Professional Courtesy: Advocate or Abdicate by Dr. Thomas Giacobbi

Dentaltown Magazine

How a recent debate between dental schools is a good reminder for practicing docs to make decisions before the decisions are made for them

by Thomas Giacobbi, DDS, FAGD, editorial director, Dentaltown magazine

Dental debates

I recently had the honor of participating as a guest judge in a debate between students from two local dental schools, A.T. Still University–Arizona School of Dentistry and Oral Health, and Midwestern University–College of Dental Medicine Arizona.

The event, “Pontics & Politics,” was hosted by the American Student Dental Association chapters at the two schools. A few other dental schools host similar events, but this is a concept that would benefit all dental schools—and, by extension, the future population of dentists.

Each school was assigned one side of two different debate topics. Each school’s two-person team argued its case in an organized debate format. To determine the winners, we evaluated the teams on the merits of their presentations, data and persuasiveness. The audience, made up of students from both schools, contributed a powerful energy to the competition. After all, school spirit and bragging rights were on the line!

The two topics were not only timely but also proved to be interesting fodder for debate. While your initial thoughts might lean to one clear side, the teams presented convincing arguments for both points of view. It served as a good reminder that as doctors already seeing patients on a daily basis, we should have a good understanding of the popular and controversial topics within dentistry, and have an idea of where our opinion lands on each.

In-office immunizations

The first debate attempted to answer the following question: Should dentists be allowed to provide immunizations to patients in their office?

I initially thought the answer should be yes, because I’ve spent plenty of time at the local Costco pharmacy waiting to receive my flu shot each year. The process seems simple enough: Fill out a short form and get a flu shot. On the other hand, I did not consider the fact that the pharmacy already has an established connection to my medical insurance, which reimburses it for the service, and the vast majority of immunizations are given to children under the age of 18.

Also, the various serums require special handling and storage, and there can be necessary education before receiving an immunization. All of this activity would take us away from providing dentistry—something already in short supply at times. This side of the argument gave a sense of the obstacles that prevent this from becoming a simple “yes” to dentist-administered immunizations.

Do-it-yourself orthodontics

Is DIY orthodontics good for our patients? The second debate focused on the elephant in the room that cannot be written in print for fear of litigation! However, the organizers made it clear this was a debate not about a single company but, rather, an evolving trend. There are many other companies coming into this space and they do not all share the same level of DIY-ness as you might think.

The opposing side made a great case for focusing on the companies that are doing things a bit differently than the one that first comes to mind. Some have more direct dentist involvement and examination, rather than having patients completing a self-report of their current state of dental health.

Others are collecting the initial scans or impressions, in lieu of patients receiving a box of goo in the mail. The bottom line is the desire for patients to receive limited treatment at a steep discount. Is it our place to deny them that option? Many people perform elaborate skin regimens without the supervision of a dermatologist. Some people get Botox injections at the hands of someone who took a short course without the involvement of a plastic surgeon.

Food for thought

We have the best interests of our patients at the forefront of these debates, but the fact remains that these discussions ultimately turn to the less moral topic of productivity and profit. Dentists must advocate for their patients who don’t always know what’s best, and likewise, dentists must advocate for the integrity of their profession. Having students lead these discussions was an important step to preparing them for life beyond the walls of dental school. They must understand that beyond the mountain of student debt are some very real issues that will require action and advocacy. As practicing dentists, we need to be ready to debate these topics—and many more—to know where we stand for the sake of our patients.

I sincerely hope more dental schools and practicing dentists will take the time to discuss, debate and take action on the important issues facing our profession.

Check it out!

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