Thursday, November 4, 2010

Dentists and Anesthesiologists, Brothers in Arms

The New York Times recently had an article about the underserved poor in Alaska who have trouble finding dentists. They frequently go for months with excruciating tooth decay because there are not enough dentists to take care of them. In response, the state has certified fourteen dental therapists to perform procedures like extractions and dental fillings to fill in for the lack of dentists practicing in the state. Now ten other states are considering the same action. There is even a study that shows low cost dental therapists can perform safe dental care without a dentist present.

The American Dental Association is naturally up in arms over this idea. The thought that a two year training course can allow a person to perform dental procedures is anathema to dentists. The association, which fought Alaska for five years over allowing dental therapists to work, has instead advocated dental health coordinators to perform teeth cleaning and other noninvasive procedures while referring invasive procedures to licensed dentists.

Does any of this sound familiar? Lesser trained people doing your work with a "study" to support their legitimacy? If you are an anesthesiologist, you would instantly recognize the same issues are being waged in our battle with unsupervised CRNA's. As the economy continues its slow grind and more people seek medical care, it will be hard to push back against the pressure states feel to use low cost health care providers to treat everybody. I wish the ADA luck in protecting its members' scope of practice. They couldn't do worse than the ASA. 

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