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NOTE TO MODS: This is NOT a double-post... just a FYI for people in this forum who have not ventured over to the "Dental" forum.
Friends,
I don't know how many predents out there are aware, or have even ever heard of, this initiative (advocated by dental hygienists, specifically the ADHA) to establish a mid-level (Master's-level education) dental provider comparable to that of a nurse practitioner (NP) in medicine. These providers, termed "ADHPs" (Advanced Dental Hygiene Practioners), are being proposed as a solution to the access to (oral health) care problem that currently pervades the U.S. This initiative has gained a lot of steam recently due to the unfortunate story of the Maryland child who died as a result of an untreated abscessed tooth.
As it stands now (in Minnesota), the scope of practice of these ADHPs has been designated to be "in underserved areas" - "This practitioner will have an expanded role in treating patients by providing diagnostic, preventive, prescriptive, therapeutic and restorative services directly to the public, focused on the underserved." Also, while ADHPs must enter into a written agreement with a licensed dentist, they will be under only "general supervision" by the dentists meaning that they can diagnose, create patient treatment plans, and perform procedures (of which there are MANY, see the attached file below for details) WITHOUT the presence of a licensed dentist.
View attachment Q & A on the ADHP MN facts & ADHP Fact Sheet.doc
While the notion and rationale for the creation of the ADHP role is certainly a noble one, I think all future dentists need to take careful heed of this issue as they embark on their dental careers, since this is clear evidence that the dental profession is drastically changing as we speak (i.e. the "golden era", as some have described it, of dentistry is coming to a drastic halt). Many proponents of the ADHP will claim that their intentions are NOT to encroach upon the role or importance of the DMD/DDS in providing oral health care, but it is only a matter of time before these ADHPs will want to broaden their scope of practice outside of "underserved" areas, and increase their autonomy and perceived level of expertise by possibly pushing for the creation of a "doctoral" ADHP degree. Look at what has happened to medicine as a result of the creation of the Nurse Practitioner (NP) role.
Please note that this is not just an "idea" that's being thrown around. Legislation has ALREADY BEEN PASSED in the state of Minnesota allowing for the creation of these mid-level dental providers:
http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2928
http://www.mndha.com/Legislative.html (scroll to the bottom for links to the actual legislation)
Furthermore, it should be noted that rather than the title of "Advanced Dental Hygiene Practioner" (which could make many patients in the general public highly skeptical of receiving care from an "advanced" Dental Hygienist rather than a "doctor"), proponents of the bill have changed the terminology to now read "Oral Health Practitioner". Now I'm in no position to speak to the rationale of why exactly this change in terminology was proposed, but you're all fairly intelligent people, so I leave it to you to speculate on your own. I know what I'm thinking...
I'm urging all of you predents to become well-informed and knowledeable about this initiative since it could have SIGNIFICANT implications on the livelihood of your future careers as DMDs/DDSs. There's plenty of information on-line. Talk to your own dentists about what they think about this. Many of them probably are even UNAWARE (or if they're near retirement age... APATHETIC to) of this initiative. Case in point: when this legislation was being introduced in the Minnesota State Legislature back in Feb/Mar 2008 and the MDA (Minnesota Dental Association) was trying to lobby against it, representatives in the Dental Associations of other states claimed they had never even heard of the concept of an "ADHP"!!! The Minnesota Dental Hygienists Association has jumped the first (and most difficult) hurdles to achieve this unprecendented legislation, and it will only be a matter of time before other states begin to jump on the wagon... and we can all assume that it will be a much easier-fought battle for subsequent states to follow suit. While there is nothing that dentists can really do to prevent the spread of the creation of this role, there ARE things they can do to make sure that the specifics of this ADHP position are well-definied (i.e. contact their state Congressmen to make sure that: ADHP practice is limited to underserved areas, procedures that ADHPs can perform are very specifically defined and limited, written agreements with a licensed dentist are required along with the ability of dentists to exercise discretion as far as supervision is concerned, etc.).
I know it's pretty easy right now as a PREdent to be thinking purely from a humanitarian standpoint with the mindset of "this is a great thing for our patients... this won't affect me... thumbs up here!", but I think you'll all be singing a completely different tune when your practice is being adversely impacted and your role as a dentist has been completely redefined from what we know it to be today. By then, it'll be too little too late. If left unchecked, ADHPs could potentially have an adverse impact on dentists. Don't get me wrong here... I believe that ADHPs will provide a very necessary and valuable role in helping to improve this nation's current crisis with regard to oral health care, but we also need to make sure that we (as dentists and future dentists) are actively involved in the creation of this new role so that we don't suffer the same fate that current physicians face today.
Thanks for reading... this is IMPORTANT!!!
Friends,
I don't know how many predents out there are aware, or have even ever heard of, this initiative (advocated by dental hygienists, specifically the ADHA) to establish a mid-level (Master's-level education) dental provider comparable to that of a nurse practitioner (NP) in medicine. These providers, termed "ADHPs" (Advanced Dental Hygiene Practioners), are being proposed as a solution to the access to (oral health) care problem that currently pervades the U.S. This initiative has gained a lot of steam recently due to the unfortunate story of the Maryland child who died as a result of an untreated abscessed tooth.
As it stands now (in Minnesota), the scope of practice of these ADHPs has been designated to be "in underserved areas" - "This practitioner will have an expanded role in treating patients by providing diagnostic, preventive, prescriptive, therapeutic and restorative services directly to the public, focused on the underserved." Also, while ADHPs must enter into a written agreement with a licensed dentist, they will be under only "general supervision" by the dentists meaning that they can diagnose, create patient treatment plans, and perform procedures (of which there are MANY, see the attached file below for details) WITHOUT the presence of a licensed dentist.
View attachment Q & A on the ADHP MN facts & ADHP Fact Sheet.doc
While the notion and rationale for the creation of the ADHP role is certainly a noble one, I think all future dentists need to take careful heed of this issue as they embark on their dental careers, since this is clear evidence that the dental profession is drastically changing as we speak (i.e. the "golden era", as some have described it, of dentistry is coming to a drastic halt). Many proponents of the ADHP will claim that their intentions are NOT to encroach upon the role or importance of the DMD/DDS in providing oral health care, but it is only a matter of time before these ADHPs will want to broaden their scope of practice outside of "underserved" areas, and increase their autonomy and perceived level of expertise by possibly pushing for the creation of a "doctoral" ADHP degree. Look at what has happened to medicine as a result of the creation of the Nurse Practitioner (NP) role.
Please note that this is not just an "idea" that's being thrown around. Legislation has ALREADY BEEN PASSED in the state of Minnesota allowing for the creation of these mid-level dental providers:
http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2928
http://www.mndha.com/Legislative.html (scroll to the bottom for links to the actual legislation)
Furthermore, it should be noted that rather than the title of "Advanced Dental Hygiene Practioner" (which could make many patients in the general public highly skeptical of receiving care from an "advanced" Dental Hygienist rather than a "doctor"), proponents of the bill have changed the terminology to now read "Oral Health Practitioner". Now I'm in no position to speak to the rationale of why exactly this change in terminology was proposed, but you're all fairly intelligent people, so I leave it to you to speculate on your own. I know what I'm thinking...
I'm urging all of you predents to become well-informed and knowledeable about this initiative since it could have SIGNIFICANT implications on the livelihood of your future careers as DMDs/DDSs. There's plenty of information on-line. Talk to your own dentists about what they think about this. Many of them probably are even UNAWARE (or if they're near retirement age... APATHETIC to) of this initiative. Case in point: when this legislation was being introduced in the Minnesota State Legislature back in Feb/Mar 2008 and the MDA (Minnesota Dental Association) was trying to lobby against it, representatives in the Dental Associations of other states claimed they had never even heard of the concept of an "ADHP"!!! The Minnesota Dental Hygienists Association has jumped the first (and most difficult) hurdles to achieve this unprecendented legislation, and it will only be a matter of time before other states begin to jump on the wagon... and we can all assume that it will be a much easier-fought battle for subsequent states to follow suit. While there is nothing that dentists can really do to prevent the spread of the creation of this role, there ARE things they can do to make sure that the specifics of this ADHP position are well-definied (i.e. contact their state Congressmen to make sure that: ADHP practice is limited to underserved areas, procedures that ADHPs can perform are very specifically defined and limited, written agreements with a licensed dentist are required along with the ability of dentists to exercise discretion as far as supervision is concerned, etc.).
I know it's pretty easy right now as a PREdent to be thinking purely from a humanitarian standpoint with the mindset of "this is a great thing for our patients... this won't affect me... thumbs up here!", but I think you'll all be singing a completely different tune when your practice is being adversely impacted and your role as a dentist has been completely redefined from what we know it to be today. By then, it'll be too little too late. If left unchecked, ADHPs could potentially have an adverse impact on dentists. Don't get me wrong here... I believe that ADHPs will provide a very necessary and valuable role in helping to improve this nation's current crisis with regard to oral health care, but we also need to make sure that we (as dentists and future dentists) are actively involved in the creation of this new role so that we don't suffer the same fate that current physicians face today.
Thanks for reading... this is IMPORTANT!!!
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