Private Hygiene Practices

[mike3kgt]

Hey,

Was surfing on the ADA website and came across this article:
http://www.ada.org/prof/resources/topics/report_hygiene.pdf

"The Economic Aspects of Unsupervised Private Hygiene Practice and Its Impact on Access to Care"

BACKGROUND The unsupervised practice of dental hygiene at locations remote from a dental office is a relatively new occupational choice in the United States. This paper reports on a study that analyzed the economic aspects of unsupervised private hygiene practice and its impact on access to care in Colorado where this type of practice is permitted.

CLINICAL IMPLICATION Unsupervised private dental hygiene practice has not had a notable effect on access to care in Colorado. The impact of those practices is limited in two important ways: 1) there are very few practices; and 2) they are located in areas served also by dental offices with traditional dental hygienists. The economic viability of the unsupervised hygienist business model is questionable because their prophylaxis fees, on average, are not different from traditional dental practices, which have the advantage of providing a full range of practice services. This may explain why independent hygienist practices have not expanded substantially in a state where they are permitted.

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I found this very interesting. After hearing from the AHA about the desire to expand scope of practice, I am glad to see research that actually determines what I was thinking the second I heard about the topic.

My guess:
Hygienists and the desire to expand scope of practice to 1. administer & monitor local anesthesia, 2. diagnose & treat simple restorative cases and extractions, and 3. branch out into independent practice will lead in the direction of a two-tired system and will view oral care as "going to the hygienist to get a scraping." Without Dr. supervision of case diagnosis and treatment planning will ultimately result in a poorer bill of oral health for the general public.

The Colorado study indicates that hygienists, when given the opportunity in an unregulated system, will open up practice very near other dentists, in relatively affluent sectors of the state, and will NOT greatly contribute to reducing the oral health discrepancies present in USA. The article further determines that independent hygienists charge very similar fees to those who are working under the dentist supervision. Wait time, however, for seeing a hygienist is slightly lower with independent practice.

So charging similar fees, working in non-rural non-underserved areas, and less education about diagnosis & treatment will hinder the independent practice philosophy.

Any comments? Anybody from CO with more experience with independent practice? I'll be out there skiing in March, so will probably stop by a few dentist offices to hear their comments.
-Mike

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[tx oms]

I found this very interesting. After hearing from the AHA about the desire to expand scope of practice

If you are a hygienist and want to expand your practice, go to dental school. Period. You have no business practicing without supervision, and no business doing anything more than the routine work currently allowed.

 

[12YearOldKid]

O.K. I am going to catch some serious flak for what I am about to say, but since I am veiled by the anonymity of the internet... here goes.

Not only should hygienists not be granted expanded scope of practice, they should yield some ground to well-trained assistants. Let's face it, hygienists were created to perform a function that basically no longer exists - at least not in the same way.

Back in the day when dentists thought cementum absorbed loads of toxins from the oral flora it was standard practice to carve the roots of every tooth that came into the office down to nice, little hourglasses. That was the job of the hygienist. But you know what? We don't do that anymore. There is absolutely no reason we need these highly trained individuals for a simple scale and polish.

Assistants could easily be given adequate training to do supraginigval scaling. Every dental student out there should be able to vouch for this. What do we get, like a 3 hour lecture on hygiene before they set us loose in clinic to do all the hygiene we want? Maybe another hour of lecture and we're permitted to use the cavitron. Seriously, this is slam dunk stuff. We let average, ordinary, completely unskilled people brush and floss their own teeth every day at home and nobody dies. A supragingival scale and polish isn't that much more complicated.

I am not knocking the level of training of the hygienist, in fact I think they are too well trained to be doing rubber cup prophys all day. These girls should be doing root planing and sub-g scaling all day long; that is why the field was created. They may have to work at more than one office in order to work a full week under that model, but leaving the scale and polish to the assistants would certainly take care of the access to care problem that the AHA pretends to be so concerned about. And it would certainly make it easier for dentists to justify the hygienist's $30-40/hr paychecks - heck, maybe even a raise would be in order if they were doing nothing but root planing all day long.

But no way they should be granted more privileges than what they have now. The nearer I get to graduation the less confident I become that 4 yrs of dental school is sufficient for what we do. NY has the right idea by setting the standard of INCREASED schooling for the practice of dentistry, not delegating it to auxilliaries.

 

[airvent]

Regular cleanings by a hygienist is standard maintenance practiced in many offices. The reason a hygienist has more training is because they are capable of doing more then just scraping teeth. Some can do sealants, injections, etc…quite a bit short of doing any actual cutting or making a treatment plan. This gives the dentist more time to deal with the more serious procedures. As well as a good marketing scheme to get new patients into the office.

I have no problem with expanding the functions of the hygienist or the dent. asst. But separating them from the presence of a doctor would be a mistake. Some one with the training and deeper understanding of oral health should be calling the shots.

 

[TaliaTN]

Back in the day when dentists thought cementum absorbed loads of toxins from the oral flora it was standard practice to carve the roots of every tooth that came into the office down to nice, little hourglasses. That was the job of the hygienist. But you know what? We don't do that anymore. There is absolutely no reason we need these highly trained individuals for a simple scale and polish.

Assistants could easily be given adequate training to do supraginigval scaling. Every dental student out there should be able to vouch for this. What do we get, like a 3 hour lecture on hygiene before they set us loose in clinic to do all the hygiene we want? Maybe another hour of lecture and we're permitted to use the cavitron. Seriously, this is slam dunk stuff. We let average, ordinary, completely unskilled people brush and floss their own teeth every day at home and nobody dies. A supragingival scale and polish isn't that much more complicated.


Responding to these statements as a hygienist... first of all I agree that hygiene private practice is a bad idea... why any hygienist would want that is beyond me.

However, I am against the idea of "supragingival scale and polish" by assistants. Maybe for kids it would be okay, but the vast majority of people I see each day have at least some subgingival calculus. I might see one each day that does not, but I don't know that until I explore, probe and instrument the area. Most all adults have some calculus subg, even if it is only on the lower anteriors or upper molars. I brush and floss regularly and I always have calculus.... not a lot, but some. And most people dont take care of their teeth like I do. I want all my teeth instrumented subgingivally every 6 months, and I think that is what most patients want and need, whether they can communicate it or not.

Just my 2 cents

 

[J2AZ]

It is sad to see the little respect some dental students have for hygienists. Do you not realize that they will be the back bone of your practice? Its all about the 6 month recall. If you dont know that now you will upon graduation.

I highly doubt many hygienists want to expand their duties to include restorations and extractions. If they wanted this they would need to add an additional one to two years to their training. This would be called dental school. Also, dont confuse dental schools lack of training time in the area of periodontal disease and scaling with sufficient training.

 

[omfsres]

It is sad to see the little respect some dental students have for hygienists. Do you not realize that they will be the back bone of your practice? Its all about the 6 month recall. If you dont know that now you will upon graduation.

I highly doubt many hygienists want to expand their duties to include restorations and extractions. If they wanted this they would need to add an additional one to two years to their training. This would be called dental school. Also, dont confuse dental schools lack of training time in the area of periodontal disease and scaling with sufficient training.

Try at least four more years. DH is a bachelors I believe, ask txoms since he's done it. Dental school is another 4 years. In addition most would probably have to take more undergrad stuff like organic and upper level bio courses. This would be at least 5 years, maybe more. I see many mid level providers(DH, nurses, PAs, NPs, RTs) that make the mistake of assuming a smaller knowledge gap between themselves and Dentist and Physicians. They simply are not aware of what they do not know. It sounds harsh but it is true. I'm not trying to put anyone down it is just lack of formalized education and training not lack of intelligence.

 

[Fullosseousflap]

Back in the day when dentists thought cementum absorbed loads of toxins from the oral flora it was standard practice to carve the roots of every tooth that came into the office down to nice, little hourglasses. That was the job of the hygienist. But you know what? We don't do that anymore. There is absolutely no reason we need these highly trained individuals for a simple scale and polish.

Assistants could easily be given adequate training to do supraginigval scaling. Every dental student out there should be able to vouch for this. What do we get, like a 3 hour lecture on hygiene before they set us loose in clinic to do all the hygiene we want? Maybe another hour of lecture and we're permitted to use the cavitron. Seriously, this is slam dunk stuff. We let average, ordinary, completely unskilled people brush and floss their own teeth every day at home and nobody dies. A supragingival scale and polish isn't that much more complicated.


Responding to these statements as a hygienist... first of all I agree that hygiene private practice is a bad idea... why any hygienist would want that is beyond me.

However, I am against the idea of "supragingival scale and polish" by assistants. Maybe for kids it would be okay, but the vast majority of people I see each day have at least some subgingival calculus. I might see one each day that does not, but I don't know that until I explore, probe and instrument the area. Most all adults have some calculus subg, even if it is only on the lower anteriors or upper molars. I brush and floss regularly and I always have calculus.... not a lot, but some. And most people dont take care of their teeth like I do. I want all my teeth instrumented subgingivally every 6 months, and I think that is what most patients want and need, whether they can communicate it or not.

Just my 2 cents

Glad to hear that you are going back for additional training!

Best of luck!

 

[USAF_Dentman]

Try at least four more years. DH is a bachelors I believe, ask txoms since he's done it. Dental school is another 4 years. In addition most would probably have to take more undergrad stuff like organic and upper level bio courses. This would be at least 5 years, maybe more. I see many mid level providers(DH, nurses, PAs, NPs, RTs) that make the mistake of assuming a smaller knowledge gap between themselves and Dentist and Physicians. They simply are not aware of what they do not know. It sounds harsh but it is true. I'm not trying to put anyone down it is just lack of formalized education and training not lack of intelligence.

I agree, it seems like the mid level providers are trying to get more and more rights to further practice. I think that the classes the DH's take in college are not of the same type for a regular degree (ie, things like chem, bio, etc.).

 

[12YearOldKid]

Try at least four more years. DH is a bachelors I believe, ask txoms since he's done it. Dental school is another 4 years. In addition most would probably have to take more undergrad stuff like organic and upper level bio courses. This would be at least 5 years, maybe more. I see many mid level providers(DH, nurses, PAs, NPs, RTs) that make the mistake of assuming a smaller knowledge gap between themselves and Dentist and Physicians. They simply are not aware of what they do not know. It sounds harsh but it is true. I'm not trying to put anyone down it is just lack of formalized education and training not lack of intelligence.

Actually, it's usually an associate's degree. The bachelor's program is optional and usually for those who want to teach in a hygiene school.

 

[Darksunshine]

If you are a hygienist and want to expand your practice, go to dental school. Period. You have no business practicing without supervision, and no business doing anything more than the routine work currently allowed.

LOL, got to love that "I am GOD" the dentist attitude from you.

 

[Darksunshine]

Regular cleanings by a hygienist is standard maintenance practiced in many offices. The reason a hygienist has more training is because they are capable of doing more then just scraping teeth. Some can do sealants, injections, etc…quite a bit short of doing any actual cutting or making a treatment plan. This gives the dentist more time to deal with the more serious procedures. As well as a good marketing scheme to get new patients into the office.

I have no problem with expanding the functions of the hygienist or the dent. asst. But separating them from the presence of a doctor would be a mistake. Some one with the training and deeper understanding of oral health should be calling the shots.

Well said, and thoughtful.

 

[Darksunshine]

First of all, there are many types of "dental hygienist's" across the country. Not all states allow or teach all functions. There are different pre-req’s in most cases and yes some "preceptorship" type hygienist's shouldn't be allowed NEAR a patient unless the dentist is in the room. (AKA: Alabama)

Out west where we have a lot more freedom and are licensed to do everything WITHOUT the dentist even being in the office but deliver nitrous some hygienists have become more like periodontal therapist's then just polisher's/teeth-scrapers.

All jobs struggle with economics and legalities of expanded functions whether it is dentistry or being a lawyer. The states like CO and others (mostly out west that have limited type practice acts for hygiene) provide care in an ethical environment, and by a very well trained professional who deserves such a title. I can't see why individuals who have the desire to further their training can't continue to keep learning and become more responsible. Periodontal disease is a venue in dentistry that dentist's rely on the hygienist's for. That is that some 75% of the population has some form of gum disease (ADA studies and Insurance billing codes.). Assistants in no way have enough training to be a hygienist. Just like a hygienist doesn't have enough training to pick up a drill and cut a prep. Now I know that Txoms is going to selectively cut and paste like he does to all others posts, but hygienist's can and do treat periodontal disease all the time. They are the motivators, educators, and the clinicians that diagnose it (Yes, of course the GP wave’s his mirror over the hygienists head as she tells him her finds motioning his consent to her tx plan.) Most GP are just to busy to probe when they need to and they would rather harass the patient about that crown, and not worry about that 6 mm plus pocket on the back of it. Sure there are hygienists out there that don’t WANT or have that much experience and therefore shouldn’t have ton’s of responsibility but there are plenty that are very capable and do want it.

I have always found in interesting that some dentists would love to teach an assistant to do what the hygienist does so they can expect to pay them less for more work and knowledge. This is a ploy used in all business to get something more for nothing. Why do they keep trying to "dumb" down hygiene? I don't know the answer to that. I just know that when I become a dentist, I will be supportive of what my hygienist can do and not be afraid of the fact that they may get more responsibilities in the future.

I mean really, if the general public was always saying, "You know Dr.'s don't need that much school, I just want someone who can carve a turkey just so.. Lets cut some training out there so we can pay less for that suture...”

Essentially this is what is going on in dentistry with the myth you can eliminate hygiene, and the by the elimination you can reduce their schooling (preceptorship vs. bachelor degree) there by pay them less. This is eventually why the nursing profession developed into nurse practitioner, which are "DR's" in their own right and can do everything a doctor does except prescribe a specific class of drugs, I believe. The do have prescription righting privileges. Hey, we are all entitled to our opinion right. I just think that there are always to sides to an issue and those on the right don’t have total control any more and they know it.

 

[Darksunshine]

I agree, it seems like the mid level providers are trying to get more and more rights to further practice. I think that the classes the DH's take in college are not of the same type for a regular degree (ie, things like chem, bio, etc.).

Well this is not true. All of my hygiene pre-reqs counted toward my dental pre-req requirement. Sorry to burst your bubble. I only had to take physics (which I didn't need for hygiene) and biochemistry. I had already taken A & P and chemistry. BTW I was accetped to into 6 schools so those classes must be universally acceptable considering they were university level and taken with dental students.

 

[USAF_Dentman]

Well this is not true. All of my hygiene pre-reqs counted toward my dental pre-req requirement. Sorry to burst your bubble. I only had to take physics (which I didn't need for hygiene) and biochemistry. I had already taken A & P and chemistry. BTW I was accetped to into 6 schools so those classes must be universally acceptable considering they were university level and taken with dental students.

Well, i hate to burst YOUR bubble, but not all the requirements are the same at different dental hygiene schools..

For instance, my cousin is going to a tech school to be a dental hygenist..Lets see her chem requirement is this "CHEM 1101: Survey of general and organic chemistry, 4cr. 1sem."
Now i dont know about you but this isnt the same course that is required to get into dental school.
Alot of the courses are "survey" courses..of which wouldnt count..

You have to realize that not all the DH schools have the same requirements across the board.

Now dont get me wrong, i think DH's are very important and i respect them, but i think leaving them unsupervised is a bad idea..

So if you could please think before you post. Thanks.

 

[Fullosseousflap]

Most dental hygiene programs here in California are now based at Community Colleges.

Only a few dental school based ones still survive e.g USC, Loma Linda and didn't they just eliminate UCSF (?).

It used to be a B.S. in dental hygiene was common.

Independent practice ..... nopers doesn't work for a wide variety of reasons!

 

[Darksunshine]

Well, i hate to burst YOUR bubble, but not all the requirements are the same at different dental hygiene schools..

For instance, my cousin is going to a tech school to be a dental hygenist..Lets see her chem requirement is this "CHEM 1101: Survey of general and organic chemistry, 4cr. 1sem."
Now i dont know about you but this isnt the same course that is required to get into dental school.
Alot of the courses are "survey" courses..of which wouldnt count..

You have to realize that not all the DH schools have the same requirements across the board.

Now dont get me wrong, i think DH's are very important and i respect them, but i think leaving them unsupervised is a bad idea..

So if you could please think before you post. Thanks.

Hmmm. Maybe you should learn to ready, James buddy.

I didn't say ALL hygiene programs were the same and I DIDN'T say all hygienists were the same either. For instance those Albama hygienist taught under preceptorship are little better than glorified assistants.

That is pretty typical of the southern schools. I was only speaking to my degree. None of the classes I had to take as pre-reqs for dental school or dental hygiene school were that challenging. I commented on my personal situation since your previous post seemed to sum up hygienist in general. My hygiene program is probably unique, sure I would agree to that. I mean we take first year dental classes as well with the IDEP Creighton students and we do as well or better than them. So, hey, NOT all programs are a like. I never said that.

Please read what you say that people respond do before you get all huffy about knowing everything about hygiene when you obviously don't. I don't feel like it is possible for a person to be an expert on everything, there is just to much knowlege that you would have to cram in your brain. Just an opinion james, but hey I know, you already know it all.

 

[Darksunshine]

I found this very interesting. After hearing from the AHA about the desire to expand scope of practice, I am glad to see research that actually determines what I was thinking the second I heard about the topic.

My guess:
Hygienists and the desire to expand scope of practice to 1. administer & monitor local anesthesia, 2. diagnose & treat simple restorative cases and extractions, and 3. branch out into independent practice will lead in the direction of a two-tired system and will view oral care as "going to the hygienist to get a scraping."
Any comments? Anybody from CO with more experience with independent practice? I'll be out there skiing in March, so will probably stop by a few dentist offices to hear their comments.
-Mike

To the OP:

Hygienist are licensed to adminster & monitor local anesthetic already. In OR we don't need the Dr. to be in office or diagnose it's use. Pretty handy when he is running late and needs YOU to numb up his first patient, but mostly it is used in periodontal therapy.

Again, the legality of this varies from state to state, but many states have laws that allow hygienist to be licensed to do this. It is fairly common.

 

[USAF_Dentman]

Hmmm. Maybe you should learn to ready, James buddy.

I didn't say ALL hygiene programs were the same and I DIDN'T say all hygienists were the same either. For instance those Albama hygienist taught under preceptorship are little better than glorified assistants.

That is pretty typical of the southern schools. I was only speaking to my degree. None of the classes I had to take as pre-reqs for dental school or dental hygiene school were that challenging. I commented on my personal situation since your previous post seemed to sum up hygienist in general. My hygiene program is probably unique, sure I would agree to that. I mean we take first year dental classes as well with the IDEP Creighton students and we do as well or better than them. So, hey, NOT all programs are a like. I never said that.

Please read what you say that people respond do before you get all huffy about knowing everything about hygiene when you obviously don't. I don't feel like it is possible for a person to be an expert on everything, there is just to much knowlege that you would have to cram in your brain. Just an opinion james, but hey I know, you already know it all.

Again, you are wrong. You were trying to put your SPECIFIC situation as the norm for the GENERAL pre-reqs, and that is simply not true.

And yes, i was correct, in that the MAJORITY of the DHs' pre-reqs are not of the same level of the dental curriculum..

 

[tx oms]

They simply are not aware of what they do not know.

Sounds like someone I know...

I know that Txoms is going to selectively cut and paste

Yes I am. Sorry to take so long, I've been busy.

I commented on my personal situation since your previous post seemed to sum up hygienist in general.

Anecdotal stories don't negate generalizations.

I mean we take first year dental classes as well with the IDEP Creighton students and we do as well or better than them.

I hear similar claims from PA's regarding medical students. Making this arguement requires one to admit that there is a higher standard one WANTS to, but does not, equal. Seriously, if you/hygienists know so much, why don't people compare your/hygienists' knowledge to a dentist's knowledge? Based on your statement, you probably don't need to go to dental school with all the vast knowledge you possess.

Please read what you say that people respond do before you get all huffy about knowing everything about hygiene when you obviously don't.

What?

I don't feel like it is possible for a person to be an expert on everything, there is just to much knowlege that you would have to cram in your brain.

Some people are calculus experts. Some people are addition experts. All calculus experts can add. Not all addition experts can do calculus. In the same way, a dentist is, by default, a hygiene expert and an expert in other areas as well. Not so for a hygienist.

some hygienists have become more like periodontal therapist's

I thought periodontists were periodontal therapists.

I can't see why individuals who have the desire to further their training can't continue to keep learning and become more responsible.

Me neither, that's why I went to dental school after college.

 

[Darksunshine]

Sounds like someone I know...


Yes I am. Sorry to take so long, I've been busy.


Anecdotal stories don't negate generalizations.


I hear similar claims from PA's regarding medical students. Making this arguement requires one to admit that there is a higher standard one WANTS to, but does not, equal. Seriously, if you/hygienists know so much, why don't people compare your/hygienists' knowledge to a dentist's knowledge? Based on your statement, you probably don't need to go to dental school with all the vast knowledge you possess.


What?


Some people are calculus experts. Some people are addition experts. All calculus experts can add. Not all addition experts can do calculus. In the same way, a dentist is, by default, a hygiene expert and an expert in other areas as well. Not so for a hygienist.


I thought periodontists were periodontal therapists.


Me neither, that's why I went to dental school after college.

Well, it is nice to see that you are staying on point.

Also, when I have addressed my post's to others on the web, "try" not to take it personal and comment on it like I addressed it to you. JamesD knows less about dentistry than I do and loves to make generalization about things he really knows nothing about YET.

I agree, I want more knowledge, and I far as I can tell I am on the right track to get it. BUT, I do think that not all hygienist's or hygiene programs are created equal and that all hygienist's clearly have differing responsibilies based on the state. I have never said the we know more than dentists about denistry in general, just that we have a place in treating periodontal disease that is very important, and that an asstistant can no more fill a hygienists shoes in that department than I hygienist can got cut a prep. Enough said.

I think all people should strive to learn more and if an advanced hygiene practitioner degree should emerge I think that a hygienist with a BS in Science such as myself and others could do an additional 2 years on top of the 4 they got already to fill this role. So with more training, of course I think this is possible. Again, only my opinion and notice I did say a hygienist with a BS should get more school to have this privaledge. (Not the AA only or the preceptorship, they would clearly need a lot more than that since BS hygiene program are disappearing with some speed because of funding issues.)

 

[USAF_Dentman]

JamesD knows less about dentistry than I do and loves to make generalization about things he really knows nothing about YET.

Yes i was making a generalization in that what courses you took are not the same as others...Yes, its a generalization, but a correct one at that...What cant you understand about that....

Most hygenists do NOT the same pre-reqs as pre-dentals..

Is that generaliztion wrong?

 

[Darksunshine]

Yes i was making a generalization in that what courses you took are not the same as others...Yes, its a generalization, but a correct one at that...What cant you understand about that....

Most hygenists do NOT the same pre-reqs as pre-dentals..

Is that generaliztion wrong?

 

[ThreadkillerMD]

How 'bout another generalization. Why are all hygienists frickin HOT??

 

[mike3kgt]

I just see how the NP and PA programs have changed medicine, while not drastically, may result in a two-tiered level of care.

I have been to hospitals and other doctor offices a few times in my life, but only once, I have had a PA see me rather than the doctor. I described my symptoms to the PA several times and each time he had to make a decision, he would excuse himself to see the physician to ask a question. He came back into the room for the 4th time and I said, you know what, just send the doctor in please, I am done with seeing you.

Can they (PA, NPs) take a decent bp, recognize a RTI and ultimately write a good prescription? Sure, no problem, just fine. Can a DH take a decent bp, recognize periodontal disease, and inform the doctor to diagnose? Sure, that's great!

Let's keep it that way, I don't want to see oral health delegated to people without Dr. in front of their name like medicine has allowed with NP/PAs.

-Mike

 

[OzDDS]

Let's keep it that way, I don't want to see oral health delegated to people without Dr. in front of their name like medicine has allowed with NP/PAs.

-Mike

Well.. the way the've decided to fix this problem is to just give "doctorate" degrees to all allied health.. just look at physical therapy and nursing.

"Recently, at the national level a decision was made to transition all advanced nursing practice masters to the clinical doctoral level. Programs that educate NPs, CNS, anesthetists, and midwives must all convert to the Doctorate of Nursing Practice not later than 2015."
http://www.up.edu/up_sub.asp?ctnt=121&mnu=210&chl=400&lvl=1

The American association of physical therapist has already started making the same transition to move all PT programs to the "doctorate" DPT degree.

Very unfortunatly for Americans..Gone are the days of having an MD "medically trained" GP/Family practiciner.


Check out these threads..

http://forums.studentdoctor.net/showthread.php?t=176012

http://forums.studentdoctor.net/showthread.php?t=177874

http://forums.studentdoctor.net/showthread.php?t=178405

 

[omfsres]

.

 

[tx oms]

Go to dental school if you want to be a dentist. Go to medical school if you want to be a physician. Otherwise, stop talking to me and go carry out my orders.

 

[lnn2]

Well.. the way the've decided to fix this problem is to just give "doctorate" degrees to all allied health.. just look at physical therapy and nursing...

That woud confuse the hell out of everyone. A Doctor Nurse?