Close the mouth and keep working silently?

Jan. 1, 2011
A male hygienist from Colorado, Howard Notgartnie, recently resurfaced, much to my surprise.

by Mark Hartley
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A male hygienist from Colorado, Howard Notgartnie, recently resurfaced, much to my surprise. From 2003 until 2007, he wrote about 10 articles or so that appeared in RDH. Howard, who is married and raising a family, decided to pursue an advanced degree in addition to practicing full time. So he took a break from writing. You know how that goes.

But he wanted to share a little gem that he uncovered during some research.

He wrote, "I came across a comment in some research that I think is worthy of a comment [by me in this Editor's Note]. In the past few years, some states have come across a way of allowing dental hygienists to work almost autonomously by using the doublespeak term 'collaborative practice,' in which a dental hygienist with a practice is required to have a dentist concur with certain types of decisions made by the dental hygienist.

"Although the arrangement is called collaborative practice in some states, the requirement of that arrangement actually makes it a supervised practice. The comment in the research that made this doublespeak come to mind was by Cheng (2009), who pointed out that a connotation of the word collaboration in Cantonese means 'to close the mouth and keep working silently.'

"I thought when you are in one of those encouraging moods you might want to encourage our profession to reject that particular connotation."

I don't know if I can really add anything to that, Howard. You state it quite well, and thanks for sharing. The article by Brenda Siu Shan Cheng appeared in the Journal of Dental Education, if you're interested.

Howard interrupted me. I was busy reading my U.S. News & World Report about the "50 best careers of 2011." Dental hygiene, of course, was on the list. The best part about it were the comments from obvious hygienists who refuted the news magazine by pointing out that there are no jobs in dental hygiene:

• "I don't want to burst anyone's bubble, but I am taking this time to warn prospective students to re-consider applying [to dental hygiene school]."

• "What articles like this often fail to mention is that many dental hygienists are not offered medical and vision benefits ... I'm positive, however, that there must be some jobs out there that have awesome benefits; just don't expect them in this field. ... Also, at least in our area, there are way too many hygienists and not enough positions."

• "I have been a hygienist for 20 years and never has it been this difficult to find a job. ... The salary for a hygienist is very good but the work is very hard and physical. It is a demanding job and it is stressful due to the tight schedule and unpredictability of each day. ... I have never worked in an office where I could choose the hours that I work. That is a fallacy. You can choose whom you'd like to work for if they choose you, but don't count on dictating the hours you work."

U.S. News and World Report, of course, is a consumer publication, so hopefully individuals considering a career change will read the hygienists' comments after the article. I'm glad the hygienists stepped forward to publicly reject some of the rosy forecasts for the profession.

The hygienists' comments in U.S. News and World Report echo many of the comments you will read in this issue's "salary survey" (pages 36-51). It truly is a depressing article to read. But it is time to stand up for what you believe in – preventive dentistry, more than ever, needs skilled professionals to deliver health care and feel good about doing it as a career.

The "statistics" for the salary survey, by the way, were published in RDH eVillage during the last months of 2010. You can view all of the articles on

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