Medical and Dental Integration in the AF and Army

[Deep Impact]

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Hey guys,

Many of you may have heard about the integration between the medical and dental commands in the Navy. Has the integration occurred or will occur in the AF or the Army? How is the AF and Army dental corps structured? Do you have your own dental command or are you part of the big medical umbrella?

 

[ddhm]

hi, i myself hadn't heard of the medical-dental integration for the navy. could you please explain how an integration of command affects the outlook for military dentists? will it have a great impact at all on your daily work as a dentist? or is it just some cost-saving bureaucratic measure?

sorry, im much less informed than others it seems.

 

[Kunsan]

Dental has their own command... However, they still fall under a Medical Command. That was my understanding while as a MSC officer in the Army...

 

[Deep Impact]

hi, i myself hadn't heard of the medical-dental integration for the navy. could you please explain how an integration of command affects the outlook for military dentists? will it have a great impact at all on your daily work as a dentist? or is it just some cost-saving bureaucratic measure?

sorry, im much less informed than others it seems.

Here is an article from 2004 US Medicine:
"November 2004 [SIZE=+1]Navy Dental Corps Undergoes MTF Integration Process[/SIZE] - Sandra Basu
WASHINGTON-Approximately 84 dentists in the Navy Dental Corps will be assuming new positions as part of the Navy's effort to integrate Navy Medical Treatment Facilities (MTFs) and Dental Treatment Facilities.
By February of 2005, 12 of the 15 Navy dental commands worldwide will be de-established and integrated with the respective geographic MTF. The integration is designed to improve the management process and save money, while offering the same standard of care in dentistry, according to Navy officials.
"Last summer, the Surgeon General [at the time, Dr. Michael Cowan] of the Navy decided he wanted to look at all of Navy Medicine's organizational structures to ensure that we were a cost effective business, that we were delivering health care in a state of the art, but in a very streamlined, economized type of manner," said Capt. Barton R. Wilbourn, DC, USN, a Navy Bureau of Medicine and Surgery spokesperson.
The integration will initially entail 24 dental corps officers and approximately 60 enlisted dentists moving from administration positions to mostly dental care positions. The dental commands and medical commands have in the past operated separately, with their own commanding officers. The integration will involve moving the dental corps commands to under the leadership of the command of MTFs. Dr. Wilbourn said that this would allow Navy Medicine to eliminate duplicate positions.
"Many facilities had the medical and dental assets in the same building, except they had two commanding officers, two executive officers and two of everything. There were almost 99 administrative duplicate functions in some of our facilities in the same building. We thought we could economize that," Dr. Wilbourn said.
The cost saving over the next five years as a result of the integration is estimated to be slightly under $5 million. Dr. Wilbourn said that the billets that will be eliminated will be returned to the chief of Naval Operations and can then be filled with warfighters.
Navy dental commands both in the United States and outside of the United States will be a part of the integration. Dentists who are moving from administrative to dental care positions will incur no pay difference as a result of the integration.
Dr. Wilbourn said that an example of how the integration will play out is the de-establishment involving the U.S. Naval Dental Center Europe.
"Currently in Europe, we have one very large dental command. That commanding officer of dental activity has purview over our clinics in London, [England;] Naples, Sigonella, Italy; Rota, Spain; etc. On the medical side, we have MTFs with medical commanding officers in every one of those places. Therefore, in Naples, when we de-establish the dental command, that dental command in Naples will come under the command of the commanding officer of the hospital that is already there. In Rota, that former branch dental facility will come as a directorate under the Rota Naval Hospital," he said.

Impact on Dentists And Patients
For dentists, the integration will result in a cutback in the number of leadership positions. In the long-term, however, Dr. Wilbourn said that the integration will enhance opportunities for leadership among dentists in the Navy, because there will be opportunities for leadership on committees at MTFs. In addition, he said that coming under the command of the MTF will give dentists the opportunity to become better acquainted with how MTFs operate and help train them for leadership positions in Navy Medicine.
In the future, Dr. Wilbourn says he foresees that dental corps officers will serve as commanding officers at major hospitals.
"If you want our people to have the opportunity to learn the business of Navy medicine, by integrating, we're going to have it," he said.
According to Dr. Wilbourn, developing a career path for dental officers to compete on a level playing field to be future commanding officers, and serve in other leadership capacities at MTFs, is important and is something that the current Navy Surgeon General, Vice Adm. Donald C. Arthur, MC, USN, is supporting.
"He has made it crystal clear that he wants the dental corps officer to be able to compete with nurse corps officers, with medical service corps officers for these MTF positions in the future. However, with that said, we in the dental corps, have to develop appropriate training pathways to get our people educated and have the right tool sets to compete for these jobs," he said.
Dr. Wilbourn said that Navy Medicine does not anticipate that the changes will affect any of the civilian workers in its facilities because the changes are impacting administrative positions.
"The vast majority of civilians that we employ now are dentists, dental hygienists or dental technicians. We still have a dental requirement, so no one in the treatment field is going to be downsized," he said.
Dr. Wilbourn said that the patients should not notice any changes in their care.
"The facilities will not change at all. One of our primary objectives is to ensure there is a seamless transition to integration. We do not want them [patients] to perceive any decrement to access to care," he said. "

This kinda explains the process. The outcome of integration is up for debate and still on-going...with many old-timers leaving in disgust and many new leaders becoming frustrated from what I hear. The issue I have is that we fall UNDER medical, whereas in the civilian world, the two professions stand side by side. Can you imagine if ADA all of a sudden belonged to the AMA? That's an exaggeration, of course, but you get the picture.
BTW, this thread was started when I was searching for some info about my next command. Nothing much was posted about the dental department. Sad thing is, I remember the dental command website so clearly during my senior year in dental school with all the info I was seeking. Now, most websites for MTF commands don't even have a working link to dental anything. Only one I found was the 1st dental battalion's website (Marine corps MTF and DTF are not integrated. Don't ask me why. Maybe someone else can answer this).
I'm staying in for a while longer, and I hope the Navy Dental Corps stays strong and attract the best out there...just curious about the af and the army now. Logic would tell me this would occur across all branches, but I've heard that's not the case as of now.

 

[BQuad]

The Army is struggling to hang on to it's Dental Command. There has always been talk of it, there also has been talk about integrating all medical and dental into a tri-service corps. The Army denitst are hoping we all get to do 4-6 months tours like the Air Force and the Air Force is probably scared the Army is going to mess up the good thing they've got going.

Working under a medical command is difficult because they don't understand how expensive and supply intensive dentistry is, they just don't think of us as the micro-surgery specialists we really are. Budgeting becomes the real issue, so the Army is trying to hang on.

 

[SNOZBERRIES]

The Army is struggling to hang on to it's Dental Command. There has always been talk of it, there also has been talk about integrating all medical and dental into a tri-service corps. The Army denitst are hoping we all get to do 4-6 months tours like the Air Force and the Air Force is probably scared the Army is going to mess up the good thing they've got going.

Working under a medical command is difficult because they don't understand how expensive and supply intensive dentistry is, they just don't think of us as the micro-surgery specialists we really are. Budgeting becomes the real issue, so the Army is trying to hang on.

The AF has the Dental Corps. There is alot of talk about the Tri-service corps. Most of us in the AF are not big fans. BQuad did hit on a big concern we have. I don't know why it is, but it seems in the AF we have more liberties to practices dentistry (IV sed for general dentists, cosmetic dentistry, etc). We are concerned if medical/dental go "purple" we will loose our rights to do some things. Who knows, maybe the other branches will be able to do more.

At the Wing level (the base) we fall under the Medical Group. You are right that, outside of the dental clinic, the Med Group has no idea what we do. I fight everyday with logistics to get what we need. They don't understand why we need all these "things". It is not so bad at a big base because there are alot of O-6s to throw around their eagles, but it can be difficult as an O-3 conviencing people why you need all that Versed/fentanyl/dexamethazone and torodol.