Q&A with the ADA by Dr. Thomas Giacobbi

Dentaltown: In February, the ADA Board of Trustees approved the creation of the dental licensure objective structured clinical examination, or DLOSCE. It looks like if everything goes as planned, this national clinical exam will be available in 2020, and will finally remove the ethical and logistical challenges of dental students finding live patients for their board exams. The entire profession has been aware of this for a long time; explain why the process has taken so many years. In other words, is it really the ADA’s decision? Or had it been up to the states, the board exam or the regional exam people?

Dr. Joseph P. Crowley: Each state’s licensing board has the legal obligation to say what it expects for an initial licensure and continued licensure for a dentist to practice in that state. Over the years, regional testing agencies have tried to improve their tests; in fact, some curriculum-integrated format types of test deliveries have taken them into the dental schools, who have tried to solve some of what were considered ethical issues to the live patient exam.

In conjunction with work that this board of trustees has done with the American Dental Education Association and the American Student Dental Association, we sat down and decided now is the time to move forward. The ADA believes who better to develop that exam than the ADA?

It coincides with another thing that we’re doing—working with state licensing agencies to ask them to accept all current licensing pathways, so a candidate can come to their state with any licensing pathway that’s available today. That’s kind of parallel work that we’re doing right now.

Dentaltown: The ADA has committed in the neighborhood of $18 million to a three-year campaign called “Find a Dentist,” which directs consumers to an online database of ADA member dentists. What sorts of messaging would you have for dentists who are ADA members to be aware that this resource exists to them?

Crowley: There are a lot of people in the world who think they should be going to a dentist, but they lack the time or whatever. This marketing is targeted to consumers and will direct them through online search. This “Find a Dentist” tool will pop up when they look, and hopefully will drive them to find a dentist in their area who’s in the American Dental Association. It’s a finely tuned campaign to a specific set of patients.

The number of dentists who’ve signed up to appear on the “Find a Dentist” tool is rising rapidly, so we feel that we’re on the first end of it.

Dentaltown: The ADA recently launched a credentialing service powered by CAQH ProView, which aims to provide a more streamlined approach to insurance credentialing. What is the goal for the Council for Affordable Quality Healthcare in providing the service at no charge?

Crowley: The CAQH is a professional nonprofit organization that has been in the health care field arena for a long time. The medical field has used it in the credentialing process, and its tools work to help streamline that process. Every dentist, whether by their state licensing agency or dental third-party payer programs that they might be involved in, is expected to credential himself or herself—sometimes as often as every three months.

The CAQH provides a pathway to put your credentials in and be updated on a regular basis so that your credentials are on a one-document item. When third-party payers come and say, “Doctor, we need your credentials,” we’re going out to the third-party payers and to the people who need the credentialing and asking them both: “Is this a tool you can use?” The third-party payers are paying, so there are no costs to the member dentists or to any dentist who wants to sign up. And the third-party payers streamline their business because they don’t have to chase members.

Dentaltown: That sounds great! One of the items proposed at this year’s ADA House of Delegates was to create a new agency called the National Commission on Recognition for Dental Specialties and Certifying Boards. Did this pass?

Crowley: It did—in fact, Resolution 30 is officially formed as an entity. The current nine recognized specialties will each have a position, and now there will also be nine general dentist positions on this board. They’ll be the final say in whether a specialty that applies to become a recognized specialty does or does not meet the requirements to receive recognition as such.

Dentaltown: In your address to the House of Delegates at the meeting, you encouraged ADA members to work together with stakeholders such as dental schools, specialty groups, medical schools and DSOs. With respect to the DSOs, how do you think the growth of that practice segment has influenced the profession?

Crowley: It’s an interesting phrase the way you say it, because in the best of all cases it shouldn’t influence the profession and who we are. The model of delivery of care is all over the place, and the rise of DSOs and dental service organizations makes a lot of sense. You interview people and they’re saying, “You know what? I love being a dentist, but I don’t want to do the business part of it anymore,” so there was a natural place for this to fall. There’s some conversation around the fact that the student debt that’s coming out now, with the young people coming out with so much debt, plays a little bit of a role in practice decisions on where they will go.

That’s why in my address I said, “Come on, everybody, this is part of the game. Let’s make it the best game we can, because our ultimate goal is to be able to deliver dentistry to people where they want to go.” My dream would be that a patient has a dentist they trust and want to be around, and a pathway that they can get the care they need, and the delivery model really should not influence that.

Dentaltown: Let’s touch on the ADA and its relationship to schools and students. How do you see the evolution of who the dental students are and what they’re choosing to do after they graduate?

Crowley: We understand that the lifeblood of our profession is there—and, selfishly, the lifeblood of the American Dental Association is there, too, because we want to be a profession that represents member dentists and dentistry to the highest level.

I like going in and talking to students, saying, “There is no doom and gloom in our profession; in fact, the future of it is brighter than ever before. The role you’ll play in a person’s life moving forward is going to be as big and as bright as it ever has been.” We’re not only disease eradication concerns, we’re also preventing it from the get-go.

There’s a new awareness of the importance of oral health. Now science is connecting the dots, and that’s the final five-star moment when all the science that’s being accomplished and the evidence-based dentistry is showing that we have methods to keep this disease from happening. I’m really excited about that.

Dentaltown: As the newly installed president of the ADA, are there any fun perks associated with the position?

Crowley: I’ll define the perk: I am on the front end of every single thing that’s happening in dentistry. That’s amazing! The science inside our place, the practice changes, the third-party issues, the DSO rising up as a place during the last part of my career and watching them work, and the women in dentistry today and how that changes maybe the look at what our profession is. I know already that at the end of 12 months, that’s what I’m going to miss.