The Federal Trade Commission filed a comment on a state law in Georgia to expand the scope of practice for dental hygienists:
The comment, submitted by staff of the FTC’s Office of Policy Planning, Bureau of Competition and Bureau of Economics, says that that Georgia House Bill 684 “would likely enhance competition in the provision of preventive dental care services and thereby benefit Georgia consumers, particularly underserved populations with limited access to preventive care.”
Under current Georgia law, dental hygienists generally must work under the direct supervision of a licensed dentist, which means a dentist must be physically present at the location where the services are being provided. As a result, dental hygienists may be unable to provide care in locations, often rural or underserved areas, where dentists are scarce or unavailable….
HB 684 would broaden the settings where direct supervision is not required, aligning Georgia’s supervision requirement with those in most other states. The FTC staff comment concludes that fewer restrictions likely would enhance competition in the provision of preventive dental care services and expand access to care, especially for Georgia’s most vulnerable populations.
This is not sexy, this is not lucrative, this is not the way political programs are built as the slogan “Minor administrative changes to marginally increase competition by redefining scope of service delivery laws when do we want them —NOW” does not fit on a bumper sticker.
However these are the types of gains that need to be made to reduce the guild power of high end medical providers. Most of the people, most of the time, don’t need high end care. Their basic needs can be met by trained individuals who are not over-trained. Part of the training, of course, needs to be on the recognition of situations which are above the current level of training and therefore the patient needs to go up the ladder of care. But basic dental services, basic primary care services, basic preventative services can often be performed perfectly adequately at the master or bachelor level clinician level instead of a doctorate level clinician level. Those rules are overwhelmingly determined at the state level, so that is where the long slow slog of reform needs to come.