Teeth and allA national dental scheme is desperately needed in the face of mounting evidence that our general health very much depends on the state of our mouths. Cancer, arthritis, heart disease are all more common if you have tooth and gum disease and poor oral health makes good nutrition more challenging for the elderly. So a dental scheme would be a good public health strategy and needs to be developed not just around dentists but to include other members of the dental team - assistants, hygienists and oral therapists—all well trained and working in a delegated model of care to dentists. Dentists do team care much better than medics since medical care is still very much centred on the medical model in which doctors call all the shots. This model is slowly changing with increased access to the various funding streams by nurses, allied health professionals, and even pharmacists, but such changes need to speed up.
No "I" in teamWith modern communication technology, there are no longer any reasons for a doctor to see the whites of a patient's eyes before providing advice. In fact, doctors may not even need to be involved in initial consultations. Rather, what we need are appropriately trained professionals as part of a care team that recognises both their competencies—what they know—and their incompetencies—what they don't know and when and how to ask for help. This isn't rocket science but good team management with each having a role to play to make the whole system more productive. Indeed, as we move into 2014 with a new government, this is one of Hon. Peter Dutton's major challenges—how to get more productivity into the health system. The Productivity Commission report on Health Workforce (2006) suggested the healthcare system (particularly the public hospital system) was 20% inefficient and all we have done since is provide it with more funding. We need to look carefully at why the private system is so much better in term of outputs and outcomes. Is it because they have different nurse/patient ratios? Is it the complexity of the illnesses they deal with? Or, is it renumeration incentives—there must be some answers here? We should know the answers to these questions because it is our health system—our taxes fund it and we should demand greater accountability from it. Although we have one of the best such systems on the planet, costs are rising dramatically.
Creative thinkingSome of the new health arrangements, such as Medicare locals, open opportunities for real patient engagement but only if we shift the focus from a medical model of health to one that is more focussed on the community—on education, employment and other social determinants of health. The Chronic Disease Management Scheme was—in theory—a great step toward multidisciplinary team health care which included Medicare funded dental care. Under this plan people with a chronic conditions are able to get benefits to cover allied health services that help manage their condition. Unfortunately, dentistry is no longer covered under this scheme, as of December 2012.
Bite Dental doing their part!Dental care is a very important part of the overall care plan for people with chronic disease - especially in relation diabetes. However it is often a part that is overlooked. Under the Chronic Disease Scheme, we were able to look after the oral care of many people with diabetes who would not have access to dental care otherwise. Now that the scheme has been amended, the gap of people without adequate access to dental care is a real concern. In an effort to relieve this hole in preventive dental care, Bite Dental are working together with a range of allied health professionals to provide free gum disease risk assessments and education for people diagnosed with diabetes. Simon and Jenna are also lead organisers for complimentary Diabetes Education Nights around Brisbane, where experts from a number of different health professions donate their time to provide valuable information. If you would like more information on any of these initiatives, don't hesitate to ask us!