Dear Dianne McKnight:
I read the "newsworthy" item about you in the ADA News. It would be helpful if you were to clarify precisely the statement you allegedly made: "I don`t think it (independent practice) is in the best interest of the public."
Enlighten me, Mrs. McKnight - during your hygiene training, were you taught:
- To review your patient`s medical history?
- To establish baseline data?
- To conduct diagnosis preparation, including dental charting and periodontal assessment?
- To draw a realistic treatment plan?
- To include your patient in undertaking a course of action, including thorough and comprehensive review of home care?
- To make the appropriate referral for dental and periodontal care?
- To be legally responsible for the above under the licensure agreement?
If you have replied in the positive, would you please describe the difference between delivering the above under supervision, as well as without supervision? Unless you are one of those citizens who need policing to remain lawful!
Now, allow me to pose the same set of questions in your practice setting this time. Have you been able to follow the above in earnest, or did you have to compromise your professional (and often personal) integrity to accommodate the practice`s realities, including philosophy, economic goals, hygiene appointment time, relationship to dentist, etc.
What is evident from this statement is that you did not ponder upon "independent practice" carefully and even responsibly. Let me expand your horizon - it includes screening school-age children and conducting assessments of their risk for decay and their need for sealant; it includes providing routine hygiene care to the ever-increasing dentate elderly; it includes addressing the oral health needs of a large population in institutionalized facilities. Do I need to list more, Mrs. McKnight?
Fronted by organized dentistry, this empty slogan of "not in the best interest of the public" becomes meaningful only when the word "public" is replaced by the word "pocket." However, hearing this statement uttered by someone as distinguished and accomplished a hygienist such as yourself is extremely disturbing.
Sara Monajem, RDH, MA, MPH
Brighton, Massachusetts
