Preceptorship is working, but Im not

OK, I said I wouldn`t do this. Ranting about the Alabama Dental Hygiene Program has been done to death. Ditto for its effects on the quality of dental care for patients. Not enough training, lack of a college degree; it`s all been harped on since before they invented cotton. When I had to leave the best paying job I`ve ever had, I promised myself that I wouldn`t get upset about moving to Alabama. I`ve been here before, due to my husband`s military career. Although my health then did not allow me

anonymous

OK, I said I wouldn`t do this. Ranting about the Alabama Dental Hygiene Program has been done to death. Ditto for its effects on the quality of dental care for patients. Not enough training, lack of a college degree; it`s all been harped on since before they invented cotton. When I had to leave the best paying job I`ve ever had, I promised myself that I wouldn`t get upset about moving to Alabama. I`ve been here before, due to my husband`s military career. Although my health then did not allow me to work as much as I had wanted, I still temped in an office with ADHP hygienists. The staff was supportive and friendly - qualities some Northern offices could use.

I came here with a `chin up` attitude. Upon being repeatedly questioned by the inquisitive Mark Hartley, the RDH editor, I assured him that I hadn`t yet gotten serious about finding a job. Lots to do when you first move in. But the house eventually became organized. I was getting itchy to start work again - two to three days a week, that`s all I wanted. I knew the salary would be almost a 50 percent pay cut, but then the cost of living is a little lower down here. Still, there has been an increase in prices since I left northern Alabama three years ago.

It`s not just about bringing home a paycheck. I love my work, and I miss my patients. So I sent out resumes to the most desirable offices in town. I always start at the top and work my way down. Since I prefer perio offices, I started with them. At my last place of employment, the staff went to a seminar in Maryland about "What`s New in Dental Hygiene." I was pleased to discover that our office was already implementing all of the latest techniques and medicaments to improve dental and gingival health. We proudly were on the cutting edge of dentistry.

Surely, I naively thought, I shouldn`t have too much trouble landing a job in a similar kind of office in Alabama. I can`t speak for central or southern parts of the state, having never lived there, but northern Alabama does have dentists that keep up with the latest in their fields and specialties.

The problem I didn`t anticipate was saturation. The job market is saturated with Alabama Dental Hygiene Program hygienists, many of whom were assistants when I lived here three years ago.

The subject came up when sitting in the orthodontist`s operatory while he and his assistant were treating my son. After the doctor told me of his proposed treatment plan, he pointed to me, looked at his assistant, and said, "This is the person you should talk to."

His assistant`s face lit up. "I want to be a hygienist!"

Remembering where I was, I replied, "Great! Are you going to go to college or go through the Program?"

"The Program."

"So you don`t ever plan on leaving this state? Ever?"

"No."

OThen you might as well just go though the Program,O I surrendered. There was nothing more to be said. The dentist just kept smiling.

That was my introduction. Since then, I have called several offices to follow up on my resumes. One told me there were no openings. The office would not even need me for temping because, they said, OAll of our assistants are hygienists too!O Now there?s a kick in the pants!

OThat is not the normal state of affairs at the typical Alabama dental office,O a friendly woman working at Alabama?s board of dental examiners reassured me. She said she gets calls all the time from employers searching for hygienists. I left my phone number with her. She did tell me that the dental hygiene program at the college in Birmingham was shut down five years ago. I hadn?t realized that when I spoke to the assistant. Right now, only one college in the state has a dental hygiene program.

Preceptorship is a dish better served in states where an ORDHO is not the main meal. It seems to be working in Alabama, although I?m not. Each state makes its own rules. As much as we rail against Alabama?s program, we are not going to change it to a two- to four-year college curriculum.

But, being a lonely little RDH in an ADHP patch, I can only say that if preceptorship comes to your state, it will take a special kind of dentist to hire an RDH with the salary we expect. How enticing is a hygienist at half the cost to the doctor, while the fees stay the same? Lower hygiene salaries will become the rule of the day. Then all your college years, tuition payments, master?s degrees, and bachelor?s degrees won?t amount to a hill of beans to most doctors who have five kids to put through college and no financial aid. The preceptorship people can?t very well ask for more money because of a lack of college degree, and the dentists are just as happy not to pay them more. Still, they have the jobs.

I looked in the classified ads and found a lonely ad that read: Dental Hygienist, Experience required, 999-9999.

That scares me.

All I can say is, the people are so friendly down here that it?s hard to get upset with them. It?s their state, and they can do as they wish. The assistants going through the program are happy to become hygienists. They get a pay increase and greater responsibilities. The doctors are happy as clams because they have low hygiene salaries and dual coverage; no need for a temp in some offices, unless it?s a temp for his assistant because she?s practicing hygiene. The patients don?t seem to know the difference or care, for that matter, unless they?re from another state and they ask for college credentials.

This is the way it?s been in Alabama for a while now. They didn?t ask me to come here. And if I get an interview and take the job, it will probably be on their terms. (It?s that, or sit home/find another career/write for Mark.)

I will probably make what the ADHP hygienists make, whatever the going rate is. I was told last time that my boss couldn?t pay me like they did in Maryland. But the dental fees are basically the same as they are up North. You figure it out. The hygienists are not paid as well here. Why? The doctors swear they are performing Othe same duties.O Or do their employers use their lack of a college degree as a reason? And if they are pulling in big bucks for their employers, why aren?t they paid what they?re worth? It?s a mystery.

Well that?s the fine mess I?ve gotten myself into. Of all the assignments in all the Army, they had to send us to a preceptorship state. But I?m thankful that if I have to be temporarily unemployed, it?s here, where the people are neighborly and the cotton is high.

Let me take another look at that ad.......

? Befuddled in Bama

The author is a frequent contributor to RDH, and RDH granted her request to remain anonymous.

More in Periodontitis