I read with interest Mark Hartley's editorial, "Close the mouth and keep working silently," in the January 2011 issue of RDH magazine. I would like to thank Mark for his years of dedication to the dental hygiene community and all his efforts through RDH magazine to maintain a lively discussion about the direction and future of our profession.
I would, however, like to take a moment to address what I think may be a few misperceptions on the topic of collaborative practice and its place in the future of dental hygiene. In the January editorial a contributor implied that collaborative practice was doublespeak and just another form of supervision by dentists. The contributor pointed to an article by Cheng (2009) in which the word collaboration was taken back to a Cantonese connotation meaning "to close the mouth and keep working silently." I wonder how many of the dental hygienists from all across the country who are currently practicing collaboratively would agree that this is an accurate way to describe what they do and how they treat their patients?
The fact of the matter is that collaborative practice between a dentist and a hygienist can be a positive situation for both dentist and dental hygienist and at the same time bring much needed dental care to underserved populations. Normandale Community College, which is currently preparing the first class of Advanced Dental Therapists, a new provider educated under ADHA's ADHP model, refers to collaborative practice in the dental arena as "a dynamic process, a commitment to interact on a professional level that empowers the participants to blend their talent, to achieve a goal that neither can do alone." Hygienists are practicing collaboratively in roughly 22 states serving many communities, including the developmentally disabled, Medicaid patients, seniors, and other underserved populations. Collaborative practice and the movement toward the Advanced Dental Hygiene Practitioner (ADHP) and combined dental hygiene/dental therapy models are opening up doors and opportunities for dental hygienists. Put simply, collaborative practice equals much needed new job opportunities in many new practice settings for dental hygienists living in states that permit this type of direct access.
Before closing, I would also like to mention ADHA's commitment to diversity in both our association and our profession. In the December editorial in RDH, ADHA was described as "defending the purpose and goals of primarily Caucasian women who are often married and earn $30 to $50 per hour." Historically this may have been true but anecdotal information indicates that the numbers of male and minority hygienists are growing and it is important to note that ADHA represents all dental hygienists, whether they are members or not. Last year the ADHA Board of Trustees included increasing the diversity of our profession into the organization's strategic plan and appointed a diversity committee to address this important issue. ADHA is dedicated to developing a diverse and growing dental hygiene community for the future. Look for more information on the diversity committee in the weeks and months to come in ADHA publications.
I welcome thoughts and comments from dental hygienists on these or any other topics. Please feel free to contact me via the ADHA Central Office.
Caryn Solie, RDH
As a hygienist who re-entered the profession after raising my family, I read with great interest the comments of hygienists from all over the country. The changes are very interesting. Although the work of providing excellent oral health care is basically the same – with many new methods available – the attitude of the dentist seems to be different.
Now it seems more and more hygienists are working in more than one office, rather than one office, a certain number of days a week, and, as a consequence, are being paid as "day laborers" rather than professionals (for days worked and by the hour). Therefore, benefits, bonuses, and other considerations are not a factor with the dentist. When I graduated, all of the hygienists in my area were paid on a commission basis with benefits.
I fully understand there are reasons for working part time, and certainly don't fault anyone for doing so. I also understand the downturn in the economy, and the struggles dentists have. I do feel that if a hygienist was able to be in one office for however many days a week the unity would be very beneficial in these hard times – a sharing if you will of duties and responsibilities, and the friendships with coworkers.
There must be a way to solve this problem so hygienists feel valued as the engine that runs the office.
As the product of a dental family (my father and great uncle were dentists), and as someone who re-entered the profession with a wonderful dentist and office staff, I feel a sadness for those who are not so fortunate. One's worklife is very important for good general health. I really felt a need to respond and hope that my comments are respected, for they are made with caring for hygienists and dentists.
Michie McHardy, RDH
New Orleans, Louisiana
I read with interest the article on "the mood out there" (January 2011 RDH) and how unhappy many hygienists are. However, I had to comment on the article, "Evolving the dental hygienist" (February 2011 RDH). The comment "What sets me apart from other hygienists?" sums up the problems with dental hygiene perfectly. We must stop seeing ourselves in competition with each other or our wonderful field will end up with a lot of bitter, poorly trained technicians.
I have been a hygienist for 47 years. I recently retired from my last "full time" position and now only work at my part-time job. I have worked in many types of practices. When I began my career, there were times when I was the only applicant for a position. I have worked for wonderful doctors, as well as the opposite. The main reason I left this last job was because the doctors started paying us on 25% commission only. Plus, I had to work in whatever room was available.
I have given the dilemma of dental hygiene a great deal of thought and why we are having so many problems. Years ago, we were respected and paid well, better than most nurses. Unlike nurses, we mainly work alone and have little interaction with other hygienists. We hate to share our patients, rooms, or equipment. Nurses had "power in numbers" and unionized. They are able to work without direct supervision and have far more control in their practices. Meanwhile, we almost solely work in private practice. Somehow we must make a "mind change" to help keep our profession healthy.
Carol Serventi, RDH, BS
Fairlawn, New Jersey
To submit letters to the editor, send to: RDH, P.O. Box 3408, Tulsa, OK 74101; [email protected]; or (918) 831-9804 (fax).
Past RDH Issues