Abstract
PURPOSE:
Oregon
allows dental hygienists to provide services without the supervision of
a dentist if they hold an expanded practice permit (EPP). This study
surveyed practicing and non-practicing EPP holders with the purpose of
assessing perceived barriers to practicing independently and better
educating students to begin independent practice upon graduation.
METHODS:
A
survey was developed, approved by the institutional review board and
pilot tested with current Expanded Practice Dental Hygienists (EPDHs). A
list of EPDHs was obtained from the Oregon State Dental Board, and 181
surveys were mailed in November 2011.
RESULTS:
The
response rate was 39% (n=71). Data from this study indicate a large
number of new EPP holders, with 62% (n=41) holding their permit for 3
years or less, but only 41% (n=29) of respondents are actually providing
care in a setting requiring an EPP. Responding practicing EPDHs
reported barriers including: challenges with insurance reimbursement,
lack of knowledge/acceptance, equipment cost/maintenance, difficulty
obtaining a collaborative agreement/cooperating facility, advertising
and inability to make a living wage. Responding non-practicing EPDHs
reported barriers including: currently working in another setting, lack
of business knowledge, time, start-up cost, inability to make a living
wage, lack of opportunity, reimbursement difficulties and lack of
experience.
CONCLUSION:
Perceived
barriers to practicing independently differ between those practicing
utilizing their EPP and those not practicing. Ways to eliminate barriers
for both practicing and non-practicing EPDHs should be explored. There
is potential to reduce the barriers to independent practice through
curricular changes, public health partnerships among EPDHs, and new
health care systems that specifically address barriers found through
this study.
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