I know editorials are supposed to stimulate thought, discussion and debate, but I feel that the March JADA editorial, "Lessons Learned: Implications for Workforce Change" (
JADA 2008;139[3]:232, 234[Free Full Text]
), by Drs. Michael Glick and O.T. Wendel was beyond reasoned thought.
Trying to equate dentistry to any medical model is a futile academic exercise. Medical diagnosing cannot be compared with "invasive" dental procedures.
What do the authors mean by "access to care"? Do they define the phrase as meaning an undefined lower level of care from a less-educated provider, or an undefined midlevel of care from some midlevel-educated provider? Or does this mean access to comprehensive care from a qualified dentist? Offering the targeted group of patients something other than real, complete care from a dentist may soothe some social consciousness for the authors but, frankly, that is an insult to those patients.
A.T. Still University in Arizona is a fairly new dental school and its mission, in addition to educating dental students, should be a commitment to the oral health needs of the citizens of Arizona. This could mean, for example, outreach clinics staffed by faculty, with student rotation in those areas of Arizona where access to care is an issue.
If local, state and federal governments would adequately fund existing dental programs, the qualified dentists could afford to serve in communities, and the populations in need would only benefit from the care they would provide. In addition, if all states would examine their licensure laws, then perhaps those states’ needs could be filled by allowing some form of credentialing.
There is no such thing as a junior dentist, with some or limited privileges, regardless of the acronyms. You either are a dentist, or you are not. The debate should not be about creating some new level of provider with limited abilities, but ensuring that those people who need dental care have access to quality dental programs that are staffed by an adequate number of dentists, and providing those qualified caregivers with adequate compensation.
