I have long contended that the traditional use of live patients for state board examinations is nothing less than unethical. If a pulp is exposed during the G.V. Black Class II Amalgam test, the patient has no recourse. The patient is left to seek resolution on his or her own. That, quite simply, is patient abandonment. So, I think Res. 64H [a measure adopted by the 2000 ADA House of Delegates calling on testing agencies to phase out the use of live patients] is a step in the right direction.
But it is not enough. State board examinations are a relic that should have been abandoned a long time ago. We are the only health care professionals required to demonstrate our competence in each state, or region as the case may be.
Brain surgeons, heart surgeons, optometrists, podiatrists, veterinarians, nurses and chiropractors can achieve licensure in any state without having to actually perform clinical skills in a state board examination. They proved their competence by virtue of graduating from their respective programs.
Ironically, all U.S. dental schools have to meet the same standards to be accredited. In other words, the standard for dental school education is universal across all 50 states. So, logically, all dentists who have graduated from a U.S. dental school have met the same standards.
If we feel the competence of dentists who wish to cross state lines should be tested or proven, what does that say about our confidence in our dental schools? It’s ridiculous. Are our schools guilty of graduating incompetent dentists in the pursuit of profitability? I’d like to think that is not the case.
The requirement that specialists perform general dental procedures is further evidence of how ludicrous our system of licensure is. Now, in the case of foreign-trained dentists, I agree that clinical and written examinations are warranted.
Here’s the real reason we continue to have clinical state board examinations: turf protection. Plain and simple. We dentists are so insecure, we feel we have to limit our perceived competition (dentists). Market forces will accomplish that without our interference. We are our own worst enemy. As an old saying illustrates, "If you ask a group of dentists to form a firing squad, they will stand in a circle."
When will we realize that other dentists are not our competition? Frankly, the whole thing is an embarrassment. If the ADA took a stand on this issue, I predict many of the non-members who claim the ADA does not represent them would stand in line to join!
