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SELF-GOVERNANCE AND PUBLIC SAFETY
L E T T E R S
LETTERS
J
ADA welcomes letters from readers on articles that have appeared in The Journal. The Journal reserves the right to edit all communications and requires that all letters be signed. Letters must be no more than 550 words and must cite no more than five references. No illustrations will be accepted. A letter concerning a recent JADA article will have the best chance of acceptance if it is received within two months of the article’s publication. For instance, a letter about an article that appeared in April JADA usually will be considered for acceptance only until the end of June. You may submit your letter via e-mail to “jadaletters@ ada.org”; by fax to 1-312-440-3538; or by mail to 211 E. Chicago Ave., Chicago, Ill. 60611-2678. By sending a letter to the editor, the author acknowledges and agrees that the letter and all rights of the author in the letter sent become the property of The Journal. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated. SELF-GOVERNANCE AND PUBLIC SAFETY
Dr. Daniel Orr’s August JADA guest editorial, “Cottages No More” (JADA 2009;140[8]: 960-964), is a perceptive and prescient view of the current environment of regulatory safety issues in office-based health care. The state regulations discussed by Dr. Orr are a response by legislative bodies to real and perceived health threats to the constituency. The safety of citizens is a reasonable and appropriate concern of local legislatures. It is also the concern of individual dentists and
the profession of dentistry, which has a long history of making patient well-being the focus of its work, with water fluoridation being a major public health advancement in the 20th century. The mission of the American Dental Society of Anesthesiology (ADSA) is continuing education for all dentists interested in pain control and anesthesia. The ultimate goal of this education is improved patient safety. We strongly support the professional right and responsibility to self governance addressed by Dr. Orr, with patient well-being the intended outcome of this oversight. The suggestion by Dr. Orr of a facility evaluation by dentists for dentists to maintain infection control and patient anesthesia safety standards is an interesting one. The ADA Foundation (ADAF) is facilitating development of a patient emergency rescue course with an emphasis on airway management. The ADSA Anesthesia Research Foundation was privileged to receive the ADAF grant to develop this course. This course, developed by dentists for dentists, could be the foundation of a simulated patient rescue experience as a national facility evaluation for patient safety is considered. [Editor’s note: Plans also are under way for the ADA to offer this course in 2010.] Thanks to Dr. Orr for bringing this issue of self-governance, with the ultimate outcome of improved patient safety, to our attention. Karen E. Crowley, DDS President American Dental Society of Anesthesiology Chicago
JADA, Vol. 140
REGULATING DENTAL PRACTICE
A better title for Dr. Daniel Orr’s August JADA guest editorial, “Cottages No More” (JADA 2009;140[8]:960-964), should have been “Dental Capitalism No More.” Dr. Orr is advocating increased regulation of dental practices. It seems Dr. Orr cannot appreciate the remote possibility that some dentists are managing their own practices quite nicely. His bad idea, ripped from the overregulated medical industry, is to give dentists antifree-market, antipatientoriented medical service. Yes, let’s increase the cost of treatment to solve some kind of problem that may or may not be there. With Dr. Orr’s proposal, the cost of dental care will go up more than even he predicts. There are more negative legal and business consequences than he knows. The quest for regulatory perfection is the search for the Holy Grail. There will be even more regulatory laws to follow. There will be less competition, lower incomes for dentists and less choice of dentists for the consumer. There will be more force and threat of force by the state. Higher taxes, less productivity and lower standards of living for all will be the result. Dentists will become more guarded in their decisions. Risk-taking, ingenuity and the entrepreneurial spirit will be reduced. Dr. Orr is using fear to motivate organized dentistry to make bad decisions. Thus, let’s hurry up and make some bad laws now to make dentistry less competitive and more expensive to prevent some strange, upuntil-now-unknown group from
http://jada.ada.org
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
December 2009
1465
LETTERS
J
ADA welcomes letters from readers on articles that have appeared in The Journal. The Journal reserves the right to edit all communications and requires that all letters be signed. Letters must be no more than 550 words and must cite no more than five references. No illustrations will be accepted. A letter concerning a recent JADA article will have the best chance of acceptance if it is received within two months of the article’s publication. For instance, a letter about an article that appeared in April JADA usually will be considered for acceptance only until the end of June. You may submit your letter via e-mail to “jadaletters@ ada.org”; by fax to 1-312-440-3538; or by mail to 211 E. Chicago Ave., Chicago, Ill. 60611-2678. By sending a letter to the editor, the author acknowledges and agrees that the letter and all rights of the author in the letter sent become the property of The Journal. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated. SELF-GOVERNANCE AND PUBLIC SAFETY
Dr. Daniel Orr’s August JADA guest editorial, “Cottages No More” (JADA 2009;140[8]: 960-964), is a perceptive and prescient view of the current environment of regulatory safety issues in office-based health care. The state regulations discussed by Dr. Orr are a response by legislative bodies to real and perceived health threats to the constituency. The safety of citizens is a reasonable and appropriate concern of local legislatures. It is also the concern of individual dentists and
the profession of dentistry, which has a long history of making patient well-being the focus of its work, with water fluoridation being a major public health advancement in the 20th century. The mission of the American Dental Society of Anesthesiology (ADSA) is continuing education for all dentists interested in pain control and anesthesia. The ultimate goal of this education is improved patient safety. We strongly support the professional right and responsibility to self governance addressed by Dr. Orr, with patient well-being the intended outcome of this oversight. The suggestion by Dr. Orr of a facility evaluation by dentists for dentists to maintain infection control and patient anesthesia safety standards is an interesting one. The ADA Foundation (ADAF) is facilitating development of a patient emergency rescue course with an emphasis on airway management. The ADSA Anesthesia Research Foundation was privileged to receive the ADAF grant to develop this course. This course, developed by dentists for dentists, could be the foundation of a simulated patient rescue experience as a national facility evaluation for patient safety is considered. [Editor’s note: Plans also are under way for the ADA to offer this course in 2010.] Thanks to Dr. Orr for bringing this issue of self-governance, with the ultimate outcome of improved patient safety, to our attention. Karen E. Crowley, DDS President American Dental Society of Anesthesiology Chicago
JADA, Vol. 140
REGULATING DENTAL PRACTICE
A better title for Dr. Daniel Orr’s August JADA guest editorial, “Cottages No More” (JADA 2009;140[8]:960-964), should have been “Dental Capitalism No More.” Dr. Orr is advocating increased regulation of dental practices. It seems Dr. Orr cannot appreciate the remote possibility that some dentists are managing their own practices quite nicely. His bad idea, ripped from the overregulated medical industry, is to give dentists antifree-market, antipatientoriented medical service. Yes, let’s increase the cost of treatment to solve some kind of problem that may or may not be there. With Dr. Orr’s proposal, the cost of dental care will go up more than even he predicts. There are more negative legal and business consequences than he knows. The quest for regulatory perfection is the search for the Holy Grail. There will be even more regulatory laws to follow. There will be less competition, lower incomes for dentists and less choice of dentists for the consumer. There will be more force and threat of force by the state. Higher taxes, less productivity and lower standards of living for all will be the result. Dentists will become more guarded in their decisions. Risk-taking, ingenuity and the entrepreneurial spirit will be reduced. Dr. Orr is using fear to motivate organized dentistry to make bad decisions. Thus, let’s hurry up and make some bad laws now to make dentistry less competitive and more expensive to prevent some strange, upuntil-now-unknown group from
http://jada.ada.org
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
December 2009
1465