Dentistry’s partnership role in achieving total health for our patients
By Theodore E. Wymyslo MD, FAAFPChief Medical Officer, Ohio Association
of Community Health Centers
Comprehensive, coordinated healthcare is the hallmark of the new model of care many of you have been hearing about around Ohio – the Patient-Centered Medical Home (PCMH). In this model of patient care, managing the patient’s total health means addressing their biological, psychological and social needs, many of which occur when the patient is not in your office. Being patient-centered entails designing your system to be available and easily utilized by patients according to THEIR needs, schedules and definitions – not around the convenience of the providers. The term “home” refers to where all the known health information on the patient resides – the collection of data and communications from ALL the points of health contact in the community. For the PCMH model to work, there must be a sense of TEAM among all providers so that each knows what the other is doing, and so they can effectively co-manage decisions with the patient as partner. In order to be effective, its communications must extend beyond its own walls and into the rest of the community into the Patient-Centered Medical Neighborhood.
Electronic Health Records (EHRs) can be a useful tool for this information exchange, but only if the various health providers can push and pull information with the primary care office where the total health Dentistry’s partnership role in achieving total health for our patients information resides. This process allows the dental practice to reinforce health advice and plans of the primary care practice, inject their own oral health plan into the patient’s personal plan of care, and make joint health decisions with the primary care provider (PCP) to optimally benefit the whole patient. Similarly, the PCP reinforces the oral health plan of care to enhance patient adherence.
Many feel expanding the role of the dental office in the total health of patients presents a wonderful opportunity to more effectively address the cause of 70 percent of premature death and chronic disease prevalence in our population – lifestyle choices. All of us in health care need to be engaged in the solution to this problem if we hope to be successful. Indeed, the Robert Wood Johnson Foundation has undertaken a new direction with this challenge in mind … that of “Creating a Culture of Health in America.” They anticipate this will be a 20 year effort – one whole generation – to realize the culture change we need to get our entire population focused on optimizing health and well-being, rather than treating illness and trying to correct the adverse effects that poor lifestyle choices have had on our patients.
Unless the health professions all join together in this effort and utilize a system of care that facilitates patient co-management and care coordination, it is unlikely we will be successful in battling the epidemics of obesity, inactivity and addiction that plaque our population today.
So I will challenge dentistry to keep expanding its focus by joining with the PCMH model of care in addressing the total health of the patient – their biopsychosocial well-being. Help us reinforce the importance of good nutrition, encourage greater physical activity, confront and discourage addictions of all types, pay attention to the safety of relationships and housing, reinforce the importance of immunizations, be aware of fluoride in the water and lead in the paint in our patients’ communities, and be sure your patient is part of a coordinated health care delivery system. I will similarly challenge medical health care providers to increase their efforts to achieve good oral health, reinforcing your guidance given to your dental patients when they visit our medical practices. Only by all health professions working together as a team, with the patient, can we achieve the culture change we look for and need to achieve in America.
Dr. Wymyslo will present “Dentistry’s Role in the Patient-Centered Medical Home Model of Care” at the ODA Leadership Institute on March 28. Leadership Institute is March 27-28. Visit oda.org/events for more information and to register.
