Are midlevel providers the right answer?

Sept. 1, 2012
Dentists have a choice in this dental provider/access to care “crisis,” and we need to create a solid solution ourselves or the government will provide one for us.

By Bill Blatchford, DDS

Dentists have a choice in this dental provider/access to care “crisis,” and we need to create a solid solution ourselves or the government will provide one for us. Right now the choice is ours, and it is important to the future of free-enterprise dentistry.

The media is on a path to prove that America has a dental manpower shortage, shouting about the crisis in dentistry for the poor and underserved. The media’s answer to this inequity is to create a new category of midlevel providers to work in underserved and poor areas. They site two states where midlevel providers now serve — Alaska, where they are only on federal lands that are First Nation areas, and Minnesota, where providers work under the supervision of dentists.

No doubt there are small towns in America where there is no regular dental care. Vans visit schools for prevention, but finding a clinic with a dedicated dentist to complete the diagnosed dental work is a challenge.

Many dentists volunteer regularly, either in their own practices or in local clinics. Yet, there are parts of America that have no access to dental care, especially for children. Unless dentists take action with our own solution, an unsatisfactory “solution” will be thrust upon us.

We as dentists, privileged members of an exclusive club, need to increase our existing volunteer dental activities and take on the challenge of caring for those who are not receiving it, particularly the poor and children. We must let people know about existing care so they can avoid going to the emergency room.

The interesting fallacy in training midlevel providers to serve in areas of need is that this has been tried before, and it failed. The federal government (your check is in the mail) mandated dental schools to double their class size in the 1960s. There would be federal funds to enlarge facilities, acquire more equipment, and pay for more professors. The idea was more dentists would practice in the areas where the dental need is great.

The result is what you would expect. There are many more dentists in urban areas around dental schools where income is higher, and many spouses are professionals who can find employment more easily in a large city. The hinterlands are still underserved.

The proposed midlevel provider would also be an entrepreneur who needs to cover overhead, and might find an urban environment to be a more successful place for a business than the counties where there are no dentists. Training another layer does not answer the concern.

We have an opportunity to take action through dental societies or individually. We can strive to create more volunteer days in our offices, and publicize them online and in the media. Do people know of your avenue to care? Does your community know how much dentistry you do on a volunteer basis?

Perhaps we are shouting under a false assumption of need. Even people who have insurance do not use it fully. There is agitation for midlevel providers. Do we really believe this will be the answer and that they will indeed practice in underserved areas?

What can you do? Become involved. Contact your congresspersons on the national, state, and local levels. Share how you are involved and what actions you feel would provide solutions for your area.

Bill Blatchford, DDS, America’s premier dental business coach, has produced a new comprehensive business course called Blatchford in a Box – the Classic. Requiring no travel and no contact, Dr. Blatchford is offering his coaching lessons on leadership, profitability, bonus, strong systems, an accountable team, marketing, and sales. See Amazing results can be yours for $1,595. Dr. Blatchford is also author of two books, “Playing Your ‘A’ Game” and “Blatchford BLUEPRINTS.” Contact him at [email protected] and

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