Dentistry and Health Care Reform in the USA

Abstract

What will the practice of dentistry look like in the United States when the health care delivery systems are changed? This question makes two likely assumptions. One assumption is that the health care systems are going to change. It is hard not to see the wave of demand for improvements in this sector. The other is that it is hard to imagine that some of the very significant changes under discussion will not impact dentistry and orthodontics. We all know that potential contentious issues are best addressed before they are encountered. We also know that orthodontics draws many of the finest minds in dentistry. It is human to lean toward favoring the status quo when we are doing well, but it is time that we begin to look at the effect some of the proposed changes can make on our discipline. The buzz I hear these days’ is about the presumed efficiency and cost savings inherent in the transfer of many patient care duties to a lesser trained person. This arises from the concept of a transfer of the medical nurse practitioner concept to dentistry. The concept is tantamount to saying that a portion of health care is technical in nature and can be properly and more economically delivered by someone with lesser education and training. The debate is largely focused on capturing the economy of such a shift with the resistance citing the need to guarantee the patients’ quality of care. While there are undoubtedly many approaches being discussed in various states, the one I hear most commonly cited is the Minnesota proposal. This is where I live and the facts are that the Minnesota legislature did address this question in 2008. The first proposal to enlarge upon dental hygiene education for certain hygienists was replaced by a second bill that is now law. This second bill provides for the creation of a new level of dental care provider, the oral health practitioner. Under the new legislation, The Board of Dentistry will license the new oral health practitioner and the oral health practitioner will work under the supervision of a dentist. The details of the final bill can