Midlevel Practitioners – Are They Needed in Dentistry? by Gordon J. Christensen DDS, MSD, PhD


Midlevel Practitioners – Are They Needed in Dentistry?

A letter expressing candid opinions on the now in vogue concept among politicians
by Gordon J. Christensen DDS, MSD, PhD

To view and discuss this issue online, please visit www.dentaltown.com/midlevel.

As a long-time educator, practitioner and researcher, I have watched opinions vary as history has repeated itself for over the last half century. At this time, we are in yet another movement to satisfy the “access to care” challenge by saturating the dental manpower marketplace. Several factors are evident currently that relate to this movement:

There is no question that auxiliary dental staff persons can accomplish some oral preventive and treatment procedures. I am well known to be a proponent of dentist supervised staff persons accomplishing many clinical tasks.

However, does dentistry need another category of practitioner? In my considered strong opinion – definitely not!

As I provide courses around the country – 80 programs in 2012 – I see thousands of dentists in major financial distress. There are dentist bankruptcies in almost all cities. Although the recession appears to be slightly recovering, dentists’ financial challenges are still present. Many specialists have nothing to do, since GPs are not busy and are accomplishing specialty procedures. There is no dental manpower demand, and there will be none in the foreseeable future. Many dentists are unemployed.

New dental schools are opening across the country. Most of them are not in conventional research and service- based universities. These schools are further saturating the dental marketplace with dentists. Numerous other dental schools are in the planning stages.

New dentists have school debts that average about $250,000 to $300,000. They are financially stressed and forced to do anything to survive.

Many new dental hygiene schools have opened in recent years. In numerous geographic locations, dental hygienists cannot find employment. The misguided plan that saturating the market with dentists, midlevel practitioners, dental hygienists and others will satisfy the access to care problem has been disproven numerous times in recent history and in other countries. Practitioners of any type choose the place they prefer to practice, and market saturation has not improved access to care in those locations where others have tried it.

A few months ago, I made a survey of the profession relative to the challenges “real-world” practitioners see, and I provided that survey to the ADA Board of Trustees. The survey supports my points.

It is time for those who actually deliver oral health care and see the challenges on a daily basis to speak up! Currently, midlevel practitioners are not needed and have not in the past and will not in the future satisfy the access to care problem.

Author's Bio
Dr. Gordon J. Christensen is CEO of Clinicians Report, and founder and director of Practical Clinical Courses (PCC) in Utah. This group is an international continuing education organization providing courses and videos for all dental professionals. He is also co-founder of the nonprofit Gordon J. Christensen Clinicians Report (previously CRA), as well as an adjunct professor for Brigham Young University and University of Utah. He is a diplomate with the American Board of Prosthodontics. Dr. Christensen has presented more than 45,000 hours of continuing education throughout the world and has published many articles and books. Further information is available at www.pccdental.com.

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