FALMOUTH – As a dentist practicing in the state of Maine and as a member of the Maine- Care Dental Advisory Board, I would ask for a “no” vote on Question 2, a bond to establish a dental school in Maine, for the following reasons.
1) Maine has taken a not-so-good Medicaid system, called MaineCare here, and has managed to make it a lot worse over the last five years by expanding eligibility and delaying payment to providers.
That in turn has hurt existing rural low-income clinics, making it difficult for them to pay staff and buy supplies.
If Maine had better managed what resources it had, it might not have to try this stunt.
Through MaineCare mismanagement, Maine has lost practitioners in many health care disciplines. The MaineCare system still owes $400 million to the hospitals of the state and more to private providers.
2) This school will potentially graduate students who are underqualified to practice dentistry in any state because they will not be able to get adequate mentoring from specialists when they are at off-site locations.
More of the students’ time may be spent providing emergency care, extracting teeth and making dentures than practicing skills learned in class for treating children, and repairing and preserving teeth in poor repair.
These are skills that are part of the average dentist’s daily routine for patients of all ages.
3) The dental students will not get any real experience in treating children of any age.
They will only get experience in referring them to pediatric dentists.
No dental school in New England gives its undergraduate dental students adequate exposure in treating kids without dental disease, let alone kids who come in with dental infections or even a slightly decayed tooth.
It is not part of the curriculum. They do not need to know it for the New England Regional Board of Dental Examiners.
4) This bond is ultimately to support a private institution with public money in its goal to have an instate dental school, the University of New England Dental School.
That school may ultimately graduate poorly qualified dentists who will probably only be able to practice in the more remote areas of Maine, New Hampshire and Vermont because they lack the necessary skills to pass boards in other regions of the United States.
For that matter, NERB may decide they lack the proper preparation to be certified, period.
5) The cost of education at a UNE-sponsored program will be too expensive for any student ($45,000 tuition and $10,000 for double-occupancy room per year) to be able to think realistically about practicing in a low-income area and be able to pay back that debt.
UNE will not forgive any debt for any reason regardless of where you practice.
Estimated costs of the A.T. Still University College of Dentistry, the Arizona model for UNE’s plan, is $92,000 for each of the first two years and estimated total cost is $242,000.
Federally backed student loans will forgive most of the debt if the student works for six-plus years in a certified low-income clinic.
After the first three and four years of graduates enter the low-income clinic payback program, where will new graduates go to work? All the positions will be filled nationally.
Assuming that UNE came up with a crackerjack program that was the envy of all, why would any graduate with more than $200,000 in debt elect to work in a low-income area where Medicaid would be the principal bread and butter.
6) Finally, UNE currently operates the dental hygienist training program that was operated for years by the former Westbrook College.
Westbrook College had a program that efficiently trained capable graduates in a difficult curriculum in two years, awarding them an associate degree and a rewarding career.
UNE now offers a four-year degree (for the same $55,000 in tuition and room and board). UNE has trouble finding patients for the its dental hygiene student clinic. It now advertises on the radio to ask people to come in to be patients.
It’s hard to believe that this patient availability will improve with the UNE Dental School. Tufts University College of Dental Medicine in downtown Boston has trouble getting appropriate patients for their students to meet requirements.
Finally, it’s doubtful that Maine can afford any bond issue at this time, and this one is simply unwise spending.
– Special to The Press Herald
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