Isolationism is a policy of remaining apart from the affairs or interests of other groups. That has been dentistry’s policy for the last one hundred years. Dentistry today has been practiced in a solitary, sequestered manner, with little oversight, quality assurance, or relationship to medicine. This isolationism is true for solo as well as group practices of every size.
Dentistry has been a world unto itself. But this is changing, and the velocity of change is accelerating rapidly.
Below is a recent article from the Journal of Family Medicine and Primary Care. Their report presents a clear picture of the future of dentistry: inevitably, dentistry will be integrated into primary care. It is a fait accompli: a done deal.
Nevertheless, as is the custom of dentistry, it will resist this seismic shift. Dentistry will only change under coercion from outside agencies rather than be responsible and do it from within. Dentistry will be forced to change, and this will occur only at the very last minute — costing millions of dollars more.
“Dentistry is neither an allied health profession nor a paramedical profession. It is the only anatomically focused health care profession that is university-based and for which primary care responsibility is maintained by profession. Dentists must have reliable knowledge of basic clinical medicine for safely and effectively treating individuals with chronic and other diseases, which make them biologically and pharmacologically compromised. With changes in the life expectancy of people and lifestyles, as well as rapid advancement in biomedical sciences, dentists should have similar knowledge like a physician in any other fields of medicine. There is number of primary care activities that can be conducted in the dental office like a screening of diabetics, managing hypertension, etc.; The present review was conducted after doing an extensive literature search of peer-reviewed journals. The review throws a spotlight on these activities and also suggests some the measures that can be adopted to modify dental education to turn dentists to oral physicians.”
— Primary Care in Dentistry: An Untapped Potential
There are increasing pressures emanating from the healthcare industry now coming to bear on dentistry. These pressures will push and shove dentistry directly into primary care. And dentists and their organizations are woefully unprepared for the impact this will have on their practices and their businesses.
Looking to the Future
However, there is a group of dentists and their companies that sees this future very clearly. They are designing their companies to include primary care. Some groups that we are working with today are hiring primary care physicians with hospital affiliations.
The healthcare landscape is becoming dotted with medical-dental expressions. Kaiser Permanente, with 160 dentists and 6,000 PPO members, has been a leader at the forefront of integrating dentistry into primary care.
Healthcare costs in this country are $3 trillion, and eat up 17.5 percent of the GDP. Costs are accelerating greater than the rate of inflation and the cost of living: this is unsustainable. Patients in dental offices can have diagnostic and health-status checks which would cost twice as much if done in a hospital or physicians office. Equally as important, these tests could be done more frequently if performed in a dentist’s office: Sixty-five percent of the population sees a dentist. The tyranny of the obvious.
Changes in Healthcare
Furthermore, as more information moves to the cloud and the Electronic Patient Record (EPR) becomes mandatory for dentistry, the pressure will increase for dentistry to integrate into primary care.
The rapidly expanding knowledge that oral inflammatory disease is directly linked to chronic diseases, along with the associated costs of managing these chronic diseases, adds to the pressure for dentistry to integrate with primary care.
These pressures will be intensified by government (state and federal), insurance companies, and patients themselves. It is not unimaginable that a dentist will soon need to note patients’ vital records.
Dentistry has lived in its own world for decades, an island unto itself. Dentistry has remained remote from the rest of medicine — until now. But all that will change. I suggest you begin with this inquiry: “How do I prepare myself and my practice(s) for the changes that will be occurring?”
As Mr. Dylan once said: “The times, they are a-changing.”
