General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsHoly effing s--t:
Look what I just got in my email
I wonder what theyre expecting...this is the first time in my lifetime that an order like this has come down:
Expansion of Scope of Practice to Provide Assistance in Responding to COVID-19
Dentists and Oral Surgeons
On May 6, 2020, Governor Tom Wolf signed an Order of the Governor of the Commonwealth of Pennsylvania to Enhance Protections for Health Care Professionals (the Executive Order). Its purpose is to afford health care practitioners protection against liability for good faith actions taken in response to the call to supplement the health care provider workforce battling COVID-19.
During the course of the pandemic and the disaster declaration associated with it, the Wolf Administration has used its authority under the declaration to suspend a number of regulations and regulatory statutes. The effect of several of the suspensions is to expand the scope of practice and to relax supervision requirements for numerous health care licensees, allowing these professionals to perform acts they would not otherwise be authorized to perform in the ordinary course of their practice.
More specifically, as set forth in the Executive Order, temporary suspension[s] of portions of 63 P.S. §§ 42.2, 271.2, 422.2, 625.101-625.1106, and 49 Pa. Code §§ 18.502, 18.509, 25.702, 25.709, 33.208 have been granted to provide opportunities to trained health care practitioners, not currently on the front lines of the pandemic response, with the opportunity to assist in response efforts if they so desire. The expansion of the scope of practice of Dentists, Oral Surgeons, Athletic Trainers, Chiropractors and Podiatrists would permit MDs and DOs to delegate certain practices to these practitioners to support the efforts to expand the response needed in hospitals, emergency departments, nursing homes and long-term care facilities during the COVID-19 disaster emergency. For dentists and oral surgeons, the effect of these suspensions is as follows:
Dentists and oral surgeons (DDS and DMD) may perform the following tasks for the duration of the emergency declaration: triage; providing care in hospital and health systems; accepting emergency referrals from hospitals and health systems; collecting throat cultures; performing nasal swab testing; prescribing, administering and dispensing medications without regard to the requirement that such prescribing occur in the course of a dentists professional practice, or the requirement that such prescribing be within the scope of a dentist-patient relationship; conduct examinations and take medical histories in conjunction with prescribing, without regard to the requirement that such examination focus on the patients dental problems, and without regard to the requirement that an entry be made in the patients dental record; ordering a renewal or refill of an emergency prescription without regard to the requirements that the dentist give the patient a dental examination and take a medical history; oral surgeons who hold unrestricted anesthesia permits can assist in stabilizing patients; performing other tasks lawfully delegated by an M.D. or D.O.
A licensees obligation to competently perform their duties consistent with their level of training, education and experience is a guiding principle that is both constant and unwavering. Neither the Executive Order nor the temporary suspensions alters that obligation. Moreover, when performing tasks to aid in the COVID-19 response that are outside of their normal scope of practice, licensees (and those working towards licensure) shall not undertake any activity for which they are not already licensed or authorized to perform without first obtaining the appropriate training and support to perform those tasks competently.
The Executive Order shall remain in effect for the duration of the disaster emergency.
malthaussen
(17,175 posts)Since it appears that dentists can prescribe medication that has nothing to do with oral hygiene, the question is raised as to what qualifications, actually, are requisite to write an Rx. Then the last paragraph appears to cancel the whole thing, since it requires licensees to be trained first. As a literary exercise, the XO leaves me scratching my head.
-- Mal
PCIntern
(25,489 posts)Systems, so that if someone couldnt reach their PCP, we could represcribe Meds or worst case scenario do what has to be done at that moment. We have all taken physiology and pharmacology and are familiar with meds, side effects, and indications. Im not saying I know as much as a competent MD but youre better off with me than you are with the idiot in the WH who would have you drink bleach.
malthaussen
(17,175 posts)I wonder if vets are also going to be so empowered? Or psychiatrists? They both have similar basic training, do they not? The problem I see is that the lines are rather blurred: carrying out "delegated" tasks can be reasonably done by any relatively intelligent health care worker (even EMTs, one would thing), but originating dx or rx would seem to require a bit more training and experience.
-- Mal
PCIntern
(25,489 posts)And are physicians in every sense of the word. As dentists we are trained in managing infection and pain control including those that are life-threatening. You might be surprised at the depth of our training, although I would never put it on the same level with that of a well trained physician. Oral surgeons are extremely highly trained in their specialty and are basically physicians who practice under another diploma.Some of the most confident hospital-based physicians I have ever known are surgeons who did maxillofacial reconstruction. None of them had an MD. And I might add, I know physicians who dont know their own ass from a hole in the ground.
malthaussen
(17,175 posts)... that latter was her opinion of most of the physicians she knew.
-- Mal
PCIntern
(25,489 posts)Yeah.
Ms. Toad
(33,999 posts)We lucked into him, since the original surgeon (who has an MD) rejected our insurance a year into the process (after removal of wisdom teeth, and about 9 months into the braces designed to align her teeth for post-surgery). In addition, we only had a few months before a change in insurance companies (and approval for the surgery was not certain because it is sometimes considered cosmetic).
So we looked for anyone on our insurance plan who could get the job done. We landed with a DDS. I am so glad we did.
The original MD insisted on a mock surgery using molds (adding to the costs) and predicted a 4-hour surgery, with about 6 weeks before she would be close to normal.
The DDS didn't do a mock surgery, told the hospital crew (who normally works with the MD) that he would be done in an hour. The hospital crew took us aside and told us there was no way that he would be done in an hour - it would be several hours.
Less than an hour after we sent her off, our DDS walked into the waiting room and told us it had all gone well. That was on a Wednesday, before the Monday school started. We had been told (by the MD) to expect her to be wired and swollen for weeks - so we had prepared the school. By Monday, no one who had not been told she had had a chunk of her lower jawbone removed would have even known she was less than a week post mandibular reduction surgery.
In contrast - a buddy of hers has surgery with our original MD. Her surgery took every bit of 4 hours - and it took weeks before she looked even close to normal.
Our DDS was just so gifted in being able to see how things would fit togther - and surgically skilled - that he was in and out without beating her up beyond the minimum necessary to accomplish the goal. I think that is the primary difference.
But boy am I glad our original MD was such a jerk (about refusing to work with us when he stopped accepting our insurance most of the way thorugh a year+ process.). He actually stopped shortly after he had removed her wisdom teeth and didn't bother to notify us for months. I think he figured wd'd just pony up the extra money because it was so late in the process.
lindysalsagal
(20,584 posts)and so I'd be quite nervous about jumping into such a different role without the internships and residencies that docs need to gain real-world experience.
Don't think I'd have my hand raised...
PCIntern
(25,489 posts)When it comes to Good Samaritan laws: my guess is that its been made a part of that grouping.
Im not looking to do vrain surgery believe me
Hermit-The-Prog
(33,258 posts)The situation is or is anticipated to be serious enough to warrant allowing you to provide such assistance, but it's not quite dire enough to conscript you into service.
PCIntern
(25,489 posts)PCIntern
(25,489 posts)The reason for posting this release is that it is clear that the commonwealths government is expecting additional severe problems. Otherwise in no way shape or form would this state in particular issue an order such as that. We have an extremely conservative bent in the state with regard to professional behavior and allowable duties and the rules are extremely stringent here And enforced ruthlessly.
When I received this, I was shocked, and it takes an awful lot to shock me at this point.
SWBTATTReg
(22,077 posts)By the way, I trust fully my dentist to any procedures. I suspect that the schooling, training, internship, etc. is probably just as rigorous as any other...Be safe.
PCIntern
(25,489 posts)Ms. Toad
(33,999 posts)I've just gotten weary of talking about what I expect will be here in a little over a month.
LiberalLoner
(9,761 posts)all dentists can act as general practitioners during this epidemic. Because...they think the number of sick people will overwhelm the ability of the current MDs?
Or am I misunderstanding this? Because thats what it sounded like to me. Im fine with that, dentists are doctors after all. Even veterinarians can give medical aid in a pinch, Im guessing. Not comparing the two groups, just saying, in an emergency where we need all hands on deck, there are probably a number of groups that can be brought in. Medical students near graduation. Maybe RNs. I dont know.
But what Im getting from this is, they expect to be overwhelmed with sick people.
gibraltar72
(7,499 posts)Anybody with medical training is better than someone who doesn't have some. I hope it isn't that dire, but we know it can be. I think Wolfe has done a great job.
LiberalLoner
(9,761 posts)Kid Berwyn
(14,801 posts)The nation is being harmed, intentionally, by the IMPOTUS.
As the Guv understands, the People of Pennsylvania are fortunate to have you on their team.
panader0
(25,816 posts)Karadeniz
(22,473 posts)Radioactive waste...probably the safest place in town to be!
PCIntern
(25,489 posts)Ill pass that around...with attribution!!!