What the ADA can learn from the NBA

Abstract

L et me start by saying that I am not a huge basketball fan. At best, I halfheartedly board the play-off bandwagon each spring if the Bulls or Raptors are doing well. But the National Basketball Association (NBA) did something very interesting this past season that is newsworthy for health care providers, dentists included. Beginning in March, the NBA began reviewing and evaluating all referee decisions within the final 2 minutes of close games. According to an NBA press release, this is the “latest step in the league’s effort toward more transparency in its officiating program.” NBA Executive Vice President of Referee Operations Mike Bantom stated, “Our policy in the past was pretty much to wait until we had something that was controversial enough to really garner a lot of interest . , so we tried to come up with a system that would allow us to provide some insight into our process and set a criteria that would allow us to be more standardized and more consistent.” Now it is not quite clear to me whether a physician or a dentist is analogous to the referee, the player, the coach, the team owner, the arena owner, the general manager, or some combination of all (or none) of the above. There are also obvious differences in producing “health” compared with producing a properly officiated basketball game. For example, there are few gray areas when it comes to officiating. There are correct calls and incorrect calls. Health care is far more complex. Physicians and dentists deal with a lot of gray areas. My assessment as a nonclinician is that dentistry in particular has a less robust set of clear-cut, evidence-based treatment protocols and well-defined clinical pathways compared with other areas of medicine. But forget these issues for a second. Although interesting and important, they are not relevant to the point I want to raise, which is that the underlying trends toward increased transparency, accountability, data-driven metrics, and emphasis on quality and outcomes that drove the NBA’s decision are precisely the same forces that are radically transforming the health care system. In fact, from my perspective, this new “value agenda” in health care is one of a handful of major game changers that will fundamentally reshape the dental practice environment over the coming decades. The results of the American Dental Association’s (ADA) recent environmental scan also reinforce this point.