Mid Level Provider program at my school.

[txlonghorn]

What exactly is the scope of the work that MLPs can perform? Will they be able to do about 70% of the work dentists do? 50%? If it is a high percent, then there is no point for anyone to become a dentist, and the market will eventually slide that way - with more MLP and fewer dentists. However, if they are only going to perform a few procedures, then I don't see what the problem is. Are people getting upset that they are going after the bread and butter procedures? If they perform the easy procedures, dentist can then just up their fees to make up for it - at least that is what I would do so that I can pay back my loans and make somewhat of a decent living. i understand this prob would not work in areas like socal.

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[Oracle DMD]

What exactly is the scope of the work that MLPs can perform? Will they be able to do about 70% of the work dentists do? 50%? If it is a high percent, then there is no point for anyone to become a dentist, and the market will eventually slide that way - with more MLP and fewer dentists. However, if they are only going to perform a few procedures, then I don't see what the problem is. Are people getting upset that they are going after the bread and butter procedures? If they perform the easy procedures, dentist can then just up their fees to make up for it - at least that is what I would do so that I can pay back my loans and make somewhat of a decent living. i understand this prob would not work in areas like socal.

i think that is a big problem. nobody knows what the scope of practice would be, and how and if dentists will be in charge of how they are deployed. to many ifs right now. i think we're all waiting to see how it goes. lots of hurdles to get over until it becomes a reality.

 

[SMC2UCLA2_]

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.

I wrote this huge long post and then said ****it. Here's to quality dentistry

http://www.royalcrestdental.com/cosmetic_dentistry_upstate_sc/gallery.html

Im disgusted by what is occuring in all these fields. Especially nurse anesthesiologists. In the first place I am slightly skeptical of dental anesthesiologists as is. I used to doubt their comprehension of the bare minimum required to handle an emergency. My opinion has changed, but I still think that a regular anesthesiologist, on average, is better prepared. Nurse anesthesiologists scare me.

 

[BestDoctorEver]

You guys would be crazy if you let the same cr..p that happened to medicine happen to dentistry. Let me name a few: NP(CRNA), PA, DPT, DC, OD ect...

 

[dmd87]

this thread makes me wanna throw up and pick another profession

 

[dmd87]

ok so i did some research on the cdn thing a bit, and its only in saskatchewan, which sort of makes sense. and their income in saskatchewan is also not that high. i could see there being a need for dental therapist in a place like saskatchewan where there is not much and majority of the province is very rural. sort of like why they have this in alaska. the thing is, it has not caught on at all in the rest of the provinces and I don't understand why it would catch on in the rest of the states when there are enough dentists per capita. if they were meant to treat underserved populations, then thats all they should be treating... if even that.

 

[jmick101]

Ok, the only one arguing for MLPs is Oracle. That is normally all I need to know for me to know what is going on. I find it funny that Oracle gets trashed by every licensed dentist on the thread, responds by saying "think about it... etc", and THEN has the nerve to bully the kid in High School.

News flash: Oracle YOU are the high school kid compared to the guy who has made 310 payrolls.

But that is Oracle for you, typical Jarhead . I happen to believe that he doesn't care about the issues so much as he likes to argue a point and play devils advocate. I know he is loving all the attention.

Here is the way that I see it: MLPs will, like everyone else, go where the money is when they are able. Sure, they may have a short leash now, but in a few years, they won't. Then they will go to where they can make more money, and that will not be the boondocks or whatever, but exactly where all the dentists are. Then we are right back to square one with our access to care problem. Why Oracle insists that the same thing that has happened every other time something similar has taken place in our country but won't in this case is crazy. (You all remember the definition of crazy don't you...)

Furthermore, if less training is adequate to do what a dentist does, then why am I going through all the trouble? Either there is more that needs to be known before someone can perform irreversible procedures or there isn't. If there isn't, then the gig is up and most of us here are wasting our time. If there is good reason to believe that more knowledge is needed, then the entire MLP concept is fundamentally flawed from the beginning, regardless of the supervising dentist stipulations.

If they really wanted to solve the access to care issue I believe that it would take care of itself nicely if they sweetened the pot for new dentists and eased up on the paperwork.

 

[SMC2UCLA2_]

Furthermore, if less training is adequate to do what a dentist does, then why am I going through all the trouble? Either there is more that needs to be known before someone can perform irreversible procedures or there isn't. If there isn't, then the gig is up and most of us here are wasting our time. If there is good reason to believe that more knowledge is needed, then the entire MLP concept is fundamentally flawed from the beginning, regardless of the supervising dentist stipulations.

If they really wanted to solve the access to care issue I believe that it would take care of itself nicely if they sweetened the pot for new dentists and eased up on the paperwork.

 

[txlonghorn]

Ok, the only one arguing for MLPs is Oracle. That is normally all I need to know for me to know what is going on. I find it funny that Oracle gets trashed by every licensed dentist on the thread, responds by saying "think about it... etc", and THEN has the nerve to bully the kid in High School.

News flash: Oracle YOU are the high school kid compared to the guy who has made 310 payrolls.

But that is Oracle for you, typical Jarhead . I happen to believe that he doesn't care about the issues so much as he likes to argue a point and play devils advocate. I know he is loving all the attention.

Here is the way that I see it: MLPs will, like everyone else, go where the money is when they are able. Sure, they may have a short leash now, but in a few years, they won't. Then they will go to where they can make more money, and that will not be the boondocks or whatever, but exactly where all the dentists are. Then we are right back to square one with our access to care problem. Why Oracle insists that the same thing that has happened every other time something similar has taken place in our country but won't in this case is crazy. (You all remember the definition of crazy don't you...)

Furthermore, if less training is adequate to do what a dentist does, then why am I going through all the trouble? Either there is more that needs to be known before someone can perform irreversible procedures or there isn't. If there isn't, then the gig is up and most of us here are wasting our time. If there is good reason to believe that more knowledge is needed, then the entire MLP concept is fundamentally flawed from the beginning, regardless of the supervising dentist stipulations.

If they really wanted to solve the access to care issue I believe that it would take care of itself nicely if they sweetened the pot for new dentists and eased up on the paperwork.

I agree. However, we are dealing with politicians, so common sense does not always prevail in an argument.

I looked into some literature that is available online, and it indicates that dental therapist perform decent work in NZ and some other countries, so it might be that we are moving away from a knowledge based profession to a technical skills based profession. I guess the guys in Anesthesiology are feeling the same way as us.

What really stinks about the dental therapist model is that their scope is very wide (looking at what MN approved and what is done in many other countries) and all they need is an undergrad or undergrad + 2 years (to work without the supervision of a dentist). This provides a VERY low barrier to entry and screws it up for current dentists.

The good thing about this is that many people will have dental care available to them at a cheap price. The downside is that dentist will have to either bring down their costs and make less money, which means a lower quality of life after paying back huge loans and giving up so much time in school. Gotta love how people only see what you are making now and not that you were making a negative income for so many years.

I guess I should put away the DAT study material and pick up an MCAT book...wait, the doctors are screwed too!

 

[JPevzner]

Ok, the only one arguing for MLPs is Oracle. That is normally all I need to know for me to know what is going on. I find it funny that Oracle gets trashed by every licensed dentist on the thread, responds by saying "think about it... etc", and THEN has the nerve to bully the kid in High School.

News flash: Oracle YOU are the high school kid compared to the guy who has made 310 payrolls.

But that is Oracle for you, typical Jarhead . I happen to believe that he doesn't care about the issues so much as he likes to argue a point and play devils advocate. I know he is loving all the attention.

Here is the way that I see it: MLPs will, like everyone else, go where the money is when they are able. Sure, they may have a short leash now, but in a few years, they won't. Then they will go to where they can make more money, and that will not be the boondocks or whatever, but exactly where all the dentists are. Then we are right back to square one with our access to care problem. Why Oracle insists that the same thing that has happened every other time something similar has taken place in our country but won't in this case is crazy. (You all remember the definition of crazy don't you...)

Furthermore, if less training is adequate to do what a dentist does, then why am I going through all the trouble? Either there is more that needs to be known before someone can perform irreversible procedures or there isn't. If there isn't, then the gig is up and most of us here are wasting our time. If there is good reason to believe that more knowledge is needed, then the entire MLP concept is fundamentally flawed from the beginning, regardless of the supervising dentist stipulations.

If they really wanted to solve the access to care issue I believe that it would take care of itself nicely if they sweetened the pot for new dentists and eased up on the paperwork.

. Exactly! You said it all, bro. Now all we need to do is figure out how to keep those damn rascals out of our pristine profession...I know...lets start a massive dental student riot!

 

[jmick101]

. Exactly! You said it all, bro. Now all we need to do is figure out how to keep those damn rascals out of our pristine profession...I know...lets start a massive dental student riot!

Whoah, easy there killer! If I understand things right, the ADA has been doing its dangdest to keep this from happening all along. It is a testament to their organization and lobbying ability that they have prolonged things this far. They couldn't go along poo-pooing this thing without being seen as anything other than obstinate Cassandras. The ADA had to make some concessions in order to remain in the conversation. And that is what this comes down to now: everyone who has interests at stake in this situation absolutely must get on the team, pay their dues, and jump in the fray. We need to NOT say as Oracle does that MLPs are a great thing, but educate those involved of the long term consequences to the profession and ultimately the public at large of going down this route.

Leave it to the same state that elects Al Franken (a literal clown) to the senate to institute something like this but ranting about liberal lunacy is not the topic of this thread.

This is something that I think we can do. Dentists are a tight bunch, much tighter than our physician friends. ADA membership is around 60-70% last I heard. AMA membership is half that. ADA conferences are well attended in ways that the AMA envies. I think that part of the solution to the MLP problem is exactly what has taken place, namely, make it so difficult to actually become one that you might just as well go to Dental school. Then we can just let it rot and go away since it doesn't really solve any problems and isn't worth the trouble of perpetuating without looking like the bad guy.

Long story short: join the ADA, pony up some cash for our lobbying efforts, become part of the conversation (except you Oracle), and then watch as the MPLs flounder and go away.

Lets hope so anyways.

 

[txlonghorn]

Whoah, easy there killer! If I understand things right, the ADA has been doing its dangdest to keep this from happening all along. It is a testament to their organization and lobbying ability that they have prolonged things this far. They couldn't go along poo-pooing this thing without being seen as anything other than obstinate Cassandras. The ADA had to make some concessions in order to remain in the conversation. And that is what this comes down to now: everyone who has interests at stake in this situation absolutely must get on the team, pay their dues, and jump in the fray. We need to NOT say as Oracle does that MLPs are a great thing, but educate those involved of the long term consequences to the profession and ultimately the public at large of going down this route.

Leave it to the same state that elects Al Franken (a literal clown) to the senate to institute something like this but ranting about liberal lunacy is not the topic of this thread.

This is something that I think we can do. Dentists are a tight bunch, much tighter than our physician friends. ADA membership is around 60-70% last I heard. AMA membership is half that. ADA conferences are well attended in ways that the AMA envies. I think that part of the solution to the MLP problem is exactly what has taken place, namely, make it so difficult to actually become one that you might just as well go to Dental school. Then we can just let it rot and go away since it doesn't really solve any problems and isn't worth the trouble of perpetuating without looking like the bad guy.

Long story short: join the ADA, pony up some cash for our lobbying efforts, become part of the conversation (except you Oracle), and then watch as the MPLs flounder and go away.

Lets hope so anyways.

I don't think it will be that easy. The law is essentially trying to train college students on how to drill and fill in 4 years ( I do not understand how they will adequately train dental therapists while having them take the basic classes too).

I think the whole dental therapist plan assumes either one of two things: 1) going to dental school is not useful, as much of what we learn is useless and can be taught to a person in a community college in 4 years as part of their undergrad program or 2)we are alright with providing inferior dental care to the poor and people in rural areas. As the whole dental therapist model has somewhat worked out in some countries, I suspect that the dental profession will be somewhat brought down a bit. What makes it worse is that a few more dental schools will be opening up too. I guess we will see our profession go down similar to the way Anesthesiologist are seeing CRNA's ask for nondiscriminatory reimbursements for the work they do in the healthcare bill.

 

[jmick101]

I don't think it will be that easy. The law is essentially trying to train college students on how to drill and fill in 4 years ( I do not understand how they will adequately train dental therapists while having them take the basic classes too).

I think the whole dental therapist plan assumes either one of two things: 1) going to dental school is not useful, as much of what we learn is useless and can be taught to a person in a community college in 4 years as part of their undergrad program or 2)we are alright with providing inferior dental care to the poor and people in rural areas. As the whole dental therapist model has somewhat worked out in some countries, I suspect that the dental profession will be somewhat brought down a bit. What makes it worse is that a few more dental schools will be opening up too. I guess we will see our profession go down similar to the way Anesthesiologist are seeing CRNA's ask for nondiscriminatory reimbursements for the work they do in the healthcare bill.

Agreed. I just wonder what, if any, barriers to entry exist for the MLPs. If all it takes is an EKG to get in, then legislators have effectively taken a big dump on our profession.

 

[Oracle DMD]

Ok, the only one arguing for MLPs is Oracle. That is normally all I need to know for me to know what is going on. I find it funny that Oracle gets trashed by every licensed dentist on the thread, responds by saying "think about it... etc", and THEN has the nerve to bully the kid in High School.

News flash: Oracle YOU are the high school kid compared to the guy who has made 310 payrolls.

But that is Oracle for you, typical Jarhead . I happen to believe that he doesn't care about the issues so much as he likes to argue a point and play devils advocate. I know he is loving all the attention.

Here is the way that I see it: MLPs will, like everyone else, go where the money is when they are able. Sure, they may have a short leash now, but in a few years, they won't. Then they will go to where they can make more money, and that will not be the boondocks or whatever, but exactly where all the dentists are. Then we are right back to square one with our access to care problem. Why Oracle insists that the same thing that has happened every other time something similar has taken place in our country but won't in this case is crazy. (You all remember the definition of crazy don't you...)

Furthermore, if less training is adequate to do what a dentist does, then why am I going through all the trouble? Either there is more that needs to be known before someone can perform irreversible procedures or there isn't. If there isn't, then the gig is up and most of us here are wasting our time. If there is good reason to believe that more knowledge is needed, then the entire MLP concept is fundamentally flawed from the beginning, regardless of the supervising dentist stipulations.

If they really wanted to solve the access to care issue I believe that it would take care of itself nicely if they sweetened the pot for new dentists and eased up on the paperwork.

OK if you wanna call me out then here i am. i didn't bully the high school kid. also, i know the "guy who made 300 payrolls" so to avoid a personal shot at the guy, let's just say if you knew him you would understand what i mean.

my position concerning MLP's has always been the view from a patient care standpoint....not a buisness standpoint. if the result of MLP's is an increase in patient care, then the right thing to do is to support the addition MLP's in those communities. will it take a bit of $$ away from dentists? maybe. will dentist still be doing OK? definatly.

typical jarhead? you're right. Marines don't worry about themselves when it comes to doing the right thing.

we aren't even sure what their scope of practice will end up being, so i'd rather not argue over training or whatnot since its still hypotheitical.

 

[AZ2thDOC]

also, i know the "guy who made 300 payrolls" so to avoid a personal shot at the guy, let's just say if you knew him you would understand what i mean. .

You know me, HUH???!!! When have we ever met???!!! Have we ever exchanged words? Nice try at belittling and assassinating my character. I know who I am and what I stand for as a dentist and as a person, as well as dozens of other friends and colleagues and patients.


I believe I've made my peace w/ Dr. Simonson--we just believe differently on Mid Level providers. I'm still amazed that politicians and dental academics who'll never have to do the actual "wet-fingered" work of dentistry want to dictate the terms under which the great dental profession operates.

 

[txlonghorn]

we aren't even sure what their scope of practice will end up being, so i'd rather not argue over training or whatnot since its still hypotheitical.

I think if you just google the scope of dental therapists, it is easy to find what the scope is in different countries and also what is being planned in Minnesota.

http://www.dentistry.umn.edu/programs_admissions/DentalTherapyPrograms/home.html

What worries me is not the dental therapist program, but the masters program that would allow hygienists to work independently. Don't be fooled by what they are saying about working in nursing homes, etc. They will setup shop competing with dentists.

http://www.adha.org/media/facts/adhp.htm

 

[jmick101]

OK if you wanna call me out then here i am. i didn't bully the high school kid. also, i know the "guy who made 300 payrolls" so to avoid a personal shot at the guy, let's just say if you knew him you would understand what i mean.

my position concerning MLP's has always been the view from a patient care standpoint....not a buisness standpoint. if the result of MLP's is an increase in patient care, then the right thing to do is to support the addition MLP's in those communities. will it take a bit of $$ away from dentists? maybe. will dentist still be doing OK? definatly.

typical jarhead? you're right. Marines don't worry about themselves when it comes to doing the right thing.

we aren't even sure what their scope of practice will end up being, so i'd rather not argue over training or whatnot since its still hypotheitical.

Your SDN handle is ridiculous "Oracle." I think something more appropriate should be "Myopic." Based on the long and sad experience of our medical brethren in similar situations the MPLs will not solve any access to care problems (see my previous post for my argument). It is a business deal AND a patient care deal because in the end we wind up back at square one access wise and the only thing that has been accomplished is that a lot of time and money has been wasted.

Typical Jarhead not in questioning whether or not they always do the right thing, but in that they automatically assume that whatever they are doing is right... all the time... It is an admirable quality in a grunt, but in a debate... not so much.

 

[jmick101]

You know me, HUH???!!! When have we ever met???!!! Have we ever exchanged words? Nice try at belittling and assassinating my character. I know who I am and what I stand for as a dentist and as a person, as well as dozens of other friends and colleagues and patients.

This should be good.

 

[Greensalad]

Damn those dental hygienists regretting not going to dental school. (Dental hygienists pushed the MLP bill.)

 

[KinKs]

Hi Colleagues,

I wish to present a view to this argument that may not be radically different from some others. The fact is collegues that change is the only constant and we must adapt or be left behind.
Some of you would know that not long ago, you practically got a haircut and a tooth extraction at the same place and the barber was responsible. Eventually the professions differentiated. I wonder if the barbers at the time were upset at this new profession taking away some of their business.

We also know certain facts:

1. Education is an investment and investments are motivated by returns. What I mean is that if Dentistry no longer makes money, then fewer people will gravitate to the profession.

2. Consumers dictate products and services. In other words, if our consumers decide that an MLP can adequately manage their oral health at a cheaper price, then, we are eventually doomed regardless of our lobbying capabilities through the ADA.

What I however envision is an evolution of the practice dentistry. If MLPs become a new member of the oral health team (as they are destined to), then the best way for us to protect the profession is to welcome these new team members and hasten our evolution. We must acquire new techniques and procedures with better outcomes that are beyond the scope of the MLP. Only this can ensure that our current levels of income and leisure are maintained.
Take for example Dental Implants. The first one was placed in 1965 (by an orthopaedic surgeon). Now the procedure is a key to many dental practices. Such is the current tide, swimming against it is useless.

Below is an interesting article about dental implants – check it out

http://www.nytimes.com/2009/11/17/health/17brod.html?http://www.nytimes.com/2009/11/17/health/17brod.html?=1&scp=2&sq=dental+implant&st=nyt=1&scp=2&sq=dental+implant&st=nyt

 

[txlonghorn]

Hi Colleagues,

I wish to present a view to this argument that may not be radically different from some others. The fact is collegues that change is the only constant and we must adapt or be left behind.
Some of you would know that not long ago, you practically got a haircut and a tooth extraction at the same place and the barber was responsible. Eventually the professions differentiated. I wonder if the barbers at the time were upset at this new profession taking away some of their business.

We also know certain facts:

1. Education is an investment and investments are motivated by returns. What I mean is that if Dentistry no longer makes money, then fewer people will gravitate to the profession.

2. Consumers dictate products and services. In other words, if our consumers decide that an MLP can adequately manage their oral health at a cheaper price, then, we are eventually doomed regardless of our lobbying capabilities through the ADA.

What I however envision is an evolution of the practice dentistry. If MLPs become a new member of the oral health team (as they are destined to), then the best way for us to protect the profession is to welcome these new team members and hasten our evolution. We must acquire new techniques and procedures with better outcomes that are beyond the scope of the MLP. Only this can ensure that our current levels of income and leisure are maintained.
Take for example Dental Implants. The first one was placed in 1965 (by an orthopaedic surgeon). Now the procedure is a key to many dental practices. Such is the current tide, swimming against it is useless.

Below is an interesting article about dental implants – check it out

http://www.nytimes.com/2009/11/17/health/17brod.html?http://www.nytimes.com/2009/11/17/health/17brod.html?=1&scp=2&sq=dental+implant&st=nyt=1&scp=2&sq=dental+implant&st=nyt

I agree with what you mentioned. My main concern is not with another group doing some of the procedures, but the level of quality provided by them.

Here are some good articles that detail what is going on. What worries me is the advanced dental hygienist model, which will give them a broad scope on the work they can do.

http://www.drbicuspid.com/index.aspx?d=1&sec=nws&sub=rad&pag=dis&ItemId=303489&wf=34

 

[TedyBearSuicide]

Some of you would know that not long ago, you practically got a haircut and a tooth extraction at the same place and the barber was responsible.

Sounds like we are back to square one, considering the competency of these dental technicians to the modern day dentists.

 

[KinKs]

Sounds like we are back to square one, considering the competency of these dental technicians to the modern day dentists.

The statement served the sole purpose of demonstrating the evolution of dentistry and nothing more. How exactly does this sound like a comparison between a dentist and a dental technician?

 

[Oracle DMD]

You know me, HUH???!!! When have we ever met???!!! Have we ever exchanged words? Nice try at belittling and assassinating my character. I know who I am and what I stand for as a dentist and as a person, as well as dozens of other friends and colleagues and patients.


I've believe I've made my peace w/ Dr. Simonson--we just believe differently on Mid Level providers. I'm still amazed that politicians and dental academics who'll never have to do the actual "wet-fingered" work of dentistry want to dictate the terms under which the great dental profession operates.

OK I should have said know ABOUT you. I'm not attacking your character. I have heard about you from people whom you knew very well. that post had nothing to do with MLP's, but a previous disagreement between us, and that he didn't know what i was talking about w/ regard to that post.
i was puposely not getting into who told me what about you to not get too personal or slanderous, in which case i'll get back to the topic.

Your SDN handle is ridiculous "Oracle." I think something more appropriate should be "Myopic." Based on the long and sad experience of our medical brethren in similar situations the MPLs will not solve any access to care problems (see my previous post for my argument). It is a business deal AND a patient care deal because in the end we wind up back at square one access wise and the only thing that has been accomplished is that a lot of time and money has been wasted.

Typical Jarhead not in questioning whether or not they always do the right thing, but in that they automatically assume that whatever they are doing is right... all the time... It is an admirable quality in a grunt, but in a debate... not so much.

my handle is ridiculous? you can call me Jason if you want tough guy. believe me when i say if you were standing in front of me, your mouth would certainly become as conservative as your politics; but i digress.

what i have contended is that patient care is where the arguement should begin, not that buisness isn't important, but it's certainly less important.

also i'm feeling an anti Physician Assistant thing goin on here. is that the tie from MLP's in dentistry to the field of medicine? PA's are a good thing. are you talking about something else? you must be. amazingly...doctors still do OK.

 

[SMC2UCLA2_]

what i have contended is that patient care is where the arguement should begin, not that buisness isn't important, but it's certainly less important.

also i'm feeling an anti Physician Assistant thing goin on here. is that the tie from MLP's in dentistry to the field of medicine? PA's are a good thing. are you talking about something else? you must be. amazingly...doctors still do OK.

My argument against MLPs is patient focused. As a senior in dental school, I don't feel that any of my time spent was redundant or extraneous. I don't think any of the courses or sim sessions could have been shortened or removed. I don't think anyone could work harder than I did and in less time and be a comparable "dental provider".

I don't think that any less than what I provide is acceptable to patients. I don't think an MLP will be prepared to handle an emergency dental situation- I know that many dentists and dental students are still uncomfortable with the thought of a dental emergency and infact some still flop when the **** hits the fan. I doubt this is something that will improve by lowering the bar.

Also, I doubt an MLP can learn the oral-systemic links and the oral sequelae of medications as well as treatment modifications based on patient conditions. While some will argue that the MLP will only execute a previously initiated treatment plan, there are situations where this will be cloudy:

If i have treatment planned a patient who returns 6 months later for his filling, meanwhile having had stroke and new medications...is the MLP going to know to get INR? to get physican clearance? Is he going to to even update medical history? If he is practicing without a dentist on site it would be hard to catch this.

I could go on forever but ill finish with this. As health professionals we are committed to the ADA principles of Ethics and Code of conduct. The patient comes first. Three of 5 of these core principles will not be adequately met with an MLP including: beneficence, and nonmaleficence and Justice.

You dont fix a clogged toilet by ****ing in the sink. I don't know about you but I don't want **** on my patients.

 

[exPCM]

The Washington Times is now touting these dental therapists to "improve access to care".
See: http://www.washingtontimes.com/news/2009/dec/27/minnesota-trains-dental-therapists-in-bid-to-impro/

 

[KOM]

so it might be that we are moving away from a knowledge based profession to a technical skills based profession.

This is where I see the profession heading unfortunately.

 

[Oracle DMD]

You dont fix a clogged toilet by ****ing in the sink.

hahahaha i love it. i get it and i respect your position, and i will defer how i feel about MLP's until they get here and i see what they're doing i guess. i will be using that quote as soon as possible tho! lol

 

[jmick101]

my handle is ridiculous? you can call me Jason if you want tough guy. believe me when i say if you were standing in front of me, your mouth would certainly become as conservative as your politics; but i digress.

what i have contended is that patient care is where the arguement should begin, not that buisness isn't important

I give this a 6 or 7 on threats of physical violence scale. Not nearly as good as the classic from Remember the Titans "I am going to hit you so hard you are going to need a new haircut when you wake up" but not nearly as lame as the "I am gonna make you eat a knuckle sandwich."

Solid effort Oracle

So bullying threats aside, the argument remains about whether this is good for patients or not. To keep this very simple for anyone who has been in the Arizona sun for too long (just kidding Chuck Noracle, don't hurt me!).

My answer (again) is no because the access care problem will not be solved because MLPs will eventually end up where the money is and everyone in the boondocks will be screwed again. All this after the government wastes a lot of time and money that could just as well be put as incentives to work in the boonies which is the real problem. If they put forward a plan that gave good pay for working in the sticks you would see dentist lining up a hundred deep. Just look at the California prison dental jobs and you will see what I mean.

Also, no MLP has irreversible surgical procedures in their scope of practice, not PA's, not anyone without a DR. in their name, let alone someone with just two years of post high school education. This exact point was made to the Senate Committee on Indian Affairs by the President of the ADA Dr. Tankersly as one reason why he could not support legislation expanding the use of MLPs in Indian Reservations.

 

[Oracle DMD]

I give this a 6 or 7 on threats of physical violence scale. Not nearly as good as the classic from Remember the Titans "I am going to hit you so hard you are going to need a new haircut when you wake up" but not nearly as lame as the "I am gonna make you eat a knuckle sandwich."

Solid effort Oracle

So bullying threats aside, the argument remains about whether this is good for patients or not. To keep this very simple for anyone who has been in the Arizona sun for too long (just kidding Chuck Noracle, don't hurt me!).

My answer (again) is no because the access care problem will not be solved because MLPs will eventually end up where the money is and everyone in the boondocks will be screwed again. All this after the government wastes a lot of time and money that could just as well be put as incentives to work in the boonies which is the real problem. If they put forward a plan that gave good pay for working in the sticks you would see dentist lining up a hundred deep. Just look at the California prison dental jobs and you will see what I mean.

Also, no MLP has irreversible surgical procedures in their scope of practice, not PA's, not anyone without a DR. in their name, let alone someone with just two years of post high school education. This exact point was made to the Senate Committee on Indian Affairs by the President of the ADA Dr. Tankersly as one reason why he could not support legislation expanding the use of MLPs in Indian Reservations.

I'm not threatening anyone. it is very matter of fact. you have that internet courage. i'm PMing you after this post as to keep this thread on track.

i am not sure of exactly what they will be doing and under what supervision. it seems like a lot of speculation at this point. i'm waiting for the legislation here before contiuing.

 

[jmick101]

I'm not threatening anyone. it is very matter of fact. you have that internet courage. i'm PMing you after this post as to keep this thread on track.

i am not sure of exactly what they will be doing and under what supervision. it seems like a lot of speculation at this point. i'm waiting for the legislation here before contiuing.

It was "internet courage" that led me to volunteer for the Airborne Infantry and go to Ranger School right? Right. You can ask my classmates on this board and see if they think I am scared to speak my mind to peoples face or not. Furthermore, you really wouldn't question my courage if you saw the poopy diaper that I just changed, scary. That is all I will say about that, but I couldn't leave that hanging out there and not address it.

I don't think waiting for legislation is a good idea either. That seems a little backward. The time for forward thinking and action is exactly right now, before bad laws and regulations get put in stone. But I can see you want to let this drop for now, and will oblige.

Till the next round.

 

[EnamelTuft]

Basic Economics. Supply and demand curve will shift towards MLPs. Just look at Wal-mart. And how many times have you heard people mentioning about how much health care costs are? Yes, quality will probably take a hit, but eventually what the consumer wants prevails. We can legislate all we want but consumers are the ones that will push this whole mid-level provider. It's sad but the truth.

Just specialize if you want to still live a lavish lifestyle or else get ready to be limited to an "average" income.

 

[EnamelTuft]

The access to care issue will be effected. By producing MLP's, the access to care will be increased INdirectly by saturating the dental provider field in areas of metro and eventually will force MLP's and dentists into boondocks because those areas will be the only places to find patients. That's the goal of the government is to saturate the playing field which drives competition, which drives prices down. Bingo!!

 

[MWUtoothmaster]

I just wanted everyone to know that many of us at Midwestern are opposed to this program. I am a student there. I know Jason is a great guy, but I and many other students do not share his views.

It WILL hurt dentistry. It IS a mistake. We are at one of the most expensive schools in the country, and Dr. S does something that will decrease our income. I was VERY surprised by this, but in retrospect I am sure that this has been his plan for a while. He is very smart and always thinks 3 steps ahead. I admire the man, and consider him a friend and mentor, but I do think he is dead wrong on this one.

I ask that everyone out there please realize that this is a great school, its just that with the admin being so gung ho for this mid level provider stuff everyone is afraid to speak up against this new program. This is especially true for the class council, since most of them are trying to specialize and Dr. S's rec means everything, so they are not ever going to say anything against him.

If u know of a way for us to fight this without going toe to toe with the admin, please let us know.

Thanks guys

 

[TJNova2011]

I just wanted everyone to know that many of us at Midwestern are opposed to this program. I am a student there. I know Jason is a great guy, but I and many other students do not share his views.

It WILL hurt dentistry. It IS a mistake. We are at one of the most expensive schools in the country, and Dr. S does something that will decrease our income. I was VERY surprised by this, but in retrospect I am sure that this has been his plan for a while. He is very smart and always thinks 3 steps ahead. I admire the man, and consider him a friend and mentor, but I do think he is dead wrong on this one.

I ask that everyone out there please realize that this is a great school, its just that with the admin being so gung ho for this mid level provider stuff everyone is afraid to speak up against this new program. This is especially true for the class council, since most of them are trying to specialize and Dr. S's rec means everything, so they are not ever going to say anything against him.

If u know of a way for us to fight this without going toe to toe with the admin, please let us know.

Thanks guys

Tell them to untie their balls and stand up for their future profession. Being professional and standing up for what you believe in is what counts and Dr. S. can admire that. He doesn't care if he degrades the profession. Hell, no one in academia does because they are essential sheltered behind those four walls.

 

[TedyBearSuicide]

I just wanted everyone to know that many of us at Midwestern are opposed to this program. I am a student there. I know Jason is a great guy, but I and many other students do not share his views.

It WILL hurt dentistry. It IS a mistake. We are at one of the most expensive schools in the country, and Dr. S does something that will decrease our income.

First post and in this thread. That is understandable as your school is new and is developing a reputation in dentistry. Say what you want to about the fallacious SDN, but one look at this thread by an indecisive pre-dent will deter him/her from MWD, three pages full of experienced dentists undermining the school's gloating new program.

 

[TJNova2011]

First post and in this thread. That is understandable as your school is new and is developing a reputation in dentistry. Say what you want to about the fallacious SDN, but one look at this thread by an indecisive pre-dent will deter him/her from MWD, three pages full of experienced dentists undermining the school’s gloating new program.

If they do not like what the school does/will stand for, what's wrong with that?

 

[Oracle DMD]

I just wanted everyone to know that many of us at Midwestern are opposed to this program. I am a student there. I know Jason is a great guy, but I and many other students do not share his views.

It WILL hurt dentistry. It IS a mistake. We are at one of the most expensive schools in the country, and Dr. S does something that will decrease our income. I was VERY surprised by this, but in retrospect I am sure that this has been his plan for a while. He is very smart and always thinks 3 steps ahead. I admire the man, and consider him a friend and mentor, but I do think he is dead wrong on this one.

I ask that everyone out there please realize that this is a great school, its just that with the admin being so gung ho for this mid level provider stuff everyone is afraid to speak up against this new program. This is especially true for the class council, since most of them are trying to specialize and Dr. S's rec means everything, so they are not ever going to say anything against him.

If u know of a way for us to fight this without going toe to toe with the admin, please let us know.

Thanks guys

yo. obviously i do not speak for anyone other than myself. i am with you on class councils in general, but being worried about the dean's rec is not why council are ineffective and gutless. that is the nature of politics friend! haha come and meet me when we get back.

i think the best thing to do would be to get everyone together and have Dr. Simonsen talk to us as a group about the MLP program and its effect on dentistry. I'm sure he would have no problem answering all of these unanswered questions and concerns.

1st things first....be prepared! write down some of your thoughts and the concerns of our collegues on this thread as well, and we'll get the word from the big guy. cool?

 

[Andrew324]

Midwestern is the Center of all the greatest threads

 

[Innulja]

My patients is gone. I'm writing an email to this dean at Midwestern. (It most likely want change much) Any body want to help? expressing our complaints here on forum is not going to change anything. He should probably factor in his own reputation not only the dental school he is trying to advertise (that's my feeling of what's going on there). He sees this as a business opportunity for the new school and therefore his own enrichment. That's ethics .
It would be perfect if we could get some more opinions from other respected dentists/professors/deans regarding all this.

 

[Oracle DMD]

My patients is gone. I'm writing an email to this dean at Midwestern. (It most likely want change much) Any body want to help? expressing our complaints here on forum is not going to change anything. He should probably factor in his own reputation not only the dental school he is trying to advertise (that's my feeling of what's going on there). He sees this as a business opportunity for the new school and therefore his own enrichment. That's ethics .
It would be perfect if we could get some more opinions from other respected dentists/professors/deans regarding all this.

i would very much enjoy reading the letter you write Dr. Simonsen scolding him about ethics.

There are few things (if anything) that Dr. Simonsen cares about more than ethics.

 

[Innulja]

i would very much enjoy reading the letter you write Dr. Simonsen scolding him about ethics.

There are few things (if anything) that Dr. Simonsen cares about more than ethics.

Seems like there are many who don't believe in it and why should I? I'm really hoping your not doing this just to kiss somebody elses ass.
Happy New Years!

 

[Oracle DMD]

Seems like there are many who don't believe in it and why should I? I'm really hoping your not doing this just to kiss somebody elses ass.
Happy New Years!

what you believe is a seperate issue than ethics. really doing what? i'm not specializing, so who exactly would i be ass kissing? and for what? i hope you grow a pair and write that letter haha i really do!

 

[Andrew324]

I must say I am surprised Midwestern hasnt told you guys to stop using SDN. At least saying something to the two classes. I mean after last years hoopla and this stuff. Come on. Midwestern must be the most called out school of anywhere and you guys feed it.

 

[Innulja]

what you believe is a seperate issue than ethics. really doing what? i'm not specializing, so who exactly would i be ass kissing? and for what? i hope you grow a pair and write that letter haha i really do!

You know better who's ass your kissing and for what. i don't give a dam!

 

[LIDOPAIN]

I wonder if it will be awkward when the MWU ASDA chapter trys to "undo" the lobbing done by Dr. Simonsen when they go to Washington.

 

[Oracle DMD]

There is a big presentation tomorrow at lunch about MLP's from dr. simonsen. any burning q's you want answered? post 'em and i'll do my best.

 

[The Hammer]

what you believe is a seperate issue than ethics. really doing what? i'm not specializing, so who exactly would i be ass kissing? and for what? i hope you grow a pair and write that letter haha i really do!

I got your back J

 

[TJNova2011]

There is a big presentation tomorrow at lunch about MLP's from dr. simonsen. any burning q's you want answered? post 'em and i'll do my best.

So what went down?

 

[coolslugs]

So what went down?

Here is my take from the presentation. The summary is basically that dental therapists are necessary and will provide access to dental care for the poor, and that changes are unavoidable, so be willing to embrace it. Also, having these mid-level providers, dentists will have more of a management role (which is a pro). He also talked about the MN model. https://www.revisor.mn.gov/statutes/?id=150A.105

However, there weren't too many straight answers during the Q&A because the policies for this position is so new. Some of the questions that stood out to me were 1) dentists will be 100% responsible for these dental therapists, including procedures done under indirect supervision, so it can lead to higher malpractice insurances. 2) Why can't they just provide incentives for dental students/dentists to practice in the underserved areas?...something like a scholarship program (instead of putting in 35 seats in the dental lab to train DTs). 3) What would prevent dental therapists from serving in an urban area or preventing your patients from seeing you (as a dentist) and go to see a dental therapist who charges less...this depends on state regulations. 4) How will a 40mo. bachelor level program prepare someone to do surgical procedures?