The focus of dental practice and public expectations is shifting to a more holistic and biological base centering on pathological, general health issues. Ironically, our most qualified experts often express the feeling that they are less included in the treatment of some challenging issues in dental treatment. It would seem logical that as the scope of treatment for many patients enlarges, the importance of use of experts in various fields would be more sought after than previously. Actually, the converse in some areas seems to be prevalent.As oral health providers, we should realize that as knowledge expands and treatment modalities and equipment become more complex, Certified Specialists should be more important in our everyday practice. Examining the current interface between general practitioners and certified specialists shows existence of an overlap of General Practitioners (GP) and Certified Specialists (CS).
Recognized Certified Specialists
The Royal College of Dental Surgeons of Ontario lists the following as recognized specialists in Ontario:1. Dental Anesthesiologists2. Endodontics3. Oral and Maxillofacial Radiology4. Oral and Maxillofacial Surgeons5. Oral Medicine Specialists6. Oral Pathology7. Orthodontics and Dental Facial Orthopedics8. Pediatric Dentistry9. Periodontics10. Prosthodontics11 .Public Health Dentistry
Potential for Overlap of Specialists with General Practices
The possibility exists of an overlap of specialists with general practices in the following areas:Dental Anesthesia, Endodontics, Oral and Maxillofacial Surgery, Orthodontics and Dental Facial Orthopedics, Pediatric Dentistry, Periodontics, Prosthodontics.
As oral health providers, we should realize that as knowledge expands and treatment modalities and equipment become more complex, Certified Specialists should be more important in our everyday practice.
Historical Relationship VS Current Trends
Why is there an apparent disconnect between the historical relationship and current trends vis-a-vis crossreferring? Although the established parameters for GPs to perform almost all aspects of dentistry legally, provided they have adequate training and expertise, it is left to GPs’ judgment whether to refer or treat in-house. Some of the active drivers to promote in-house treatment include the following:a. The availability of extra-curricular hands-on courses (mostly offered by CSs) add some postgraduate training components to GPs’ skillset;b. The degree of diminished busyness of some GP offices in larger urban areas opens up time to expand the level of offering in the office;c. The expansion of many multi-provider group practices allows clinicians the option to focus on areas of dentistry of their interest and gain knowledge and proficiency to offer to their patient base.
From Patients’ Perspective
Some Issues Regarding Referral
The proper supportive interaction between the generalist and the certified specialist is beneficial for all stakeholders of our profession, particularly the wellbeing of the patient as well as the professional relationship between CS and GP. The mutually supportive interaction between GP and CS bodes well for the continuing ethical professional growth of our practices.PA
Ron Weintraub is a founding partner with the Bayview Village & Downtown Dental Associates and brings over thirty-five years of knowledge and experience in the practice of general dentistry to The Professional Advisory. Large companies such as Patterson Dental, Ash Temple Ltd, Henry Schein Arcona, & the former Canadian Dental Co. have benefited from his insight. As owner of Innovative Practice Solutions, Ron advises dentists on practice enhancement, practice purchases, sales, location evaluations, associate buy-ins, and business mergers. Dr. Weintraub can be contacted at (905) 470-6222 Ext. 221 or email@example.com.