Innovative Primary Care Training: The Cambridge Health Alliance Oral Physician Program

We evaluated the Oral Physician Program, a dental residency sponsored by Harvard Medical School, Harvard School of Dental Medicine, and the Cambridge Health Alliance that offers an innovative model for training dentists to provide limited primary care. The didactic and clinical experiences increased residents'' medical knowledge and interviewing skills, and faculty assessments supported their role as oral physicians. Oral physicians could increase patients''—especially patients from underserved groups—access to integrated oral and primary care services.Static and fragmented curricula are failing to prepare graduates of health professional schools for current population health challenges, including the growing burden of chronic diseases.1 Primary care must be a pillar of clinical training,1,2 and dentists, as oral physicians, should be trained to provide limited preventive primary care and disease prevention.3 During their predoctorate clinical training years, dentists learn about the oral manifestations of more than 100 genetic and systemic disorders,4 including developmental and eating disorders, cardiovascular disease, diabetes, osteoporosis, and cancers, as well as substance and child abuse.5 Thus, dentists should be well positioned to identify numerous systemic conditions in addition to oral diseases, often at an early stage, through oral manifestations.Advanced oral physician training following dental school can provide skill strengthening and the practice necessary to adapt to the changing health needs of today’s most vulnerable populations by increasing early disease detection and referral. Dentists practice as oral physicians, for example, when providing or overseeing complete dental care and aspects of primary care,6 such as taking vital signs, screening for diabetes and other major health problems, and administering vaccines.7 By providing a range of preventive health care services, dentists can help increase access to care and improve the health of the community as part of the primary care prevention and referral system.8 The training model of the oral physician decompartmentalizes oral and general health and meets the primary care training objective of “interprofessional and transprofessional education that breaks down professional silos.”1^(p1924)