The winds of change are swirling all around us. New members of the dental team are being discussed and implemented in states around the country.
Legislation allowing mid-level providers has passed in two states and is being pushed in 19 more. Expanded function dental assistants (EFDA) have been working in 23 states and in the military for decades. Community dental health coordinators (CDHC) are already employed in Wisconsin along with seven other states.
The hope is that these additional team members will increase efficiency in the delivery of dental care which could ultimately reduce costs. In theory, those with limited financial means would have more access to treatment. EFDAs are a proven model of success, while more data is needed relating to mid-levels and CDHCs.
Currently, the Wisconsin Dental Association is positioned to be in opposition to mid-level providers in our state with EFDAs as a fall-back option if legislation is introduced.
We may want to reevaluate our strategy. I’m not suggesting the WDA introduce legislation to allow for EFDAs immediately, but we may not want to wait for mid-level provider legislation to be introduced. I would prefer to see the WDA be proactive rather than reactive on this issue.
The winds of change are coming. We can dig our feet in and let them knock us over or we can spread our wings to propel oral health in Wisconsin in the right direction for future generations.
How many dentists are going to use EFDA’s to increase the number of Medicaid and underserved patients they see? Won’t the same barriers to care remain with EFDA’s as exist now or with introduction of midlevel? Transportation, availability of providers, language, inability to take off jobs, etc. Can we drill and fill our way out of this problem?
I believe the same barriers will existing. Without proper funding most, if not all of the proposed changes will have little to no impact on access to dental care for those who feel they cannot afford it in my opinion. Unfortunately, outside forces see things differently and are pushing for some of these changes to occur. I prefer we Wisconsin move in a direction with proven track record of making dental teams more efficient for all care as opposed to creating an entirely new model with no proven impacts long term.