An option to consider
ANY health initiative that will reduce cost without compromising patient care merits consideration. Health Minister Khaw Boon Wan's suggestion that dentists leave simple procedures to oral health therapists appears sensible, but it will mean lower prices only if patients have confidence in this new category of private practitioners come January, when the new Dental Registration Act takes effect. Therapists, who typically undergo a three-year diploma course at polytechnic, will charge less than dentists, but will they draw patients even for less complicated extractions and fillings? Dentists, on the other hand, may try to preserve their earnings by raising fees for treatments only they are competent to handle.
Mon, Jul 09, 2007
The Straits Times
Therapists fill a widely recognised role in the school dental service here, as in many developed countries. There is some difference, however, between taking care of schoolchildren and treating adults with more complicated complaints, both medical and dental. Therapists may be good at practical work requiring manual dexterity, but will they possess the requisite theoretical and analytical skills to draw up treatment plans for the best outcome? Five years of mandatory supervision under a dentist may appear to be a demanding requirement, but will it prepare them to operate independently?
Team practice is the best route to putting therapists to best use. This has to be the case in Singapore, if the minister's proposal is to have any chance of taking off. The presence of a dentist for quick consultation will be reassuring to patients. It will allow dentists to triage less demanding work to these colleagues, without referring patients outside the practice. Therapists will be in a position to continue what they have been doing well among schoolchildren, namely, promote dental health awareness, and thus help generate patient demand for scaling and other preventive and hygienic procedures they are competent to perform. The lower-income group, being the therapists' target patient base, will benefit from cheaper alternatives but without compromising standards of care. Wider public health benefits are obvious from early detection of periodontal problems, for researchers think they are associated with such disorders as diabetes, heart disease and pre-term low birth weight. The advantages of allowing oral health therapists in private practice may extend beyond cheaper options, but the system needs to be structured properly in a group setting to bring best results.