Midlevels now taking over Dentistry...

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It is starting in Alaska where there is a true shortage of dentists for the native peoples. It is spreading to the lower 48, too.

They have half of the training and charge less. Let me introduce to you the dental midlevel:

DENTAL THERAPISTS (cue the spooky music).

http://www.nytimes.com/2010/11/02/health/02dental.html?ref=health

The therapists, who receive two years of training, help fill a vacuum: Alaska has long had trouble attracting and retaining licensed dentists. Sixty percent of Alaska Native children ages 2 to 5 have untreated decay, and 20 percent of Native adults over 55 have no teeth at all.

Now a two-year foundation-supported study has reignited the debate over which practitioners are qualified to provide dental care, especially to underserved populations in high-poverty areas. It found that Alaska’s dental therapists provide “safe, competent, appropriate” care. (The therapists refer cases beyond their scope to supervising dentists.)

Ten other states, including Connecticut, are considering midlevel dental provider systems for underserved residents. These practitioners can be trained for relatively little money, said Dr. Allen H. Hindin, who is on the board of the Connecticut State Dental Association.

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Man, I'm scared enough of going to the dentist as it is-I mean they're using power tools in your mouth! I dunno who'd be lining up to see someone who had half the training.
 
Man, I'm scared enough of going to the dentist as it is-I mean they're using power tools in your mouth! I dunno who'd be lining up to see someone who had half the training.


I forgot to mention, they only have two years of training straight out of high school.

No undergrad education necessary.

DDS: 8 years

Dental Therapist: 2 years
 
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i dunno who'd be lining up to see someone who had half the training.

maybe someone who would never get dental care otherwise....
Ok, all you dentists. You can prevent this. Move to alaska right now and start giving care to folks who can't pay you.......what, no takers?.....didn't think so....
 
Health care is a ridiculous thing now :thumbdown:
 
maybe someone who would never get dental care otherwise....
Ok, all you dentists. You can prevent this. Move to alaska right now and start giving care to folks who can't pay you.......what, no takers?.....didn't think so....

So these non-dentists are working for free...? Interesting business model. :rolleyes:

I'm getting pretty tired of hearing about how "expensive" real medical care is when most of the so-called "cost-effective" alternatives aren't any cheaper than what I charge an uninsured patient.

Not surprising, really, once you cut out the insurance-related bull$hit.
 
Check out the training website at the university of washington dentex program. They are required to have >50% of their pts on public assistance. This program was started because dentists just aren't up there in sufficient #s to care for the population. Sure, they are getting paid but probably something like 35-50k/yr. Find me a dentist who will work for that and send them up there.
Read some of the profiles on the training site. these folks are all working in very rural communities with zero other dental care like the aleutians. there are no alaska dentists up in arms about this because they all work in the major metro areas where the paying customers are.....
 
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Sure, they are getting paid but probably something like 35-50k/yr. Find me a dentist who will work for that and send them up there.

Last time I checked, dental school wasn't free. As long as people have to fork over their own money for their education, you can bet your bottom dollar they're going to want to pay themselves back.

Hope these non-dentists have good malpractice insurance. Lawyers take cases on contingency, so even the destitute can sue.

I've never understood the "some care is better than no care" mentality. Hasn't anyone ever heard of "first, do no harm?" Lowering the bar for independent practice simply for the sake of convenience is a Really Bad Idea.
 
Called it.

It was a simple matter of time before people started to catch on to the dental thing. It's a sweet gig, and anytime someone in health care works hard to achieve a nice setup, people immediately begin to figure out how they can have it without putting in the work, money, time, sacrifice, etc. I actually read an article about one of these programs being debated in a dental thread a while back. I'd say within a decade, it will spread and be a heated discussion topic. I'm not sure if it can penetrate to the level of CRNA/DNPs, etc, but who knows. I could probably argue that it'd be easier for dent techs to spread faster. The ADA should get in contact with the AANP's PR team as quick as possible and book them ... that way, the techs can't use them to start an extreme effective, militant campaign against evil money grubbing dentists who are trying to block these humble individuals seeking to fill crucial gaps in primary dental care (conflict of interest)!
 
Check out the training website at the university of washington dentex program. They are required to have >50% of their pts on public assistance. This program was started because dentists just aren't up there in sufficient #s to care for the population. Sure, they are getting paid but probably something like 35-50k/yr. Find me a dentist who will work for that and send them up there.
Read some of the profiles on the training site. these folks are all working in very rural communities with zero other dental care like the aleutians. there are no alaska dentists up in arms about this because they all work in the major metro areas where the paying customers are.....

Of course that's how it's set up right now ... that's how it always starts. Do you think CRNAs made 170k, acted like they were better than physicians, wanted to be called Dr in a clinical setting when they first started programs? Of course not. People would have figured out that trick right away. You need to use some of those awesome talking points like 'underserved,' 'filling a gap,' 'rural populations,' 'insufficient professionals,' etc, etc first ... then get your foot in the door, then break it down. It's text book.
 
you are all missing the point. this isn't like crna vs mda as there is currently NO DENTAL CARE OF ANY KIND in the areas they are allowed to work. it's not like they will be putting the local dentist out of work. as I said in my first post, if dentists don't like it they could stop it easily by committing to work with those populations and taking whatever compensation the state will give them for doing so. and these folks aren't doing major procedures, they are cleaning teeth and doing simple extractions. do you really need even 2 yrs of training to do that? navy corpsman learn basic dentistry for the field in something like a week.
I understand the concerns over other midlevels competing with docs in areas in which both work but there is currently no one else doing the work they are undertaking.
 
you are all missing the point. this isn't like crna vs mda as there is currently NO DENTAL CARE OF ANY KIND in the areas they are allowed to work. it's not like they will be putting the local dentist out of work. as I said in my first post, if dentists don't like it they could stop it easily by committing to work with those populations and taking whatever compensation the state will give them for doing so. and these folks aren't doing major procedures, they are cleaning teeth and doing simple extractions. do you really need even 2 yrs of training to do that? navy corpsman learn basic dentistry for the field in something like a week.
I understand the concerns over other midlevels competing with docs in areas in which both work but there is currently no one else doing the work they are undertaking.

I 100% see what you're saying, but I don't think you can deny that this is honestly a very solid springboard and, in many cases, how these situations begin. For example, they do it here (let's say it IS because they don't have dentists), no one dies, complains, etc, they now come to the lower 48, pick out some place to open a program and say 'look, we did this in Alaska, patient satisfaction was great (obviously, they didn't have dental care before), helped fight oral diseases, no deaths, lawsuits, (all things that are obviously influenced by the situation at hand),' and open a program to serve 'underserved' areas. Next thing you see is proliferation based on the same platform.

Just today, I read an article about how CRNAs are 100% cleared for non-supervised gas in CA. How did it start - they lobbied for it because there weren't gas physicians in certain rural/underserved areas of CA (probably like central valley). Do you think it will stay isolated to those areas??? Based on what we've seen with the CRNA movement in general ... I doubt it.
 
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you are all missing the point. this isn't like crna vs mda as there is currently NO DENTAL CARE OF ANY KIND in the areas they are allowed to work. it's not like they will be putting the local dentist out of work. as I said in my first post, if dentists don't like it they could stop it easily by committing to work with those populations and taking whatever compensation the state will give them for doing so. and these folks aren't doing major procedures, they are cleaning teeth and doing simple extractions. do you really need even 2 yrs of training to do that? navy corpsman learn basic dentistry for the field in something like a week.
I understand the concerns over other midlevels competing with docs in areas in which both work but there is currently no one else doing the work they are undertaking.
The problem with giving leeway for this initial, "simple" thing is that it sets a precedent for future expansion of scope. We've already seen this happen with nursing midlevels. What makes you think it won't turn out similarly in the case of dentistry?
 
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Next thing you see is proliferation based on the same platform.

.

YUP, wouldn't it be horrible if folks in the deep south and appalachia got dental care as well as the native alaskans? we need to stop this now!
again, if the dentists are worried about this why don't they tackle the problem of unserved populations? it's put up or shut up. if they won't do the work someone else will do it for them.
yes, some care is better than no care. will bad things be missed? sure.
would these also be missed if no one ever saw them? yup.
so what's better for the population; adequate dental care and a chance that bad things will be picked up or no dental care and no chance that they will be picked up?
anyone know what % of medicaid pts most alaskan dentists have in their practices? I bet it's very low...kind of like all the docs who complain about pa's and np's taking over but only take cash or good insurance....put up or shut up folks....
 
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Also, increasing the scope of practice of midlevels doesn't mean they'll practice in underserved areas. There's a reason health care providers avoid underserved areas. What makes you think midlevels are any different than than physicians/dentists?

With the increased independence of nursing midlevels, for example, I have not come across any data at all that suggests they're serving the underserved more than physicians are. Midlevels are human, just like physicians/dentists, and there's a reason certain areas don't attract practitioners. It's not going to change by allowing lesser trained individuals gain an increased scope of practice...
 
YUP, wouldn't it be horrible if folks in the deep south and appalachia got dental care as well as the native alaskans? we need to stop this now!
again, if the dentists are worried about this why don't they tackle the problem of unserved populations? it's put up or shut up. if they won't do the work someone else will do it for them.
yes, some care is better than no care. will bad things be missed? sure.
would these also be missed if no one ever saw them? yup.
so what's better for the population; adequate dental care and a chance that bad things will be picked up or no dental care and no chance that they will be picked up?
anyone know what % of medicaid pts most alaskan dentists have in their practices? I bet it's very low...kind of like all the docs who complain about pa's and np's taking over but only take cash or good insurance....put up or shut up folks....
Really? Do you truly not understand that certain areas are not attracting practitioners because of the undesirable qualities they have? Do you really think that midlevels somehow are magically going to solve this problem of lack of access to health care providers in underserved areas? Like I said already, there's no data to suggest that the underserved populations are being treated preferentially by midlevels, at least in medicine. In fact, midlevels seem to be accumulating in urban cities just like physicians. And midlevels also seem to be moving towards practicing in "lifestyle" fields like derm, etc. You can see this with the dramatic increase in NP/DNP "residencies" in specialties that are highly reimbursing/have a high lifestyle factor involved.

What makes you think, then, that it'll turn out differently with dental midlevels?

anyone know what % of medicaid pts most alaskan dentists have in their practices? I bet it's very low...kind of like all the docs who complain about pa's and np's taking over but only take cash or good insurance....put up or shut up folks....

You want to cite me a study that shows midlevels taking significantly greater numbers of Medicare patients than physicians? Especially after taking into account confounding factors?
 
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you are all missing the point. this isn't like crna vs mda as there is currently NO DENTAL CARE OF ANY KIND in the areas they are allowed to work. it's not like they will be putting the local dentist out of work. as I said in my first post, if dentists don't like it they could stop it easily by committing to work with those populations and taking whatever compensation the state will give them for doing so. and these folks aren't doing major procedures, they are cleaning teeth and doing simple extractions. do you really need even 2 yrs of training to do that? navy corpsman learn basic dentistry for the field in something like a week.
I understand the concerns over other midlevels competing with docs in areas in which both work but there is currently no one else doing the work they are undertaking.

Dont play coy man. We see thru your smoke too. Arent you the same guy who claimed that PAs should get automatic entry into MD residency programs? Yes, that was you (see my sig). We all know where this is going. Its the same old song and dance the PAs and NPs have used for years. First its all about the "rural access" crap and then 10 years later you've got idiot NPs trying to start up their own dermatology residencies in Miami Florida (yes that really did happen). This is about the $$$. Providing rural services has absolutely NOTHING to do with it.
 
Also, increasing the scope of practice of midlevels doesn't mean they'll practice in underserved areas. There's a reason health care providers avoid underserved areas. What makes you think midlevels are any different than than physicians/dentists?

With the increased independence of nursing midlevels, for example, I have not come across any data at all that suggests they're serving the underserved more than physicians are. Midlevels are human, just like physicians/dentists, and there's a reason certain areas don't attract practitioners. It's not going to change by allowing lesser trained individuals gain an increased scope of practice...

About 10 years ago New Mexico passed a law giving script rights for psychologists. Supposedly there's some huge psychiatrist shortage in the state and nobody could get their atypical antipsychotics. The psychologist organizations loved it, they went on TV claiming that the "evil MDs" were ignoring the poor rural people and that this legislation would fix the problem. 10 years later, guess how many psychologists are scripting meds in rural areas? ZERO. Not a single one of them relocated, they are in the big cities where all the MDs are. Its a farce and a lie, all of it.
 
YUP, wouldn't it be horrible if folks in the deep south and appalachia got dental care as well as the native alaskans? we need to stop this now!
again, if the dentists are worried about this why don't they tackle the problem of unserved populations? it's put up or shut up. if they won't do the work someone else will do it for them.
yes, some care is better than no care. will bad things be missed? sure.
would these also be missed if no one ever saw them? yup.
so what's better for the population; adequate dental care and a chance that bad things will be picked up or no dental care and no chance that they will be picked up?
anyone know what % of medicaid pts most alaskan dentists have in their practices? I bet it's very low...kind of like all the docs who complain about pa's and np's taking over but only take cash or good insurance....put up or shut up folks....

ROFL ... what flavor is the koolaid? Is it cherry? I might drink it too if it was cherry.

UMM, of course it would be great if this was their actual intention. It isn't ... NPs started on the platform to work in underserved areas, bring care to those who physicians won't treat, fill a gap, etc, etc ... the first time I really started researching DNPs it was because they were opening up a 'nursing dermatology residency' at the University of South Florida. Cosmetic dermatology in South Beach ... I can't think of a more worthy population. Wake up man.
 
Dont play coy man. We see thru your smoke too. Arent you the same guy who claimed that PAs should get automatic entry into MD residency programs? Yes, that was you (see my sig). We all know where this is going. Its the same old song and dance the PAs and NPs have used for years. First its all about the "rural access" crap and then 10 years later you've got idiot NPs trying to start up their own dermatology residencies in Miami Florida (yes that really did happen). This is about the $$$. Providing rural services has absolutely NOTHING to do with it.

Wow ... pretty interesting thing in your signature (lol we both brought up the USF derm 'residency' as well).
 
But seriously though, Emedpa, do you have any studies you can cite that have evidence suggesting that midlevels are taking care of populations that physicians seem to be neglecting? Especially after confounding factors such as indebtedness, undesirability of location, etc, are taken into account? The website you linked didn't really give much information other than what dental therapists are and other basic things like that.

In my searches regarding nursing midlevels, I couldn't find any such studies. However, there is obviously a chance that my keywords sucked, so if you know of any studies regarding what I'm asking for, I'd be happy to critically read them.
 
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there was a study a few yrs ago looking at where pa's, md's, and do's were practicing 5 yrs after graduation( to r/o those doing loan repayment then leaving). the # staying in rural and underserved areas was pa>do>md.
I'll look for it.
NOT THE STUDY REFERENCED ABOVE BUT SAME IDEA:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466573/

and another:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360931/

there have been native medical health care aides in alaska for yrs:http://www.akchap.org/
I think their training is something like 6 months and they do maybe 1/2 what a pa does(minor procedures, health maint. stuff, etc). am I worried that they will come down to the lower 48 and take my job? not in the least. in fact if I go work up there I will help train them.
 
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Called it.

It was a simple matter of time before people started to catch on to the dental thing. It's a sweet gig, and anytime someone in health care works hard to achieve a nice setup, people immediately begin to figure out how they can have it without putting in the work, money, time, sacrifice, etc.

Agree with the sentiment Jagger, but I think that this line of thought is misleading. It is DENTISTS who advocated for and created the "dental therapy" profession in the first place. These were academic dentists who advocated for midlevels for social purposes; it's not like these lazy dentist-wannabes instituted this. Dentists currently have all the power to hamper the rise of this new practitioner as they are taught in schools of dentistry. If you want to criticize anyone, don't criticize the actual dental therapists... criticize the dentists who have allowed and are allowing this to happen.
 
Agree with the sentiment Jagger, but I think that this line of thought is misleading. It is DENTISTS who advocated for and created the "dental therapy" profession in the first place. These were academic dentists who advocated for midlevels for social purposes; it's not like these lazy dentist-wannabes instituted this. Dentists currently have all the power to hamper the rise of this new practitioner as they are taught in schools of dentistry. If you want to criticize anyone, don't criticize the actual dental therapists... criticize the dentists who have allowed and are allowing this to happen.

I'm 99% sure it was the physicians who started the DNP as well. Or at least it began at Duke (?) medical school (I think, I could be off on this one). In my opinion, schools, and the higher-up physicians associated with them, do this stuff to profit in the present. The problem is that it then becomes an issue for their colleagues who will practice in the future.
 
I'm 99% sure it was the physicians who started the DNP as well. Or at least it began at Duke (?) medical school (I think, I could be off on this one). In my opinion, schools, and the higher-up physicians associated with them, do this stuff to profit in the present. The problem is that it then becomes an issue for their colleagues who will practice in the future.

The pa concept started at duke.
the np concept started at u. colorado a few yrs later.
the first dnp program was at columbia.
 
I'm 99% sure it was the physicians who started the DNP as well. Or at least it began at Duke (?) medical school (I think, I could be off on this one). In my opinion, schools, and the higher-up physicians associated with them, do this stuff to profit in the present. The problem is that it then becomes an issue for their colleagues who will practice in the future.

The DNP is granted through schools of nursing, which is a separate entity from the school of medicine at a university. This is what makes the "DNP issue" different from the dental therapist issue. The fact that schools of nursing can be completely autonomous allows nursing bodies to create their own degrees without any physician approval. So it really doesn't matter if a physician started the DNP degree or not (I don't know if that is true), the fact is, nurses COULD HAVE founded this degree completely of their own will.

As far as I know, dental therapists are actually graduating through affiliated programs in dental schools, not some separate "dental hygiene" or "dental therapy" school. Dentists can and need to use this difference to their advantage.
 
You know, as a medical student who is actually very concerned about the mid-level 'situation' in medicine, I'm actually in favor of this. (Yeah, hypocritical--I know)

I firmly believe dental care is important, but it's simply unaffordable for a lot of people. That's true in both urban and rural areas. I don't really see the harm in having lower paid, and less trained, people providing basic care, such as cleanings and tooth extraction.

Maybe it's just cause I'm sick and tired of seeing so many patients w/ $hitty-ass dentition every day.
 
You know, as a medical student who is actually very concerned about the mid-level 'situation' in medicine, I'm actually in favor of this. (Yeah, hypocritical--I know)

I firmly believe dental care is important, but it's simply unaffordable for a lot of people. That's true in both urban and rural areas. I don't really see the harm in having lower paid, and less trained, people providing basic care, such as cleanings and tooth extraction.

Maybe it's just cause I'm sick and tired of seeing so many patients w/ $hitty-ass dentition every day.


Hypocrisy is the lifeblood of America. :laugh:
 
The pa concept started at duke.
the np concept started at u. colorado a few yrs later.
the first dnp program was at columbia.

Columbia! Damn, I knew it was one of the big names. Thanks for clarifying
 
The DNP is granted through schools of nursing, which is a separate entity from the school of medicine at a university. This is what makes the "DNP issue" different from the dental therapist issue. The fact that schools of nursing can be completely autonomous allows nursing bodies to create their own degrees without any physician approval. So it really doesn't matter if a physician started the DNP degree or not (I don't know if that is true), the fact is, nurses COULD HAVE founded this degree completely of their own will.

As far as I know, dental therapists are actually graduating through affiliated programs in dental schools, not some separate "dental hygiene" or "dental therapy" school. Dentists can and need to use this difference to their advantage.

In theory, you're right - DNP isn't really controlled by medicine (ironically enough since it's what they want to practice), but the dental techs would probably be under control of the dental boards, through the schools, etc. However, the problem still remains - the dentists, admins of dental schools, etc, will open these programs now for profit and screw it up for people in the future. For example: say a program opens in a certain state because the school saw a way to make a nice little chunk of cash. People enroll, and the state dental board gives these techs (or whatever they're called) a certain sect of rights. They get out, practice, start spewing the anti-dentist attitude (much like the NPs/DNPs do) and the situation essentially becomes no different than the NP/DNP situation despite having a different origin. The school isn't going to shut down the program ... it's making them too much money. The state board isn't going to cut their rights, it would result in a huge lawsuit and by the time this rolled around, they would have probably established a significant lobbying group that would interject at multiple levels.

Unless the rules state that these techs MUST work under a dentist's license (which it won't because they wisely founded themselves upon the mantra that they work where there ARE NO DENTISTS - are you guys seeing the pattern yet), then the end result should really be no different than the issues happening in medicine right now.
 
Preventative dental care is not that expensive. There are many 35 dollar deals for first time patients offering a cleaning, x-rays, and oral exam. One could (emphasis on could) keep going to new dentists every 6 months.

I don't have dental insurance but spent 80 dollars for 2 cleanings this year from dentists. (40 dollars each) In the event that there is a cavity, I will have to pay about 100-150 dollars--it won't break the bank.

Toothpaste is very inexpensive; less than a dollar for 6.4 oz tubes on sale. Toothbrushes can be a dollar each on sale (quality colgate or crest ones), floss from the generic brand is a dollar for 100 yards, and mouth wash is about 2 dollars for a 1.5 liter container.

You know, as a medical student who is actually very concerned about the mid-level 'situation' in medicine, I'm actually in favor of this. (Yeah, hypocritical--I know)

I firmly believe dental care is important, but it's simply unaffordable for a lot of people. That's true in both urban and rural areas. I don't really see the harm in having lower paid, and less trained, people providing basic care, such as cleanings and tooth extraction.

Maybe it's just cause I'm sick and tired of seeing so many patients w/ $hitty-ass dentition every day.
 
You guys worry too much:
old-man-laughing.jpg
 
Preventative dental care is not that expensive. There are many 35 dollar deals for first time patients offering a cleaning, x-rays, and oral exam. One could (emphasis on could) keep going to new dentists every 6 months.

once again folks..we are talking about places that have no dentists in residence(see the map I posted a few posts back( post #18) about where they work).
some of these places are a 6 hr plane ride from a dentist...that's why they are training these folks to go work where the pts are.....
I have a friend who is a pa who works in the aleutians. the nearest doc( his sp) is a 6 hr flight away IF they can get a flight out. he is the only medical provider on the island aside from a few medics that work with him. he frequently has to stabilize critical pts and hold on to them for > 24 hrs before they can evac them off island....we're not talking about downtown anchorage here, we're talking about hrs from anywhere...another buddy of mine works at a place in ak that requires 2 bush plane rides and a 2 hr snowmobile trip to get to....we're talking little villages with less than 100 folks ....
 
Preventative dental care is not that expensive. There are many 35 dollar deals for first time patients offering a cleaning, x-rays, and oral exam. One could (emphasis on could) keep going to new dentists every 6 months.

I don't have dental insurance but spent 80 dollars for 2 cleanings this year from dentists. (40 dollars each) In the event that there is a cavity, I will have to pay about 100-150 dollars--it won't break the bank.

Toothpaste is very inexpensive; less than a dollar for 6.4 oz tubes on sale. Toothbrushes can be a dollar each on sale (quality colgate or crest ones), floss from the generic brand is a dollar for 100 yards, and mouth wash is about 2 dollars for a 1.5 liter container.

Dentists in my area charge $80-$100 per cleaning, so you are getting a deal at $40. That also sounds inexpensive for the cavity fillings. But even still, if you have 3 kids, each with 1 or 2 cavities, it adds up if you don't have a job. (Note: I'm not arguing the benefits of good oral health, which go beyond simply oral health.)
 
Dentists in my area charge $80-$100 per cleaning, so you are getting a deal at $40. That also sounds inexpensive for the cavity fillings. But even still, if you have 3 kids, each with 1 or 2 cavities, it adds up if you don't have a job. (Note: I'm not arguing the benefits of good oral health, which go beyond simply oral health.)

Dental schools basically charge nothing for most procedures and you have a supervised dental student performing procedures on you.

Then again, you would need to be close to a dental school.
 
there was a study a few yrs ago looking at where pa's, md's, and do's were practicing 5 yrs after graduation( to r/o those doing loan repayment then leaving). the # staying in rural and underserved areas was pa>do>md.
I'll look for it.
NOT THE STUDY REFERENCED ABOVE BUT SAME IDEA:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466573/

and another:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360931/

there have been native medical health care aides in alaska for yrs:http://www.akchap.org/
I think their training is something like 6 months and they do maybe 1/2 what a pa does(minor procedures, health maint. stuff, etc). am I worried that they will come down to the lower 48 and take my job? not in the least. in fact if I go work up there I will help train them.
Thanks for the links. I'll read through them either later tonight or tomorrow when I get a chance.
 
Most of the dentists around where I live also charge 80-100 for cleanings. You have to be creative and look around. :)

Well, if you have 3 kids then your spouse hopefully is bringing in a second salary. Just keep them from drinking unhealthy soda, juice (juice is so bad for teeth!).


Dentists in my area charge $80-$100 per cleaning, so you are getting a deal at $40. That also sounds inexpensive for the cavity fillings. But even still, if you have 3 kids, each with 1 or 2 cavities, it adds up if you don't have a job. (Note: I'm not arguing the benefits of good oral health, which go beyond simply oral health.)
 
I wasn't referring to dental care in the boonies; I don't know if that's what the other person was talking about.

once again folks..we are talking about places that have no dentists in residence(see the map I posted a few posts back( post #18) about where they work).
some of these places are a 6 hr plane ride from a dentist...that's why they are training these folks to go work where the pts are.....
I have a friend who is a pa who works in the aleutians. the nearest doc( his sp) is a 6 hr flight away IF they can get a flight out. he is the only medical provider on the island aside from a few medics that work with him. he frequently has to stabilize critical pts and hold on to them for > 24 hrs before they can evac them off island....we're not talking about downtown anchorage here, we're talking about hrs from anywhere...another buddy of mine works at a place in ak that requires 2 bush plane rides and a 2 hr snowmobile trip to get to....we're talking little villages with less than 100 folks ....
 
YUP, wouldn't it be horrible if folks in the deep south and appalachia got dental care as well as the native alaskans? we need to stop this now!

emed, my friend ... as always, I am silently applauding your attempts to reason with med students and pre-meds. But you and I both know that these cyber-folk aren't the ones who accompanied you to Haiti, these are kids who most likely have little to no experience working with the underserved (other than perhaps some required high school volunteer work). They likely have little to no experience working with the sick and suffering at all (other than perhaps rotations/internships) ... I won't include Residents, as most of them are likely starting to get the picture by that point, although I can't say I've never met a terrible Resident who was obviously angry that their 'alpha dream job' involves being empathetic towards the sorrowful conditions of others.

I've seen some pretty terrible teeth in my day, belonging to people who have bad credit and no way to take care of their condition. Sadly, it's not as easy as some might think, to even find an emergency clinic who will take them on for what they need. Such is our world, but all we can do is continually try and make it better.

As long as these dental 'midlevels' are supervised by those with more training, I fail to see any harm in their induction.

Anyhow, props to you old man.
 
emed, my friend ... as always, I am silently applauding your attempts to reason with med students and pre-meds. But you and I both know that these cyber-folk aren't the ones who accompanied you to Haiti, these are kids who most likely have little to no experience working with the underserved (other than perhaps some required high school volunteer work). They likely have little to no experience working with the sick and suffering at all (other than perhaps rotations/internships) ... I won't include Residents, as most of them are likely starting to get the picture by that point, although I can't say I've never met a terrible Resident who was obviously angry that their 'alpha dream job' involves being empathetic towards the sorrowful conditions of others.

I've seen some pretty terrible teeth in my day, belonging to people who have bad credit and no way to take care of their condition. Sadly, it's not as easy as some might think, to even find an emergency clinic who will take them on for what they need. Such is our world, but all we can do is continually try and make it better.

As long as these dental 'midlevels' are supervised by those with more training, I fail to see any harm in their induction.

Anyhow, props to you old man.

Thanks for clarifying. At first, I thought what every other midlevel group, organization, etc, has done thus far was a better gauge as to what this identical midlevel group is trying to accomplish. However, clearly your missionary work in an entirely different country makes a far better argument. Don't know how I didn't see this perfectly linear connection before. I think I'll link this post to the CRNA discussions in the gas forums and the DNP discussions in the FP, IM, Cards, etc, forums.
 
This is great news! Why should the public have to suffer if the dental therapists demonstrate they can safely perform the same tasks as a dentist at a cheaper price? Let the market decide whether or not it's worth it to spend the extra money and time to see a dentist.
 
Man, I'm scared enough of going to the dentist as it is-I mean they're using power tools in your mouth! I dunno who'd be lining up to see someone who had half the training.

People that are in extreme pain that don't have the resources to obtain services from a dentist.
 
This is great news! Why should the public have to suffer if the dental therapists demonstrate they can safely perform the same tasks as a dentist at a cheaper price? Let the market decide whether or not it's worth it to spend the extra money and time to see a dentist.

The thing you dont realize is that these dental therapists or whatever want to live in alaska and rural areas just as much as dentists which is NONE. They will get their legislation to practice from "helping the underserved" and then high tail it to the desirable places to live.
 
The thing you dont realize is that these dental therapists or whatever want to live in alaska and rural areas just as much as dentists which is NONE. .
dude...do some research....look at the bios of these students on the dentex site...they are all alaskans and are all serving in their home communities...they WANT to be there.
 
dude...do some research....look at the bios of these students on the dentex site...they are all alaskans and are all serving in their home communities...they WANT to be there.

You are blatantly ignoring the fact that all midlevel movements start out this way. It's how they get their foot in the door and get the general public to support what they do. Tell someone you want to start a program to get care into underserved areas, help the needy, fill crucial gaps, etc, and you'll have their support. Be honest and say that you realized you can manipulate the system and take some decent cash from the dental game without having to put in the work and sacrifice of going to dental school ... and my guess is that people will not be as supportive. Helping the underserved, fill gaps, etc, are the same talking points NPs, DNPs, etc have been using for years. Can you honestly tell me that DNP dermatology residencies in South Florida (with cosmetic components) are filling these crucial gaps? Why are we to believe that this movement will be somehow drastically different than the various others that have created such a hostile, confusing health care landscape?
 
why are we to believe that this movement will be somehow drastically different than the various others that have created such a hostile, confusing health care landscape?
because this program was invented by, taught by, and is overseen by dentists WITH INPUT FROM PHYSICIANS WHO RUN ONE OF THE BEST PA PROGRAMS IN THE COUNTRY( u.wa). Not similar at all to the dnp movement. They are regulated by the dental board just like pa's are regulated by the medical board. They couldn't expand their practice parameters without the ok from dentists any more than a pa could start doing lap choles without ok from the medical board. The dental board could just say "dentex grads may only work in communities of under 1000 people and may only see those on public assistance" and that's the end of the story.
These folks are not np's. They are more like pa's who are tightly regulated and can do nothing without the explicit ok of the medical board. If i wanted to do laser tattoo removal i would have to get them to sign off on it. If these folks wanted to do crowns or bridges or whatever the dental board would need to sign off. These folks are overseen by dentists and are not independent providers of care. There is oversight in place BY DENTISTS...if they don't like the concept a yr from now they could pull all of their licenses. career done.
 
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