Dentists' Departures Threaten Veterans' Dental Health Care

Article excerpt

Dear Sgt. Shaft:

Clear documentation was presented on April 12 at a House subcommittee on health hearing which delineated the demise of dental care being provided to our deserving veterans by the Department of Veterans Affairs. Dentists, particularly oral and maxillofacial surgeons, are leaving the VA in unprecedented numbers. Most of the vacated positions are being eliminated by local administrators.

In the past three years the number of dentists employed by the Veterans Administration had fallen from more than 850 to fewer than 650. In the past three months at least 21 dentists have left, many of them to enter private practice. In the 1970s and the 1980s there were up to 1,100 VA dentists. The dental health care needs of the eligible veteran population has increased, not diminished since 1970.

In August 1996, 89 oral and maxillofacial surgeons, mostly full-time surgeons, were employed. Today, only 62 oral and maxillofacial surgeons provide surgical care at VA hospitals. Four have resigned already this year. Three others have announced imminent resignations, 25 work less than half-time, 13 are administrators, and only 23 remain to provide full-time surgical care for veterans at 172 VA hospitals. Several states and even some regions of the country have no surgeon to provide oral and maxillofacial surgical care for their patients.

Veteran patients are medically, psychiatrically and/or physically compromised. Many have more than one handicap. Through no fault of their own, these veterans are the most difficult patients to treat.

Results of the above are easily understood. Fewer dentists, who are more stressed and who have lower morale, are providing fewer veterans with the dental care they need, they earned and they deserve. Fewer dental procedures are being completed. Less dental research is being accomplished. The number of dental educational residencies is decreased. The amount of dental care for head and neck cancer patients is diminished. And because there are too few dentists employed by the VA, medically compromised veterans are experiencing more dental pain.

In the rare instances when recruiting is attempted, it is unsuccessful because salaries for VA dentists are the lowest of any group of dentists in the U.S. Young and midcareer dentists are leaving in increasing numbers. According to the American Dental Association, the overall average net income for all dentists practicing in the U.S. is nearly double that of VA dentists.

Bipartisan bills have been introduced in Congress that address at least part of the retention and recruitment problems by way of increasing special pay for VA dentists. These bills are stuck in committee, but need to be marked up immediately for consideration by the Congress.

Paralyzed Veterans of America and several other veterans service organizations along with the National Association of VA Physicians and Dentists, the American Dental Association, the American Association of Oral & Maxillofacial Surgeons, the Academy of General Dentistry, the American Dental Education Association and all other contracted dental organizations strongly support these bills. …