Of course its my opinion. How many deaths are there in OMFS offices each year? I'm positive that number exceeds the number of deaths in offices where the anesthesia and surgery are not performed by the same operator.
You want to argue access to care as the reason for needing one provider to do two jobs... I can teach a monkey to do a stainless steel crown or take out a tooth. Should we employ monkeys to provide these services because of access to care. Get a clue dude.
As a pediatric dentist, how can I safely observe the patient's vitals, measure the appropriate medications, administer those medications, manage the airway and still provide EFFICIENT dentistry? You can't. Its a difficult enough task to restore 16 teeth on a child, let alone focus on the anesthesia as well.
OMFS is not unique. Let's be real about this. You completed a surgical residency just like thousands of other surgeons out there today. Your typical OMFS rotated for 5-6 months on the anesthesia service, not 4 years. I'm not arguing that OMFS is the most well trained to handle a sedated patient, but that's not saying much, because in reality, you're the only specialty doing it.
Finally, if you are so well trained and you can provide the same level of care, then why doesn't the hospital allow you to act as both the anesthesiologist and the surgeon for your cases? Same goes for the guy who wants to be a hero and play the pediatric dentist/anesthesiologist. As far as access to care goes (your biggest concern) this seems a like a no-brainer. We can just do away with anesthesia and provide every surgeon/pediatric dentist with 5-6 months of anesthesia training and call it a day. Hospitals would save a ton of money.
You say that you are positive that the amount of deaths in OMFS offices is greater when OMFS is the provider/anesthetist...please show us the literature/evidence to support these claims.
Your next point about training a monkey is completely asinine, and I don't understand what you're saying at all. The access to care issue isn't with the operative dentistry portion, it's the anesthesia portion. There are not enough anesthesia providers in the country to provide anesthesia for all the patients who receive sedation everyday. I really don't understand why training a monkey to do the operative portion has ANY relevance to the barrier to care I described with anesthesia providers. Please get a clue. And I by no means think that access to care should be increased at any cost (i.e. training a monkey), but access needs to be as high as possible without compromising safety. All of healthcare is a compromise as we live in the real world where money, time, and resources are a real limiting factor in nearly all aspects of care.
In terms of monitoring vitals, administering medications, and managing an airway safely...OMFS does this everyday. The literature available shows that this method of anesthesia is extremely safe, and readily accessible. And it should be mentioned that even when there is A SEPARATE anesthesia provider the operative dentist is still monitoring vitals, airway, and anesthesia...if they aren't doing this then they are failing as a surgeon.
And in terms of being EFFICIENT...You believe that doing GA cases in the hospital is efficient? The costs and time it takes to run a case in the OR far far exceed those done outpatient.
OMFS is certainly unique...debating this is foolish. I elucidated many points as to why it is unique. Combined medical/dental training, the second most anesthesia training of any doctorate level provider, and the most in-office procedures requiring sedation. And it isn't just 5 months of anesthesia, OMFS does countless sedations throughout their 4-6 years in addition to their OR anesthesia rotation. And you didn't understand my point about the airway. OMFS is the most trained of any provider (Anesthesiologists, Emergency Room, or any other physician) in managing a sedated airway because they do both the anesthesia provider training as well as countless airway procedures including emergent airway access procedures.
The hospital doesn't allow OMFS to act as anesthesia attendings because there are physicians who are better trained at providing anesthesia. Legally, however, an OMFS has the same anesthesia privileges as any anesthesia provider.
Finally, you state that we should provide every surgeon/pediatric dentist with anesthesia training to do away with the hospital...I never insinuated that the hospital doesn't have its place. Complex patients, or complex procedures often require a separate provider to administer/monitor the anesthesia. No one wants to do away with hospitals. But having well trained providers who can perform their own anesthesia and operate allow our system to remain both efficient and safe at the same time.
You have shared your unsubstantiated opinion, and you're entitled to it...but the bottom line is that the current system has worked and will continue to work for years and years. There is no pending laws that may remove the ability of well trained dentists and specialists from providing their own anesthesia. Sorry you are dissatisfied with this system, but you don't have to ever deal with it if you don't want to...and I think someone who is as weary as you are about the operator/anesthetist model absolutely should never attempt it themselves.