Haveman: Shortage of dentists makes case for change

James Haveman

I have long been a proponent of legislation and policy that would expand the scope of practice for many health professionals. This means a different way of approaching our health care professionals, putting more emphasis on unique skills and roles within a health team rather than relying on traditional titles and legacy exclusiveness of a particular degree.

We are facing a shortage of health professionals, particularly at the top. Let’s look at one specific area — dentistry. A report issued last summer by the Center for Health Workforce Studies, School of Public Health at the University of Albany, found that in our state, “limited access to oral health services is a persistent problem in some geographic areas and for some populations. Improving access to oral health services is a difficult proposition that requires multifaceted strategies.”

It’s a problem that will only worsen given the large number of retirements coming among these top practitioners. Half of Michigan’s dentists are 55 and older, according to an American Dental Association survey.

A major step toward increasing access to quality health care is being used in other states with good results: Make it easier for highly trained health professionals who have received extensive training to take on additional responsibilities, under proper supervision, that state law currently requires to be provided by dentists and physicians.

Looking again at dentistry, states around the nation are creating new midlevel dental care providers, a middle ground between highly trained dentists and dental hygienists, to expand the reach of dental care into places where there are few dentists, or where certain traditionally underserved populations like children, pregnant women, the elderly and the developmentally disabled need additional dental care.

These professions can be filled by individuals who are willing to complete advanced training, at a level equivalent to a master’s degree.

These highly trained dental professionals would have the capability of providing certain services that now must be delivered under current state law by dentists. This would bring vital dental care to more Michigan citizens — particularly those in rural areas where long-distance travel to health centers becomes a challenge, or in urban areas where few practices are choosing to locate.

Reducing barriers to qualified health care practitioners in appropriate areas, including dentistry, should be a priority for lawmakers seeking to improve the health outcomes here in Michigan. We should all welcome the introduction of legislation to create a midlevel dental care provider. Michigan has an opportunity to lower its health care costs, improve outcomes and expand access to health care services.

James Haveman is former director of the Michigan Department of Community Health.