Oral Health Practitioner Work Group Divided Over Level of Supervision
The Oral Health Practitioner (OHP) Work Group established by the 2008 legislature has met five times over a ten week period, most recently on October 8. Over the course of these five meetings, all ten issues identified by the legislature for the Work Group to address have been discussed but not resolved. The legislation establishing the Work Group presumes the existence of an oral health practitioner, but leaves the definition up to the Work Group and future action by the legislature.
While not yet resolved, the core issues of the Work Group have taken shape. Nothing is finalized yet, but opposing positions on some of the key issues have been established. Here is a description of competing positions on one key issue. Other issues will be laid out in subsequent issues of MDA News and Views.
Level of Supervision of an OHP
If a new member of the dental team is trained and allowed to provide a defined set of surgical procedures, what should the role of the dentist be?
- One approach, advocated for by the safety net clinics, the MNSCU higher education system, and the Minnesota Dental Hygienists' Association promotes an OHP who would work under the general supervision of a dentist using a "collaborative management agreement." Under this agreement the dentist would prescribe the OHP's practice parameters. These prescribed services would be required to fall within the official scope of practice authorized by the legislature and taught by the OHP educational program. The dentist would control which patients an OHP would provide services for, what procedures the OHP could provide to those patients, and what the OHP would do when a patient's needs exceed the Oral Health Practitioners scope of practice. According to this approach, the OHP would be allowed to work on patients outside the dentist's office and without a dentist having first provided an exam, diagnosis, or treatment plan. The OHP's license would allow them to diagnose a patient and treat them within their scope of practice and the allowances of the collaborative management agreement. The advocates of this approach feel this is the best way to address access to care for the underserved.
- The approach supported by the MDA Board of Trustees would require an exam, diagnosis, and treatment plan to be provided by a Minnesota licensed dentist prior to the OHP performing surgical procedures. In addition, an OHP would need to be supervised by a dentist who is onsite whenever the allowed surgical procedures are provided by the OHP. The Board believes this approach is critical to ensuring the safe delivery of quality care for patients in need.
More discussion of the supervisory relationship of a dentist with an OHP will certainly be occurring "at the table" over the next month and a half. For more information regarding the legislative workgroup, visit their website. You may also contact the MDA for more information.