‘Because I Say So’ Is Not Sufficient Reason For The ADA To Ask Dentists And Patients To Forsake Their Rights
Do members of the American Dental Association’s governing councils and board hear and see with the same human ears and eyes as the rest of us?
Sure, there are some
If so, toward what possible end? Only the
At the moment, the
Here is a question that every ADA member should be asking his or her local and national representatives: Where are the dentists who regularly practice adult OCS under existing ADA guidelines and have come forward to warn the ADA that the guidelines need to be stricter? WHERE ARE THEY?
Do the elite of the ADA truly believe that they alone know what is good for patients, ignoring the dedicated and honorable men and women who treat those very patients day in and day out?
What does it say about the ADA’s faith in its own members if the ADA doesn’t trust them to be honest and sufficiently public-minded to report a public health risk when they spot one?
But we see no such evidence of dentists who regularly utilize OCS on adults in their practices and have come to believe OCS is unsafe. Moreover, we strongly suspect that no such evidence exists.
ADA member dentists by the hundreds are writing and calling TEAM 1500 to express their dismay at the ADA’s proposals. We are publicly documenting some of these letters on our web site (www.team1500.org) and will present them en masse to the ADA for its review.
In that same spirit of full public disclosure, TEAM 1500 hereby calls upon the ADA to go beyond intimations and publicly document the existence of any scientific evidence of morbidity or mortality that supports the need for new, significantly stricter guidelines on those dentists who offer OCS. Moreover, let the ADA make public for all to see – patients and dentists alike – the logs of calls and letters that the organization has received from dentists who actively practice oral conscious sedation and report that OCS is unsafe when practiced within existing guidelines.
Come on ADA, show us what you’ve got!
I will say this for the dentists who I’ve been in contact with since the formation of TEAM 1500: Not a one of them would knowingly risk his or her patient’s safety. Indeed, if the ADA can produce documented, clear evidence of harm done to adult patients as the result of OCS as practiced in conformity with existing guidelines, then I’m certain that most supporters of TEAM 1500 will immediately yield to the ADA’s position.
Will the ADA do likewise?
If the ADA lacks any such concrete evidence, will it yield to reason and drop its ill-conceived revisions? Or will the ADA proceed with its campaign against OCS just to prove that it retains the clout to pretty much do whatever it well pleases, and let its members and the public at large be damned?
This issue presents a crisis of purpose for the ADA. The organization which is charged first and foremost with ensuring public safety is in danger of losing its credibility with that very public.
Will the ADA come to its senses, open it eyes, ears and hearts, and let reason and public need prevail? Or will it persist in the egocentric belief that it alone knows what is right and good for us – even in the absence of any supportive science – and we should all follow along just because the ADA says so?
The first path is not only the correct one for the ADA, it is the only one that can preserve its reputation for integrity. The second course will lead the ADA to a slow but certain demise.
-- DEAN ROTBART
I have got this feeling that TEAM 1500 is juat another name for DOCS and their doctor clientle. This is just like the Anti-Kerry Swift Boat PAC. It's not that I dont simpathize with you...its the deception that I don't like
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Dr. Urban: There is no deception here. Since DOCS has trained more than 7,000 dentists, it isn't exactly surprising that many of its graduates are among our most ardent supporters. Who would you expect to be most vocal in this fight but the dedicated men and women who practice OCS on a weekly basis?
That said, TEAM 1500 is not DOCS. How so?
1. We are not funded by DOCS. Our funding comes from hundreds of individual dentists, their staff members and concerned patients.
2. We are not governed by DOCS. While I welcome the leadership DOCS has shown in this effort, I speak my mind -- often in a way that does NOT reflect the views of DOCS.
3. TEAM 1500 embraces all dentists and organizations, including those who compete directly with DOCS and who are openly critical of DOCS. On this issue, we are looking out for patients' rights first and foremost.
TEAM 1500 would not exist today were it not for the generous support of DOCS members and the initial impetus given us by DOCS. But this movement has grown quickly larger than DOCS members alone. We are receiving support and endorsements from many general dentists who don't practice OCS, but see the harm in trying to restrict those who do.
Moreover, I'm also getting encouragement from non-medical associations who applaud our commitment to equal access healthcare for all. You'll be learning more about this soon.
It seems to me that it is hard to deceive anyone when the facts are all in the open.
DEAN ROTBART, Director
TEAM 1500
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I agree with the intent of the article but not the "bring them on" tone. I would like to hear from the ADA before becoming as angry as the article I just read. I do agree that we have not had any untoward events using ocs in our office and have not heard of any.
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I am a practicing dentist in Arizona. In this state we have recently (2004) had the state board of dental examiners(BODEX)mandate an additional regemin of training and board intervention in your practice(on site inspection of your facilities and equipment,personal questioning of your knowledge of emergency protocols) this along with the additional expence of paying for an additional oral conscious sedation permit, has changed the way we are able to practice in this state. I was practicing ocs for 20 years prior to this change without incident, but the state chose to implement this plan regardless of what the majority of practitioners thought, and we are now stuck with it.I have had to increase my fee for this proceedure(ocs)by almost 200% to cover the cost of additional C.E.,permit cost,additional documentation and paperwork time.
I practiced ocs for 20 years prior to the changes mandated by BODEX safely and without incident. Are patients safer now, probably, but at what cost. I feel that all ethical dentists practice with the ultimate welfare of their patients at heart. Additionally, no one wants to be sued for malpractice, or lose their license and livelihood. If they don't feel that they can safely perform a proceedure they either refer to a more qualified collegue, or get the additional training necessary to become competent in that area. This they do on their own, without coercion or mandate by state or national organizations. Unfortunately,there are many out there who don't realize that our ability to practice dentistry as we see fit, is gradually slipping away as we allow big brother to limit or define our scope of practice. I personally do not want or condone this control, and I hope that others feel the same way. Sincerely, Dr Steve Rubisch
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Wake up, wake up, wake up! I think that's the tone of the author. Add a dash of anger and indignation and you have politics as usual in our country.
I am simply perplexed at how global the "solution" the ADA is trying to enforce upon the generalists. They know it will be onerous and achieve their goal of severely restricting OCS use by generalists. I suspect it is because they (oral surgeons, and periodontists -who are over represented in the ADA and who can't practice at all without sedation) are afraid of an outright ban or severe restriction on their private practice privileges IF some generalists act irresponsibly and kills or harms patients with OCS. They are acting proactively and defensively to protect their way of life from a perceived threat. Hence the theme of their argument is "public danger". The success of organizations like DOCS in training greater numbers of generalists has simply catalyzed their reaction.
Their tactics are clever, because on the surface the argument appears reasonable, and it is hard to argue against education and training when the argument is framed around public safety.
Of course it is just classic turf protection. The author is right in observing that there is not a groundswell of public or wide professional fear of this practice as a public threat. It is manufactured. My "public" is extremely grateful not fearful. Safe pills are infinitely more attractive to our fearful patients than sharp needles. OCS better serves our much different mission - to serve the fearful. OCS is clumsy and slow for the oral surgeon's daily schedule of many patients, but it is elegant for the generalist treating 1 or 2 fearful patients in our day.
The best defense against it should be morbidity and mortality statistics - if they are kept. I would bet that they would show IV sedation, which is also exceedingly safe, results in more emergency procedures.
If M& stats are not readily available to us then our only recourse become purely political as suggested in the "back it up with specific complaints" approach the author suggests.
Also, I wish debate could be about establishing protocols based on classes of sedatives.
The validity of arguments about pharmokinetic variables being less controlled with oral rather than IV administration, vary greatly with the class of sedative and the protocol used.
In a practical sense, that is why OCS is so successful for us. With drugs that have huge margins of safety, and the ability to provide antagonists with sublingual injections, the oral route is the choice for nearly all generalists.
It is a canard, and I will really miss the opportunity to help people I have come to enjoy rather than avoid. Helping the fearful with OCS has become one of the most professionally satisfying things I do.
For the specialists IV sedation is artful and OCS is crude, and I just don't think they can appreciate how grateful I am for OCS. Some of my patients in fact cry in gratitude for it.
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