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MSSNY urging limitations for OMFS
https://www.mssny.org/App_Themes/MSSNY/pdf/S1918-_A5632-_OPPOSE_-_Dentists--letterhead.pdf
The Medical Society of the State of New York has submitted an opposition to the scope and practice of “dentists” (but they mean OMFS). Granted this was done back in January of this year, but it’s bonkers to me that in 2015 this crap is still going on.
Highlights w/ my opinions of how badly this opposition is written:
1. “Dentists have argued that their doctoral training as well as their post-doctoral residency training is equivalent to that which a physician obtains including a board certified plastic surgeon, dermatologist, otolaryngologist or orthopaedic surgeon. This argument is categorically false. If it were true, there would be no need to differentiate post-graduate degrees (DMD/DDS vs MD).”
2. “It is asserted that some dentists with advanced training such as the oral and maxillofacial surgeons, are performing reconstructive trauma surgery. There may be some multi-disciplinary teams in which oral surgeons scrub with trauma surgeons, ophthalmologists, plastic surgeons and otolaryngologists with a combined approach; however, to our knowledge, these large combined procedures are relatively small in number. There may even be occasions in which a surgical specialist will permit an oral and maxillofacial resident to “scrub” on some of these surgical procedures, but they are not performing the surgery. They are acting as an assistant to the surgeon. Even where an oral surgeon in a rare instance may perform mandibular trauma surgery or some mid-facial and bony trauma surgery, we contend that such surgery is of a significantly lower level complexity than virtually all cosmetic medical procedures.
3. “Dentists, even oral and maxillofacial surgeons, are not trained in the systemic management of disease and, therefore, are not prepared to conduct a proper pre-operative evaluation, assess what surgical approach is most appropriate, or determine how to manage complications which may arise”
4. In addition to opposing the scope of practice definitions proposed by the bill, the MSSNY further proposes that that legislations should “[provide] for a study of whether an oral and maxillofacial surgery profiling program should be established”. This is actually scary. Donald Trump must have inspired this ridiculousness.
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Seems like opposition to OMFS doing anything within our scope has a periodic reprisal. See this thread from 2010:
http://forums.studentdoctor.net/threads/ama-trying-to-limit-omfs-scope.704911/
https://www.mssny.org/App_Themes/MSSNY/pdf/S1918-_A5632-_OPPOSE_-_Dentists--letterhead.pdf
The Medical Society of the State of New York has submitted an opposition to the scope and practice of “dentists” (but they mean OMFS). Granted this was done back in January of this year, but it’s bonkers to me that in 2015 this crap is still going on.
Highlights w/ my opinions of how badly this opposition is written:
1. “Dentists have argued that their doctoral training as well as their post-doctoral residency training is equivalent to that which a physician obtains including a board certified plastic surgeon, dermatologist, otolaryngologist or orthopaedic surgeon. This argument is categorically false. If it were true, there would be no need to differentiate post-graduate degrees (DMD/DDS vs MD).”
False – The premise of this argument is absurd. This is not about whether or not dentist are ‘doctors’, rather the argument suggests that dentists consider themselves equally trained as physicians. Since they use the word ‘dentist’ but do not distinguish between OMFS and a generalist, let’s break down this argument. No general dentists thinks they are equally trained as a physician (nor should they). Dentists are experts in the mouth. That’s it. Dentists do not manage systemic disease nor have we ever advocated to do this. OMFS (single degree for the sake of their argument) receive surgical training appropriate to our scope. Key word is training. Dual degree OMFS makes this argument completely moot. See the next point for how this argument ridiculously progresses.
2. “It is asserted that some dentists with advanced training such as the oral and maxillofacial surgeons, are performing reconstructive trauma surgery. There may be some multi-disciplinary teams in which oral surgeons scrub with trauma surgeons, ophthalmologists, plastic surgeons and otolaryngologists with a combined approach; however, to our knowledge, these large combined procedures are relatively small in number. There may even be occasions in which a surgical specialist will permit an oral and maxillofacial resident to “scrub” on some of these surgical procedures, but they are not performing the surgery. They are acting as an assistant to the surgeon. Even where an oral surgeon in a rare instance may perform mandibular trauma surgery or some mid-facial and bony trauma surgery, we contend that such surgery is of a significantly lower level complexity than virtually all cosmetic medical procedures.
With all due respect MSSNY, you’re knowledge is incomplete. Yet another demonstration that little research was performed before composing this opposition. To be defined as a Level 1 trauma center, a hospital must have OMFS services available. As such, it typically means that facial trauma is split between relevant services independently. In some cases, OMFS is the only facial service at a hospital. At my hospital, we take >50% of the facial trauma. Compare outcomes between all services (ENT, OMFS, PRS) and they are equivocal. Also hilarious that the cosmetic sentence is thrown in, which IMO reveals the true premise of this whole opposition à they don’t want OMFS performing cosmetics ($$$) under the guise that they don’t want “dentists” performing anything outside the mouth.
3. “Dentists, even oral and maxillofacial surgeons, are not trained in the systemic management of disease and, therefore, are not prepared to conduct a proper pre-operative evaluation, assess what surgical approach is most appropriate, or determine how to manage complications which may arise”
See premise #1. Sure, a general dentist is certainly not trained in this. Fine. But again, without understanding of OMFS training this statement is easy to say. And let’s pretend this argument were true (which it isn’t). What about the dual-trained OMFS’s with MD’s? No mention or distinction is made with this. Don't even get me started about managing complications either. By this rationale, our anethesia colleauges should know how to reimplant and correctly position teeth when they accidently knock them out during oral intubation. By this argument, plastic surgeons who f*** up occlusion (no disrespect) during orthognathics or facial reconstruction shouldn't be allowed to page OMFS to fix the problem then.
4. In addition to opposing the scope of practice definitions proposed by the bill, the MSSNY further proposes that that legislations should “[provide] for a study of whether an oral and maxillofacial surgery profiling program should be established”. This is actually scary. Donald Trump must have inspired this ridiculousness.
via Imgflip Meme MakerSeems like opposition to OMFS doing anything within our scope has a periodic reprisal. See this thread from 2010:
http://forums.studentdoctor.net/threads/ama-trying-to-limit-omfs-scope.704911/
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