When dinosaurs congregate

Aug. 1, 1999
Well, well, well ... The latest issue of RDH is simply packed with stuff to which I am compelled to react. Where to begin? Let`s start with your guest commentary by Dr. Wilde. He seems like a pretty nice guy, actually. I hate it that I must contradict his proclamation that the "root cause of the hygienist/dental conflict (is) money." But, in 30 years of practicing dental hygiene, I have found that the most likely underlying cause of conflict is never money. But rather it is the lack of respect.

Dear RDH:

Well, well, well ... The latest issue of RDH is simply packed with stuff to which I am compelled to react. Where to begin? Let`s start with your guest commentary by Dr. Wilde. He seems like a pretty nice guy, actually. I hate it that I must contradict his proclamation that the "root cause of the hygienist/dental conflict (is) money." But, in 30 years of practicing dental hygiene, I have found that the most likely underlying cause of conflict is never money. But rather it is the lack of respect. I liked Dr. Wilde`s ideas for increasing revenue, and I am certain that they will work in most practices to increase revenue, but to end conflict? Sorry, I don`t think so. This is a much bigger problem than increasing revenues can solve.

Even though it isn`t a solution, Dr. Wilde is right when he suggests that our three choices when faced with conflict are:

- Surrender to your fate

- Continue to battle the existing system

- Identify an office with superior motivation, etc., and seek employment there

So right you are! But when hygienists leave these dinosaur (disrespectful, insecure, neurotic, obtuse, self-serving, arrogant, unreasonable, and rigid) dentists, the poor fellows explain away the hygienist`s exodus by saying that she was looking for more money. Clue: Hygienists do not like working for dentists like this. They (the dinosaurs) develop bad reputations as employers. Dinosaurs get the impression that there is a shortage of hygienists because they can`t get any but the most desperate hygienists to work with and for them. They form associations with other dinosaurs to see if they can solve their problem (they need someone to clean teeth in their practices). They conclude that hygienists are greedy, spoiled, and over-educated.

This gives them the idea that the answer to their problem lies in the creation of new dental hygiene training programs which, of course, they control, so as not to turn loose such uppity and demanding hygienists. Dentistry as a whole and dental consumers will suffer greatly if these types of dental hygiene programs become the standard.

I can say with certainty that hygienists will stay in practices where they are honored and respected, even if they are paid less. Not every practice is as driven by dollars as some others. (I like dollars, don?t get me wrong, but there is so much more to think about when providing care to others and getting compensated for it. Compensation comes in several forms.)

I hope that Dr. Wilde is viewing the dentist/hygienist conflict the way he does precisely because he is not a dinosaur and really can?t relate to it. It would be unusual for a dentist to work in as many practices as a typical hygienist does throughout her career. This gives her a much broader perspective than a typical dentist. Dr. Wilde, ask some hygienists who you know if what I?m saying is true. I?d bet some of my (not that fabulous) income that hygienists will say that conflict arises from lack of respect and not money. Which brings me to another unbelievably disrespectful comment I read in RDH this month.

I can?t tell if the author of the article, OThree on the BoardO (Cathy Seckman, RDH) or one of the interviewees (three members of the Wisconsin Dental Examining Board who are hygienists) was being quoted, but I nearly coughed up my lunch as I read, OWe exist at the discretion of dentists.O Oh my. Perhaps in Dr. Fone?s and Irene Newman?s day that could be said with a straight face, but please! I hope things have progressed somewhat beyond that which was true in 1906.

Dental hygiene is a profession, recognized and licensed by individual states. We exist because the public benefits from the existence of our profession. Hygienists provide preventive, educational, and therapeutic care to patients. We are licensed, professional oral-health caregivers. We deserve honor, respect, and compensation for our role in providing care to patients. We aren?t perfect, we make mistakes and fall short of our mark sometimes. But to say we exist at the discretion of dentists (an idea that was echoed somewhat by Dr. Wilde when he said, O...organized dentistry has the power and will to end the profession of hygiene as we know it, should direct confrontation occur. Consider Kansas as a recent example.O) reads like one of those overly controlling, offensive dinosaur sentiments I referred to earlier. Organized dentistry should not have this kind of power over our profession! No wonder some hygienists want to gain some autonomy by putting distance between themselves and those who think like this. Why aren?t the dinosaurs extinct yet? I?ll never know. Evolve already!

As for Dr. Neiburger?s comments in the Reader?s Forum, my response is this: A person who is properly trained to perform dental hygiene services is a dental hygienist. Period. And the public most certainly can afford the services of properly trained hygienists. In fact, our preventive and educational services are a real health-care bargain. Care that is provided by inadequately prepared clinicians winds up being the most expensive and least effective and efficient care there is. It may not even be care at all. It?s careless.

Linda Jorgensen, RDH, BS

River Falls, Wisconsin