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A conversation with the president-elect: Part 2

Dr. Summerhays offers insights on the Association’s challenges, accomplishments

November 02, 2015
Clinical photo of Dr. Carol Gomez Summerhays
Experience: Dr. Carol Gomez Summerhays learned the value of the ADA throughout her career. “The ADA has ensured that American dentistry is the gold standard for the world.”
Editor’s note: This is the second part of a conversation about issues facing dentistry with Dr. Carol Gomez Summerhays, ADA president-elect, who will be installed as the 152nd president of the American Dental Association Nov. 10 in Washington, D.C. Part 1 was printed in the Oct. 19 ADA News. ADA News Editor Judy Jakush interviewed Dr. Summerhays.

ADA News: Outreach to dental schools and students is a priority for the Association. Student debt/new dentist debt particularly continues as a deep concern for the profession. How is the Association addressing these issues?

Dr. Summerhays: It has been a great experience traveling the country visiting dental students, meeting with the deans and faculty. Engaging in discussions of issues important to them: dental student debt, initial licensure, portability of licenses and finding a job has helped us focus on solutions.

We’ve got great news. The Association has an exclusive endorsement of a bank (DRB) that allows ADA members an opportunity to refinance existing federal and private students loans at a lower rate. Dr. Maxine Feinberg appointed a Student Debt Work Group to determine the best solutions to help reduce the burden of dental school debt.

The ADA announced the relationship in September, and we’re happy to offer a program that will save qualifying new dentists an average of $30,000 in interest.

It will be extremely competitive to what’s available on the market. Generally, there is a reduction in interest rates of several percent below loans offered through federal programs. DRB will reduce the interest an additional 0.25 percent to ADA members. There are no application fees. The ADA is providing this as a member benefit. Not a dime is coming back to the ADA: this is purely for the support of our new dentists to support them.

We advocate on the federal level for student loan reforms. The total amount of debt that students are graduating with now is higher than ever, double what it was in 2002. Proposed reforms include the ability to write off interest payments without a cap on income.

The ADA has financial management resources online in the Center for Professional Success to help new dentists personally and in their practices. Life and disability insurance through Great West Life is an excellent benefit which protects dentists and their families.

The use of human subjects in the examination process for initial licensure is an ongoing concern. There are many ADA policies that address this issue. Some are 15 years old. This year, the Association began moving policy into action. In March, the Board of Trustees held a half-day strategic discussion session on dental licensure with the American Dental Student Association board and the members of the New Dentist Committee. Following the meeting, Dr. Feinberg appointed a Licensure Task Force chaired by Dr. Gary Jeffers, ADA Ninth District trustee. We’ve participated with the American Dental Education Association Licensure Taskforce chaired by Dr. Steven Freidrichsen, dean of the College of Dental Medicine at Western University of Health Sciences.

One of the immediate outcomes is a dedicated ADA staff member who will maintain the most current and comprehensive information online for state-specific dental board requirements for licensure.

New models of initial licensure are emerging. California implemented the portfolio model this year. Minnesota has the OSCE (Objective Structured Clinical Examination) model, which is the national licensing exam in Canada. New York was the first to adopt a mandatory PGY-1 (a postgraduate dental education program of at least 1 year in duration). About eight states accept PGY-1 for initial licensure.

Portability of licensure is increasingly important. We know the dentist of today will move more than the dentist of the past. Some dentists work in several states to fill their workweeks.

Our ADA Licensure Task Force will continue its work this year to develop a 3-5 year strategy to move ADA policy into action.

ADA News: Practice models such as dental service organizations and large group practices are growing. What is the ADA’s role in outreach to these dentists and in recognizing the growth of DSOs?

Dr. Summerhays: Our Health Policy Institute has produced research, published papers and videos and provided presentations regarding DSOs, small and large group practices and the consolidation of practices.

New models of practice are providing job opportunities for new graduates. DSOs represent one model of practice. According to HPI, no single model will overwhelm the other models.

Many of the dentists who work in DSOs, may eventually wish to own or have an equity in a practice. We are also seeing a dynamic whereby dentists who have been in practice for a long time join DSOs or group practices to continue patient care but give up business management.

We have engaged in conversations with owners of these new models to increase value to employee dentists. Some of the benefits to the dentists are peer review, continued education, clinical guidelines and advocacy at the state and national levels. Additionally, the ADA is informing our members about the changing practice landscape and new models of practice.

Whatever the future brings, I am fully confident that the graduating dental students and new dentists will adapt and thrive in a new world.

ADA News: Your role in leadership means you have to focus on the future of the Association, which depends on membership. How do you answer when dentists ask why they should join the ADA?

Dr. Summerhays: Joining the ADA is the best insurance to support you and the profession. This continues to be the No. 1 driver for membership. No. 2 is advocacy for the patient and the profession. Perhaps because we’ve built a great profession, some may take for granted what organized dentistry has done. It’s important to give concrete examples of what we have in daily practice as a result of the ADA.

One example is the uniform insurance form that can be transmitted digitally for rapid reimbursement. That didn’t happen by accident. I remember the days of paper forms specific to the insurer that had to be completed manually for each patient.

We take for granted that products we use for our patients are safe. The ADA Standards Committee on Dental Products develops the standards for dental materials, dental products, dental equipment and dental instruments to give us peace of mind.

Advocacy is another aspect of the ADA that is easy to take for granted. There are thousands of different laws that are passed at the state or national level that impact our patients and the way dentists practice. Organized dentistry supports dentists so they can focus on their patients.

Another example is the accreditation standards for dental schools that ensure excellence in the education of dentists, dental hygienists and dental assistants.

The ADA Principles of Ethics and Code of Professional Conduct celebrates its 150th year in 2016 of putting patients first. Surveys show this is a differentiating factor for patients when they choose a dentist.

The ADA has ensured that American dentistry is the gold standard for the world. These are just a few examples of why I believe 100 percent of dentists in this country should be members.

ADA News: What are the opportunities and challenges of Medicaid for the profession.

Dr. Summerhays: Medicaid reform is a significant initiative within our Action for Dental Health. There has been a large expansion in the number of adults eligible for dental benefits through Medicaid. We have committed resources to help dentists who want to participate in the program, which varies from state to state and even within the state. The ADA has developed a Medicaid contracting manual.

We’re launching a credentialing service in 2016 to facilitate and simplify the process for dentists who wish to participate. The service would be accepted by managed care programs within the Medicaid system as well as other entities that require verification of a dentist’s professional credentials.

We support state efforts to increase Medicaid reimbursements. We know from the ADA Health Policy Institute’s research that to encourage more participation, a viable program requires an adequate reimbursement rate and a reduced administrative burden for dentists.

A top issue for our members has been the Medicaid Recovery Audit Contractor Program. The RAC audits involve outside contractors who often receive a percentage of the fines collected for violations found. In some cases, the auditors have no dental experience or expertise. Fines have often been imposed for minor administrative errors with the extrapolation of the violations exorbitant. The ADA has been working at the federal and state levels to ensure a fair and transparent practice.

Each state is different but we are making progress and expanding the safety net.

ADA News: What do you hear from dentists as their top requests for action from the Association?

Dr. Summerhays: The No. 1 frustration is with third party payers. That impacts every dentist in practice. Without organized dentistry, an individual dentist is on his or her own. Members can be assured the ADA has their back at the national level and their constituent dental society protects them at the state level.

As issues arise, the ADA is a resource for information on how to deal with them and often will intervene on behalf of the member. The ADA alerts members of emerging issues around the country and, if necessary, the ADA will take action. This is a fall-on-your-sword issue for our members. Solutions can vary from simply negotiating change to legislation or litigation.

We support federal legislation, HR 3323, the DOC Access Act, a bill sponsored by U.S. Rep. Earl L. Carter, of Georgia, which prohibits all health plans offering a dental or vision benefit from dictating what a dentist may charge for services not covered by the plan. Rhode Island was the first state to successfully challenge the noncovered services provision by some insurance companies and since then, a majority of states have followed.

The beauty of organized dentistry is the tripartite structure that allows each part to strengthen the other: it’s the local, state and national associations sharing knowledge, learning from each other and working together.

ADA News: What should every member know about the Association — is there something you value of which others may not be aware?

Dr. Summerhays: I don’t think most members realize all the work being done in science both in Chicago and at the ADA Foundation Dr. Anthony Volpe Research Center in Maryland.

In the recent Ebola scare, the country turned to the ADA for guidance on dental visits for potential carriers of the Ebola virus. Webinars and communications were available to guide dentists in their practices.

For the public, Science bestows the ADA Seal of Acceptance for consumer oral health care products that meet strict guidelines. We will strengthen the ADA brand to the public through the ADA Seal.

Much of what is in use today in dental practice was developed at the Volpe Research Center. This includes composites, high-speed handpieces and panoramic X-ray equipment. There is a renewed focus on the research at the Volpe Center that will impact the future of dental practice.