Doesn’t the destruction left behind Hurricane Katrina lead us to think of a better way to rebuild our health-care system?
The phoenix is a symbolic and magical bird that died in flames and was reborn from the ashes. J.K. Rowling’s Harry Potter novels feature a phoenix named Fawkes. In Harry Potter’s world, the phoenix can carry enormous weight, and its tears have extraordinary healing powers. With its great beauty, the phoenix creates excitement and inspiration, and represents our capacity for vision.
I believe a phoenix will rise from the ashes of Hurricane Katrina. Thousands of homes and businesses were destroyed, and the landscape was decimated in what may be the most destructive storm in U.S. history. Victims were stranded and in need of immediate medical care, food and water, and tens of thousands of people needed temporary housing for months. Dentists will be without their practices for months, and even if their practices were not destroyed, they may have no patients. This tragic event impacted hundreds of thousands of lives, including many hygienists. Dental hygienists throughout the region suffered not only catastrophic losses of their homes, but damage to their offices, labs, and classrooms.
Most of us were not directly affected by Katrina, but imagine everything you know being wiped out, including your dental practice. We can be part of the reconstruction. Before rebuilding, some questions need to be addressed. Do we rebuild the way it was, or is it time to change the model into something better? What does the optimal hygiene experience consist of so that it’s appreciated and profitable? Is it about the building, the equipment, or is it about something more? What is your vision for the future?
It may be time to focus on a prevention-oriented practice. Every time a dentist removes decay and prepares a tooth for restoration, it is surgical amputation of a body part. This is a last resort in medicine, yet the most common procedure in dental practices, and what is commonly taught in most dental schools. As hygienists, we should consider that every time we identify a cavity or periodontal disease, it is a failure. Dental hygienists are preventive specialists, and our primary task is disease prevention and health promotion. Yet we are more oriented in looking for disease than seeking health.
Do we really believe periodontal disease, dental caries, oral cancer, and tooth loss are preventable? We say we do, yet dental practices center on the discovery and repair of breakdown. Disease drives treatment. Treatment deals with the visible, and detection often occurs too late in the process to prevent disease. Repair rarely results in a condition as good as the original health. Hygienists are prevention specialists, yet continue to perpetuate a disease-oriented model.
It costs more to treat disease than to prevent it. When compared to other industrialized countries, the United States has the most expensive and least equitable health care system with the greatest access to care issues. Our current care model shows poor results. Americans don’t like to see themselves this way. We really believe that our system is the best. We are fighting to keep our health care model functioning, when in reality fewer people have access to it. The phoenix can rise above the reality and see that it’s time to burn the status quo and promote change.
ADHA publishes many important documents, and two of important relevance to this article appeared in June 2005. Dental Hygiene: Focus on Advancing the Profession (www.adha.org/downloads/ADHA_Focus_Report.pdf) is the ADHA plan for advancing the profession. Katie Dawson, RDH, BS, ADHA president, reminds us that this is a three-year quest and the goals of this document are not yet in place. These goals will be prioritized and incorporated into the ADHA strategic plan. The ADHA strategic plan is a three-year document that drives the activities of the trustees and councils. This document is based on a very important question. “What would the future of dental hygiene be if it were written by dental hygienists with the freedom to envision, aspire, and accomplish?” We can all benefit thinking about this question.
The Dental Hygiene Diagnosis Position Paper (www.adha.org/downloads/DHDx_position_paper.pdf) states that not only can we make a diagnosis, we are actually obligated by our education and licensure to do so. “The position of ADHA is that dental hygienists, by virtue of graduation from an accredited dental hygiene program, are educationally prepared to conduct a dental hygiene diagnosis and that the formulation of a dental hygiene diagnosis is the responsibility of the dental hygienist in the delivery of quality oral health care.”
A revolution of sorts has begun. It’s called Oral Medicine (OM), and it’s the 21st century version of dentistry. There is a trend to develop more biological and tissue-preserving techniques and treatments. OM gives patients the benefits of all our knowledge, not just as a technician trained to clean teeth. OM merges our early learning with knowledge gained from research and continuing education, and incorporates it into evaluation and treatment considerations. A concept promoted by OM is minimally invasive/minimal intervention (MI) therapy, which ranges from the primary prevention of disease to surgical methods involving minimum trauma. There will still be amputation surgery in dentistry, yet there are techniques that make it possible to preserve tissue or minimize side effects. Patients are becoming increasingly health conscious, and informed and demanding about their choices.
MI is not just fluoride varnish, glass ionomer sealants, and xylitol gum; it is a philosophy. MI is a concept that involves all aspects of dentistry, and the idea is to preserve original tissues as much as possible. It embraces treatment procedures, but also stresses early diagnosis, risk assessment, and health promotion. MI will happen through the empowerment of hygienists.
The means, methods and opportunities for MI are available, but there is a lack of incentives. For some reason, many patients, third parties and dentists are convinced that replacements are the only things that count. They think it is OK to pay for a filling, but not for procedures that can help avoid that filling. Our task is to spread the word that maintaining the original tissue is worth at least the amount of a replacement.
It is time to stop thinking in a linear way, allowing the past to predict the future. We do not have to continue in the same way we always have. To put it into a humorous light, linear thinking can be used regarding Elvis impersonators. In 1977, the year Elvis Presley died, there were 44 Elvis impersonators worldwide. By 2002, there were 42,000.
If we predict future based on the linear method, by 2006 one of every three people will be an Elvis impersonator. Linear thinking can lead to rather strange thinking and real mistakes. It is time to turn to visionary thinking.
We need to re-envision our reality. Vision is funny because it can be exciting to think about new things. But when you return to your place of employment from acontinuing education class that got you all fired up, what happens? Nothing. It is one thing to dream about what could be, but getting there is different. We get stuck where we are even when we are uncomfortable. This is because the vision was not our own. Speakers and authors can open a window for us to gaze through, but we have to find the door, turn the doorknob, and walk through the door.
When a crisis like Katrina occurs, it’s time to reflect. Though our current health system is not working well, we don’t have to wait for its destruction. We can be the phoenix with its beauty, excitement and inspiration. We can create our own vision, then use our enthusiasm to make that vision real.
Patti DiGangi, RDH, BS, is a speaker, author, and practicing dental hygiene clinician offering CE courses to national audiences through her company, Professional Direction Conferences. She can be reached to schedule courses at [email protected] or (630) 292-1473.