Latest / The Word of Mouth Podcast / The Hygienist Revolution: What Full Practice Authority Means for Your Practice | WOM 015
Transcript
- Jeffrey Lunt: Welcome to the Word of Mouth Podcast, your weekly rundown of the business, trends, and news shaping dentistry. I'm your host, Jeff, and I'm here with Sarah, my co-host. Sarah Lunt: Hi, Jeff. It's good to be here today. Jeffrey Lunt: So last week we ⁓ talked about our book announcement. Super excited about that, the inside out practice. we'll have a link in the description if you want your free copy. But this week we're gonna talk a little bit more about hygienists and the way hygienists are working could be changing and how that will shape the modern dental practice. Sarah Lunt: Yeah, Jeff, I think hygienists ⁓ ⁓ labor shortage in dentistry, that's generating a lot of discussion right now. ⁓ And recently the American Dental Hygienists Association has adopted Several new policies supporting what they're calling full practice authority for dental hygienists, basically giving them a little more range of what can do. ⁓ And a lot states are adopting policies allowing hygienists to practice without the supervision of a dentist. So there's lots of big changes for hygienists, and we're gonna dive a little deeper into that today. Jeffrey Lunt: Yeah, I mean, historically hygienists have worked under dentist supervision. A few weeks back we talked about Utah passing a law that allows hygienists to work independent of dentists in certain settings, so in hospitals or other places, where the state and dentistry as a whole has allowed in Utah hygienists to work with autonomy. And that's kind of what the ADA is pushing towards. We're seeing states pass these laws that are allowing dental hygienists to practice independently. And there's some f forces that are kind of moving dentistry towards this. Sarah Lunt: Yeah, Jeff, I think we can attribute a lot of these changes and a lot of movement in that direction of autonomy for these hygienists to the workforce shortages. We've talked a lot about that on our podcast. access to care challenges. There are lots of rural areas that just need access to this dental care, ⁓ hygienists can possibly help in being that solution. There's also a growing demand for preventative services, which is more of what the hygienists are helping with in these dental offices, As well as increased educational requirements. So it's for hygienists to get into hygienist school. ⁓ And there are more requirements within that educational path. So you know, the education is also higher for hygienists. Jeffrey Lunt: Yeah, I just had a friend over the other day and she was talking about her journey through dental hygiene school. And one of her comments was, I just don't understand if there's such a shortage of hygienists why there is not more acceptance in hygienist school and ⁓ in those programs. And so I that whether it's the dentist who's feeling it, whether it's the hygienist who's feeling it, or the patient who's feeling it, this hygienist Shortage is kind of multifaceted ⁓ ⁓ a result, it's not a question of ⁓ if are going to change, it's just a question of how much. So as we look forward, there's some data kind of driving these decisions. There's sixty million Americans who live in what we call a dental desert, a place where they don't have access to sufficient care. Meanwhile, four out of ten dental practices right now is hiring, actively hiring a hygienist. so we see that there's the demand from the patient needing more dental care, but we also see there's demand in the practices there isn't enough hygienists to kind of fill the roles. Sarah Lunt: yeah, and I mean the aging populations require more preventative care. So there is that demand for this preventative care. And there just an overall increased awareness of oral ⁓ Health. We've talked about that in the past, just Overall ⁓ holistic health becoming ⁓ really popular so there is an increased demand for routine services and this ⁓ preventative care. Jeffrey Lunt: Yeah, I think the more people learn about medicine and about what it takes to take care of their bodies, hygiene is part of that, oral preventative care, oral health, all of those things go into kind of this movement of people towards being healthier, ⁓ or at least trying to be. And so you've done a little bit of research on this, Sarah. What is full practice authority? Sarah Lunt: Yeah, so full practice authority is this policy supported by the American Hygienist Association ⁓ that basically aims to expand what hygienists can do within their scope of practice. We've talked about them working independent from dentists or, you handling more of the evaluation or ⁓ you know, ⁓ dental hygiene or developing treatment plans ⁓ it just broadens kind of the horizons for what dental hygienists can do independently. Jeffrey Lunt: Yeah, and just talking through this, I'm remembering a conversation I had probably six years ago with our uncle about the dentist, and he was saying, Man, it just seems like There's such a great opportunity for a hygienist to go be like the optician at Walmart that you just stop by, get a quick cleaning, and get out. And there you don't need to see a dentist. if you do need to see a dentist, the hygienist can tell you, hey, this is something beyond kind of dental hygiene, preventative cleaning scope. And so you'll need to go see a dentist for this problem, and and consult with them. And that happens all the time in medicine where you go to a practitioner, they kind of diagnose you if they can't handle your X, Y, or Z, they send you to a specialist, they refer you to a specialist. And so dentistry has that a little bit where you go to a general dentist for your kind of cleanings and then get referred out for oral surgery, maybe. But it seems like you could take it a step further. ⁓ and allow these hygienists more autonomy. with that comes the burden maybe of owning your own business. And ⁓ hygienists, I think, a lot of them like the idea of having a job being an employee, kind of the security that comes with that. But I know that there are a lot who are saying we need increased pay, and this is certainly opportunity where this is a thing to. ⁓ continue to drive that dental innovation. We're talking about that all the time on the podcast where it if you want things to change, you have to change something. You can't just kind of keep going through the motions. And so being innovative, coming up with creative ideas, ⁓ both for the dentists on how to work with hygienists, it might be that, moving forward, hygienists are given a share of the practice and they have now the burden of assisting in running the practice, attracting new patients. we talked a couple weeks ago about hiring good and that be way that dentists can hire good work is that they get hygienists who are bought into the practice, who are independently creating business opportunities for the practice. It can allow the dentist to move more of their time. into doing higher value services like implants, veneers, full mouth restorations, and focusing their efforts on marketing that while the hygienist brings in the regular cleanings. And so I think a lot of people might like is maybe a move backwards. but like I said earlier this is a move that's coming. it's not a matter of if it's a matter of when and how much that movement happens and so being positioned to take advantage of it is super important for both dentists and hygienists. Sarah Lunt: Absolutely, Jeff. I think at the end of the day, the goal is to reduce the barriers to care, which we've seen particularly in rural across the country. ⁓ these can definitely help with that, but also to allow hygienists and dentists to practice at the highest level of their training. ⁓ I think it makes a lot of for hygienists to take on some of the preventative care so that dentist can focus on, like you mentioned, implants and more of these higher end services, these cosmetic surgeries ⁓ that they've been to do rather than being in the office all day doing cleanings, right? These dentists have gone to a lot of school, the hygienists have gone to a lot of school, I think ⁓ it makes sense them to practice at the highest level of this training they've received. Jeffrey Lunt: Yeah, I think there's huge opportunities. I think for some patients, the traditional model of you go see the dentist, the hygienist does the cleaning and assessment, and then the dentist comes in and kind of confirms that. That may still work for some practices and some patients. But there's also opportunities like our uncle, who was talking about I just I don't necessarily care about seeing the dentist. I know he went to a lot of school, but I know the hygienist went to school, and I'm happy to just see them and have them give me their assessment because that's really for me as a consumer, as a patient, that's what matters. And so I think that there will continue to be, as true of all businesses, opportunities to fill in the cracks and ⁓ find people, find the find the patients who are looking for what. That you provide as a service. and so this obviously helps with longer wait times because you're not needing the dentist to come in. but on the other hand, again, there's people who are more traditional slow adopters, and so ⁓ figuring out who you want to target and what kind of practice you want run as these changes become alive, I think is one of the critical things. Sarah Lunt: Yeah, I think something we've mentioned a little bit today is ⁓ improving access care. there really is a shortage of both hygienists and dentists nationwide. And many ⁓ who in of hygienists having some of this are pushing for it because ⁓ are many communities nationwide that limited dental access, have long wait times, people can't get into the dentist for months because they're all because they're booked out for months, ⁓ there aren't many dentists in their area. So ⁓ supporters arguing that like you said, there is an opportunity for creativity, for hygienists to have this autonomy to provide preventative services through mobile clinics or schools, like you mentioned, opticians in the grocery stores that you can just kind of stop in and get your community health centers, public health programs. There's just lots opportunity for hygienists if they can practice independently to kind of weave their way into the community so that these communities can have more access to this preventative care. Jeffrey Lunt: Yeah, and I think that the preventative care is the key. The people who are supporting this are big supporters of preventative health versus kind of reactive health. they see hygienists operating independently as an opportunity for better to preventative and a focus on preventative care by the hygienists, where the hygienists become more of the preventative dental and the dentists become more of the ⁓ reactive, like once there's a problem, that's what they do for dentistry. and again, I think it hurts. Any changes hurt. but that's kind of where these people feel like ⁓ is a good and movement of the dental industry. on the other side, you've got people who are pushing back. So we talked a bit about. ⁓ people who like a traditional dental experience where they go in, they see their hygienist, and then their dentist comes in. And ⁓ I think there's something to be said for someone who has ⁓ advanced training for years, doctorate, coming in and telling you, Hey, your teeth are okay, like kind of confirming what the hygienist did ⁓ and an examination saying there's nothing I see beyond what they said, or hey, I'm seeing this and And ⁓ this is something we we oughta take care of. So I think that there is pushback from people who like that kind of treatment, the from the patients, from hygienists who like kind of their role in the dental sphere ⁓ and of that ⁓ employee mindset and employee preference of Hey, I I just wanna go to work. I don't wanna be a business owner. I don't wanna have to drive and do all the marketing, which totally get. that it's definitely a a kind of a personal preference thing. And then there's a lot of dentists who I think are concerned about the ability for their patients to get the the right care, and hygienists maybe overstepping ⁓ the perceived education gap between what a hygienist gets in terms of education and a dentist gets. in terms of education. I think as kind of like a practical less intense analog. I worked in the lab ⁓ at the hospital when I was in college and we had nurses ⁓ and And in experience the nurses knew a lot of the practical stuff because they're in it every day. As part of their education, there's clinical hours and all of those things. and the doctors sort of Had a different strength where they definitely had more of kind of the traditional education, the kind of the book smarts and of course practical ⁓ applications but ⁓ it's just a a a totally different dynamic of what nurses get and hygienists get in terms of education and practical experience, and dentists get in terms of practical education and doctors get. And Dentists tend to be more focused on like the academic side and staying up on studies and reading kind of academic papers, whereas hygienists tend to be more practical what's working. And so I think that there's some pushback from ⁓ and pe patients who have more traditional values of I want someone who's academically inclined, someone who is staying up to date and has that doctorate. ⁓ there is something to be said, especially in medicine, for having the the MD or DDS or DMD. and so anyway, I've kind of rambled a little bit, but I think that those are the kinds of people who are maybe pushing back as the people who like the ⁓ roles a hygienist and a dentist traditionally and think that the hygienist should always consult the dentist because the dentist has more education. Right, wrong or otherwise, I think that those are kind of the two parties is. Like you said, people who feel hygienists have great education, we ought to be taking advantage of that. And people who say hygienists have great education, but dentists have more of it and so we should lean on the dentist. Sarah Lunt: Yeah, And ⁓ don't want our listeners to think that the critics are trying to undermine the importance of hygienists. there's no debate that hygienists are valuable ⁓ in dentistry. a fundamental building block of dentistry. ⁓ I it's ⁓ really trying to find where the line should be drawn between access and oversight. And I think ⁓ pros cons to everything, right? ⁓ I think both in favor and those opposed to maybe some of these changes have good intentions and really do want what's best for for dentistry. And like you said, change is hard. Change is gonna come with challenges ⁓ but it's happening. of someone stands, whether they're in favor or opposed to these changes, ⁓ the role of hygienist is and evolving, and that's just something the dental industry is going to need to adapt to as those changes take place. Jeffrey Lunt: Yeah, and going back to kind of the very beginning of our conversation when we talked about access to education as one of the ⁓ primary issues currently affecting dental hygienist shortage. I think that that is something that as these changes happen, these hygiene schools have to be preparing their hygienists to practice. I know that we talked a little bit ago about a different program in Florida about a dentist assistant or something like that, ⁓ where they kind of practice in between a hygienist and a dentist. And I think that that's also something where if we look to medicine as an analog and we say There's nurses, there's physicians assistants, and then there's doctors or physicians. ⁓ I think that there maybe is an opportunity there as well to kind of redefine some of the roles within dentistry where it's not just assistants, hygienists, and dentists. Maybe there's something in between hygienists and dentists that requires a little more education but has more autonomy than a hygienist traditionally has. ⁓ so I think that there are different states looking at this different ways. But that autonomy as we continue to move forward is becoming more of a topic and roles will expand change. And can be hard, but I think it's also really exciting to see where that's headed. I think that this ⁓ from a business perspective makes all the sense in the world. ⁓ I think from a access to care perspective, it makes all the sense in the world. So ⁓ super about the opportunities and we'll just keep. kind of keeping on top of this and letting our listeners know what changes are coming and how they affect dentistry and what opportunities they provide because any change provides opportunities. Sarah Lunt: Yeah, And I mean, at the end of the day, full practice authority is still a policy goal. It's not a nationwide reality. It's the direction in which we're headed. So moving forward, it's just important that all of us, including our listeners, are keeping an eye out for ⁓ legislation surrounding scope of practice, ⁓ new workforce like you've mentioned, public health pilot programs ⁓ involving of the hygienists, expanded hygiene pathways. You also mentioned that ⁓ more. Hygiene programs or more acceptance into these hygiene programs, as well as additional states experimenting with independent practice models. Jeffrey Lunt: Yeah, I think this is a conversation that's just getting started. So it's something to keep an eye out for. ⁓ but I as I've said many times on this podcast, I think there's ⁓ so opportunities that ⁓ are coming as a result of this. And so staying on top of it, being kind of an early adopter is a huge advantage right now in a business model that hasn't changed largely for Hundred years. some kind of final takeaways, workforce changes are coming. access to care remains a challenge. Hygienists are taking on a larger role in dentistry, And the debate is about more than just dentistry. This mirrors the larger debate around medical autonomy in terms of nurses and doctors and physicians' assistants and all of those things. So this is a debate and access to care across medicine, across dentistry. Both of those things kind of mirror one another. And so it's worth keeping up on what's happening with the nurses and of those things on that side of medicine and then on the dental side of medicine, keeping up with what's coming with the hygienists ⁓ and obviously very closely linked, but both industries should be watching one another because once kind of the domino tips on one side it it will probably tip on the other. So whether you're a dentist, hygienist, or just a practice owner, hopefully this conversation's been helpful talking through some of the changes that are coming down the line. really appreciate you sticking with us ⁓ and interest in this topic. I think that We're in for some really exciting movement in the dental industry over the next few years. If you got value, we're here on YouTube. ⁓ love hanging out with our dentist friends. ⁓ comment. ⁓ we love connecting in the comments with our inside outers, I think ⁓ is what we're gonna call our listeners of our podcast. We're also on anywhere where you get your podcast, Apple, Spotify, Overcast, anywhere where you get your podcast episodes, we're there. we're here every week. ⁓ we're gonna start bringing you interviews with dentists who are talking about their practices, things that are working, things that ⁓ they're excited about in terms of ways that they're moving their practices forward. And so those will start rolling out on Thursdays. So we should have two episodes a week and super excited about that ⁓ we'll plan to see you in the next one.