Will a DO/MD analog happen in dentistry?

[MONKEYBOY]

Given the rate at which most dental schools have expanded their classes to prepare for the high need of dentists, do you think that a phenomenon like the DO (from what I know got large in the 60's) but in the practice-real of dentistry?

If you have a great opportunity that is unmet (read: high demand), it is likely that someone creative may find a way to get a piece of that pie (if not the whole pie).

Maybe the Oral Health Therapist (OHT) is this position?

Maybe International Dental Graduates (IDG) will fill this need?

If this does occur and compromise patient care (I do not infer that an International person practices inferior dentistry), I blame those in dentistry for allowing this to happen.

My reasoning is that if demand is left unmet for so long, this is disrespectful to patients needs. Second, if a huge swell happens from someone other than our typical dental graduate dentist--causing price slashing and inherent quality decreases (McDonalds phenomenon) only those with their hands on the dental steering wheel are to blame.

What are your thoughts? Should we:

1.) push to increase American dental graduates
2.) recruit and use brain drain from other countries
3.) consider more schools like the A.T. Still University AzDOH?
4.) Keep access to care small and keep prices high? Is this ethical?

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[Squished Rat]

Given the rate at which most dental schools have expanded their classes to prepare for the high need of dentists, do you think that a phenomenon like the DO (from what I know got large in the 60's) but in the practice-real of dentistry?

If you have a great opportunity that is unmet (read: high demand), it is likely that someone creative may find a way to get a piece of that pie (if not the whole pie).

Maybe the Oral Health Therapist (OHT) is this position?

Maybe International Dental Graduates (IDG) will fill this need?

If this does occur and compromise patient care (I do not infer that an International person practices inferior dentistry), I blame those in dentistry for allowing this to happen.

My reasoning is that if demand is left unmet for so long, this is disrespectful to patients needs. Second, if a huge swell happens from someone other than our typical dental graduate dentist--causing price slashing and inherent quality decreases (McDonalds phenomenon) only those with their hands on the dental steering wheel are to blame.

What are your thoughts? Should we:

1.) push to increase American dental graduates
2.) recruit and use brain drain from other countries
3.) consider more schools like the A.T. Still University AzDOH?
4.) Keep access to care small and keep prices high? Is this ethical?

Can you be more specific as to what your question is? Are you saying you think access to care is a problem and what can we do about it? Are you worried about a glut of dentists? If you could be more specific on what you are asking, it might make responding a little easier.

 

[KOM]

In medicine it's not so much just the MD/DO critique anymore as it is with more and more mid-levels expanding their function as well as a new group of docs called "naturopaths" I believe. I'll have to read more up on it.

Anyhow, no - I don't think there will be an equivalent in dentistry if we're speaking strictly the MD/DO comparison. Will there be expanded functions of hygienists opening the door to more mid-level groups? Yes, I believe there will.

Do I think this will be good for the patient population? I suppose it depends on the shortage.

I think as this comes about, dental schools will attempt to better prepare their students for more specialized areas of dentistry. As hygienists or any other mid-level providers begin to upgrade their scope of practice, dentists will just have to do the same.

 

[I'mFillingFine]

I agree that there may be more hygienists doing dental procedures, especially in dentist-shortage areas.

However, I don't think there's a push for holistic dentistry (which is part of the way that osteopathy came into being.) From what I understand, to become a DO, there is a lot of musculoskeletal manipulation and "whole person" approaches. Oral care tends to be a lot more active disease control and tissue manipulation. So I don't think we'd go in that direction.

 

[Dr.Millisevert]

"whole person" approaches.

The "we're different because we treat the whole person" crap is the biggest wishy washy ball of marketing sh1+ I have ever heard. I challenge anyone name a single MD granting medical school that does not encourage a biopsychosocial model of treating patients and a multidisciplinary approach to management.

 

[MONKEYBOY]

This thread has gone to a more productive topic than it started, but what I refer to is someone not a DDS or DMD getting onto the prctice rights that Dental Doctors treat.

Doctor of Nurse Practitioner, P.A., bla bla ... any positions going to spring up and try to overtake an area that dentists are specifically trained to treat?

The Oral Health Therapist fits the bill in Alaska.

If the Oral Health Therapist came to the mainland of USA, do you think patients will be smart enough to demand to see an actual Dental Doctor instead of a Oral Health Therapist.

This issue is one of the many parts of the reasons that dentists should not let underserved areas happen. If we sit on our hands long enough like those in medicine have, someone somewhere is going to make an Oral Health Therapist or other substandard level of care.

Substandard healthcare workers do not stay contained in the underserved areas their title was created for. They go to the downtown Seattle and do veneers or climb up and STAY at the limit of their domain of practice.

I agree, the 'treat the whole person' thing is a nice lofty goal--but is just another mission statement transparent lie.

 

[KOM]

This thread has gone to a more productive topic than it started, but what I refer to is someone not a DDS or DMD getting onto the prctice rights that Dental Doctors treat.

Doctor of Nurse Practitioner, P.A., bla bla ... any positions going to spring up and try to overtake an area that dentists are specifically trained to treat?

The Oral Health Therapist fits the bill in Alaska.

If the Oral Health Therapist came to the mainland of USA, do you think patients will be smart enough to demand to see an actual Dental Doctor instead of a Oral Health Therapist.
This issue is one of the many parts of the reasons that dentists should not let underserved areas happen. If we sit on our hands long enough like those in medicine have, someone somewhere is going to make an Oral Health Therapist or other substandard level of care.

Substandard healthcare workers do not stay contained in the underserved areas their title was created for. They go to the downtown Seattle and do veneers or climb up and STAY at the limit of their domain of practice.

I agree, the 'treat the whole person' thing is a nice lofty goal--but is just another mission statement transparent lie.

I'm gonna tackle the bold statement at the end.

Growing up in AK, I always thought of "the lower '48" joining the mainland of Alaska. After all, don't people only care about AK when it comes to oil?

In AK their designation is dental therapists. What you will find is that the program has been working quite successfully much to practicing dentist's and the ADA's chagrin. It fulfills immediate needs to patients that haven't and wouldn't have been previously provided for on a cost effective basis.

What it doesn't do very effectively is teach prevention. Native Alaskan's drink soda in these communities like it was water and if they drink water, it's non-fluoridated. A ripe recipe for caries. It also doesn't effectively teach more complicated cases...but at least they have someone to look at the problem and refer it out. Sound familiar?

What it means to the profession is one thing. Patients can and will find cheaper alternatives. Some of the "bread and butter" of restorative dentistry will switch hands. If my training was condensed to the point where all I needed to do was read a radiograph and fill a cavitated lesion...give me a few solid few months period.

Here's what I think will happen in a condensed version. As soon as insurance companies get wind of the opportunity to offer cheaper quotes based on these new provider's cost-basis (they're operational costs will be very specific hence less overhead) then they will. Insurance companies will finally be able to absorb dentistry giving them a profitable margin. The new mid-level providers will begin by working under practicing dentists who are employing them seeking their own profits, and eventually they will branch out on their own.

Malpractice lawsuits for these mid-levels will garner national representation and I guarantee they will be protected more efficiently than you and I bringing about more competition.

If you don't accept insurance...no worries...you'll just lose out to THE MILLIONS of new patients that begin to subscribe and then eventually...you'll be sucked in just like the MD's and DO's. Insurance companies will begin to dictate your prices and your treatment. This is Nixon for you, except Nixon wasn't thinking far enough ahead. Nixon didn't think that insurance companies would eventually gain more power than the health care industry and confront them in a pretty pickle of greed.

Capitalism breeds greed.

In short, don't quote me on this, but the golden era of dentistry will begin its demise in less than 10 years. The current generation of dentists will be marginally affected.

...and your dedicated work as an individual in society providing a meaningful service will go to pay for bloated "fat cat" insurance corporation members and share-holders that have absolutely no idea the harm they are doing to the health-care of America.

Dentists will begin to wonder if they'd rather put some of their gains in the government who may better represent the American health-care needs than the insurance companies.

As far as the bold goes...I agree, DO's have nothing more going for them than an MD except for a comprehensive musculoskeletal OMM discipline that in most cases, only aids in their board examinations. My wife is in a D.O. program and she doesn't buy into the whole "holistic" and "treating the patient vs symptom" buzzwords. What she cares about is being a doctor. Similarly, we as health-care providers need to realize that if we can't fulfill a basic necessity to the public, then we shouldn't be surprised at other's moving in on our territory. We did it to ourselves.

Analogy - Ivy league colleges too expensive...I'll save 100K or so to buy the textbooks on my own, go to a CC, and pass the DAT with flying colors.

 

[KOM]

I'm seeing this happening with my own family and their friends...a few MD's. Now that their own greed is becoming stale-mated by insurance companies greed they are beginning to think more and more that a govt. run health-care is in order.

 

[armorshell]

The "we're different because we treat the whole person" crap is the biggest wishy washy ball of marketing sh1+ I have ever heard. I challenge anyone name a single MD granting medical school that does not encourage a biopsychosocial model of treating patients and a multidisciplinary approach to management.

I can't wait until some search happy DO manipulation freak finds this post and craps all over the dental forum.