Winter 2017-18

11 nmdental.org State of the Workforce | continued 2018 continued on next page  A CDHC Scouting Report By Tom Schripsema— NMDA Executive Director The 2011 film Moneyball recounts the story of Oakland A’s general manager Billy Beane and their successful 2002 season. Having lost three top players to free-agency, Beane is faced with rebuilding a team on a shoestring budget. He takes a chance on a scientific method of assembling a team that flies in the face of conventional thinking and succeeds with players that were rejected by other clubs. The team, despite criticism from traditionalists, succeeds by matching the longest winning streak in major league history, only to once again lose in the playoffs. Beane is convinced the experiment has failed, but his method became the winning formula for many successful teams since. The movie was based on a non-fiction book and was fairly romanticized, but the scientific approach of designing a team and filling needs by matching often overlooked skills, has become an essential part of baseball. About the time that Oakland was finding Moneyball success, I attended a meeting in nearby Lake Tahoe. This was a first-of- its-kind gathering of dentists, policy makers, state and federal officials and dental laypersons. We heard presentations and panel discussions on a variety of topics related to “access-to- care.” The group was far from homogenous in its thinking, but I believe everyone benefitted by looking at the issue from a variety of perspectives. While lack of funding was a recurrent theme, there was a recognition on everyone’s part, that this was a complicated multi-faceted problem and that traditional approaches were not adequately addressing the problem. In the years that followed, leadership at the ADA started to consider ways to better address the barriers to care that had been identified at the conference. Things like childcare, time off work, and proximity of services were compounded by language and cultural barriers. It became clear that the problem was not so much a deficiency of available care options, but difficulty in navigating the system. With limited financial resources, the challenge was determining how to connect people to available care resources. Medicine had faced a similar problem decades earlier as specialization became the norm. Case management provided essential navigation for patients with multiple health issues and physicians. In time, this came to include cultural and financial barriers to care, as well. Dentistry has a decidedly different model. The vast majority of care is delivered by general practitioners in a team approach. The “Dental HOME” was the case management model in dentistry, with a general dentist providing for most patient needs, while making occasional temporary referrals for specialized care. For the vast majority of people, this model worked as an efficient and cost-effective means of accessing dental care, and still does. What the conference had pointed out, was that for a significant and growing population that was dependent on financial assistance for care, the model was failing to meet their needs. Was there a way to modify the existing dental team to allow the Dental HOME model to meet this population’s special needs? What would a new dental team member look like? Taking a Moneyball approach, the designers took case management elements from community health workers, cultural competency elements from traditional promotoras, and dental skill elements from existing dental team members to create a curriculum for the new Community Dental Health Coordinator (CDHC). COMMUNITY DENTAL HEALTH COORDINATORS (CDHC) 3 GRADUATES 9 IN THE PIPELINE 115 GRADUATES 130 IN THE PIPELINE NMDA/ADA 2017 NMDA 2017 3 GRADUATES 9 IN THE PIPELINE COMMUNITY DENTAL HEALTH COORDINATORS (CDHC) 3 GR DUATES 9 IN TH PIPELINE 115 GRADUATES 130 IN THE PIPELINE NMDA/ADA 2017 ADA 2017 115 GRADUATES 130 IN THE PIPELINE COMMUNITY DENTAL HEALTH COORDINATORS (CDHC)