starting at the top (the supervising physician). I do NOT cost my practice money. I make money hand over fist for my practice, and a little for me. Do you know how much I billed last month? $72k working an average of 35 hr/wk, in February, the shortest month of the year. it helps that we have a lot of ancillary services (CT/MRI, lab, xray, other billables) that all contribute to the bottom line.
Now, are we saying that the average family physician is making less money because of the proliferation of midlevel providers? I'm not sure if that's true. I'm not sure if we could really extrapolate that data since midlevels have been around for forty years, as long as Medicare and Medicaid. Quite frankly the low bar that Medicare sets has done more damage to the profitability of practice than I believe midlevels possibly could.
ADH could add profit to a busy dental practice as well as extend services. There may be many reasons dentists don't want to embrace this concept--but I foresee it coming down the pike, probably sooner than later.

2. The proliferation of mid-level practioners would occur as it is happening now. P.A.’s and N.P.’s have reduced the incomes of general physicians greatly, and this will happen to the general dentist..

 

[gyzeus]

WRONG, WRONG, WRONG.
Incomes of primary care physicians have not suffered directly because of PAs/NPs. PAs/NPs bring in significant revenue to a practice and so their practice profits, most often starting at the top (the supervising physician). I do NOT cost my practice money. I make money hand over fist for my practice, and a little for me. Do you know how much I billed last month? $72k working an average of 35 hr/wk, in February, the shortest month of the year. it helps that we have a lot of ancillary services (CT/MRI, lab, xray, other billables) that all contribute to the bottom line.
Now, are we saying that the average family physician is making less money because of the proliferation of midlevel providers? I'm not sure if that's true. I'm not sure if we could really extrapolate that data since midlevels have been around for forty years, as long as Medicare and Medicaid. Quite frankly the low bar that Medicare sets has done more damage to the profitability of practice than I believe midlevels possibly could.
ADH could add profit to a busy dental practice as well as extend services. There may be many reasons dentists don't want to embrace this concept--but I foresee it coming down the pike, probably sooner than later.

The difference with PA/NPs with ADH is that PA/NPs are required to be supervised by physicians whereas the ADH are asking to be only in collaboration with the dentist where agreements must be reviewed and updated only once a year.

Also, the majority of dental students go associate for a few years after graduation to pay off loans and go up from there. But if dentists were to hire ADH instead of associates to reduce overhead, the results would be pretty similar to the NAFTA.

 

[jlc111]

WRONG, WRONG, WRONG.
Incomes of primary care physicians have not suffered directly because of PAs/NPs. PAs/NPs bring in significant revenue to a practice and so their practice profits, most often starting at the top (the supervising physician). I do NOT cost my practice money. I make money hand over fist for my practice, and a little for me. Do you know how much I billed last month? $72k working an average of 35 hr/wk, in February, the shortest month of the year. it helps that we have a lot of ancillary services (CT/MRI, lab, xray, other billables) that all contribute to the bottom line.
Now, are we saying that the average family physician is making less money because of the proliferation of midlevel providers? I'm not sure if that's true. I'm not sure if we could really extrapolate that data since midlevels have been around for forty years, as long as Medicare and Medicaid. Quite frankly the low bar that Medicare sets has done more damage to the profitability of practice than I believe midlevels possibly could.
ADH could add profit to a busy dental practice as well as extend services. There may be many reasons dentists don't want to embrace this concept--but I foresee it coming down the pike, probably sooner than later.

While I agree with you that “the low bar that Medicare sets has done more damage to the profitability of practice than ….. midlevels possibly could”, in my state there are many primary care clinics that are run by NPs’ who practice medicine without supervising physicians. Are you telling me that these clinics are not in competition with family physicians? This is what dentists are (correctly) afraid of.

 

[primadonna22274]

I won't argue with you that NP-run clinics might compete directly with FP docs, but that's the beauty of the PA: the PA doesn't compete with you, s/he works with you cooperatively (who do you think is making the majority of the $72k I billed last month on those 46+ patient days?? unfortunately it wasn't me although there will be some kind of nebulous as-yet-undefined bonus....)
I don't know enough about the ADH concept to say whether they will augment dentistry (ala the PA concept) or compete with it. At any rate it looks like you guys & gals have your work cut out for you.

While I agree with you that “the low bar that Medicare sets has done more damage to the profitability of practice than ….. midlevels possibly could”, in my state there are many primary care clinics that are run by NPs’ who practice medicine without supervising physicians. Are you telling me that these clinics are not in competition with family physicians? This is what dentists are (correctly) afraid of.

 

[gyzeus]

While I agree with you that “the low bar that Medicare sets has done more damage to the profitability of practice than ….. midlevels possibly could”, in my state there are many primary care clinics that are run by NPs’ who practice medicine without supervising physicians. Are you telling me that these clinics are not in competition with family physicians? This is what dentists are (correctly) afraid of.

Can I ask which state that is?
Most of the clincs that are run by NPs or PAs I know of are actually run by physicians, it's just that these physicians don't directly see the patients but they just supervise his employess. But I do know that the NPs in many states are trying to pass a bill for independent practice.

 

[rambo2006]

I don't believe that comparing NP/PA to ADHPs works completely. One of the major issues DDSs face is reimbursement. When an NP treats an MA patient, they don't face problems of reimbursement that DDSs do. ADHPs can expect to also face the same struggle DDSs do, that is reimbursement. A bib, saliva ejector, and all the operatory costs are the same for a DDS and an ADHP (assuming they are doing similar work). Even if ADHPs have a cheaper upfront cost, they will still face the dilemma of poor reimbursement by the MA. This $$ dilemma is what makes the ADHP model incomparable to that of the NP/PA model. In Medicine, reimbursement for treatment isn't such a huge issue. You can blame those positions that still go to their barbers for dental work and are still UNAWARE that their mouth is connected to their body and that if they ignore your teeth they will just leave them alone. Dentistry isn't an elective field. It's a field where a lot of surgery takes place, infection control is huge and things cost a lot. Preparing the operatory before the patient even is seated is costly whether it's an ADHP or a DDS. Politicians need to forthright with the public and address the issue of reimbursement, that way if I am from a small town, I can afford to live their as a dentist, serve my community and pay my loans reasonably.

 

[OceanDMD]

This isn't uncommon. How many times do you recall seeing people not getting it right in pre-clinic labs?

Real patient care just complicates the matter because you have the human element added onto the required minimal dexterity. Even the simplest thing like border-molding isn't all that easy on a real patient while doing it in the gentlest manner.

But diagnosis and treatment planning are something you can always be prepared for. You can always take CE courses and read textbooks on your own.

It's far easier to tell the patient of his/her condition and what the pros options are. But actually doing the treatment is another thing. Diag and treatment planning are done only in the intial visit, while manual procedures are planned for like the next 5 appts ahead. Like I said, manual dexterity accounts for ~90% of dentistry and nearly 100% of mental stress.

And there are no shortcuts to learning hand-skills either. It takes a loooong time to make it close to second-nature.

Let me be as blunt as possible. You have no clue. My understanding is that you graduated and quit dentistry. So how do you know anything about manual dexterity, clinical skills, and CE. After a little experience your handskills have nothing to do with whether you fail as a dental BUSINESS. Ask anyone with experience, the clinical part is the fun part. The business part is 95% of the stress. You are completely wrong.


As far as this BS going on with the thread, why are all of the future dentists worrying? Its expensive to run a dental business, it expensive to do quality dentistry. As far as malpractice issues, all it will take is one of these "super hygienists" to screw up, and the dentist supervising *** is in a sling, or the hygienist is buried. Do you really think when a hygienist sinks that burr into a pulp horn while prepping a simple class I that a general dentist is going to bail them out with the endo? Im not. Sorry. I dont want to own that iatrogenic hygiene problem. This whole thing is a joke. As far as Im concerned, I dont want the patient looking for the lay-away dentistry. You special hygienists can have them. Enjoy the stresses of this litigious society, and remember there is NO-ONE to bail you out except your fellow hygienists.

Oh, and by the way, you may be quite surprised with those "simple extractions". There is nothing like that broken root tip, which if you leave it could turn into alveolar resorption, or a cyst. But make sure you dont pop that sucker into the sinus, or bang that alveolar canal, then you will surely get sued.

This is an ffffing joke. Its not the access to dental care, its what the insurance companies are doing. Most of those skyscrapers are owned by insurance companies. These insurance companies are worth Billions. They choose to deny claims, pay squat for dental treatment, and maintain their 1000/year allowances since the 70's. Thats why you never hear about insurance companies having financial problems. Even after all of the natural disasters lately. They have no product. Their profit is based on screwing somebody(the physician or dentist). If you hygienists want to treat all of the HMOS be my guests. Good luck.

 

[Taurus]

I don't believe that comparing NP/PA to ADHPs works completely. One of the major issues DDSs face is reimbursement. When an NP treats an MA patient, they don't face problems of reimbursement that DDSs do. ADHPs can expect to also face the same struggle DDSs do, that is reimbursement. A bib, saliva ejector, and all the operatory costs are the same for a DDS and an ADHP (assuming they are doing similar work). Even if ADHPs have a cheaper upfront cost, they will still face the dilemma of poor reimbursement by the MA. This $$ dilemma is what makes the ADHP model incomparable to that of the NP/PA model. In Medicine, reimbursement for treatment isn't such a huge issue. You can blame those positions that still go to their barbers for dental work and are still UNAWARE that their mouth is connected to their body and that if they ignore your teeth they will just leave them alone. Dentistry isn't an elective field. It's a field where a lots of surgery takes place, infection control is huge and things cost a lot. Preparing the operatory before the patient even is seated is costly whether it's an ADHP or a DDS. Politicians need to forthright with the public and address the issue of reimbursement, that way if I am from a small town, I can afford to live their as a dentist, serve my community and pay my loans reasonably.

Currently, 11 states allow NP's to work completely autonomously from physicians. They open their own clinics, see their own patients, prescribe the same meds that a physician would, etc. They constantly are trying to expand the number of states. Penn was the latest example. The health clinics at the Wal-Mart's and CVS's are staffed by NP's and PA's. In 14 states, CRNA's have complete autonomy and again they are trying to expand that number. They are so audacious as to think they can begin to expand their scope into other areas even though they have no training in it.

From reading your posts, I don't think you appreciate the threat the ADHP's are. You seem to want to justify and rationalize their existence. Don't make excuses for them. If you don't have enough dentists, then make more of them. Increase class sizes or open more schools. Don't create a new group who has lower qualifications and less training and yet will lobby for the same rights that dentists have. The trajectory of the ADHP's is very predictable. Once created, they will lobby for autonomy. After autonomy, they lobby for expanded scope. 20 years from now, an ADHP and a dentist may offer nearly identical services.

NP's are have used the fact that they fall under the board of nursing to insulate themselves from the regulations of medicine. The nursing groups are actively pushing for equivalence with physicians. Physicians are able to counterbalance the NP's with another group of midlevels, the PA's who fall under the boards of medicine. If NP's get too greedy, then just don't hire them. That's why the medical groups have promoted the PA's. They have started to establish a competing medical group to the CRNA's called the AA's. Guess what, the CRNA's put out propaganda how the AA's are inferior to them. The same tactic that the NP's tried with the PA's. Dentists need to use their hiring powers to their advantage. Hire your future inferior competitor at your own risk to your profession.

 

[gyzeus]

So I guess this is a 2 sided war of dentistry vs HMO & dentistry vs ADH

We should learn from the CRNA case and not hire the ADH but I also have a feeling that HMO will start setting up corporates to hire huge numbers of the ADH with a couple of their supervising dentists to kill all the private practice, both dental or ADH. All they need is to just throw in a few of those big smile adds to show how safe and affordable their treatments are compared to those costly small clinics around the corner. Just like how they did it with pharmacy.
If you think about it, it would be just so much easier for the HMO or corporates to get the ADH to work under them at a lower cost that dentists would never take. As Rambo mentioned it is going to be just as expensive for a ADH to run a practice as it would be for a dentist + they don't get to do asthetics (at least for now) + many patients that could actually pay for their treatments would prefer to go to a dentist So considering all these factors it would be highly likely that a ADH would work for corps instead of going into private practice.
Dentistry is such a lucrative market but dentists haven't been so cooperative with corporates or insurance companies. So I guess now they've came up with plan B. It makes me laugh that I've actually believed even for a minute that Universal health care just might really come true in this country.

 

[Bifid Uvula]

A couple of my posts from the Dental Town Website... I'm too lazy to retype everything, so I'm just gonna cut and paste a bunch of them below.

_________________________________________________________________

This is NOTHING LIKE having "Nurse Practicioners and Physician Assistants." They try to pass this off as something similar and hide behind the "access to care issue." The moment these "advanced hygienists" get a little more #'s they are gonna lobby for more and more autonomy.

A much better solution to this problem would be multi-faceted and still uphold the STANDARD OF CARE!

- Increase reimbursement and provide better incentive for dentists to see more medicare/medicaid patients in their offices. Do so by not breaking their backs... 5% of patients or less. Everybody takes a little bit on. We pay taxes into the medicare/medicaid system and in turn that system just turns around and rapes us for agreeing to treat these patients.

- More Funding/Loan Repayment Options for dental grads. Take a position at one of these clinics, we'll knock off a significant portion of your student loans and pay you a decent salary as well for every year you practice.


***Foreign Trained Dentist Option: To me they are a much better alternative than these "advanced hygienists." First of all, most of the foreign trained dentists can actually become licensed hygienists here and so this would become some sort of weird option for them. Instead of making them pass the written boards, and do 2-3 years of ADA Accredited Dental Schools, why not do the following....

Require the Foreign Grads to Pass the Written Part I and Part II National Boards and Require them to Pass the State/Regional Dental Licensing Exam just like we did. Once they pass those exams/clinicals grant them a "limited license" to "practice/train" in these special "RESIDENCY PROGRAMS/ CLINICS" for a period of 2-3 years (instead of 2-3 years of dental school). They can be paid a decent salary ($65-80K) and supervised by licensed attending dentists. At the completion of 2-3 years they can be granted full-unrestricted licenses and join the rest of us in keeping HYGIENISTS from playing doctor!***

They can do a lot more good this way, still be supervised, and provide a lot more care to patients than they could in a dental school. Everybody benefits this way.
_____________________________________________________________

GP's who can competently perform certain specialist procedures don't get compensated the same by the insurance companies. Now its gonna go to the next extreme...

This is bad from all aspects...

Bad for patients (major safety/health-concerns)
Bad for practicioners (the value of our profession and services will take a huge dive).

8-14/16 years of training... condensed into some do-it-yourself home study kit (complete with a sub-specialty certificate in Biofilm Studies and Invasive Cardio-Periodontology).
_____________________________________________________________
The lawyers are gonna have a field-day with this... And you can bet that the GP's and Specialists are gonna be lining up outside the courts to testify as Expert Witnesses.

This is bad politics, bad policy, and bad health-care.

If you read the ADHA's PDF file its filled with so much dis-information, mis-information and propaganda its almost comical.

The proposed educational model doesn't even come close to the breadth, depth and scope of training that PA's and RNP's receive. It certainly doesn't even come close to the scope of training the dentists receive. So how on earth can they be qualified to perform the same procedures to the same standard of care?

95% of PA's have bachelor degrees. They have to submit GRE and/or MCAT Scores. They typically have a pre-med science background (at university/advanced level, not A.A/A.S. degree level courses) that includes the following:
1 Year of Biology with Labs
1 Year of Chemistry with Labs
1 Year of Calculus
1 Year of Physics
1 Year of Organic Chemistry with Labs
1 Year of English
Plus most have advanced coursework in Biological Sciences like Anatomy, Physiology, Psychology, Microbiology, Genetics, etc etc...

Once they enter PA School they train for another 2-3 years.

This includes 1-1.5 years didactic training in:
Biochemistry, Medical Microbiology, Gross Human Anatomy, General Pathology, Medical Physiology, Pharmacology, History & Physical Diagnosis, Internal Medicine, Clinical Medicine, Medical/Legal/Ethical Issues, Emergency Medicine and some Electives.

Then they spend 1-1.5 years on clinical rotations (the same way medical students are trained) in:
Family Practice, Internal Medicine, Emergency Medicine, Pediatrics, Surgery, OB/Gyn, and Psychiatry.

They have to sit through TONS of Clinical and Practical Exams. They have to sit for National and State Exams. They have to Re-Certify their Board Exams every few years. They have to maintain a lot more than the 30 hours of CE every 2 years that most dentists and hygienists are required.

Their training is INTENSE. Its filled with many hours on call and often involves working/training alongside residents and medical students in life and death situations. Its not some cake-walk program. This is why they are qualified to make important decisions for the patients they treat. This is why they can prescribe medications effectively/safely.

Any monkey can cut a class II prep. But it takes a lot more critical thinking, background information and intuition in making a decision about whether that class II prep is in the best interest of the patient. Like I said... understanding the physiology of the kidney in a patient with renal disease and making adjustments to the antibiotics or pain meds you are prescribing. Knowing how your Rx is gonna interact with the patient's existing poly-pharmacy and adjusting accordingly.

Practicing dentistry is not about performing text-book procedures from start to finish. Its about being able to adjust and adapt accordingly in the middle of a procedure when you encounter something non textbook. That is where our expertise and years of training comes into play.

Flying is expensive and not everybody can afford it. The solution isn't to train more flight-attendants to be "Advanced Flight Attendants" If you wouldn't let a Flight Attendant who has dabbled a little in flight-training fly your Jumbo-Jet across the Atlantic, why on earth would you let a hygienist make critical decisions regarding your oral health and safety?????????

 

[kato999]

Even those that don't live in MN if you are want to do something more than complain or rehash this on SDN please contact these reps! If we stay united as a dental profession we may just beat this thing.

email:
ADHP HEARING TOMORROW

The House Health and Human Services Committee will meet Wednesday, March 12 to hear HF 3247, a bill to create an Advanced Dental Hygiene Practitioner (ADHP).

Please contact your representative, tell them you oppose this bill and ask them to talk to a committee member (listed below) about opposing the bill.

Your representative:

Rep. Alice Hausman
(651) 296-3824
[email protected]

Talking points
This bill – the first of its kind in the nation - includes drastic changes to the dental care system.
· The new hygienist position will put people at risk by allowing hygienists with half the formal education of a dentist to do the following without a dentist in the building:
o Cut and fill teeth
o Perform surgical procedures like drilling primary and permanent teeth
o Extract primary (baby) and permanent teeth
o Diagnose and prepare treatment plans
o Render a final diagnosis
o Prescribe drugs
· Despite being framed as a solution for treating the underserved in low-income and rural areas, the new hygienist proposal does nothing to require or even encourage hygienists to work in underserved areas and does not address this need at all. Furthermore, underserved people often have the most complex dental issues and can be medically compromised. These are the people who need the comprehensive knowledge and skill of their dentist the most.
· This is a significant – and untested – departure from the existing legal relationship between dentists, dental hygienists and dental assistants.
· This proposal does not require an objective, third-party clinical examination as is required of all other dental professionals.
· This new hygienist position is a radical solution that has not been properly considered and will put patient's safety at risk. A wide variety of oral health experts, including the American Dental Association, have voiced their strong opposition to this proposal.

House Health and Human Services Committee
Rep. Paul Thissen
Rep. Patti Fritz
Rep. Laura Brod
Rep. Jim Abeler
Rep. Bruce Anderson
Rep. Julie Bunn
Rep. Tom Emmer
Rep. Brad Finstad
Rep. Steve Gottwalt
Rep. Rod Hamilton
Rep. Thomas Huntley
Rep. Tina Liebling
Rep. Diane Loeffler
Rep. Erin Murphy
Rep. Kim Norton
Rep. Mary Ellen Otremba
Rep. Maria Ruud
Rep. Cy Thao
Rep. Ken Tschumper
Rep. Neva Walker

You are encouraged to reply to this email to let us know if you have spoken with your representative. We will be glad to provide additional information that may be of assistance to you.

 

[gryffindor]

Sent off an email to hopefully counteract all the griping I do on SDN. I am appaled that the last email sent to me from the ADA was about lead content in crowns made in overseas labs. Seriously, there should have been an update saying "Contact these reps NOW to stop the creation of this stupid position."

If this thing goes through I wonder if I will be getting an email from the ADA in about a week saying "MN creates unique position to increase access to care!" I'm getting the feeling that the priorities of the ADA are a bit screwy with regards to who they are supposed to represent.

 

[gyzeus]

I've already sent an email stating that I'm a D0 also in opposition to the ADHP.


http://www.mndental.org/dentist_home/news/

 

[OBL1V1ON]

email sent

 

[OBL1V1ON]

any news?