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Private practitioners push back against dental therapy in WisconsinSubmitted: 03/18/2019
Story By Stephen Goin

Private practitioners push back against dental therapy in Wisconsin
LAND O'LAKES - People in rural Wisconsin face some hardship when it comes to getting dental care. Some don't have access to it and many can't afford it. Both Gov. Tony Evers and state lawmakers hope that a new class of healthcare providers called "dental therapists" can help solve this issue. Local dentists aren't convinced.

Known for the quirky commercials they use to promote their family-run dental practice, father-daughter dentistry duo Drs. Pete and Laura Schindelholz are all business.

"Practicing in northern Wisconsin, practicing with my father, it's great," said Laura.

They know the issues Wisconsinites face when it comes to dental care. According to the Wisconsin Office of Rural Health, at least one county in Wisconsin needs more than 14 dentists to fix area shortages. Across the Northwoods, it's much less. Vilas county is the highest; they would need 1.3 new dentists to no longer be considered a healthcare provider shortage area.

But the younger Dr. Schindelholz doesn't think these shortages come from a physical lack of care.

"It's not for lack of dental staff and professionals, it's that connection between those wanting care and the professionals that we already have," said Laura.

Gov. Evers and state lawmakers don't hold those same views. They want to license a new kind of mid-level dental provider called a "dental therapist," often likened to physician's assistants or nurse practitioners. Wisconsin Senate Bill 89 would allow them to work in the state legally.

Even with bipartisan government support, the Wisconsin Dental Association opposes the bill saying that dental therapists wouldn't fix access to care issues. "It's not a model that works," said Pete.

Ideally, dental therapists could fill cavities and provide other routine services at a reduced cost while giving dentists more time to take care of difficult cases. But Dr. Pete says that wouldn't solve the real problem.
"The problem is not having somebody inexpensively do fillings. The problem is the amount of money delegated to the Medicaid program," said Pete.

On average, dentists in Wisconsin who take Medicaid patients only get $0.27 for every dollar they would have made from a fully paying customer according to the Wisconsin Dental Association. That's the second lowest reimbursement rate in the country. In his budget proposal, Gov. Evers proposed a 30 percent increase in Medicaid reimbursement to dentists who take at least 5 percent of their patients from the Medicaid pool. Dr. Pete says he would still lose money even with that increase.

"We choose our charity, this would be forced charity," said Pete.

Despite the opposition from WDA and local practitioners, lawmakers are still hoping that their bill will pass. Rep. Patrick Snyder, a sponsor of Senate Bill 89, says if dentists don't like dental therapy, that's okay.

"If a dentist doesn't want a dental therapist, they don't have to hire one," said Snyder.

But Dr. Laura believes that even licensing these providers would give patients a choice they shouldn't have to make.

"By creating the dental therapy position, we're saying that it's okay to receive compromised care because you can't afford the highest quality, and that's not okay," said Laura. 

Senate Bill 89 has been introduced and referred to the Committee on Health and Human Services. 


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