In this issue...

When someone asks me, "Why create a partnership between dentistry and nursing?" I say, why not? You have to start somewhere, and a dentistry/ nursing alliance is as good a place as any to begin to deal with the enormous healthcare challenges facing our nation.

The United States spends 16 percent of its GNP on prevention and treatment of disease, yet we lag behind other Western nations on such basic indicators of health as infant mortality and life expectancy. Nor are there signs that this trend will reverse anytime soon. On the contrary, it is estimated that by 2015, America will spend 20 percent of its GNP on health care, and that number is expected to rise to a staggering 50 percent by 2050. Yet despite these huge expenditures, tens of millions of Americans cannot afford basic treatment and must put their health care on hold, which leads to worsening conditions and even greater healthcare costs down the road—a classic example of negative return on investment.

Adding to the dysfunction of the current system is the fact that, by 2030, the number of older adults in the US will almost double, and the nation is not prepared to meet their social and healthcare needs.

In 2002, the Institute of Medicine (IOM) convened a group of over 150 leaders and experts from health professions education, regulation, policy, advocacy, quality, and industry to discuss health care in the US and help develop strategies for restructuring clinical education to be consistent with the principles and goals of 21st century health care. In its 2004 report, Health Professions Education: A Bridge to Quality, the IOM published the group's consensus, which called for a radical overhaul of all health professions education.

According to the report, it is past time to dispense with the traditional practice of educating health professions students in "silos" when patients expect them to work in collaborative teams in clinical practice. In place of the "silo" approach, the report calls for all healthcare professions to pursue new, interdisciplinary directions in education, research, and clinical care. The IOM mandate is clear: There must be immediate systemic change in the way we think about, educate for, and deliver health care.

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"It's all about the patient." That has always been the philosophy of the nursing profession and of the nursing program at NYU. Since its inception in 1923, nursing at NYU has been committed to addressing the expectations of the public for accurate information, quality delivery systems, and ever-expanding access to humane health care.

This commitment is at the heart of the NYU College of Nursing/NYU College of Dentistry alliance. It holds that nurses, dentists, physicians and, indeed, all healthcare providers, have an obligation to collaborate across disciplines to create a more holistic healthcare environment, one that increases the value of each and every patient visit.

Our national healthcare crisis demands no less. In the United States today, an estimated 40 million Americans forgo necessary care each year due to cost, and 22,000 uninsured adults die prematurely each year as a direct result of lacking access to care, a situation that calls out for us to utilize all points of entry into the healthcare system—including dentistry—as a means of expanding access to care.

In a society in which access to health care is woefully inadequate and has severe consequences, including the promulgation of health disparities, it no longer makes sense for a patient to be able to access only one type of care at the point of service. The fact that there are well-documented common risk factors for oral health problems, such as periodontal disease, and for systemic health problems, such as diabetes, cardiovascular disease, autoimmune diseases, cancer, and premature birth, further supports the relevance of and need for interdisciplinary care.

Accordingly, the NYU dentistry-nursing alliance is developing interdisciplinary educational programs, evidence-based practice models, and research partnerships, especially those that explore the connection between oral and systemic health. These initiatives are providing dental, dental hygiene, and nursing students with opportunities to collaborate in assessing current educational, research and healthcare delivery practices; in viewing the oral-systemic link as a two-way street; and in applying this broader perspective to patient needs and pathologies that might otherwise go undetected.

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