The Not-So Boring Truth About Rules and Regulations
By Sarah Thiel, RDH
When I hear the words “rules and regulations,” I instantly want to get in my jammies, grab a soft blanket, light a fire, and fall asleep. There is nothing in that phrase that makes me want to continue listening. However, when I hear the words “inactive license” or “license is in default,” my blood pressure rises and I am listening to Every. Single. Word.
Dental hygiene school was one of my greatest achievements. Nothing makes me feel sicker to my stomach than the thought of compromising my license. Let’s be honest. I don’t know one person who has actually pulled out their 200-page book of rules and regulations, sat down, and read them since passing their jurisprudence exam. Why is that you might ask? We assume, or at least hope, we are in compliance or praying to not get audited.
The crazy thing is that there are so many different rules in every single state that I had no clue about until I started doing my research for CE Zoom. Through my research, I acquired pertinent facts. It was this research that fueled my motivation and made me even more passionate about the CE Zoom solution.
For those of you who hate completing continuing education and like to cheat the system, I’m probably not going to be your best friend, and you are going to curse my name. But for those of you who do stay compliant and truly care about furthering your knowledge and education, making you more valuable to your office and your patients, you will be excited to read more about how we are changing the way states regulate licensed professionals and how we are changing the way conferences track your attendance and earned credits. In addition, your recording system becomes much easier.
What’s an approved provider?
Let us start off with some facts that hopefully will make you start thinking about your own license. Did you know that most states require you to obtain CE from an approved provider? Do you know what an approved provider is, or how to find one? You may be aware that most states require you to receive some of your credits by attending a live course and some credits can be earned through home study. That’s the easy stuff that is clearly laid out while reading your rules and regulations.
But did you know some states only allow a few hours toward your renewal in courses with topics on business, self-improvement, motivational speaking, or business finance? Some states don’t accept those topics at all?
What about a course topic on ergonomics? Every dental professional could use a course on ergonomics and the proper way to position themselves to help achieve a long, pain-free career in dentistry. Most would never doubt that this course should count towards their required CE for license renewal, but how is an ergonomics course “directly” related to patient care? Would you consider this course “self-improvement”? In fact, many states call out that you cannot acquire credit for courses related to self-improvement.
CPR courses not necessary?
During the preliminary phases of our company development, we received feedback from several licensed professionals stating that they didn’t have to complete a CPR course to renew their license. Surrounded by state guides to rules and regulation. I found these statements very interesting. CPR, along with infection control, is something every practicing dental professional has to maintain.
I called the state licensing department and asked them personally. The answer was different from the feedback we had received; the state didrequire CPR, and the state officials couldn’t believe that professionals thought they didn’t! I was also directed to where the statement was located in their rules and regulations so I could read it for myself.
I can only speak for myself, but I’m going to go ahead and believe that no one in the profession of dentistry has a desire to be a rebel and not be compliant. We all strive to do the right thing and want to attend courses that we know will count for our state. Unfortunately, it is not always black-and-white. There are so many questions with minimal answers. Reading a state’s rules and regulations requires a great deal of knowledge on how to read them. We aren’t lawyers, but the rules are written in such a language.
Everything at a conference counts?
I have another question. Do you assume that, when you attend a “dental “ conference, every course you take counts towards your individual state’s rules? How about if it’s your own states annual session? Without a doubt, right?
CE Zoom participated in a conference several months ago that shed light on a few things I found to be a bit alarming. As I was entering the conference courses into CE Zoom’s software program, I realized that three of the seven courses didn’t fulfill the state’s rules and regulations according to our understanding and studying of that particular state. Again, this was a state’s association providing the CE programs. A dental professional would “assume” every course would be approved because it’s being sponsored by a state association.
Then I thought to myself: Why would we have these rules “un”clearly written out for us if the state didn’t want us to follow these rules? What do you think? Should those courses count or not? Again, not black-and-white.
An association recently approached me; asking me questions about wanting CE Zoom to approve their courses. Unfortunately I had to inform them that we must follow the state’s rules and regulations. CE Zoom does not approve CE courses, it is simply a tool to help dental professionals stay compliant by keeping them aware of what their state requires. We do not guarantee compliance but, our program has the best information available about what states do and do not require.
We have called states to clarify a guideline in their rules and regulations only to be told that in order for me to understand my rules to keep mylicense I have to hire an attorney. If they tell me something and I assume it means something it doesn’t, the state could be held liable. Seriously? Why is it so difficult to stay compliant?
Not so funny way to find out things
Funny story. I have been obtaining my CPR from the same provider for the past 15 years. We all love her! She’s funny, entertaining, and, most importantly, we get through our training in a timely manner. It wasn’t until I created CE Zoom and was entering in my own CE that I realized my CPR doesn’t count for my state. The woman giving my CPR isn’t an approved provider for the state in which I am licensed. Therefore, it would never make it through an audit.
My question is, what is the problem with this? Does it even matter? Let’s say the worst-case scenario is what if I have a patient die in my chair because I didn’t perform correct CPR? What do you think will happen? Will I be sued? The doctor? The state? All three of us? Would you want to find out the answer after the fact? Needless to say, my CPR is now in good standing.
The burden of proof
I didn’t write this article to blame or incriminate anyone. I have read several surveys, and there are numerous dental hygienists upset about the fact that there needs to be better regulation at the state level. Individuals feel everyone should be held to the level stated in the rules. Based off the years I have been studying this topic, I feel confident thinking most states want to do a good job, and some states do a phenomenal job.
Yet, the fact is dental board members are all volunteers. These volunteers don’t get paid for their time and are undertaking a large responsibility for their state. Before I started my research, I assumed I was being watched with laser vision from every person at the state level, and they knew that I didn’t get my CE until right before I was supposed to turn it all in. I just knew it! I was completely wrong!
Now I know some states are very good about the regulations. For others, it’s all they can do to tell you that you’re being audited and have their 5% of the licensees send in the proof. When the 20 to 150 pieces of paper arrive for the state to audit, the dental staff member who is completing the process has a daunting task ahead of them if they do not have a dental education or legal mind.
Imagine sifting through numerous documents trying to place them in categories. Imagine making sure they aren’t allowing more than a certain amount in one category. Imagine making sure they met the requirement in another category—all while trying to tally “live” or “home study” or whether they took at test with the home study to count correctly.
There’s a lot to go through with each audit. It’s to the point that we’ve had several states flat out tell us that they don’t audit because they don’t have the means to do so. When I go to the doctor, I want to feel comfortable that this doctor who has been practicing for 30+ years is up to date with information and not practicing 30-year-old dentistry!
We all know how fast the technology and science are changing! We are learning information faster than some people can put it into effect before something new is taught! When I graduated from school, we were premedicating for everything! Now, it’s a rare occasion if we premedicate at all.
Continuing education is so important to our profession. I am facing an uphill battle. No one likes change. Technology is not everyone’s favorite new thing, until they are without it. Remember when we were switching from film to digital radiographs? How difficult was that process?
Now think about going back to film. We would be doing patients a disservice. You and I both know we can diagnose better with digital and cause less radiation. Remember how hard it was for your office to go from paper to paperless? Trusting the computer is the hardest thing to do, but could you go back to paper? Not a chance. Since my office switched to paperless, we are much more efficient, and patients aren’t getting lost, slipping through the cracks! We have a way to stay on top of their treatment and let them know we truly care about their oral health and want to better them.
It’s the same with CE Zoom. It’s a new concept, however it is completely necessary and one day we won’t be able to go back to the old way of filing cabinets and digging through mounds of paper.
Sarah Thiel, RDH, has been in the dental field since 2000, and has been a dental hygienist since 2007. She is currently serving as secretary on the state of New Mexico dental hygiene committee of the dental board and is very passionate about continuing education along with regulation and compliance. Her greatest goal in life is to help regulate CE requirements and make it an easier process for everyone to understand so they can focus on what’s most important—learning.