Interprofessional Education, New Workforce Models, Corporate Relations with Dental Schools, New Dental Schools, Research Capacity, and EHR Incentives
Dr. Byrne and I recently attended the ADEA Annual Dean’s Conference and there are many things to share from the meeting. The theme of the meeting was Changing Relationships: Implications of Interprofessional Education, New Workforce Models, and the Changing Corporate Environment for Dental Schools.
Interprofessional Education
The keynote address was given by Dr. Carol Aschenbrener, Executive Vice President of the American Association of Medical Colleges (AAMC). The AAMC is the medical education counterpart to ADEA. She discussed the healthcare workforce issues in medicine, future demand for primary care, and what role other practitioners like nurse practitioners and dentists might play. One day of the program was dedicated to discussing examples of education and practice between dental students and nursing students and pharmacy students. As you might know, the Schools of Dentistry and Nursing are combined at NYU and within the dental school there is a primary care practice run by nurse practitioners.
New Workforce Models
One morning was for discussion of the new oral health professional models. What started in New Zealand many years ago as the Dental Health Aide Therapist (DHAT), has now recently become the most politically charged issue in organized dentistry. DHATs work under remote supervision of a dentist and can perform restorative and surgical procedures. There was an equal level of debate from all of us attending the meeting. The ADA has taken a strong stance by stating only a dentist should provide diagnosis, treatment planning, and delivery irreversible or surgical therapy. ADEA is trying to steer through this debate by taking the position that it can determine how to train a new type of worker but is not recommending any specific workforce model. The big unknown is whether any new workforce model will improve access to care and furthermore improve oral health indicators. Still the care must be paid for and new types of workers will not practice in areas where they cannot earn a living.
Corporate Relations with Dental Schools
The final session was about dental school-industry relationships. Most of the conversation indicated that the major group to be concerned was ADEA itself since industry supported the entire meeting. There was debate about ADEA developing “policy” about the relationship between the schools and industry. In general the deans felt it was a waste of ADEAs time because the relationships are usually set at the University level. Some from industry said that students were meeting with them off campus and asking for industry to give them money towards their “galas” etc. That was eye opening. Class officers “sell” access to their class.
New Dental Schools, Research Capacity, and EHR Incentives
One afternoon was a business meeting with just the deans. The three most important issues discussed were new dental schools, research capacity of dental schools, and electronic health record incentive payments from Medicaid. Since 2000, there have been six new schools open in Florida, Nevada, California, North Carolina and Arizona (2). Eastern Carolina University (ECU) accepted is first class this fall. Except for the school at the University of Nevada Las Vegas and ECU, all are associated with private universities that have nursing, pharmacy, and/or osteopathic medical schools. Most are claiming to have a “new community-based education model” and little, if any research mission. There are new schools either scheduled to open or under some degree of discussion in South Jordan Utah, in Downers Grove Illinois, in Bradenton Florida, at East Tennessee State University, in New Mexico, in Mississippi, in San Diego, at the University of Utah, in Portland Maine, and at Florida A&M University. I contributed information that the UVA at Wise has study money from the Virginia Tobacco Indemnity Commission and the Virginia Coalfield Economic Development Authority to investigate starting a dental school in Wise Virginia. Needless to say this information is rather stunning and some of the discussion revolved around whether these new schools could produce a scientific practitioner or highly trained technicians. There appeared to be some tension in the room between the deans from traditional schools and research dental schools and the deans from the new schools. The dean’s office staff have compiled a report on new dental schools if you want to learn more:
New Dental Schools Report Dec 2010
Dental schools have lost their competitiveness in research capacity. Currently 40% of extramural research funding from the National Institute of Dental and Craniofacial Research (NIDCR) goes to researchers not in a dental school. Before NIDCR became the NIDCR, it was the National Institute for Dental Research (NIDR) and most of NIDR funding went to dental school researchers. Many of the deans are concerned we have lost “dental” research. There will likely be a summit meeting on this topic at the next ADEA annual session. This discussion also raised some tension regarding the differences between dental schools that do research and those that do not. The implication was that no research impacts the education of students. Depending on the dean’s point of view, the impact was different.
The third hot issue was”How can dental schools qualify for Medicaid incentive payments for implementing and certified electronic health record?” The payments are substantial and as much as $63,750 per dentist if you meet certain standards related to treating Medicaid patients. As you might expect the rules are complicated, murky, and still evolving. We have actually been working on this at VCU but it is still unclear if we can receive payments. One problem all dental schools have is there are no currently certified dental electronic health records, including axiUm and at this point the software companies are not seeing any incentive for them to become certified.
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