A framework for physician-dentist collaboration in diabetes and periodontitis.

Abstract

P rimary care, according to the American Association of Family Physicians, is “care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis.”1 Primary care forms the backbone of our health care system, providing the first line of contact for innumerable patients who may be referred to specialists based on specific clinical needs. In the United States, there is a shortage and maldistribution of primary care providers,2 and the increasing number of urgent care clinics that are frequently staffed with mid-level providers adds further testimony to the growing problem of disparities in health care.2,3 It is believed that in the United States, the impact of this shortage will be felt much more in the coming years because of the rising proportion of elderly people, who present with chronic medical illnesses.4 One suggestion to alleviate the primary care shortage is to effectively utilize the available paramedical workforce that includes nurses and other ancillary personnel as points of entry to primary care.5 Among them, dentists, as de facto oral physicians who already play a pivotal role in monitoring medical conditions such as hypertension during patient visits, can be a valuable medical resource.6 Many elderly patients see their dentists more routinely than their medical health care providers (HCPs).7 If dentists or their staffs are adequately trained to identify, monitor, and refer common chronic medical ailments, they can be a good first line of contact in the existing health care system.8 It is equally important that HCPs have the knowledge and training to diagnose common dental conditions. Because of the intricate relationship between …