THE EDITOR'S CORNER
A recent publication of the Council of State Governments is entitled "State Regulatory Policies/Dentistry and the Health Professions". It contains two suggested pieces of legislation--A Suggested State Dental Practice Act and A Suggested State Health Occupations Policy Coordinating Act. Since the suggestions of these two acts may well shape the future of dentistry in many states, significant sections of the acts are reprinted along with commentaries from the task force that formulated the acts in an article in this issue of JCO.
Suggested State Legislation has been a publication of the Council of State Governments since 1941. It was a measure, following our entry into World War II, to suggest modifications in state legislation which were intended to expedite the war effort. Clearly, what began then as a national mobilization to further our war effort has been perpetuated as an influence toward federalization of state legislation and toward uniform national standards of occupational regulation.
Traditionally, the relationship of the professions to the people has been based on a premise that the people granted to the professional person permission to practice. In return, certain things were expected of the professional. It was expected that he would be trustworthy and not engage in sharp business practices. It was expected that he would be charitable both personally within his practice and in agreeing to accept reduced fees within government welfare programs. It was expected that the profession would establish standards of required education and of professional conduct, and that the profession would police itself in these regards. It was expected that the profession would, through service gratis on professional society committees, provide the mechanisms for peer control, peer review, and a recourse for patient complaints. It was also expected that the profession would maintain scientific journals and conduct postgraduate courses and encourage the membership to continue their education and broaden their knowledge. The profession was expected to protect the public by establishing standards for products related to its field and to monitor new product development. It was expected that the profession would encourage and conduct research in the prevention of disease and in treatment methods. It was expected that the profession would educate the public toward establishment and maintenance of better levels of health. These activities were conducted and advanced by dedicated professionals in private offices, in professional schools and related facilities, and in professional societies. This compact between the American public and the dental profession has succeeded, up to this point, in elevating dentistry to high levels of accomplishment in the essential quartet of prevention, treatment, education, and research. The American public has repeatedly signaled its satisfaction with the traditional arrangement by placing dentistry at the highest levels of confidence and satisfaction in numerous polls of public opinion.
Since the work of the task force, embodied in the two suggested acts, arrived at numerous basic changes in the traditional public/professional relationships, both of these acts must be studied and evaluated very carefully. Special attention must be given to the second act--the Suggested State Health Occupations Policy Coordinating Act--because, if its premise is accepted, it will result in changes even more fundamental than are presented in the Suggested State Dental Practice Act.
The Suggested State Health Occupations Policy Coordinating Act creates a Health Occupations Council composed of health professionals and consumers. While each profession would have a representative on the Council, it would be the Council that would control, regulate and enforce all of the professions and allied occupations. Thus, each profession would lose the ability to regulate its own area. It becomes questionable that a representative of one profession or occupation would have the expertise to make a significant or correct decision with regard to the regulation of another. I don't believe that a physician, a pharmacist, a nurse, a physical therapist, an osteopath, an optometrist, a psychologist, a podiatrist, a chiropractor, a veterinarian, and assorted lay members can make decisions with regard to the regulation of dentistry better than a group of dentists could.
The work of the task force deserves careful study and analysis. It does not evoke either broad acceptance or automatic condemnation. Each section should be appraised on its own merits and accepted, rejected, or revised in accordance with the views of individual dentists and organized dentistry about what it considers to be in the public interest and in the interest of the profession. Following that, the course of action with regard to these suggested acts is for dentists and dentistry to work with state legislators, where necessary, to interpret the position of the profession on the issues involved.
