27 June 2012

As goes dentistry, so goes medicine?

Frontline, my favorite television program, just aired an enlightening and dismaying hour-long documentary on America's broken dental safety net. It focuses on the poor's lack of access to quality dental care, as well as the proliferation of for-profit dentistry chains that sometimes derive revenue through shoddy work, unethical billing, and predatory lending.

It is strange seeing how the frightening changes described in the documentary are also manifesting themselves in American medical practice. Solo medical practices are becoming unprofitable, and in their stead are large health-care conglomerates that are often focused on their bottom line. Similarly to dentists, physicians feel threatened by the rise of so-called "mid-level providers," the physician assistants and nurses that are being granted increasingly wide scopes of practice. Not that these changes are unique to America: I recently read Nobel Laureate Alexander Solzhenitsyn's Cancer Ward, a semi-autobiographical novel set in a Soviet hospital. Although written 50 years ago, the doctors' complaints of the erosion of professional standards and the demise of the solo practice would just as easily apply to this country today.

The Frontline documentary portrays a badly-broken dental system, which causes grievous harm to children and adults and which has no clear solution on the horizon. As much as I'm partial to my profession, I have to wonder, is medicine today so different? And is medicine immune to the pressures bearing upon the dental profession?

On a side note, medical students find it easy to get jealous of dental students. Dental students can practice general dentistry after completing four years of dental school, whereas medical students must undergo additional training. Also, being a general dentist today is generally more lucrative than being a primary-care physician, especially because HMOs haven't completely taken over the dental field. Dentistry is an important medical field, as the documentary clearly demonstrates. Even so, I'm happy to be in a profession that permits me to focus on almost any part of the body.