Taking Care Where It Is Needed

Taking Care Where It Is Needed

Edward J. Vigna, D.D.S.*:

I trust everyone had a nice summer, and hopefully by now the flood waters are starting to recede. This has been a most difficult situation for so many throughout the 10th District.

The season is fast approaching…the football season (we Nebraska Cornhuskers are looking forward to our entry into the Big 10!). We look forward to our visit to Minnesota, and may the best team win! It should be the Huskers, but that is all I’ll say on that matter – no bold prediction, as that is how you get in trouble.

The “dental season” is also fast approaching. We will have many state meetings, the 10th District caucus in Sioux Falls, and of course the ADA Annual Session in Las Vegas October 10-13. In previous articles this spring and summer, I have mentioned the budget and dues increase. We voted to transmit Board Report 2 (the 2012 ADA Budget) to the HOD, knowing that it is not perfect and that other factors will still come into play prior to the House. We have confidence, however, that the HOD will exercise its wisdom in identifying its priorities and making prudent decisions for using the resources that are available to us.

Financial issues, in my mind, will be the critical matters facing the ADA House of Delegates; more than just a

2012 budget and a relatively small dues increase, the broader concern is the future financial health and stability of the ADA. While the ADA is certainly financially sound, a “perfect storm” is brewing: low interest rates affecting our reserves), a corresponding drop in grants and sponsorships, our defined benefit pension plan along with a new pension funding law (2006), the longstanding financial downturn affecting the number of dues-paying members, and a host of other influences. It is paramount that we act in a fiscally responsible way. Many would say let’s wait and see what happens and deal with the issues then. I feel this is very short-sighted.

Studying and looking into the possibilities for fiscal change does not spell crisis. We must remember the perfect storm is brewing, and be prepared!

For the past two years, two members of the House of Delegates have been appointed to serve on the Budget and Finance Committee, two on the Audit Committee, and two on the Pension Committee. Their participation has been very valuable to the success and work of the committees, and the Board modified its rules at this meeting to make the HOD members’ participation on the Audit and Pension Committees permanent. (Similar action was taken in August 2010 regarding the Budget and Finance Committee.) This is a good move which I strongly support.

Another area of concern related to finances is membership. As we continue to lose market share (i.e., as percentage of membership decreases) we must understand what is happening within the demographics of dentists in this country. At our August board meeting, we spent an entire morning discussing membership issues. The strength of the ADA is critical to ensure that we remain relevant to the greatest number of fellow dentists. We are being attacked on many fronts by other organizations and agencies who see delivery of care differently from ADA members. A panel of dentists (members and non-members) including Ruchi Sahota, Cesar Sabates, April Hearns, and Gordon Christensen made presentations and shared their insights on membership from their perspective. This discussion was very valuable in helping the Board recognize areas where we need to improve to meet our members’ expectations. It also provided some measure of comfort, since some of the initiatives that are currently being rolled out by the ADA are right on target.

According to Dr. Christensen, the number one concern that dentists would like to see the ADA address is that of third party involvement. We have worked behind the scenes with ADA Legal, Dental Practice, and Governmental Affairs to make progress in this area. Now that the great distraction of the debt ceiling is out of

the way in Washington, we have been assured by our Washington office that they will make every effort to push for ERISA reform and passage of the bill repealing the McCarran Ferguson Act. This will go a long way toward resolving some of our third party issues. The Legal Division and the Division of Dental Practice are also committed to doing everything possible to ensure that dentists (in consultation with their patients) are the ones dictating appropriate treatment, not third party or governmental bureaucrats. Although dealing with third party issues is difficult and multi-faceted, we recognize its importance and are working to accomplish positive results in this area.

Issues of diversity in our dental community also surfaced during our panel discussion. We spent another morning of discussion regarding the need to reach out to all subgroups in dentistry, making them feel welcome and needed under the umbrella of the ADA. We think that the ADA is taking very positive steps in this arena, but we realize that the “rubber meets the road” in each local area. Therefore, we encourage each of you put your arm around those of a different generation, race, religion, or gender to make them feel welcome among us.

The second paper in the “Barriers to Care” Repairing our Tattered Safety Net is out and available on ada.org. If you have not seen it, take a look, as it is another very good publication.

Last but by no means least is the decision by the Commission on Dental Accreditation to establish standards for Dental Therapy Education programs. At its August 5, 2011 meeting, the Commission on Dental Accreditation (CODA) granted a request from the University of Minnesota School of Dentistry to establish accreditation standards for dental therapy education programs.

It is important to note that CODA is not evaluating any existing dental therapy program. Rather, the chair of the Commission, Dr. Donald Joondeph, will appoint a Task Force to develop new standards for dental therapy education programs. The Task Force must report to the Commission on its progress at the August 10, 2012 Commission meeting.

The Commission is committed to an open and transparent dialogue as the dental therapy standards are developed. The process of developing standards will take two years, at a minimum. The communities of interest will be able to review and comment on the draft standards, through written comment at any time during the process, or at open hearings. Dental therapy education programs are not eligible for accreditation by the Commission until the standards are finalized and implemented.

In reaching the decision to grant the request, the Commission carefully considered the University of Minnesota’s documentation and evidence for each criterion under the Commission’s “Policy on Eligibility of New Allied Dental Programs for Accreditation by the Commission on Dental Accreditation”. During the discussion of the request, the following additional points were made:

• The establishment of standards for dental therapy education is reflective of the Commission’s mission, which is to serve the public by establishing, maintaining, and applying standards regarding the quality and continuous improvement of dental and dental related education.

• The Commission is the only entity that has expertise in accreditation of dental education programs and can set standards on a national basis. There is the potential for fragmentation of the accreditation process if the state dental boards or other accrediting agencies accredit programs.

• Patient welfare and patient care could be adversely affected if there are no educational standards for dental therapy. The Commission has the ability and the obligation to set educational standards to help ensure patient safety.

As always, please feel free to contact me with any questions, concerns, or comments at vignae@ada.org or (402) 770-7070. Have a great fall season, and I hope to see many of you in Las Vegas in October.


*Dr. Vigna is the Trustee to the Tenth District of the American Dental Association, representing Iowa, Minnesota, Nebraska, North Dakota, and South Dakota