tpter1

Food for thought...
No* Dentist Left Behind
*
*

My dentist is great! He sends me reminders so I don't* forget
checkups. He uses the latest techniques based on research. He never
hurts me, and I've got all my teeth.

When I ran into him the other day,* I was eager to see if he'd
heard about the new state program. I knew he'd* think it was great.
*
"Did you hear about the new state program to measure*
effectiveness of dentists with their young patients?" I said. "No," he* said. He didn't seem too thrilled.

"How will they do that?"*
*
"It's* quite simple," I said. "They will just count the number of cavities each patient has at age 10, 14, and 18 and average that to determine a dentist's*rating. Dentists will be rated as excellent, good, average, below average,*and unsatisfactory. That way parents will know which are the best
dentists.* The plan will also encourage the less effective dentists to get
better," I* said. "Poor dentists who don't improve could lose their licenses to*practice."
*
"That's terrible," he said.
*
"What? That's not a good attitude,"* I
said. "Don't you think we should try to improve children's dental health* in this state?"

"Sure I do," he said, "but that's not a fair way to*determine who
is practicing good dentistry."
*
"Why not?" I said. "It makes*perfect sense to me."
"Well, it's so obvious," he said. "Don't you see that*dentists
don't all work with the same clientele, and that much depends on*things we
can't control? For example, I work in a rural area with a* high percentage of patients from deprived homes, while some of my*colleagues work in upper middle-class neighborhoods. Many of the*parents I work with don't bring their children to see me until there is* some kind of problem, and I don't get to do much preventive work. Also many*of the parents I serve let their kids eat way too much candy from an early age, unlike more educated parents who understand the relationship*between sugar and decay. To top it all off, so many of my clients* have well water which is untreated and has no fluoride in it. Do you have*any idea how much difference early use of fluoride can make?"

"It*sounds like you're making excuses," I said. "I can't believe that you,*my dentist, would be so defensive. After all, you do a great*job,
and*you needn't fear a little accountability."

"I am not being defensive!"* he said. "My best patients are as good as
anyone's, my work is as good as*anyone's, but my average cavity count is
going to be higher than a lot of* other dentists because I chose to work where I am needed most."
"Don't get touchy," I said.* "Touchy?" he said.* His face had turned red,*
and from the way he was clenching and unclenching his jaws, I was*afraid he was going to damage his teeth.* "Try furious! In a system*like this, I will end up being rated average, below average, or worse. The*few educated patients I have who see these ratings may believe this*so-called rating is an actual measure of my ability and proficiency as a*dentist.*They may leave me, and I'll be left with only the most needy*patients. And my cavity average score will get even worse. On top of that,*how will I attract good dental hygienists and other excellent dentists to*my practice if it is labeled below average?"

"I think you are* overreacting," I said. "'Complaining, excuse-making and stonewalling won't*improve dental health'...I am*quoting from a
leading member of* the DOC," I noted.*
*
"What's the DOC?" he asked.* "It's the Dental Oversight Committee," I said, "a group made up of mostly lay persons*to make sure dentistry in this state gets improved."*
*
"Spare me," he*said, "I can't believe this. Reasonable people won't buy it," he said* hopefully.

The program sounded reasonable to me, so I asked, "How else*would you measure good dentistry?"*
*
"Come watch me work," he said.* "Observe my processes."

"That's too complicated, expensive and time-consuming," I
said.* "Cavities are the bottom line, and you can't*argue with the bottom line. It's an absolute measure."
*
"That's what I'm* afraid my parents and prospective patients will think. This can't be*happening," he said despairingly.
"Now, now," I said, "don't despair. The*state will help you some."*
*
"How?" he asked.
*
"If you receive a poor*rating, they'll send a dentist who is rated
excellent to help straighten*you out," I said brightly.
*
"You mean," he said,"they'll send a*dentist with a wealthy clientele to show me how to work on severe juvenile*dental problems with which I have probably had much more experience? BIG*HELP!"
"There you go again," I said. "You aren't acting professionally at all."
*
"You don't get it," he said. "Doing this would be like grading*schools
and teachers on an average score made on a test of children's*progress with no regard to influences outside the school, the home, the*community served and stuff like that. Why would they do something so unfair*to dentists? No one would ever think of doing that to schools."*
I just*shook my head sadly, but he had brightened. "I'm going to write*my
representatives and senators," he said. "I'll use the school analogy.*Surely they will see the point." He walked off with that look of hope mixed with fear and suppressed anger that I, a teacher, see in the mirror so*often lately.

If you don't understand why educators resent the recent*federal
NO CHILD LEFT BEHIND ACT, this may help. If you do understand,you'll enjoy
this analogy, which was forwarded by John S. Taylor,* Superintendent of Schools for the Lancaster County, PA, School District.*
*
> Be a friend to a teacher and pass this on.*


Seeing how this thread is kind of just a mix of varied discussion, I'll thorw this log on the fire...