We in Oral and Maxillofacial Surgery have much to be thankful for. Our specialty has been spared many of the regulatory and third party payer ordeals faced by other medical and surgical specialties. Clearly, however, there is a gathering storm looming in the background. The ADA Health Policy Institute reported in January, 2016 that the average income for general dentists, our primary referral source, has steadily declined since 2005. The reasons cited for this decrease were the increasing number of dentists and a persistent decline in the number of adult patients seeking dental care.
When one combines this with additional factors such as:
- There are fewer adults with private dental plans and the plans typically provide less coverage.
- A recent Texas ruling allowing non-ADA recognized specialists to advertise as specialists.
- More dentists than ever before are doing GPRs, including advanced training in implants and anesthesia.
- Many of the newer dental schools emphasize technical skills over basic science, and promote the “super dentist” model.
- A significant degree of turf impingement from other specialties continues.
It is easy to see how one could get bitter regarding our circumstances. Nonetheless, our specialty has been remarkably resilient; this is a testament to our unsurpassed education and training.
The question now becomes: will our education and training be enough to keep us meaningful as a specialty in the eyes of the public and the policy makers as the aforementioned factors continue to unfold?
It certainly won’t help to get bitter about our circumstances. The only way to ensure our future relevance is to get better, and the key to getting better is AIR (Advancement through Innovation and Research). As in just about every industry, innovation is the key to success, but innovative ideas must be scientifically tested through research and then those research findings disseminated via publications.
There are several ways to get involved in AIR. You can do it in conjunction with an academic program, or you can do it by participating in the AAOMS Practice Based Research Network (PBRN). If you can’t or won’t do either of those, then at the very least support the AIR program financially.
There seems to be a prevalent misconception among our membership that research is just a matter of lining up some willing patients and trying out some drug or some new technique. But it is much more complex than that, and it is incredibly expensive. The costs involved in a straightforward but credible research project are significant:
- Expert review fees to ensure that the protocol is formulated in a manner that will result in an evidence based non-biased conclusion
- Statistician salary to determine the numbers needed to achieve statistical significance
- Institutional review board charges for having the study approved and monitored
- Supplies, materials, equipment use and support personnel costs
- Providing free care and compensating patients for patient research, and animal procurement and care charges for animal projects
- Fees to collate and analyze study data for potential bias, unexpected findings and statistical significance
In aggregate, these costs easily run into hundreds of thousands of dollars! It should come as no surprise that our competitors, particularly in the field of implant dentistry, have not gained ground on us by virtue of emulating our rigorous education or training. They have done this by employing AIR. Any doubters need only check the bibliographies of the presenters at the next AAOMS Dental Implant Conference.
It is my sincere hope that AAOMS members will resolve to not only get better, but to reaffirm our position as the very best at what we do, by getting involved in AIR, either as a participating investigator or by helping to provide the critical financial resources necessary to move forward. If the best way for you to contribute to AIR is through financial support, the Oral and Maxillofacial Surgery Foundation provides several effective and convenient pathways and donations are tax deductible!
Visit the OMS Foundation website or call Dwight Edwards, Executive Director, at 847-233-4325 for assistance in how you can help to maintain and even advance our position as the preeminent surgical specialty of Dentistry. There is no need to be bitter, let’s resolve to get better!
Dr. Eric Geist
AAOMS President 2014