Heidi Emmerling Jones, RDH, BS
It`s summertime. It`s hot. It`s time for sailing. Avid fans swear it is the ultimate experience. I understand their enthusiasm. When you sail, you choose your own direction. Although you can passively drift from time to time, the exhilaration comes from taking advantage of the winds and the currents. You feel the freedom and independence.
Instead of being a mere passenger or crew member, you actively chart your own course. Instead of someone like a captain dictating and charting your destination, choosing your sails, controlling your voyage, anchoring you, varying the same stale, stagnant commands over and over, for once you have a truce. You have the infinite shore as your destiny, the wind as your opportunity, and your mind, desires, and heart as your course.
Restless winds stir the crew
Let`s call our sailboat Tradition. We have gone on many voyages on this boat as loyal crew members. We`ve been able to earn safe, secure, comfortable lifestyles. It has been quite rewarding - so far. However, we grow restless. We feel moored while we feel the winds and see other boats sailing. Perhaps we wouldn`t feel so restless if we were allowed to choose to remain on Tradition without the anchor, without the mandated controls.
But now we see some challenges facing Tradition. We see the captain searching for others with less skill to do the job. We see the scope of practice narrowing. We see winds changing the course of Tradition. We see the dock in which we are moored transforming into an inescapable morass.
Like it or not, the winds are changing. Therefore, changes in our course are inevitable. We see the winds of health care reform coming and going. We see the winds of managed care emerging. We feel the winds of preceptorship threatening. We hear the winds of self-regulation, autonomy, and independent practice beckoning.
So what are we to do? Are we to wait until we are delegated the honorable position of head cleaner and feel grateful for it? Are we to remain on a boat that is to become obsolete among new winds and new sails because we are intimidated by waves or because we feel it is not our position to take responsibility for our own destiny?
Those who have traditionally been in power tell us overhead makes independent practice unwieldy and impossible, that our malpractice insurance will skyrocket, that independent practice is unsafe to consumers. However, Colorado dental hygienists who practice independently find it rewarding to reach those who otherwise would not have access to care. Colorado hygienists practicing independently have not been subject to any board discipline. So much for independent practice being too difficult for hygienists and dangerous to consumers.
Self-doubt causes us to believe the superstitions
Those in power attempt intimidation with unfounded statements. They claim self-regulation is too daunting for us frail ones to handle. They claim that our profession is too weak to support the expense and service to a board of dental hygiene. However, hygienists from New Mexico, the first state to implement self-regulation of dental hygiene two years ago, prove those statements are indeed unfounded. The problem is that our own self-doubt can fog our vision, making us susceptible to accepting these fallacies as truth. Let us see through the fog, beyond Tradition as did hygienists in Colorado and New Mexico.
New Traditions called Alternatives are bound to emerge. Perhaps more of us might choose the veterinary dental hygiene route as did Carol Weldin. Or perhaps some may choose the route for compromised, special needs passengers. Tom McGivern treats people who are HIV positive. Judy Boothby, a participant in the California health manpower pilot project, hopes that more hygienists will be able to treat homebound or nursing home patients. Christine Nielsen Nathe has practiced dental hygiene in the prison setting. Many other types of patients would also benefit from specialized dental hygiene care in alternative settings: the indigent, oncology, gerontology, pediatrics, obstetrics, and mentally and physically challenged patients.
The Alternatives may not happen with the dentist as the navigator. We might see our co-navigators on Alternatives are in governmental agencies such as the Public Health Service. Or the co-navigators could be the physicians who treat those special needs, embracing the concept that oral health is part of overall health, embracing the concept that, yes, we are the true preventive experts. We will see insurance companies acknowledge Alternatives by giving us "primary care provider" status, making us eligible for direct reimbursement. Or we might choose education, research, or corporate routes.
On going on our individual voyage, we are bound to discover other courses not yet even imaginable from Tradition and the traditional paradigm. We will see those who dare chart new courses boasting of bright sails filled with the winds of opportunity, riding the sea, waves, and all, voyaging to new destinies. Those who dare do not allow the waves to throw them. They know that waves of fear, waves of threat, waves of opposition, almost always accompany winds of opportunity. Those who dare maneuver through the waves, knowing that the winds propel them. They do not experience the so-called insurmountable tidal wave of doubt that others imagine. They find that the reality of the wave is a mere ripple.
Some navigators and crews may be the same as those to which we have been accustomed for years, captains and subordinates. Or the navigator may be a different kind of captain, one that was once a crew member that is now ready to take that awesome and exhilarating responsibility and chart her own course. Ah! Imagine that.
Heidi Emmerling Jones, RDH, BS, is a consulting editor for RDH and practices dental hygiene in Sparks, Nevada.