First Steps

In the late 1970s, a group of recovering Minnesota dentists formed one of the first dentist support groups in the country, Dentists Concerned for Dentists (DCD). DCD is still in existence today, dealing primarily with alcohol and drug addiction. This group not only functions as a support group and resource, but also serves to provide interventions for dentists in need of help.

DCD is mainly comprised of trained volunteer dentists who supply information and resources for people in the dental community. These volunteers receive phone calls from friends and families of addicted dentists or even dentists themselves who are having problems. DCD gathers the information and then decides what level of help and support is needed. Oftentimes DCD will conduct an intervention, which helps the person gain access to treatment and recovery.

As one of the first programs in the country, DCD served as a model for other states to follow. The primary goal of DCD is to assist dentists in getting help and to continue to maintain their practice of dentistry without receiving sanctions from the State Board of Dentistry (BOD).

Legal History and Ramifications

In 1994, the state legislature mandated that a monitoring program be formed to allow health care professionals to get help without being reported to their state regulatory boards. The Health Professional Services Program (HPSP) was then estalished. HPSP serves not only dentists, physicians, and nurses, but chiropractors, veterinarians, emergency medical technicians, nursing home workers, psychologists, and individuals governed by any other state licensing board that regulates health care providers.

The funding for HPSP is provided by the various state licensing boards. The Minnesota State Board of Dentistry pays for the services provided to licensed dentists, registered hygienists, and dental assistants.

It has always been felt that health care providers would not seek help and care for their problems because they feared repercussions from their Boards. HPSP allows providers to get help and be monitored for a period of time after treatment. If the individuals successfully follow recommendations, they would not be reported to the board; thus their condition would remain confidential and they would not have to face sanctions on their state licenses.

HPSP conducts intake evaluations, refers for appropriate care, and then follows individuals for anywhere from one to three years as a part of their monitoring process. People are not only seen for alcohol and chemical abuse but for any physically or mentally debilitating condition. The monitoring program generally has worksite monitoring such as a co-worker or a psychologist who sees the person on a regular basis and then provides quarterly reports to the HPSP. Individuals may also be subject to random drug screenings, which are also a significant part of the monitoring process. If the person continues to do well in recovery and has completed the progam, his or her monitoring is discontinued. If the person fails to follow monitoring requirements, he or she then can be reported to the appropriate board. People either self-report to HPSP or they can be referred from another individual.

Mandatory Reporting

In early 2002, the State Board of Dentistry changed the Dental Practice Act to require mandatory reporting of impaired practitioners. This change correlated more to the language that was included in most other health care Provider Acts. What this meant was that if any licensed or registered dental professionals were aware of another licensed or registered professional practicing while impaired either physically, mentally, or chemically, they are required by the Dental Practice Act to report this person to the Board of Dentistry or they could face sanctions against their own licenses. This was brought about to provide leverage and consequences for people who were violating the Dental Practice Act.

It is not uncommon to know of other practitioners who have problems with drugs and alcohol but fail to act because we don’t want to get involved or be the person to have to come down on a friend or colleague. This change in the Dental Practice Act gave the practitioners no choice:

They had to act or they would face sanctions on their own licenses.

It was written into this law that reporting to the HPSP would fulfill the requirements for mandatory reporting to the BOD. Since the inception of the Mandatory Reporting Act, dentistry’s participation in the HPSP has dramatically increased.

Available Resources for Help

Although DCD deals mostly with drug and alcohol problems, there have also been numerous calls on other issues facing dentists. Among them can be depression, family issues, stress management, financial problems, divorce, and suicide, to name just a few. While DCD had been handling and referring these calls, it became apparent that many of these calls required more immediate response from better qualified professionals.

At about this time, the American Dental Association was recommending that the Minnesota Dental Association create more comprehensive programs for the wellness of its dental community. Four years ago, the MDA formed the Minnesota Dentists Wellness Program and contracted with The Sand Creek Group, which is a nationally known assistance program headquartered in Stillwater, Minnesota. Sand Creek provides 24-hour crisis phone answering and also serves as a referral contact for dentists and their immediate family members. Help is paid for by the MDA.

Sand Creek responds to a lot of the critical issues outside of drug and alcohol problems that are happening in dentistry. Sand Creek also takes calls for drug and alcohol and will refer them to DCD or, in the case of multiple diagnoses, they will coordinate health care for these individuals.

Summary

As you see, the MDA and HPSP provide a wide variety of services and help for dentists. People needing to contact HPSP can call (651) 643-2120. If you have any questions, please call the MDA office at (651) 646-7454 for help or referral.

*Dr. Cannon is a general dentist in private practice in Saint Paul, Minnesota. He is a member of both Dentists Concerned for Dentists and the Wellness Subcommittee of the Minnesota Dental Association Membership Committee.

**"When the Walls Come Tumbling Down: A Pathway to Addiction", Northwest Dentistry, November-December 2005, and January-February 2006.