Dental hygienists teaming up with other health care professionals
By alun | March 14, 2012
As a follow on from my post on direct access for dental hygienists www.alunrees.com/blog/hygienists-call-for-direct-access comes this piece from Nufar Kiryati, I realise it’s from Canada but “The times they are a changin’“.
Dental hygienists teaming up with other health care professionals
Dr. Alfred Fones, a dentist from Bridgeport, Connecticut who founded the dental hygiene profession in 1913, envisioned dental hygienists working in collaboration with other health and social service workers to provide preventive health care to the public. Fones once said: “It is primarily to this important work of public education that the dental hygienist is called“. He considered dental hygienists as the channel through which preventive oral health care knowledge should be delivered to the public.
We are going in the direction that Dr. Fones already envisioned 100 years ago. I think Dr. Fones’ ideas are very much valid today as we witness a new path of collaboration work between dental health care professionals and other health care practitioners.
As part of my mission to equip dental hygienists who want to change their career paths or enhance their existing careers with the knowledge and information they need, I am constantly researching what are the new trends in the dental hygiene arena.
In my recent global scan of the dental hygiene profession I discovered some interesting and exciting information about some of the major changes we are expected to witness that will have an impact on the dental hygiene job market. These changes include the expansion of the scope of practice to become an independent profession and an increase in the length of training, having countries like Japan that offers dental hygiene studies combined with nursing schools or social worker license as well. In addition, there is a surge in demand for dental hygiene services as the public awareness to preventive care is gaining its spotlight and the baby boomers retire and create demand for more preventive dental care. In 2011, the oldest segment of the baby boom generation was 65 years of age, marking the beginning of an important demographic shift for dentistry. As seniors, boomers will continue to require dental care more than previous cohorts of seniors. The association between oral and systemic health is becoming clearer and dental practitioners will become more involved in promoting their patients’ overall health.
The real opportunity here is to understand how these trends can influence dental hygiene career opportunities. Treating seniors with complex systemic conditions and acknowledging the fact that the oral health condition is directly linked to systemic conditions should lead one of the major changes in the dental hygiene arena: working with other health care professions in group type practices.
People understand today that in order to live a healthier life, the body needs to be treated as a whole, viewing oral health as an integral part of our well-being. Therefore it is only natural to receive preventive oral health care in adjunct to other health care services. For example, a group practice offering dental hygiene services, nutrition support from dietitians, a family physician and a smoking cessation specialist – all under one roof!
In Nova Scotia, Canada, dental hygienists are collaborating with a team of nutritionists, licensed practical nurses and health educators to work together with students, teachers, parents, and the community to promote, maintain and improve the health and well-being of the school community under the “Our Healthy School” campaign which is a Health Promoting School initiative to promote healthier living. I am wondering why we are not seeing more initiatives like this one. Why aren’t we hearing more about independent dental hygienists working with other health care partners to offer a “whole body preventive” approach?
Is it the fear from the unknown? Is it the lack of knowledge about what exactly this business venture involves? Teaming up with other health care professionals could be easier then we think. After all, you will not dive into it on your own but rather have partner/s to work together with. The possibilities are out there – whether joining an existing group practice or teaming up with another practitioner to open up a new health care facility, you just need to choose your career path direction. Seeking advice from an experienced mentor and networking to find the right people to connect with can certainly help you move in this direction. It is truly a win-win situation when we team up with other health care professionals – the public wins because they get to receive a “whole body” approach to their health needs – treating their whole body and not just from the neck down, and the dental hygiene profession wins because we get the recognition the profession deserves from both the public and our colleagues.
Nufar Kiryati RDH BHA
Owner and CEO, Knowledent
Make your dream a reality. Dental Hygiene Career Change Consulting
info@knowledent.com
1-647-955-1195
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Can you surprise like KLM?
By alun | March 13, 2012
Thanks to Alan Stevens for bringing this to my attention. Great use of social media.
How can you use this for inspiration in the way you behave towards your patients, customers, clients?
“This information was written by Alan Stevens, and originally appeared in “The MediaCoach”, his free weekly ezine, available at www.mediacoach.co.uk.”
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The Monday Morning Quote #157
By alun | March 12, 2012
“Laugh and grow strong”
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Speak up on DFT application process, BDA urges dental students
By alun | March 9, 2012
09 March 2012
Speak up on DFT application process, BDA urges dental students
The British Dental Association (BDA) has launched a survey of dental students involved in this year’s round of applications for Dental Foundation Training (DFT) places. The research will put together a full picture of the experiences of final-year student BDA members that the BDA will feed back to the organisers of the DFT application process.
The research asks participants about issues including the quality and timeliness of information provided prior to the process beginning, the user-friendliness and appropriateness of the process, the way interviews were conducted, and the way places were allocated in December 2011.
Dr Judith Husband, Chair of the BDA’s Education Committee, said:
“The BDA has received informal commentary from members and non-members alike about aspects of the way the Dental Foundation Training application process has been managed this year. It’s important that feedback is provided through formal research so that a fuller picture of applicants’ experiences can be put together and fed back to those responsible for the process.
“It was clear that the previous system needed to be replaced to deliver a better experience for dental students. It’s important that this year’s applicants share their experiences to help hone the new system. I urge all those invited to participate in the survey to do so and make their voices heard so that the BDA can help to make sure that positive changes can be made next year.”
The survey is open from 6–19 March. All BDA student members who took part in the process have been invited to take part. Final year students who are not currently members but took part in the process can participate in a parallel piece of research here: http://www.bda.org/students/publications/fyg/about-training/DFT_survey.aspx
Ends
Notes to editors
1. The BDA called for action to resolve some of the issues identified with the process in January. For details visit: http://scotland.bda.org/news-centre/latest-news-articles/35030-bda-calls-for-action-to-resolve-foundation-training-issues.aspx.
2. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents more than 23,000 dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces, and includes dental students.
3. For further information, please contact the BDA’s media team on 0207 563 4145/46 or visit www.bda.org/news-centre/. You can also follow news from the BDA on Twitter: http://twitter.com/#!/TheBDA.
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Dental Hygienists call for Direct Access.
By alun | March 7, 2012
An open letter to the profession from a group of dental hygienists makes a well argued case for direct access and is worth a read and some thought.
Dear Sir,
RE: Direct Line Lack of Assurance1
As active members of a group of like-minded dental care professionals campaigning for the establishment of Direct Access (DA) for dental hygienists (DHs) we read the editorial referenced above with interest. However, our interest soon waned and turned to disappointment as it became clear this was to be no balanced debate of the issue.
It is, at best disappointing to have the anecdotal stories, of what some might perceive as the BDA’s protectionist stance, confirmed in print. Even more so when part of this argument seems to be based on apparently erroneous and disingenuous information.
The first point we would take issue with is the assumption that our case for DA is based on the premise that DA equates to Independent Practice (IP). DCPs have had the right to own and operate their own independent practices since April 2006. Some have already done so, even employing dentists. It is apposite to make it absolutely clear that DA is NOT about IP.
The first point we would agree on is that regarding the non-desirability of setting up in IP. We see DA as being very much a part of life in general practice. True, there are some who would like to set up independently but these are few and, as mentioned earlier, we feel most of those that want to have already done so. For many hygienists, DA would merely legitimise the status quo. The main point of DA is to increase access to a “Circle of Care” – another entry point into professional dental and, indeed, holistic general healthcare.
The second point we would contest is the supposed lack of precedent. The piece reports there is none, save for the anomaly of CDT’s – a group of DCPs who do have DA. This IS precedence. It is also deemed that this registrant group have sufficient skills to identify abnormalities and refer onwards to an appropriate healthcare professional. We contend that all the arguments relating to hygienists’ apparent lack of training, their apparent lack of diagnosis skills and the possible risk of missed oral cancer all fall at this point. Yet DA antagonists continue to argue that a hygienist, who has been at full time dental school for at least 24 months, treating many patients under supervision, does not have the necessary skills to recognise pathology.
The precedence angle taken in the editorial also seeks to neatly sidestep the precedence that is optometrists, nurse practitioners, midwives, podiatrists and physiotherapists, all of whom have DA to patients without first recourse to a doctor. They all work professionally within their scope and refer as necessary.
The question of competency has been raised many times. It must be remembered that a DH currently spends a minimum of 24 months, including at least 1200 clinical hours, predominately concentrating on a single subject. It must also be remembered that most students now dual-qualify as hygienists and therapists (DHTs) with a BSc primary degree after three or four years of study. This aside, we accept that DA for newly qualified Hygienists is probably not appropriate. Many nuances are gained with experience and therefore, as part of our suggested model, we would propose that a Hygienist should have 5 years equivalent post qualification experience on the register before receiving entitlement to Direct Access (DA). DHs are registered, indemnified and subject to the same regulatory structure as General Dental Practitioners (GDPs); whilst there is some discussion around the ability to diagnose appropriately, it must be borne in mind that the GDPs themselves often do not diagnose many (any) neoplastic lesions in the dental surgery. They refer the patient onwards to those that have suitable expertise and facilities to hand. Current GDC curricula and guidance determine that DHTs must also be able to recognise oral pathology and refer appropriately. This we do daily already.
We understand that BDS undergraduates complete a longer training course. In actuality, however, there are so many disciplines to cover in that time that periodontal diagnosis and training seems to take a low priority. We have heard from BDS undergraduates who make this very point. We all in our working lives may have come into contact with young, newly qualified BDS graduates who cannot carry out accurate indices and therefore cannot collect and synthesise the information needed to make an accurate diagnosis. Periodontal therapy and diagnosis takes time to perfect and feel comfortable with, and we, as hygienists, carry out these tasks all day everyday – we get a lot of practice.
It is simplistic and wrong to suggest that an experienced DH cannot diagnose periodontal disease or recognise abnormalities. Many a DH in general dental practice has to carry out initial periodontal assessments including editing Basic Periodontal Examinations (BPE) passed to them, (if they get them), appropriately in line with the current British Periodontal Society’s (BSP) guidelines. They are also deciding on the appropriate treatment plan for their patients. Indeed, one only has to look at various online forums to see the day-to-day difficulties that DHs face in practice in this respect. Perhaps the GDC should carry out some simple research to assess the extent of this problem; a few simple questions would show that in general practice very few DHs receive any kind of definitive descriptive prescription and usually work in the absence of a diagnosis. We take the recognition of the BSP to allow DHs full membership to be a true and honest recognition of the work done by DHs to recognise, diagnose and successfully treat periodontal disease within scope.
It is a truism that 50% of the population do not attend a dentist. There are many reasons for this. However, there does seem to be a demand for the periodontal services of hygienists, a demand that has been the basis of a successful business model, namely that of SmilePod. This business initially offered predominantly hygiene services ostensibly by hygienists. Their clinicians are, in fact, mainly dentists and they have now made this clearer.
We have many anecdotal accounts of patients who wish to see a hygienist but not a dentist at a particular time. We know that patients frequently ring practices asking to see a hygienist. They may not have access to one at the practice they attend. Why should a patient have to pay for another examination? It makes no sense, and is unfair. Getting a referral letter can be difficult with some GDPs seemingly reluctant to put pen to paper and seeing such an act as tantamount to signing away money. We know of persistent patients who have fought to get a referral. This would seem to run counter to the argument that DA hygienists would confuse the public.
We see DA as a means of drawing more patients into professional preventive care at a time that prevention has never been more important with the increasing awareness of oral/systemic interractions. DA would allow us to work more effectively within a practice setting as a standalone registered health professional that can assess and treat within their own competency referring when and where appropriate.
DA would also make business models including partnership a more realistic proposition for DHs. To use one of business consultant Chris Barrow’s lines, it’s not about dividing the cake into smaller and smaller pieces. It’s a whole new cake! DA is all about increasing access to professional healthcare in a safe, regulated environment.
What practice principal would turn down the prospect of a new source of patients? Particularly during these tough economic times.
Yours faithfully,
David Bridges RDH, Amanda Gallie RDH, Shaun Howe RDH,
Elaine Tilling MSc RDH DMS MIHPE
Co-signatories:
Christina Chatfield RDH, Sarah Murray RDH, Margaret Ross RDH, Dee Benton RDH,
Lesley Card RDH, Tim Ives MSc RDH, Lisa Gibbs RDH, Kate Govier RDH,
John Stanfield MSc RDH
Reference
1. Hancocks, S. Direct line lack of assurance. Br Dent J 2012; 212: No2: p53
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The Monday Morning Quote #156
By alun | March 5, 2012
“When everybody is somebody then nobody is anybody.”
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“Authentic leadership needs skill to succeed”
By alun | February 29, 2012
Nice article from Andrew Hill in the FT.
As a coach I spend time encouraging clients to discover their authentic selves, however as with all things particularly when politicians or salespeople get involved the word can become devalued.
Here’s the link
www.ft.com/cms/s/0/508107a2-5ed9-11e1-a04d-00144feabdc0.html#ixzz1nls2hKFE
Brings to mind the quote from Jean Giraudoux
“The secret of success is sincerity. Once you can fake that you’ve got it made.”
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Banks miss targets for small business lending
By alun | February 23, 2012
From Morris & Co’s newsletter
The experience of my clients is that banks are doing anything they can to avoid lending to (some not all) dental practices. Methods include buck passing, demanding the same paperwork time and again, individuals “responsible” being on prolonged holidays and courses without delegating or sharing responsibility. Those of us who have lived through this before recognise the tactics (and the excuses).
Banks miss targets for small business lending
The UK’s five main banks have missed their Government targets for lending to small businesses, a new report has revealed.
The banks met their overall lending targets, allowing new loans of £214.9 billion, but only £74.9 billion was lent to small and medium-sized businesses, compared to the target of £76 billion.
According to the banks, demand for credit fell among smaller firms during 2011 and remains weak.
The All Party Parliamentary Small Business Group has recently been examining the reasons why many small firms are still struggling to access finance.
The group’s Entrepreneurship Inquiry has explored a number of issues, including why women and mature people are less likely to apply for bank finance, and why a third of small businesses are still having problems accessing money from the banks.
The Confederation of British Industry (CBI) has called for measures to remove the barriers to increasing non-bank lending, and to tackle the current lack of demand.
John Cridland, CBI Director-General said, ‘This is as much a problem of demand as supply. Firms need independent help and support to locate the finance that’s right for them. So we must cut through the red tape and complexity surrounding non-bank finance to make it more easily understood by small and mid-sized businesses, which often lack the resources of a larger company’.
Meanwhile, the Federation of Small Businesses (FSB) has highlighted the fact that entrepreneurs lack the confidence to apply for bank finance, with many new business owners using more of their own money to fund their business.
John Walker, FSB National Chairman, said, ‘We have heard for so long that small businesses cannot access finance from the banks, but for some entrepreneurs even approaching the bank is not an option. While alternative forms of finance need to be promoted, this needs to change and confidence needs to be instilled in all sectors of society so that they know bank finance is a real option’.
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The Monday Morning Quote #155
By alun | February 20, 2012
“If you have ten thousand regulations you destroy all respect for the law.”
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Most dentists not ready for compulsory EPCs…say Frank Taylor Associates
By alun | February 15, 2012
More TLAs…..
Here’s a link to the FTA blog.
The majority of those dentists who are looking to sell their dental practices in 2012 are not ready for new legislation in regard to EPCs according to Andy Acton of Frank Taylor and Associates and Phil McCabe of the Forum of Private Business. The new changes will come into force on 6th April and mean that:
- An energy performance certificate will be required on all marketing for all properties that are to be sold or let
- The responsibility for the EPC will rest with the ‘relevant person’ – defined as either the owner or the agent. Both will have a duty to ensure an EPC is commissioned before marketing a property
- Trading Standards Officers will have new powers to force sellers and agents to produce copies of EPCs for inspection
- It will also be a mandatory requirement for air conditioning inspection reports to be lodged on the central Non Domestic EPC Register
- EPCs will need to be attached to written details of the property – the option to include the asset rating will no longer apply. The first page of the EPC must be included
- Andy commented, “This legislation may slip under the radar as it seems to have been announced quite quietly and we want to ensure that dentists are aware of this. Put simply, after the 6th April, the marketing of a dental practice just cannot happen without an EPC.”
Phil McCabe, Senior Policy Adviser at the Forum of Private Business added, “Any costs like these are an extra burden for small businesses to bear. The EPC scheme is essentially a watered down version of the unpopular Home Improvement Pack (HIP) scheme, which was dreamed up by the last Government but quickly abandoned by the Coalition after it came in to office for being unnecessary and costly. We would say the same of the EPC.
Aside from the cost implications, there’s also the extra paperwork that will be involved. More red tape and yet more form filling for businesses at a time the Government is pledging to cut bureaucracy is just not necessary.”
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