Everyone agrees Telemedicine is a thing. It has been for several decades. The American Telemedicine Association was established in 1993 and the number of patients accessing real doctors via Telehealth is massive. See for yourself in this graph on Statista:

Most Telehealth is directly supervised remotely by a licensed physician but there are instances where patients are literally using DIY medicine in emergent, life and death situations with and without the supervision of a licensed doctor. I’m talking about totally normal and universally accepted procedures endorsed by physicians, patients and even dentists. For example, diabetics use sophisticated technology to evaluate their blood chemistry and administer potentially fatal drugs with hypodermic needles. One mistake made by the layperson performing this procedure could have severe consequences but it happens every day with a very low incidence of morbidity/mortality. Of course insulin pumps are becoming smaller, more reliable/acceptable AND patients are required to visit a physician before they start doing DIY medicine but it doesn’t change the fact that it’s unsupervised DIY medicine day in and day out.

Let’s go a step further. Poison Control Hotlines and Suicide Prevention Hotlines are examples of doctors AND non-doctors coaching laypeople remotely in techniques to diagnose and treat life threatening, emergent situations in real time without an in person visit. Can you imagine medical boards prohibiting non-physicians from giving this life saving advice or requiring that the “patient” be seen in person before advice on how to administer DIY medicine could be given?

If telemedicine is a real thing (anyone who denies that it is should consider themselves a moron), then how can Teledentistry not be? Daily I see dentists and orthodontists falling all over ourselves to convince others (and ourselves) that we are, in fact, real doctors. “Oral physicians” and other similar, contrived monikers make me laugh, but hey, whatever floats your boat. The point being that if you want to be considered part of the larger medical community and be taken seriously by physicians then you cannot run around denying that Teledentistry is a legitimate and natural extension of what we dentists do. Well, I guess you can but then we are back to moron status…

Why do I write this now? I received a Facebook message this am that made me literally laugh out loud.

How many times have I written, spoken, ranted about Teledentistry, direct to consumer orthodontics and how silly dentistry’s protectionist stance is? How many times have I explained that if real doctors can use Telehealth in life or death, invasive scenarios then how can a dentist’s use of the same conduit for elective, non-invasive, largely reversible procedures be out of bounds? Not that I expect everyone to read OrthoPundit or The Progressive Orthodontist Magazine or to attend any of the talks I give, but the person who sent this message knows me well – well enough to message me several times a year. Bringing to mind the very old saying, “Crime isn’t a problem until someone steals YOUR oxen!” This morning’s message and the multitude of protectionist, anti-competitive initiatives, rules, content and attitudes displayed by state dental boards, organized dentistry like the AAO and ADA and individual dentists make it clear that dentists only care about things like access to care and the safety/efficacy of Teledentistry in terms of what we perceive it to cost dentists in lost patients and revenue. That is so messed up and contrary to the spirit of being a healthcare provider I’m speechless.

Me speechless doesn’t happen often!

Consider this a logical argument combined with a desperate plea for dentists and dental specialists to wise up, realize that Teledentistry is not only inevitable but also in the public interest and act accordingly. We must, as a profession, abandon our protectionist, guild-driven past and embrace the new reality for the good of our fellow citizens and for the good of our businesses if we have any expectation of retaining our respected status in our local, national and international communities.

P.S. If you’re interested in learning more about Teledentistry and how it works check out The American Teledentistry Association’s Guidelines on Teledental Practice. 

P.P.S. I’m sure this topic will come up at the 2019 NewConn Meeting. Check out the speaker lineup. Be there! I look forward to a spirited and enlightening debate.

P.P.S. I was an ELP (Endorsed Local Provider) for SmileDirectClub for several years but January 31, 2018 was my last day as such. I left SDC to open my new practice in Orlando, FL because I didn’t have time to do both. SDC is a great company increasing access to care while growing a business and navigating uncharted waters. I have nothing but good things to say about SDC but I’ve been asked if I still work with them – I don’t.

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