Mertz E, Kottek A, Werts M, Langelier M, Surdu S, Moore J. Dental Therapists in the United States: Health Equity, Advancing. Med Care 59: 441-48, October 2021. doi: 10.1097/MLR.0000000000001608
Available at: https://journals.lww.com/lww-medicalcare/Fulltext/2021/10001/Dental_Therapists_in_the_United_States__Health.8.aspx
Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations. The objective of this study is to qualitatively examine the drivers and outcomes of the US dental therapy movement through a health equity lens, including community engagement, implementation and dissemination, and access to oral health care.
Osakwe ZT, Kim RS, Obioha CU, Osborne JC, Harun N, Saint-Fleur-Calixte R. Impact of State Scope-of-Practice Laws on Nurse Practitioner-provided Home Visits. Geriatr Nurs. 42 (3): 674-80, May–June 2021.
Available at: https://www.sciencedirect.com/science/article/abs/pii/S0197457221000811?via%3Dihub
Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits.
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.
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.
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.