Citation: Chen C, Chung Y, Broadbent G, Mertz E. Medicare Support for Dental and Podiatry Graduate Medical Education Programs. JAMA Netw Open. 2021;4(5):e2111797. Published online May 27, 2021. Doi: 10.1001/jamanetworkopen.2021.11797.
Available at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780401?widget=personalizedcontent&previousarticle=2731442
One of the major challenges the oral health workforce faces is those that affect patient access and outcomes. Although Medicare programs provide almost 15 million a year in GME payments to teaching hospitals, there is little information about how the US invests in training the podiatry workforce.
This article evaluates Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018.
Citation: Langelier M, Surdu S. Does Education in Oral Health Competencies in Physician Assistant Education Programs Translate to Delivery of Oral Health Services in Clinical Practice? J Physician Assist Educ. 32(2):79-86, June 2021. Published online May 24, 2021. doi: 10.1097/JPA.0000000000000351.
Available at: https://journals.lww.com/jpae/Abstract/2021/06000/Does_Education_in_Oral_Health_Competencies_in.3.aspx
The purpose of this study was to determine the extent to which physician assistants (PAs) are educated in oral health competencies and the relationship of education to providing oral health services to patients.
Kottek A, Hoeft, K, White J, Simmons K, Mertz E. Implementing Care Coordination in a Large Dental Care Organization in the United States by Upskilling Front Office Personnel. Hum Resour Health. 2021;19(1):48. Published online April 7, 2021.
Available at: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-021-00593-0
Care coordination is a strategy used to improve health outcomes and efficiency, but has not been widely adopted in the dental field. To test out care coordination in the field, a large dental accountable care organization participated in a pilot project where they retrained existing administrative staff to coordinate the care of high-risk patients. Following the pilot’s success, a formal dental care advocate (DCA) role was integrated system-wide. The goal of the new DCAs is to improve care, patient engagement, and health outcomes while integrating staff into the clinical care team.
This article describes the process of DCA role implementation and assesses staff and clinician perceptions about the role pre- and post-implementation.
Leslie K, Moore J, Robertson C, Bilton D, Hirschkorn K, Langelier M, et al. Regulating health professional scopes of practice: Comparing institutional arrangements and approaches in the US, Canada, Australia and the UK. Hum Resour Health. 2021;19(15). Published online January 28, 2021. doi: 10.1186/s12960-020-00550-3.
Available at: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-00550-3
Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals.
Forte G, Langelier M, Wang S, et al. The Physiatry Workforce in 2019 and Beyond Part 1: Results from a Cross-sectional Survey. Am J Phys Med Rehabil. Published online January 11, 2021. doi: 10.1097/PHM.0000000000001692.
Available at: https://journals.lww.com/ajpmr/Abstract/9000/The_Physiatry_Workforce_in_2019_and_Beyond_Part_1_.97770.aspx
This 2-part journal article focuses on the physiatry workforce. Part 1 discusses results from a cross-sectional survey of physiatrists. See Part 2 for a discussion on supply and demand forecasting results.
Dall TM, Reynolds R, Chakrabarti R, et al. The Physiatry Workforce in 2019 and Beyond Part 2: Modeling Results. Am J Phys Med Rehabil. Published online January 11, 2021. doi: 10.1097/PHM.0000000000001659.
Available at: https://journals.lww.com/ajpmr/Abstract/9000/The_Physiatry_Workforce_in_2019_and_Beyond_Part_2_.97802.aspx
This 2-part journal article focuses on the physiatry workforce. Part 2 discusses supply and demand forecasting results. See Part 1 for results from a cross-sectional survey of physiatrists.
Surdu S, Langelier M. Teledentistry: Increasing Utilisation of Oral-health Services for Children in Rural Areas. J Telemed Telecare. Published online October 18, 2020. doi: 10.1177/1357633X20965425
Available at: https://journals.sagepub.com/doi/full/10.1177/1357633X20965425
The objective of this study was to evaluate factors influencing utilisation of follow-up oral-health services in general dentistry clinics among children subsequent to a teledentistry consultation and treatment with a paediatric dental specialist. The study found that case severity and compliance with treatment were predictors of utilisation of oral-health services in general dentistry clinics. An additional finding was that case-management interventions were important in facilitating specialty dental care.
Surdu S, Mertz E, Langelier M, Moore J. Dental workforce trends: A national study of gender diversity and practice patterns. Med Care Res Rev; Health Workforce Supplement. Published online August 28, 2020. doi: 10.1177/1077558720952667.
Available at: https://journals.sagepub.com/doi/10.1177/1077558720952667
The dental workforce is increasingly gender diverse. This study analyzed gender differences in dental practice using the American Dental Association’s 2010-2016 Masterfile and the 2017 Survey of Dental Practice. Between 2010 and 2016, the proportion of women working in dentistry increased from 24.5% to 29.8%. Overall, female dentists were more racially/ethnically diverse, more likely to be foreign-trained, and more likely to work in pediatric dentistry than male dentists. The likelihood of female dentists working as employees, part-time, and/or in metropolitan areas was 1.2 to 4.2 times greater compared with male dentists. Female solo practitioners were 1.2 to 1.8 times more likely to provide services to children and patients covered by public insurance than male solo practitioners. Gender diversification in dentistry and other factors, including generational differences and changes in the dental service delivery system and public policy, will continue to reshape the delivery of oral health services.
Fraher EP, Pittman P, Frogner BK, Spetz J, Moore J, Beck AJ, Armstrong D, and Buerhaus PI. Ensuring and Sustaining a Pandemic Workforce. N Engl J Med. April 2020; DOI: 10.1056/NEJMp2006376.
Available at: https://www.nejm.org/doi/full/10.1056/NEJMp2006376?query=featured_home
Current efforts to fight the COVID-19 pandemic aim to slow viral spread and increase testing, protect health care workers from infection, and obtain ventilators and other equipment to prepare for a surge of critically ill patients. But additional actions are needed to rapidly increase health workforce capacity and to replenish it when personnel are quarantined or need time off to rest or care for sick family members. It seems clear that health care delivery organizations, educators, and government leaders will all have to be willing to cut through bureaucratic barriers and adapt regulations to rapidly expand the US health care workforce and sustain it for the duration of the pandemic.
Frogner BK, Fraher EP, Spetz J, Pittman P, Moore J, Beck AJ, Armstrong D, Buerhaus PI. Modernizing Scope-of-Practice Regulations–Time to Prioritize Patients. N Engl J Med. February 2020;382(7):591-593. DOI: 10.1056/NEJMp1911077.
Available at:
https://www.nejm.org/doi/full/10.1056/NEJMp1911077
Over the past decade, numerous reforms have been implemented by the federal government and by states to expand health insurance coverage, change payment models, motivate organizations to reconfigure the ways they deliver care, modify eligibility for Medicaid, and better prepare the health workforce for pressing behavioral care, primary care, geriatric care, and community care needs. To realize the potential of these laudable reforms, we believe that states should eliminate overly restrictive scope-of-practice regulations that they impose on the health professions. Doing so would allow us to unlock the full potential of the country’s health workforce.
