Mid Level Provider program at my school.

[Oracle DMD]

I'm curious as to when Dr. Simonsen last practiced dentistry; a while back I asked the Dean of Arizona's other dental school when he'd last put his hands in a patients mouth -- his response was "1984".

I guess I was naively brought up with the ideal that real leadership was by done by setting an example. My point is not to put down someone who was made significant contributions to dentistry; but I believe its a fair question to ask. Any Midwestern students know the answer?

should we also ask him his opinion of your hand skills? ya know. not to put you down, but perhaps it would shed some insight to your scheduling/ buisness woes.

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[drillemfillembi]

It seems that out of all places Arizona wouldn't strike my mind as the first place that needs MLPs. They do have the highest concentration of dentists.
http://www.bls.gov/oes/2008/may/oes291021.htm
Maybe they could use more in Tuba City, but every dentist will want to work where people show up for appointments and pay their bills. MLPs will want to do the same, since they'll have to deal with costs too.
I think a big reason for this program is Midwestern University seeing an opportunity for themselves, whether it be additional profit or a bigger name.

 

[AZ2thDOC]

should we also ask him his opinion of your hand skills? ya know. not to put you down, but perhaps it would shed some insight to your scheduling/ buisness woes.

Oracle:

I know Dr. Simonsen knows a lot about dentistry including being able to judge good operative and hand skills. PM and I'll be happy to let you talk w/ my labs and get their opinion of my dentistry. I'm NOT ashamed.

As far as business/scheduling "woes" I'll just say I've made 310 consecutive bi-weekly payrolls and am current w/ all my tax, business, and personal financial obligations. How many payrolls have you ever made?

I have offered my opinions here for a few reasons:

1. I personally know several dentist colleagues who are currently struggling. Its indisputable that many of them are not poor dentists or business people. Yesterday I heard from a friend in Las Vegas that 120 offices in that area had closed their doors in the past year. (I don't know if this is accurate, I must admit)

Many struggling dentists only a few years out of dental school--just like you'll be in a few years. I care about my fellow dentists and also their patients. I firmly believe that the interests of dentists parallel the interests of the patients. To phrase it differently, when a dentist is doing well, his or her patients will also be the recipient of better care also.

I have no idea of your plans are after Midwestern, but given your crass attitude it is difficult for me to visualize any dentist I know wanting you as a colleague or employee.

2. I'm not impressed with what I know regarding mid-level providers (MLP's) outside the United States. I forsee confusion for patients and dilution of quality of care delivered. Dentistry already has a poor image with much of the public and MLP's in my opinion will not help.

3. As an Arizona dentist, I'm not interested in Midwestern University's reputation being sullied by it advocating for MLP's. If you want to be a graduate of an institution that has a somewhat tarnished reputation in the dental world, that's fine. I doubt many of your classmates feel the same.

4. Finally, as has been noted by others, the decisions regarding MLP's are being made by people who don't do dentistry. I think its O.K. to point this out. Those of us who do real world dentistry on regular basis have a visceral gut feeling about what it truly entails.

 

[Oracle DMD]

Oracle:

I know Dr. Simonsen knows a lot about dentistry including being able to judge good operative and hand skills. PM and I'll be happy to let you talk w/ my labs and get their opinion of my dentistry. I'm NOT ashamed.

As far as business/scheduling "woes" I'll just say I've made 310 consecutive bi-weekly payrolls and am current w/ all my tax, business, and personal financial obligations. How many payrolls have you ever made?

I have offered my opinions here for a few reasons:

1. I have personally know several dentist colleagues who are currently struggling. Its indisputable that many of them are not poor dentists or business people. Yesterday I heard from a friend in Las Vegas that 120 offices in that area had closed their doors in the past year. (I don't know if this is accurate, I must admit)

Many struggling dentists only a few years out of dental school--just like you'll be in a few years. I care about my fellow dentists and also their patients. I firmly believe that the interests of dentists parallel the interests of the patients. To phrase it differently, when a dentist is doing well, his or her patients will also be the recipient of better care also.

I have no idea of your plans are after Midwestern, but given your crass attitude it is difficult for me to visualize any dentist I know wanting you as a colleague or employee.

2. I'm not impressed with what I know regarding mid-level providers (MLP's) outside the United States. I forsee confusion for patients and dilution of quality of care delivered. Dentistry already has a poor image with much of the public and MLP's in my opinion will not help.

3. As an Arizona dentist, I'm not interested in Midwestern University's reputation being sullied by it advocating for MLP's. If you want to be a graduate of an institution that has a somewhat tarnished reputation in the dental world, that's fine. I doubt many of your classmates feel the same.

4. Finally, as has been noted by others, the decisions regarding MLP's are being made by people who don't do dentistry. I think its O.K. to point this out. Those of us who do real world dentistry on regular basis have a visceral gut feeling about what it truly entails.

i am not being crass. i have listened, researched, and thought about a lot of the concerns of others on this forum when genuine concerns and opinions were offered. but then you chime in with passive aggressive posts about Dr. Simonsen's clinical history; its BS and you know it, thats why you back tracked just now on the topic of his contributions and clinical relevance. i know who who you are, and i gave you a little of what you were giving, deal with it.

my remarks towards your buisness/scheduling woes was a reference to your previous posts about times being tough. your "i live in the real world and you dont" attitude is boring and baseless. i don't much care what you think about the repuation of MWU, i'm proud of what's going on here. stop thinking with your gut and start thinking with your brain.

now, back to MLP's: explain "when a dentist is doing well his patients are doing well". it seems like if a dentist is doing well, he'd be able to work less, and then serve less patients (or pass lower paying cases to younger associates). is this not the case that you find?

 

[AZ2thDOC]

now, back to MLP's: explain "when a dentist is doing well his patients are doing well". it seems like if a dentist is doing well, he'd be able to work less, and then serve less patients (or pass lower paying cases to younger associates). is this not the case that you find?

Oracle:

A dentist who does well is able to afford quality, competent staff; pay for quality dental materials and equipment (i.e. quality handpieces); and pay for quality work from their dental laboratories.

Furthermore, a dentist who is doing well can provide a clean (not necessarily opulent) relaxing environment to do dentistry in, can take the time necessary to explain procedures to patients, as well as the time required to do a job properly with skill and precision.

Also time and money is required properly sterilize instruments and maintain equipment appropriately.

All of the above factors cost a LOT OF MONEY. They'll make student loan obligations pale in comparison.

Do any of these things cost less or can be omitted just because an MLP does the work instead of a dentist? I can't think of any.

 

[Oracle DMD]

Oracle:

A dentist who does well is able to afford quality, competent staff; pay for quality dental materials and equipment (i.e. qualilty handpieces); and pay for quality work from their dental laboratories.

Furthermore, a dentist who is doing well can provide a clean (not necessarily opulent) relaxing environment to do dentistry in, can take the time necessary to explain procedures to patients, as well as the time required to do a job properly with skill and precision.

Also time and money is required properly sterilize instruments and maintain equipment appropriately.

All of the above factors cost a LOT OF MONEY. They'll make student loan obligations pale in comparison.

Do any of these things cost less or can be omitted just because an MLP does the work instead of a dentist? I can't think of any.

the above just sounds like day to day dentistry to me. even if a dentist isnt doing well, its not like he's using bootleg materials, or a subpar lab, or not sterilizing instruments, or not taking the time to properly do procedures.

MLP's might want to do more in the future, like hygienists or assistants, but that will be an issue for another day. until then why not hire these MLP's to provide care to area's without dentists? they still work for you, and not even in your office neccesarily. the people without dentist get some care, seems like everyone wins.

i guess i'm not buying into the competitive relationship between us and them that some feel is looming on the horizon. i figure hire them, make more $$$, get more care to people, and everyone wins. right?

 

[AZ2thDOC]

the above just sounds like day to day dentistry to me. even if a dentist isnt doing well, its not like he's using bootleg materials, or a subpar lab, or not sterilizing instruments, or not taking the time to properly do procedures.

Oracle, I wish you were correct about these things. Unfortunately, I think you're perhaps naive or simply incorrect as to what really happens in distressed dental offices and sometimes seemingly good offices as well.

I guess I've been around dentistry too long--hardly anything really surprises me as to some of the things I've seen or heard.

 

[50 CAL BMG]

the above just sounds like day to day dentistry to me. even if a dentist isnt doing well, its not like he's using bootleg materials, or a subpar lab, or not sterilizing instruments, or not taking the time to properly do procedures.

MLP's might want to do more in the future, like hygienists or assistants, but that will be an issue for another day. until then why not hire these MLP's to provide care to area's without dentists? they still work for you, and not even in your office neccesarily. the people without dentist get some care, seems like everyone wins.

i guess i'm not buying into the competitive relationship between us and them that some feel is looming on the horizon. i figure hire them, make more $$$, get more care to people, and everyone wins. right?

You and your family should be the first patients for these new MLP's. You'll save a little $$$, right?

 

[Oracle DMD]

You and your family should be the first patients for these new MLP's. You'll save a little $$$, right?

my family lives in the country and could use some simple, routine work done, sure.

 

[denner]

i guess i'm not buying into the competitive relationship between us and them that some feel is looming on the horizon. i figure hire them, make more $$$, get more care to people, and everyone wins. right?

Please go directly to the anesthesiology forums and ask them how that worked out with CRNAs. They have an entire subforum dedicated to that issue.

I don't see why we would be immune to that type of situation developing in the very near future (hell, it's already happening).

In reference to the bolded above, my understanding was that the anesthesiologists who took advantage of these midlevels in the beginning were able to make a killing, but in reality have sold out the field of anesthesiology to those graduating today.

The nursing lobby is nothing to sneeze at and CRNA practice/prescription rights seem to be growing by the day because anesthesiologists not only stood by and did nothing in the early days, but actually encouraged the growth of the CRNA field because of the $$$ opportunity.

CRNAs are now turning around today and saying, "Hey, we don't need you guys anymore, (remember the American way....money > lobbying > law) and actually, we provide better care because we are nurses and are good with patients to boot!" What would keep a growing population of dental midlevels from doing something similar?

Politicians don't give a **** about dentistry as a profession, they look at it and see, "Oh, we're gonna have more dentists, but not have to make the financial investment to train actual dentists, win-win, right?" as the voting population all nods in agreement.

Take some pride in the dedication you have put into your education and the time investment you're making to become a competent dentist. I don't understand why anyone wouldn't take offense to someone saying they can do the same job as them with 1/3 the training (or whatever it is). That's like telling them they just wasted years of time, effort and money that they really didn't need to. And if that's the case, then get rid of dental schools all together and we can all go to the University of Phoenix or ITT Tech School of Dentistry for a couple of months and start a'drillin'.

Is it as simple as I'm making it out to be? No. Is it as bad or as I'm making it out to be? Maybe, maybe not, but I just have to respond to those who say it's not a big deal with reasons why, YES, it is a big deal. I think and hope dentists have seen what has happened in medicine and are wise enough and prepared to fight for their chosen profession. Unfortunately, it may soon be out of their hands.

I'm not trying to attack you Oracle so I apologize if it comes off that way, I just feel you are putting far too much of your trust into those who don't have your best interests in mind (both personally and professionally), and I believe that may prove to be a foolish decision in the near future. If you don't look out for yourself, no one else will.

 

[TJNova2011]

my family lives in the country and could use some simple, routine work done, sure.

Would you want your mother to be treated by a dental therapist in your country setting. But, all of a sudden when the dental therapist is prepping her tooth, they expose some pulp. In this case, they are in need of a root canal. Wait! The dentist is 50 miles away because the treatment with the dental therapist (advanced DT) was done indirectly, remotely with technology. And by law, this dental therapist cannot do that RCT. So, you're opting for more treatment and a substandard.


You will soon realize there are NO simple extractions. In fact, some of the easier ones turn into more difficult rather quick, in my short experience.


Finally, how will dental therapists be beneficial financially? They are required to take 50% of uninsured, MA, nursing home, etc. and the rest to take your average, patients that a dentist would treat. In these tough financial times, this is what the dentists are needing to stay afloat, but you want to pawn your work off to others. Also, it isn't financially feasible to do these procedures at a cheaper cost due to the overhead. What would Suzie the soccer mom think if you're bringing homeless people into your practice? It will definitely take a hit due to that stigma. If you want to be this productive member of society Oracle, go join the peace core, Indian public health, rural areas and/or volunteer at the local community clinic and let the rest off us practice and save the profession of dentistry.

 

[Oracle DMD]

Please go directly to the anesthesiology forums and ask them how that worked out with CRNAs. They have an entire subforum dedicated to that issue.

I don't see why we would be immune to that type of situation developing in the very near future (hell, it's already happening).

In reference to the bolded above, my understanding was that the anesthesiologists who took advantage of these midlevels in the beginning were able to make a killing, but in reality have sold out the field of anesthesiology to those graduating today.

The nursing lobby is nothing to sneeze at and CRNA practice/prescription rights seem to be growing by the day because anesthesiologists not only stood by and did nothing in the early days, but actually encouraged the growth of the CRNA field because of the $$$ opportunity.

CRNAs are now turning around today and saying, "Hey, we don't need you guys anymore, (remember the American way....money > lobbying > law) and actually, we provide better care because we are nurses and are good with patients to boot!" What would keep a growing population of dental midlevels from doing something similar?

Politicians don't give a **** about dentistry as a profession, they look at it and see, "Oh, we're gonna have more dentists, but not have to make the financial investment to train actual dentists, win-win, right?" as the voting population all nods in agreement.

Take some pride in the dedication you have put into your education and the time investment you're making to become a competent dentist. I don't understand why anyone wouldn't take offense to someone saying they can do the same job as them with 1/3 the training (or whatever it is). That's like telling them they just wasted years of time, effort and money that they really didn't need to. And if that's the case, then get rid of dental schools all together and we can all go to the University of Phoenix or ITT Tech School of Dentistry for a couple of months and start a'drillin'.

Is it as simple as I'm making it out to be? No. Is it as bad or as I'm making it out to be? Maybe, maybe not, but I just have to respond to those who say it's not a big deal with reasons why, YES, it is a big deal. I think and hope dentists have seen what has happened in medicine and are wise enough and prepared to fight for their chosen profession. Unfortunately, it may soon be out of their hands.

I'm not trying to attack you Oracle so I apologize if it comes off that way, I just feel you are putting far too much of your trust into those who don't have your best interests in mind (both personally and professionally), and I believe that may prove to be a foolish decision in the near future. If you don't look out for yourself, no one else will.

i get what your saying, although im not sure its the same situation for CRNA's as it is for MLP's. i think pride can often be an obstruction to progess although i am proud of my own accomplishments, i try to keep in mind that its really not THAT amazing, many people before and after me will do/ have done what i have under way harder circumstances. i trust the research. i trust that dean lloyd at UMinn at Dr. Simonsen have the patients best interest in mind, and that other models showed a better system than ours. i should keep a skeptical eye, because you're right about not being too trusting, so i will go check out the research myself. all in all i respect where you're coming from. i do think you'd be hard pressed to say that patients will be the ones benefitting from this move, in which case i am hard pressed to be against it. if it turns out that they are unable to provide standard of care services, then i will definatly be against them.

Would you want your mother to be treated by a dental therapist in your country setting. But, all of a sudden when the dental therapist is prepping her tooth, they expose some pulp. In this case, they are in need of a root canal. Wait! The dentist is 50 miles away because the treatment with the dental therapist (advanced DT) was done indirectly, remotely with technology. And by law, this dental therapist cannot do that RCT. So, you're opting for more treatment and a substandard.


You will soon realize there are NO simple extractions. In fact, some of the easier ones turn into more difficult rather quick, in my short experience.


Finally, how will dental therapists be beneficial financially? They are required to take 50% of uninsured, MA, nursing home, etc. and the rest to take your average, patients that a dentist would treat. In these tough financial times, this is what the dentists are needing to stay afloat, but you want to pawn your work off to others. Also, it isn't financially feasible to do these procedures at a cheaper cost due to the overhead. What would Suzie the soccer mom think if you're bringing homeless people into your practice? It will definitely take a hit due to that stigma. If you want to be this productive member of society Oracle, go join the peace core, Indian public health, rural areas and/or volunteer at the local community clinic and let the rest off us practice and save the profession of dentistry.

i should let you save the profession of dentistry? HA! an arrogant and baseless thought. what are you saving it from exactly? every country that has MLP's has dentists and they are just fine. you can go tell dentists there that you are there to save them! hahaha get over yourself. you tell me if i want to go be a productive member of society, that i should stay out of private practice???!!! hahahaha you are garbage.

 

[cda]

i think that the mid-level professionals will create more of a social division in our already somewhat 'separated' society than benefits. people with great income and good private ins will seek care at the dental offices with DDS/DMD's and people who can't afford care now, will have to go to mid-level profs offices. also, who is going to oversee the practice of these new professionals? ADA? if something goes wrong, who is going to be responsible for mistakes they make?

 

[TJNova2011]

i should let you save the profession of dentistry? HA! an arrogant and baseless thought. what are you saving it from exactly? every country that has MLP's has dentists and they are just fine. you can go tell dentists there that you are there to save them! hahaha get over yourself. you tell me if i want to go be a productive member of society, that i should stay out of private practice???!!! hahahaha you are garbage.

I just mentioned what dentistry needs to be saved by, sub par practice and avoid turning dentistry into a trade, rather than a profession.

How can you help everyone while you're in private practice? Oracle, you need to get on a mission, because everyone needs to be treated. Since in America, health care is a right, not a privilege!

 

[TJNova2011]

i think that the mid-level professionals will create more of a social division in our already somewhat 'separated' society than benefits. people with great income and good private ins will seek care at the dental offices with DDS/DMD's and people who can't afford care now, will have to go to mid-level profs offices. also, who is going to oversee the practice of these new professionals? ADA? if something goes wrong, who is going to be responsible for mistakes they make?

DT practice under a general dentist. The dentist is responsible.

 

[JPevzner]

hygienists, dentists, and dental specialists are not enough for these people. They want to throw in MLP. We have enough providers in the process already to get the best treatment possible for the patient. If it is the undeserved that are the issue, let the government provide extra benefits for dentists to work in those areas. Problem solved! We do not need any glorified hygenists to ruin our profession.

 

[Oracle DMD]

hygienists, dentists, and dental specialists are not enough for these people. They want to throw in MLP. We have enough providers in the process already to get the best treatment possible for the patient. If it is the undeserved that are the issue, let the government provide extra benefits for dentists to work in those areas. Problem solved! We do not need any glorified hygenists to ruin our profession.

so your solution is for the government to pay dentists more money to provide care to the underserved...hmmmmm... seems contrary to the opposition that conservative dentists have more government being a solution to anything. also, it seems like our responsibility more than than the govt's

 

[TJNova2011]

so your solution is for the government to pay dentists more money to provide care to the underserved...hmmmmm... seems contrary to the opposition that conservative dentists have more government being a solution to anything. also, it seems like our responsibility more than than the govt's

Sure beats giving anyone a drill and telling them to go to town.

 

[Oracle DMD]

Sure beats giving anyone a drill and telling them to go to town.

if by giving anyone a drill, you mean a trained dental therapist who performs at the standard of care, then no it doesn't.

 

[TJNova2011]

if by giving anyone a drill, you mean a trained dental therapist who performs at the standard of care, then no it doesn't.

They cannot deal with the what ifs. What if that pulp is exposed and the dentist isn't on site? To me, not being prepared for the worst is sacrificing patient care, maybe they teach you different at Midwestern, but that's my philosophy.

 

[TedyBearSuicide]

Oracle, are these midlevels going to be trained in Midwestern's dental clinic?

 

[JPevzner]

so your solution is for the government to pay dentists more money to provide care to the underserved...hmmmmm... seems contrary to the opposition that conservative dentists have more government being a solution to anything. also, it seems like our responsibility more than than the govt's

That's exactly my solution. I understand that you believe that we should all be like Mother Teressa and provide free dental care to the undeserved. However, this is the real world. We go through 7+ years of schooling and take on enormous debts to live a good life. Being underpaid and working in some dump is just not going to fly with me. If you want this kind of life than more power to you; don't impose it on the rest of us. If the government wants to increase care to the undeserved than i suggest it provide additional benefits to dentists so that they would have some incentive to work under such conditions.

 

[TJNova2011]

That's exactly my solution. I understand that you believe that we should all be like Mother Teressa and provide free dental care to the undeserved. However, this is the real world. We go through 7+ years of schooling and take on enormous debts to live a good life. Being underpaid and working in some dump is just not going to fly with me. If you want this kind of life than more power to you; don't impose it on the rest of us. If the government wants to increase care to the undeserved than i suggest it provide additional benefits to dentists so that they would have some incentive to work under such conditions.

Couldn't have been said better.

I hope in a few years we see Oracle signing on the line for a public health position in the boondocks for 65k grand. Practice what you preach.

I forgot, Oracle you probably follow a philosophy along these lines:
"A liberal is a person who will give away everything they do not own."

 

[jay47]

if by giving anyone a drill, you mean a trained dental therapist who performs at the standard of care, then no it doesn't.

I think the entire basis of this debate is that the ability of a DT to practice at a "standard of care" is unknown. I do not know, so I don't want to comment.

 

[Oracle DMD]

Oracle, are these midlevels going to be trained in Midwestern's dental clinic?

i would assume so. the program isn't here yet so we will have to wait to see the details of their training.

That's exactly my solution. I understand that you believe that we should all be like Mother Teressa and provide free dental care to the undeserved. However, this is the real world. We go through 7+ years of schooling and take on enormous debts to live a good life. Being underpaid and working in some dump is just not going to fly with me. If you want this kind of life than more power to you; don't impose it on the rest of us. If the government wants to increase care to the undeserved than i suggest it provide additional benefits to dentists so that they would have some incentive to work under such conditions.

we? arent you in highschool? i really dont understand why you're saying i think we should give dental work for free to everyone. we do have an ethical obligation to help people out, and AT TIMES do work at discount fees or even for free.
this is a seperate issue than having MLP's working with the underserved to bring access to care to people that have none.

Couldn't have been said better.

I hope in a few years we see Oracle signing on the line for a public health position in the boondocks for 65k grand. Practice what you preach.

I forgot, Oracle you probably follow a philosophy along these lines:
"A liberal is a person who will give away everything they do not own."

see above. you really want to talk politics? lets stick to the script and focus on MLP's. if you want to get into liberal vs conservative, we should move this to another forum.

 

[jay47]

It seems that out of all places Arizona wouldn't strike my mind as the first place that needs MLPs. They do have the highest concentration of dentists.
http://www.bls.gov/oes/2008/may/oes291021.htm
Maybe they could use more in Tuba City, but every dentist will want to work where people show up for appointments and pay their bills. MLPs will want to do the same, since they'll have to deal with costs too.
I think a big reason for this program is Midwestern University seeing an opportunity for themselves, whether it be additional profit or a bigger name.

I thought it was funny that there were only 180 dentists in Alaska. Being the largest state in the US, you would think they would still have more than that...

 

[Oracle DMD]

I think the entire basis of this debate is that the ability of a DT to practice at a "standard of care" is unknown. I do not know, so I don't want to comment.

i agree that its unknown as of yet, but im operating on the assuption that schools will not be putting out operators of sub standard care, and also that there are MLP's in the world (canada, new zeland) and im assuming that they are working and doing sufficient work, so its possible to have a MLP do standard of care work.

 

[TedyBearSuicide]

i would assume so. the program isn't here yet so we will have to wait to see the details of their training.

Midwestern advertised that the clinic will have 240 chairs and each dental class has 110 students, so plenty of chairs to go around. But with encroachment of midlevels and addition of hygiene school will this still be true?

 

[Oracle DMD]

Midwestern advertised that the clinic will have 240 chairs and each dental class has 110 students, so plenty of chairs to go around. But with encroachment of midlevels and addition of hygiene school will this still be true?

understandable question. the MLP program is set to have 10 students so i dont think their impact on our resources would be significant. 4th years all get their own chair (110) 3rd years are 2 students per chair (55) idk how big the hygiene dept will be but im assuming that the remaining (240-165=75-5mlp chairs= 70) 70 chairs should be sufficient to handle a few hygienist and still have room for a dental specialty bay of chairs as well.

 

[JPevzner]

i would assume so. the program isn't here yet so we will have to wait to see the details of their training.



we? arent you in highschool? i really dont understand why you're saying i think we should give dental work for free to everyone. we do have an ethical obligation to help people out, and AT TIMES do work at discount fees or even for free.
this is a seperate issue than having MLP's working with the underserved to bring access to care to people that have none.



see above. you really want to talk politics? lets stick to the script and focus on MLP's. if you want to get into liberal vs conservative, we should move this to another forum.

Yes i am still in high school but i feel i must stop you from ruining the career i plan to be a part of. It's not OUR ethical obligation to do discount/free work, it's yours. If you feel you must do that then you're more than welcome. Again, don't impose your ethical and moral beliefs on others; they don't feel the same way.

 

[Oracle DMD]

Yes i am still in high school but i feel i must stop you from ruining the career i plan to be a part of. It's not OUR ethical obligation to do discount/free work, it's yours. If you feel you must do that then you're more than welcome. Again, don't impose your ethical and moral beliefs on others; they don't feel the same way.

maybe you should spend some time in a dental office before you say that we dont have an obligation to do SOME pro bono stuff. you do. we do. i do. why? because you'll find situations were you could let someone suffer, or you could bend your fee schedule to get them out of pain. at that point you will do it because its the right thing to do. not because i say so, or becasue your told to, because its the RIGHT thing to do. all the dentists that i know do some probono work. sometimes its case by case, some time dentists like to work with an organization, or their church, or their nieghbors. i dont think ive met a dentist that doesnt do these things on a semi regular basis.

these are not the ethical standards of jason keckley, these are the ethical standards of the dental profession.

 

[Andrew324]

It's not OUR ethical obligation to do discount/free work, it's yours. If you feel you must do that then you're more than welcome. Again, don't impose your ethical and moral beliefs on others; they don't feel the same way.

Agreed

 

[Oracle DMD]

Agreed

see last post. ethics classes in dental school disagree.

 

[TJNova2011]

see last post. ethics classes in dental school disagree.

Ethics. How can you comment on ethics. You're accepting a new position where the dental therapist cannot deliver the acceptable care if something goes wrong.

When you hit the clinics, you'll soon realize that those "simple extractions" or what your professors referred too, can become very difficult, very quick. It is unethical to have someone not trained to be performing these procedures that could fall in this category, Mr. Jason "unethical" Keckley. However, I do not expect you to see outside of the glorious world of glorified ethics when it comes to clinical reality, until you have dealt with it first hand.

 

[Oracle DMD]

Ethics. How can you comment on ethics. You're accepting a new position where the dental therapist cannot deliver the acceptable care if something goes wrong.

When you hit the clinics, you'll soon realize that those "simple extractions" or what your professors referred too, can become very difficult, very quick. It is unethical to have someone not trained to be performing these procedures that could fall in this category, Mr. Jason "unethical" Keckley. However, I do not expect you to see outside of the glorious world of glorified ethics when it comes to clinical reality, until you have dealt with it first hand.

you're making this very personal when its not a personal issue. if you feel that MLP's as a part of a dental team is unethical, then say so, but dont act like its my fault that they're here. i support the idea, and am interested in how it turns out. very clever nickname TJ.

so you assume that the MLP's couldnt handle extracting primary teeth because of the possible complications? and they couldn't possibly extract a tooth that is rotting out of a pts head is that right? hmmm. i think you over estimate 1. what MLP's will be doing and 2. the superiority of your training.

you say it is unethical for an untrained person to be performing these procedures. what if they are properly trained?????

 

[JPevzner]

maybe you should spend some time in a dental office before you say that we dont have an obligation to do SOME pro bono stuff. you do. we do. i do. why? because you'll find situations were you could let someone suffer, or you could bend your fee schedule to get them out of pain. at that point you will do it because its the right thing to do. not because i say so, or becasue your told to, because its the RIGHT thing to do. all the dentists that i know do some probono work. sometimes its case by case, some time dentists like to work with an organization, or their church, or their nieghbors. i dont think ive met a dentist that doesnt do these things on a semi regular basis.

these are not the ethical standards of jason keckley, these are the ethical standards of the dental profession.

Your argument is flawed. If "all the dentists you know" do some probono work, then why do we need MLP in the first place? I will now restate my point: if it is the underserved that is the problem, let the government offer benefits to dentists to work there. problem solved. No need for MLP taking over out great profession: we can handle the needs of the whole population, poor and rich, saturated or underserved. Please consider my point of view thoughtfully and i'm sure you'll see at what im getting at.

 

[Oracle DMD]

Your argument is flawed. If "all the dentists you know" do some probono work, then why do we need MLP in the first place? I will now restate my point: if it is the underserved that is the problem, let the government offer benefits to dentists to work there. problem solved. No need for MLP taking over out great profession: we can handle the needs of the whole population, poor and rich, saturated or underserved. Please consider my point of view thoughtfully and i'm sure you'll see at what im getting at.

no, dentists cannot and are not handling the amount of underserved in the country. yes they all do some probono work, but they arent everywhere. your logic is flawed because you're not seeing 1. the resposibility we have to the public on an ethical or professional level and 2. government subsidies will not drive dentists into underserved areas at a rate that will support the underserved.

understand that dentistry has a buisness component sure, we all have to try and make money and we deserve to, however dentistry is not a commodity and they are called patients and not customers for a reason.

why do you think MLP's are taking over the profession? what exactly do you know about MLP's? have you looked into the models that suggest the public is better served with them?

it seems as though you were first upset that a MLP might cut into your profit margins, then changed to the "they are not trained to do what they will be doing", and now they are taking over the profession?

 

[TJNova2011]

no, dentists cannot and are not handling the amount of underserved in the country. yes they all do some probono work, but they arent everywhere. your logic is flawed because you're not seeing 1. the resposibility we have to the public on an ethical or professional level and 2. government subsidies will not drive dentists into underserved areas at a rate that will support the underserved.

understand that dentistry has a buisness component sure, we all have to try and make money and we deserve to, however dentistry is not a commodity and they are called patients and not customers for a reason.

why do you think MLP's are taking over the profession? what exactly do you know about MLP's? have you looked into the models that suggest the public is better served with them?

it seems as though you were first upset that a MLP might cut into your profit margins, then changed to the "they are not trained to do what they will be doing", and now they are taking over the profession?

What makes you think that MLP will leave civilization and go practice in the boondocks?

 

[Oracle DMD]

What makes you think that MLP will leave civilization and go practice in the boondocks?

legislation defining the scope of practice, % of pts on govt assistance, and most importantly, the dentists that they work for.

 

[TJNova2011]

legislation defining the scope of practice, % of pts on govt assistance, and most importantly, the dentists that they work for.

And all those can still qualify to practice in an already saturated Phoenix or in the realistic, upcoming case, Minneapolis. They are required to take 50% of under served, poverty, gov't assistance.

 

[JPevzner]

no, dentists cannot and are not handling the amount of underserved in the country. yes they all do some probono work, but they arent everywhere. your logic is flawed because you're not seeing 1. the resposibility we have to the public on an ethical or professional level and 2. government subsidies will not drive dentists into underserved areas at a rate that will support the underserved.

understand that dentistry has a buisness component sure, we all have to try and make money and we deserve to, however dentistry is not a commodity and they are called patients and not customers for a reason.

why do you think MLP's are taking over the profession? what exactly do you know about MLP's? have you looked into the models that suggest the public is better served with them?

it seems as though you were first upset that a MLP might cut into your profit margins, then changed to the "they are not trained to do what they will be doing", and now they are taking over the profession?

As has been mentioned before, im only in high school so perhaps i'm not considering all aspects of the issue here. I'm just trying to think about it logically. However, why do you think that "government subsidies will not drive dentists to underserved areas at a decent rate?" I don't think i speak only for myself when i say that if the government offered full dental school loan repayment provided that i work/start a practice in an underserved area for 5 years or so i would take it in an instant. Why do you think that dentists can't handle the needs of the entire population? There are plenty to go around.

 

[Oracle DMD]

As has been mentioned before, im only in high school so perhaps i'm not considering all aspects of the issue here. I'm just trying to think about it logically. However, why do you think that "government subsidies will not drive dentists to underserved areas at a decent rate?" I don't think i speak only for myself when i say that if the government offered full dental school loan repayment provided that i work/start a practice in an underserved area for 5 years or so i would take it in an instant. Why do you think that dentists can't handle the needs of the entire population? There are plenty to go around.

1. dentists can afford their loan payments (less than 1% default).
2. they make enough money to live where they want.
3. dental students can have the armed forces pay for their loans, spend 4 years in the service, and then go live where they want.
4. who would enforce where you work/ live?
5. dentists can't handle the needs of the population, evident by the needs of the population not being met.
6. making a ton more dentists will also drive up a ton of competition for patients. MLP's might take some $$ away from some dentists, but might make more $$ for others, and better serve the population. you can send a team of MLP's into the middle of nowhere to work, whereas you cannot with an associate (or at least good luck trying).
7. there are plenty of what to go around? people? sure. but for whatever other reason you want, (mostly lack of $$$ and access to care) they are not being taken care of, and dental school tuition is really high.

example: my school loans will be about 4000/month for 10 years. it would be very difficult to go to an underserved area and start a practice (avg start up costs can get north of 750k) that is A LOT of debt to be carrying around which is also a lot of risk. so the safe play is to associate with a well established dentist, and work with them to buy in (become a partner) if all goes well over some time.

so lets say you do this in an underserved area. great. but there isnt a line forming around the block to do it. people are creatures of habit, and not very likely to move to somewhere they've either havent been or don't want to take their family, money or no money.

so while you might take that deal now, add a girlfriend/wife and/or family and you haven't a much more complicated picture.

 

[JPevzner]

While i still can't see what you're getting at, Oracle, I'll just stop arguing over a moot point and simply say: "let the chips fall where they may."

 

[OceanDMD]

no. hopefully it will greatly expand access to care for everyone, which is a big win for the overall quality of care.

You really dont get it do you? Access to care has no direct correlation to quality.

 

[Oracle DMD]

You really dont get it do you? Access to care has no direct correlation to quality.

i was figuring that care vs no care at all was an improvement in quality Ocean.

 

[DIRTIE]

i was figuring that care vs no care at all was an improvement in quality Ocean.

You are crazy! There is only one state that dental therapists, etc should ever be allowed to work/train, and that is Alaska, and only outside of Anchorage, Fairbanks, and Juneau. Everything else is a bunch of garbage being thrown at the American people.
Just like how they are making all of the allied health programs an extra year of school so they can all get their doctorate degrees--CRNAs, Occupational therapy, physical therapy, etc. Also now we have doctorate of nursing practitioners?? Just a bunch of crazy people who have their own agendas and egos is all it is. Many of these people in academics and politics want to leave their mark, their legacy.

 

[OceanDMD]

i was figuring that care vs no care at all was an improvement in quality Ocean.

We are held to standards as dentists or physicians. You can get your ass sued off in NY city as easy as Wheeling, WV. There is a reason why you need a 4 year college degree, a DAT, 3-4 more years of dental training, and possibly a residency(to work in many states) to work and make irreversible changes in humans oral healths. As a dentist or physician, you can spend 100-400k on your journey to become a physician or dentist. 8-15 years of your life after high school. Now , Oracle, you want to argue for the rights of a hygienist, of course with his/her EXTRA year or two of training, as an appropriate/advantageous addition to the dental community is ignorant. Ask yourself this question, you walk into an office, your six year old little girl has a toothache and an abcess. The dentist walks into the operatory, looks at your child, and says it needs extracted. He walks out, obviously because he doesnt want to deal with a scared kid, and asks his hygienist whos CLEANING patient just cancelled to get your kid numb and extract the tooth. Now, remember, its your little girl, and you are a dental student. How do you feel? Bottom line, the hygiene thing in Minnesota is poo pooing on all of the dental students who spend hundreds of thouands of dollars to treat people.

 

[JPevzner]

We are held to standards as dentists or physicians. You can get your ass sued off in NY city as easy as Wheeling, WV. There is a reason why you need a 4 year college degree, a DAT, 3-4 more years of dental training, and possibly a residency(to work in many states) to work and make irreversible changes in humans oral healths. As a dentist or physician, you can spend 100-400k on your journey to become a physician or dentist. 8-15 years of your life after high school. Now , Oracle, you want to argue for the rights of a hygienist, of course with his/her EXTRA year or two of training, as an appropriate/advantageous addition to the dental community is ignorant. Ask yourself this question, you walk into an office, your six year old little girl has a toothache and an abcess. The dentist walks into the operatory, looks at your child, and says it needs extracted. He walks out, obviously because he doesnt want to deal with a scared kid, and asks his hygienist whos CLEANING patient just cancelled to get your kid numb and extract the tooth. Now, remember, its your little girl, and you are a dental student. How do you feel? Bottom line, the hygiene thing in Minnesota is poo pooing on all of the dental students who spend hundreds of thouands of dollars to treat people.

Amen. Ocean knows wats up.

 

[Oracle DMD]

Amen. Ocean knows wats up.

i'm taking the day off to celebrate finishing my last final of 2nd year 1st quarter dschool and Veterans Day. Semper Fi!!!!!!! to all my brothers out there serving now, thank you, and to all those that didn't come back...i miss ya. now im headed back out to the bar! i'll argue with rush limbaugh and glenn beck another day. OOOOHHHHRAH! hahahahahahahahahahahaha

 

[knife]

You are crazy! There is only one state that dental therapists, etc should ever be allowed to work/train, and that is Alaska, and only outside of Anchorage, Fairbanks, and Juneau. Everything else is a bunch of garbage being thrown at the American people.
Just like how they are making all of the allied health programs an extra year of school so they can all get their doctorate degrees--CRNAs, Occupational therapy, physical therapy, etc. Also now we have doctorate of nursing practitioners?? Just a bunch of crazy people who have their own agendas and egos is all it is. Many of these people in academics and politics want to leave their mark, their legacy.

I agree that AK could & would benefit.. But, seeing that you're in Nevada.. you really don't think rural Nevada could benefit from such programs? How about South Dakota or North Dakota?