Northern Michigan is at a crossroads when it comes to dental care for underserved populations, and the decision being considered by local health officials could determine whether that care survives or collapses.
At the recent Board of Health meeting on June 2, discussion centered on bringing the operations of Dental Clinics North, a private non-profit started by the Health Department of Northwest Michigan, under direct government control. While this idea may sound like a straightforward way to increase oversight, history and hard-earned experience, suggests otherwise.
The dental services program to address the unmet dental needs in Northern Michigan was initiated by HDNW in the mid-90s, and by 2005 was determined to be an unreasonable administrative burden and had difficulty recruiting and retaining qualified dental personnel. So, it made perfect sense to remove clinical operations from HDNW and allow DCN, the non-profit, to administer the clinics.
Government run dental programs have been attempted across the country for decades. They have consistently failed. The reason is simple: Dental care depends on attracting and retaining skilled professionals, and those professionals require an environment that respects their training, judgment and autonomy. When non-dental administrators begin micromanaging clinical decisions, that environment disappears, and with it, the providers patients depend on.
The current DCN private non-profit model works precisely because it preserves that autonomy. Contrary to claims made in a recent presentation, DCN is not losing money, and the public it serves are overwhelmingly pleased with the care delivered. It operates within a system that allows dentists and hygienists to deliver care according to established standards, not bureaucratic directives.
If the Board of Health moves forward with absorbing DCN into its operations, the consequences will be immediate and severe.
First, the Board would inherit more than 100 employees, along with the expectation of their same wages, plus expanded benefits and increased paid time off, consistent with other government staff. The financial burden alone would be staggering.
Second, there is a structural contradiction at play. The board has expressed reluctance to operate the four clinics outside its district, yet those very clinics are essential to the system’s financial viability. Without them, the entire network risks collapse. The out-of-district clinics are located in Cheboygan, Alpena, West Branch and Traverse City.
Third, bringing dental services “in-house” would saddle the board with long-term costs that include facility maintenance, equipment replacement and capital investments for clinics outside the district.
And perhaps most concerning, major decisions about improving dental care are being proposed by individuals with no background or experience in dentistry. Good intentions cannot substitute for expertise in healthcare delivery.
The stakes here are not theoretical. If these clinics fail, as many similar government-run programs have, the result will not just be administrative inconvenience, it will be a loss of access to care for thousands of patients across Northern Michigan.
There are better options.
Rather than dismantling a functioning system, the Board of Health should pause, reassess and consider viable alternatives. One path would allow an experienced and proven existing organization to assume operations independently. Another would be to empower DCN itself to continue operating totally independent of the health department. Both options would preserve the clinic network, maintain continuity of care and remove the financial and administrative burden from the health department.
Equally important, these alternatives would protect the stability of the workforce and ensure that patients, many of whom already face significant barriers to care, are not caught in the fallout of a disruptive transition.
This is not about resisting change for its own sake. The existing contract needs replacement. But replacing a working clinical model with a government run system that has repeatedly failed elsewhere is not progress, it is a step backward.
Northern Michigan has spent more than 25 years building a dental care network for those in need. The question now is whether we preserve or dismantle it in pursuit of a model that history warns us will not succeed.
The Board of Health still has time to choose wisely.
The next Board of Health meeting is Tuesday, July 7 at 10 a.m. at the Shirley Roloff Center, 13513 Division St., Charlevoix. Concerned citizens are always encouraged to attend and share their views.
Thomas J. Veryser, D.D.S., M.H.S.A.
Boyne City
This article originally appeared on The Petoskey News-Review: When government tries to run dentistry, patients pay the price | Opinion
Reporting by Thomas J. Veryser, Guest Columnist / The Petoskey News-Review
USA TODAY Network via Reuters Connect
By Thomas J. Veryser, Guest Columnist | USA TODAY Network
