SB 6126 is a bill proposed to institute dental health practitioners (DHPs) to alleviate the lack of Washington patients' access to dental care. DHPs are proposed to take over basic dental care under the supervision of licensed dentists. The bill suggests dentists and DHPs sign a "contract" that outlines how DHPs will discuss, plan, and execute treatment plans for patients under the direction of a dentist. The contract supposes that all medical and dental emergencies for the DHP patients will be mamanged according to this contract. And the contract must be upheld at any time, with the licensed dentist coming to the immediate aid of a DHP in the event a DHP has an issue, question, emergency, or a problem with a patient's care. I am really concerned that dentistry and state government are taking a wrong turn of this bill is passed. I am not worried about my own livelihood. I am worried about the reputation of dentistry and the endangerment of quality patient care.
Today, I wrote my senators Mary-Margaret Haugen and Paull Shinn.
"Senators,
You need to vote no for SB 6126.
The quality of Washington patients' dental care is currently suffering for many reasons. I have witnessed first hand the mass exodus of patients in my practice due to the recession we faced from 2008-2010. Most of those patients have not returned for care in any capacity. An estimated 40% of residents are without dental insurance, and choose to forgo regular, basic dental care. The Washington Dental Service fee reduction in 2011 has crippled many dentists' ability to offer quality dental care to those who still choose to pursue routine care. And a future fee reduction will hinder our Washington dentists' abilities to provide the best care possible to all types of patients. And with the introduction of SB 6126, the quality of care for patients is going to suffer even further.
As an expert in dentistry, I can admit to you that it has taken me well beyond my basic training to provide intelligent, comfortable successful therapy to patients, even for the most basic dental services. I do not feel that a dental health practitioner (DHP) will be able to deliver the standard of care that patients will expect. Patient access to care may be improved, but the DHP-delivered quality of care--specifically, the patients' judgement of the treatment results--will not be significantly improved.
You should be concerned about how a patient who travels to a DHP will decide to forgo dental care because of a negative experience. I am already privy to the experiences of patients who approach me with a sordid history of a licensed dentist's substandard ability to listen, interpret, and consult about their interests, and then deliver substandard restorative and prosthetic care--even the most basic of fillings. I have to hear about inadequate anesthesia, hurried and incomplete care, the list goes on.
You should be concerned that a DHP contract can accomplish fluid treatment with dentist oversight. There is no way that all aspects of a case can be controlled with a DHP contract. And trying to implement a phased plan of care for a patient with a DHP may be harder than introducing a DHP into an existing practice. Even a DHP with direct supervision will create a burden on the dentist for the DHP to deliver quality care. Doing it remotely will add more challenges to patient outcomes.
You should be concerned about the problems that will occur when A DHP gets into a situation where a licensed dentist has to stop their care for another patient, attempt to consult with the DHP via video feed to rectify a failed case without being present to correct or salvage it. Patients will turn sour. Patients will lose trust in dental care providers. And patients may suffer needless extra care visits. This amendment of SB 6126, above all others, is in my opinion, so beyond realistic expectations that I am worried about the reputation of dentistry in general.
There are too many variables beyond lawmakers' and dentists' controls if you elect to vote in favor of SB 6126. Do the dental industry and our patients the best possible of favors: vote no for SB 6126."
The bill is put before the legislature on 2/14/2012. I hope this bill fails. For everybody's sake.
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