Several state dental associations across the country have discussed and debated the topic of the midlevel provider. One of the most recent discussions, debates, and decisions on the issue occurred in the Pacific Northwest.
On September 13, the Washington State Dental Association (WSDA) House of Delegates approved an alternative to dental midlevel providers. You can click here to read the WSDA blog about the measure's approval. Also in this blog you can read the letter sent by the WSDA president to WSDA members.
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After reading the letter from the WSDA president, I asked the American Dental Assistants Association (ADAA) for their response, which follows:
The American Dental Assistants Association has long held that a strong educational foundation coupled with a realistic scope of practice for all dental assistants – regardless of which state they practice in – will not only safeguard patient safety, but will maintain the integrity of the dental practice and can help to serve the increasing demand for dental care with which this country is faced.
Oral health care has changed a great deal over the past few years, becoming not only more expensive, but more difficult for many in America to gain access to – either because of geographic location or lack of insurance. This has created a void and a disparity in dental care for many. The result is that over the past decade, more and more states are proposing legislation that would provide dental care by what are being termed ‘mid-level providers.’ Many of these workforce models are designed for the clinical dental assistant.
Most recently, the Washington State Dental Association has introduced its own legislation “as an alternative to the dental midlevel provider legislation we have fought against in Olympia during the last two legislative sessions.” The “stated intent is to deter legislation for new oral health workforce models.” They see this as a way to fight the ‘inevitable.’
So, that begs a few questions, doesn’t it?
1. Why are they creating another, new workforce model when there are already several in place (Alaska, Minnesota, as well as legislation in 10 other states)?
2. Why is organized dentistry fighting so hard against not only the midlevel provider, but educational requirements/licensure for dental assistants?
A North Dakota state senator has stated the she understands why they oppose legislation like this – “they fear loss of control and lower-quality care.” This, however, can be circumvented with the appropriate educational foundation.
Any workforce model that incorporates expanded functions for auxiliaries must have formal education and credentialing as its foundation – and the ADAA believes that anyone working with the patient, regardless of the scope of practice, should have formal education, which will safeguard not only patient safety, but that of the entire dental team.
Note: On September 20, 2012, I requested an interview with representatives of the Washington State Dental Association about the measure. I am currently awaiting their response.