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85,000 New orthodontists
VIEWPOINT
85,000
New orthodontists*
Larry W. White, D.D.S., M.S.D Hobbs, NM.
W
hen the Federal Trade Commission, with Congress’ tacit approval, decided that professions were equivalent to trades and were subject to FTC regulation, radical changes ensued and they are still occurring. Among other things, the FTC negated the concept of ethics that had developed over the centuries in the healing arts and suddenly declared it to be little more than an enforced restraint of trade. The FK struck down the professions’ abilities to govern the ethical conduct of their members and purposely encouraged dentists, physicians, and attorneys to advertise their services and fees. The FTC justified this decision in the naive hope that increased competition and aggressiveness by professionals would result in lower health costs for the public. The FTC also has the responsibility for protecting the public from false and misleading advertising, but there is certainly no evidence they have discharged this duty in regard to professional advertising. Obviously, they don’t have enough employees to do this, so professionals have been able to make extravagant, and in some cases, dangerous claims that remain unchallenged by the FTC. We now know lower health costs did not result from the FTC decision, but there have been other, less happy, consequences. In dentistry the most notable result has been a fragmentation of the profession that isn’t likely to heal quickly. It may be only a coincidence rather than a cause, but the FTC intervention into professional life has paralleled the dental disquiet that is plaguing our house. Aggressive, and usually younger, dentists with little historical perspective have estranged older, more traditional minded dentists with their use of advertising to build and enlarge their practices. General dentists and dental specialists find themselves at cross purposes with general dentists exercising their legal right to perform procedures previously thought to be the exclusive province of the specialist.
*Reprinted with permission Newletter. 1987(July):23.
from Rocky
Mountain
Society
of Orthodontists
Unfortunately, this internecine warfare has distracted dentists from seeing a larger and potentially even more damaging threat than the original FTC decision. Dental perogatives are now being assumed by non dentists. Several states have passed denturists bills allowing non dentists the legal right to make full and partial dentures. Dental hygienists have recently advocated dental hygiene practices independent of dentists, and they have had some notable legislative successes in altering state dental practice acts. Dental hygienists seem militant about this issue and their resolve is strong, so I don’t expect this topic to diminish or disappear on its own. Orthodontists don’t make prosthetic devices and few of them employ hygienists, so they haven’t had much collective interest in joining these political questions. But this may be a colossal case of myopia. Orthodontists can’t possibly prosper and orthodontic patients can’t benefit from a professional retreat from previously high standards of patient care. It is obvious to anyone who thinks about itindependent dental hygienists will not be able to sustain themselves by performing dental prophylaxis and dental sealants. High dental office overhead combined with low income procedures will guarantee an economic struggle for independent hygienists. Obviously some enterprising dentists already understand this and have started giving weekend courses for dental hygienists on interceptive orthodontic procedures. I believe independent hygienists will make these services available to their patients where they are legally empowered to do so. Believe me, dental hygienists will not be any happier restricting their practices than dentists have been. It is only natural for them to expand their services. Dental hygienists aren’t likely to pick up an air turbine and do a crown preparation, but I don’t think they will hesitate in the least to take an impression and send it to an orthodontic laboratory to have a guidance appliance made. Whether dental patients will benefit from these ministrations has yet to be determined. But, lately, this seems to be of secondary importance to state legislators. They are more interested in lowering health costs for their constituents than ensuring high quality care. For 169
170
Am. J. Orthod.
White
some strange reason they, like the FTC, believe high quality health care will just naturally occur. Orthodontists might be well advised to become more than sideline participants in this game, because
BOUND
VOLUMES
AVAILABLE
Dent&c. Orthop. February 1988
85,000 new vendors for orthodontic services could alter orthodontics in a way we may not like. Larry White, Editor Rocky Mountain Society of Orthodontists Newsletter
TO SUBSCRIBERS
Bound volumes of the AMERICAN JOURNAL OF ORTHODONTICSAND DENTOFACIAL ORTHOPEDICSare available to subscribers (only) for the 1988 issues from the Publisher, at a cost of $42.00 ($52.00 international) for Vol. 93 (January-June) and Vol. 94 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact The C. V. Mosby Company, Circulation Department,’ 11830 Westline Industrial Drive, St. Louis, Missouri 63146, USA; phone’(800) 325-4177, ext. 351. Subscriptions must be in force to qualify. Bound volumes are not available in place of a regular Journal subscription.
85,000
New orthodontists*
Larry W. White, D.D.S., M.S.D Hobbs, NM.
W
hen the Federal Trade Commission, with Congress’ tacit approval, decided that professions were equivalent to trades and were subject to FTC regulation, radical changes ensued and they are still occurring. Among other things, the FTC negated the concept of ethics that had developed over the centuries in the healing arts and suddenly declared it to be little more than an enforced restraint of trade. The FK struck down the professions’ abilities to govern the ethical conduct of their members and purposely encouraged dentists, physicians, and attorneys to advertise their services and fees. The FTC justified this decision in the naive hope that increased competition and aggressiveness by professionals would result in lower health costs for the public. The FTC also has the responsibility for protecting the public from false and misleading advertising, but there is certainly no evidence they have discharged this duty in regard to professional advertising. Obviously, they don’t have enough employees to do this, so professionals have been able to make extravagant, and in some cases, dangerous claims that remain unchallenged by the FTC. We now know lower health costs did not result from the FTC decision, but there have been other, less happy, consequences. In dentistry the most notable result has been a fragmentation of the profession that isn’t likely to heal quickly. It may be only a coincidence rather than a cause, but the FTC intervention into professional life has paralleled the dental disquiet that is plaguing our house. Aggressive, and usually younger, dentists with little historical perspective have estranged older, more traditional minded dentists with their use of advertising to build and enlarge their practices. General dentists and dental specialists find themselves at cross purposes with general dentists exercising their legal right to perform procedures previously thought to be the exclusive province of the specialist.
*Reprinted with permission Newletter. 1987(July):23.
from Rocky
Mountain
Society
of Orthodontists
Unfortunately, this internecine warfare has distracted dentists from seeing a larger and potentially even more damaging threat than the original FTC decision. Dental perogatives are now being assumed by non dentists. Several states have passed denturists bills allowing non dentists the legal right to make full and partial dentures. Dental hygienists have recently advocated dental hygiene practices independent of dentists, and they have had some notable legislative successes in altering state dental practice acts. Dental hygienists seem militant about this issue and their resolve is strong, so I don’t expect this topic to diminish or disappear on its own. Orthodontists don’t make prosthetic devices and few of them employ hygienists, so they haven’t had much collective interest in joining these political questions. But this may be a colossal case of myopia. Orthodontists can’t possibly prosper and orthodontic patients can’t benefit from a professional retreat from previously high standards of patient care. It is obvious to anyone who thinks about itindependent dental hygienists will not be able to sustain themselves by performing dental prophylaxis and dental sealants. High dental office overhead combined with low income procedures will guarantee an economic struggle for independent hygienists. Obviously some enterprising dentists already understand this and have started giving weekend courses for dental hygienists on interceptive orthodontic procedures. I believe independent hygienists will make these services available to their patients where they are legally empowered to do so. Believe me, dental hygienists will not be any happier restricting their practices than dentists have been. It is only natural for them to expand their services. Dental hygienists aren’t likely to pick up an air turbine and do a crown preparation, but I don’t think they will hesitate in the least to take an impression and send it to an orthodontic laboratory to have a guidance appliance made. Whether dental patients will benefit from these ministrations has yet to be determined. But, lately, this seems to be of secondary importance to state legislators. They are more interested in lowering health costs for their constituents than ensuring high quality care. For 169
170
Am. J. Orthod.
White
some strange reason they, like the FTC, believe high quality health care will just naturally occur. Orthodontists might be well advised to become more than sideline participants in this game, because
BOUND
VOLUMES
AVAILABLE
Dent&c. Orthop. February 1988
85,000 new vendors for orthodontic services could alter orthodontics in a way we may not like. Larry White, Editor Rocky Mountain Society of Orthodontists Newsletter
TO SUBSCRIBERS
Bound volumes of the AMERICAN JOURNAL OF ORTHODONTICSAND DENTOFACIAL ORTHOPEDICSare available to subscribers (only) for the 1988 issues from the Publisher, at a cost of $42.00 ($52.00 international) for Vol. 93 (January-June) and Vol. 94 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact The C. V. Mosby Company, Circulation Department,’ 11830 Westline Industrial Drive, St. Louis, Missouri 63146, USA; phone’(800) 325-4177, ext. 351. Subscriptions must be in force to qualify. Bound volumes are not available in place of a regular Journal subscription.