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MASTERY CONFERENCE 2010
'The
Power of
Partnership'
Creating and Structuring a Highly
Effective Relationship with your Office Manager, Front
Desk or Executive Team
Annual Mastery
Conference
Ritz-Carlton - March 4-6,
2010
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MID-LEVEL DENTAL PROVIDERS AND
YOU
The train has left the station. The horse is out of the
barn. The soufflé cannot be put back in the oven. It's a
done deal. With access to dental care now being
pronounced a major public issue, dentistry will find
itself painted into a corner. The profession has little
power to stop the future from happening.
After years of neglect by the profession, having paid
only lip-service to the issue of access, focusing
primarily on practice growth through higher and more
expensive utilization, the public and the Federal and
State governments are declaring loudly that dental
access is a major public problem. The ADA and all
component dental societies are now scrambling to get
ahead of this curve. As a practicing dentist in private
practice, you need to get it - you can't stop it.
One outcome, which is already well in the works, is
the creation of midlevel dental providers capable of
doing simple extractions, fillings, sealants and giving
anesthetic. Resistance by private practice dentists will
be strong. The cries to "protect the integrity of the
profession" will be shouted. The "death and ruination
of all that is sacred" will be pleaded. Most private
practitioners will perceive it as a threat to their survival.
It won't matter. It's going to happen.
Already happening in Europe and now in full
expression in Minnesota, with the new health care
legislation in Congress, the midlevel dental provider is
a "time that's come." You have a choice. You can get
ahead of this curve or end up behind it. It's up to you.
Some will see this new expression as an
entrepreneurial opportunity. I am beginning to work
with a few select clients to carve out opportunities
using this force of change. As my Native American
buddy, Robert Mirabal, always tells me, "Ride the
horse in the direction it is going." I see huge
opportunities for dentists who know how to own,
manage and lead a business and not just make
money bending over the chair.
In order for these entrepreneurial dentists to win in
this new future, they'll need to think about practice and
practice management in a different way. They'll need
to transform themselves as owners and visionary
leaders. They'll need to become much more
community and socially committed to make this work;
larger organizational structures, much more effective
management, more personnel, greater efficiencies.
For those dentists who have become accustomed to
top tier fee-for-service only, high utilization, high-end of
the market, they'll have to realize that their market will
drastically shrink, leading to fierce competition for far
fewer patients. For those entrepreneurial dentists who
decide to change, it will be challenging to rethink how
to deliver dentistry through others and make it work in
this different context.
The healthcare reform bill introduced on the floor of
the U.S. Senate proposes to extend dental care to
millions of currently uninsured children, to set up new
oral health surveillance programs and to train new
dental professionals. Included in this category
of "dental professionals" are midlevel dental providers
along with their respective pilot programs. The bill
also proposes to adjust and regulate many other
aspects of oral healthcare in the U.S. as well, but
these new regulations will be a topic for a future
eNewsletter.
Contained in the Senate's 2,000+ page bill are far
reaching provisions that require health insurance
plans to be offered in "public exchanges" to provide
dental insurance for children. These exchanges would
be government run. People would be eligible to
participate in the exchanges if they don't currently have
health insurance through an employer or public plan
such as Medicare. Employers with 50 or fewer
workers could participate. For most of you, your
patients are employed within these small businesses.
The shocker is the current Senate bill includes a
mandate that prohibits plans in these exchanges from
requiring co-payments or any other type of "cost
sharing" for preventive services. Children could get
services such as cleanings, exams, consultations,
fluoride treatments, and sealants without their
guardians having to pay anything above the
exchanges (government) premiums.
Multimillion dollar grants are being proposed for
midlevel dental health care providers demonstration
projects. Job titles they are considering as midlevel
providers include advance practice dental hygienists,
independent dental hygienists, supervised dental
hygienists, primary care physicians, dental therapists,
dental health aides, in addition to some additional
classifications. Midlevel providers would be assessed
for their wherewithal to increase access to dental
health care services in rural and underserved
communities.
As I understand it, one of the big players in this is the
CDC (U.S. Center for Disease Control and Prevention)
who is being asked to formulate a five-year oral
healthcare prevention campaign with an emphasis on
community water fluoridation and dental sealants. The
CDC would be the agency empowered to award
demonstration grants to research methods of
managing caries.
The current bill also includes provisions that place a
tax on high-cost health insurance packages which
would cause employers to strip the packages of their
dental benefits. Now for many dentists who depend on
3rd parties for part or all of their revenues, this could
spell real trouble.
Will the legislation pass? Who knows? Will the
changes proposed in dentistry occur? Absolutely!
These changes will happen and they will change the
face of dentistry. Resistance, confrontation, struggle,
will do little good. Did it do any good against HIPPA or
OSHA?
I am clear that those dentists who are willing to
change and who are willing to look beyond their past,
beyond their local needs and agenda can get in front
of this change and make it work as a powerful
business expression. But it will take a basic
transformation in how these dentists envision dental
practice, how they redefine the purpose of dental
practice and its mission, and stretch themselves to
develop a breakthrough business model where
midlevel providers fully participate.
The first step toward change is awareness. The
second step is acceptance.
-Nathaniel
Branden
Recommendation:
I suggest you send this eNewsletter to your
colleagues either copying and pasting to an e-mail or
using the 'forward' function below.
Dr. Marc B. Cooper
The Mastery Company
MasteryCompany.com
REFERENCES
COPYRIGHT WARNING: This is a public notice. Do
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Dr. Marc Cooper's and The Mastery Company's
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or extensive paraphrasing of an article is fine if
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is illegal. Please show the same courtesy to Dr.
Cooper as you would expect for your own
work.
Dr. Marc B. Cooper
President and CEO
The Mastery Company
Mr. Chris Creamer
President
Sahalie Press
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