Allow me to compliment Dr. Gordon Christensen on a fine article, "What Is the Role of Specialties in Dentistry?" (November JADA). It is an extraordinary effort to shed light on a very complex issue, the delivery of the most competent care to our mutual dental patients.
The article was worthy of rereading several times to grasp and appreciate its thoughtfulness and depth. I did that.
An additional thought might be helpful to give emphasis to a point implied but not expanded in the article. Dr. Christensen states, "Clinical competence in any area of dentistry appears to require a combination of education and clinical experience." He is absolutely right, but it also requires further emphasis on something else—frequency of performance.
A great juggler may possess education and vast experience as a juggler but, if he hasn’t juggled lately, I would rather he not juggle my last dozen eggs.
Most dentists, generalists or specialists, are not better or worse, smarter or dumber, dexterous or less dexterous. They just perform certain dental procedures more frequently (read: daily), and therefore are most competent and best able to provide the most predictively successful service to a patient in need of a particular important procedure, be it diagnosis, filling, bridge placement, extraction, root canal treatment, periodontal treatment or orthodontic movement.
If the specialist and the generalist appreciate each other based on their mutual respect for the competence each has developed in the frequent delivery of difficult procedures to our patients, the harmonious relationship and interaction called for by Dr. Christensen will result.
