This is a very clever, easy-to-understand analogy to the issues educators
are facing with "No Child Left Untested," "No Teacher Left Standing"...Oh, I
mean No Child Left Behind.
-----
No Dentist Left Behind Act
(Be a friend to a teacher and pass this on.)
The Best Dentist -- Absolutely the Best Dentist
My dentist is great! He sends me reminders so I don't forget checkups. He
uses the latest techniques based on research. He never hurts me, and I've
got all of my teeth, so when I ran into him the other day, I was eager to
see if he'd heard about the new state program. I knew he'd think it was
great.
"Did you hear about the new state program to measure effectiveness of
dentists with their young patients?" I said.
"No," he said. He didn't seem too thrilled. "How will they do that?"
"It's simple," I said. "They will just count the number of cavities each
patient has at age 10. 14, and 18 and average that to determine a dentist's
rating. Dentists will be rated as Excellent, Good, Average, Below Average,
and Unsatisfactory. That way parents will know who the best dentists are.
It will also encourage the less effective dentists to get better. Poor
dentists who don't improve could lose their licenses to practice."
"That's terrible." he said.
"What? That's not a good attitude," I said. "Don't you think we should
try to improve children's dental health in this state?"
"Sure I do." he said. "but that's not a fair way to determine who is
practicing good dentistry."
"Why not?" I said. "It makes perfect sense to me."
"Well, it's obvious," he said. "Don't you see that dentists don't work
with the same clientele; so much depends on things we can't control. For
example, I work in a rural area with a high percentage of patients from
deprived homes, while some of my colleagues work in upper middle class
neighborhoods. Many of the parents I work with don't bring their children
to see me until there is some kind of problem; I don't get to do much
preventive work.
"Also, " he said, "many of the parents I serve let their kids eat way too
much candy from an early age, unlike more educated parents who understand
the relationship between sugar and decay. To top it all off, " he added,
"so many of my clients have well water which is untreated and has no
fluoride in it. Do you have any idea how much difference early use of
fluoride can make?"
"It sounds like you are making excuses," I said. I couldn't believe my
dentist would be so defensive. He does a great job.
"I am not!" he said. "My best patients are as good as anyone's, my work is
as good as anyone's, but my average cavity count is going to be higher than
a lot of other dentists because I chose to work where I am needed the most."
"Don't get touchy." I said.
"Touchy?" he said. His face had turned red and from the way he was
clenching and unclenching his jaws, I was afraid he was going to damage his
teeth. "Try furious. In a system like this, I will end up being rated
average, below average, or worse. My more educated patients who see these
ratings may believe this so-called rating actually is a measure of my
ability and proficiency as a dentist. They may leave me, and I'll be left
with only the most needy patients. Moreover, my cavity average score will
get even worse.
On top of that, how will I attract good dental hygienists and other
excellent dentists to my practice if it is labeled below average?"
"I think you are overreacting." I said.
"'Complaining, excuse making and stonewalling won't improve dental
health'... I am quoting from a leading member of the DOC," I noted.
"What's the DOC?" he asked.
"It's the Dental Oversight Committee," I said, "a group made up of mostly
lay persons to make sure dentistry in this state gets improved."
"Spare me," he said, "I can't believe this. Reasonable people won't buy
it," he said hopefully.
The program sounded reasonable to me, so I asked, "How else would you
measure good dentistry?"
"Come watch me work," he said. "Observe my processes."
"That's too complicated and time consuming," I said.
"Cavities are the bottom line, and you can't argue with the bottom line.
It's an absolute measure."
"That's what I'm afraid my parents and prospective patients will think.
This can't be happening," he said despairingly.
"Now, now," I said, "don't despair. The state will help you some."
"How?" he said.
"If you're rated poorly, they'll send a dentist who is rated excellent to
help straighten you out," I said brightly.
"You mean," he said, "they'll send a dentist with a wealthy clientele to
show me how to work on severe juvenile dental problems with which I have
probably had much more experience? Big help."
"There you go again," I said. "You aren't acting professionally at all."
"You don't get it," he said. "Doing this would be like grading schools and
teachers on an average score on a test of children's progress without regard
to influences outside of the school, the home, the community served and
stuff like that.
Why would they do something so unfair to dentists? No one would ever think
of doing that to schools."
I just shook my head sadly, but he brightened.
"I'm going to write my representatives and senator," he said. "I'll use the
school analogy - surely they will see the point."
He walked off with that look of hope mixed with fear and suppressed anger
that I see in the mirror so often lately.
Attributed to John S. Taylor, Superintendent of Schools for the Lancaster
County, PA School District.
-----
Gabe Gancarz, Assistant Librarian
Glenbard East High School
Lombard, IL
630-424-6691
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