From a purely philosophical and social perspective (and without getting into the financial implications), the thought of a dental school at East Carolina University is a noble one -- and the right one. The region would be well-served with a teaching facility for dentists -- dentists that may very likely remain in Eastern N.C. to practice.
But, of course, there is backlash. And just like when ECU was trying to establish a medical school, that backlash is coming from Chapel Hill (or those associated with that school there).
"Some say dentists in the state -- most of whom trained at UNC-Chapel Hill's School of Dentistry -- may not want to see an upstart challenge their alma mater for students, faculty and scarce state resources," writes the News & Observer.
"There also appears to be a more practical reason for the lack of enthusiasm: A new dental school would eventually pump as many as 50 new dentists a year into the existing market, creating competition for patients and, over time, making it harder to earn a good living."
Harder to make a good living? With the exception of a few, most dentists I know only work four days a week and do very well. And my assumption is that those that are concerned are worried about a glut of new dentists into the Triangle (where people are pouring into the area) and not ENC (where the dentists are needed). So what if there are more dentists in the urban areas? They are needed there as well. But not nearly as much as they are needed in the east.
Dr. Rex Card, a Raleigh dentist who is president of the N.C. Dental Society, told the N&O that the dental school could be a bad thing.
Card "said when he started practicing in the early 1980s, North Carolina and many states had an oversupply of dentists. Many did not have enough patients and left the state, he said.
"Card said some dental society members are concerned a new ECU dental program could bring back those conditions, even though it wouldn't admit its first class until 2010 or 2011, under the most optimistic timeline.
" 'For the first few years it might be a good thing,' said Card. 'But after that we might be producing too many.'"
Are Duke, UNC, Wake Forest and ECU producing too many doctors? (Oh, no! There's no such thing!)
It should surprise no one that the dental society supports expanding UNC's program. But that's not the real issue.
"There's little argument that residents of the state's poor and rural areas have a difficult time getting dental care. Ann Lamm, 64, can't remember the last time she had her teeth examined, cleaned or otherwise tended, but it has been years. She can't afford a dentist and none work at the free health clinic in the Halifax County town of Roanoke Rapids where she gets medical care.
" 'I need my teeth looked after just like anyone else,'" Lamm told the N&O, "noting that older people who don't qualify for Medicaid or who aren't old enough for Medicare are especially vulnerable. Children, too, have had trouble getting care."
1 comment:
Difficulty of access is only one of the reasons people in Eastern NC can't get care. The main reason has to do with the fact that State sponsored programs don't pay as much as they should to compensate dentists who to choose to provide care under such plans (Medicaid). Please keep in mind that as far as I know, there is no difficulty in getting care if you have money and live in Eastern NC. The poor (such as the lady in the article) are the ones complaining -rightly so.
What I think will happen is the following.
People will get into ECU dental school. They will graduate and move to nicer areas just like it happens at Chapel Hill. The ones who do chose to stay will take a limited amount of medicaid patients in order to survive at first. They will then realize that unless they started a practice in a decrepit building with used dental equipment they won't make it. The overhead is just too great to be covered by Medicaid reimbursement.
They will then either move away or stop taking medicaid, therefore creating a barrier to providing treatment. Poor patients will then complain again (rightly so) that they can't get care.
In the meantime, the graduates who chose to move to a nicer area will be stuck with a nice new office and not enough patient flow to pay for overhead due to all their classmates coming along.
Dentistry is a very difficult profession. The demands on body and mind are far greater than anything else I've ever seen (and I've had many jobs). The 4 day workweek, viewed by many as a luxury is nothing less than a necessity. Do dentists make a lot of money -most do. Do they deserve it? I most definitely think so. They have to look at a 8 sq. mm tooth (sometimes less) all day, have to be within someone's personal space all day, have to twist their back and make sure they "sculpt" the tooth to a 1/10th of a mm tolerance. That's not to mention bad breath, hepatitis B, AIDS, employees, insurance companies, legislation, the possibility of malpractice lawsuits, etc.
I can understand why the general public thinks dentists have it made. I used to as well, until I started working here. The reality of dentistry, however, is a whole different deal.
If dentists don't get compensated well for doing something that very few people are able to do, it is honestly, in my opinion (and in the opinion of many dentists I've talked to) not worth it.
I don't think the solution to access of care in Eastern NC lies in building a new school. I think it lies in promoting those areas and creating jobs and educational opportunities, so those people can stop depending on Medicaid to fix their mouths and start relying on themselves.
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