Will the job market finally kill off preceptorship?

`The record unemployment ... means it is as important for dental practices to retain their best, most highly skilled workers as it is to retain their best patients.`

May 1st, 2000

`The record unemployment ... means it is as important for dental practices to retain their best, most highly skilled workers as it is to retain their best patients.`

- Dr. Ira Wolfe

Mark Hartley, Editor

If you`re a classically trained hygienist in Alabama, feel free to stop reading this. After all, you`re sittng in the hygienist section (which is behind the smoking section, way in the back, where they used to serve only minorities) of the Preceptorship Diner in downtown Birmingham - depressed because you don`t have quite enough change in your pocket for a burger and fries. Or, if you`re a hygienist in any of the other 49 states, you might not want to read this either. According to the grapevine, plenty of registered dental hygienists who passed the courses and the boards the classical way are stunned when "preceptorship" is merely whispered in their states. Preceptorship, of course, is the concept that any working stiff can become a hygienist with a little on-the-job training.

Yes, turn your attention to something else. Maybe if you`re headed for a week of fun at the ADHA annual session next month, you could do some early packing. If you`ve missed the advertising, the ADHA is in Washington, D.C. Let`s do a little word association here. Washington ... dental hygiene ... democracy ... politics ... preceptorship ... Alabama ... civil rights movement. If preceptorship is such a 13-letter word, why doesn`t the ADHA ever host its annual session in Alabama? Wouldn`t it be kind of neat if 1,000 hygienists who lack professional sovereignty retraced Martin Luther King`s march out of Selma? If Alabama citizens are unaware of risks to their health, shouldn`t a hygienist refusing to budge from a stool at a lunch counter explain what`s happening?

But, if you`re still reading this, I`d like to argue that your real reaction to preceptorship should be this: Yawn.

The first reason for yawning is the economy. An article in Dental Economics recently caught my eye. Dr. Ira Wolfe, the author, had this to say about hanging on to good, qualified staff members: "The record unemployment - coupled with job expansion and a need to stay nimble and competitive - means it is as important for dental practices to retain their best, most highly skilled workers as it is to retain their best patients." If dentists reading the journal heed the advice, this means your skills are as important to the doctor as a new patient who has a wallet stuffed with cash.

Employers have to treat hygienists right, according to Dr. Wolfe, "since dental recruiters are headhunting your employees and lurking outside the dental office." The job market is a scary place for dentists.

In explaining how doctors need to retain staff, Dr. Wolfe devoted several paragraphs to explaining how the dazzling illusion of high "hourly wages" will not impress prospective employees for very long. Doctors who offer $25 a hour but then impose a minimal work schedule with no benefits will lose out every time to an employer who pays a little less but offers a full work schedule and benefits.

The acute demand for talent makes preceptorship seem like a bad idea, period.

The economy also fuels the second reason why I`m nonchalant about the threat of preceptorship. It`s called trust.

Whenever I go into a restaurant these days, I can`t shake the nagging suspicions I have about the qualifications of the personnel. What do you think about the restaurant industry`s ability to hire, train, and retain employees? Well, I still eat out - but I knock on wood and have a prayer on my lips.

Dentists cannot rely on the same consumer inclinations. It may be unfair, but people who are willing to chance dining at an establishment that hires people with dubious employment histories won`t take the same chance with a dental office.

For the most part, consumers trust dental professionals. If consumers question the "talent" level in dental offices, though, then the trust begins to erode. If dentists vigorously pursue a policy of "downsizing" the skill level of hygienists, consumers will pick up on it, especially if dentists lose out in the bidding war for talent in today`s job market.

If that happens, it will take a hundred years for dentists to regain the trust of consumers. Do you think dentists really want to risk that level of trust for preceptorship? I`m skeptical, but what do you think?

Editor Mark Hartley can be contacted at markh@pennwell.com

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