The Gathering of the Big Three
AADMD, AMA and ADA - at the AADMD’s Historic One Voice for Inclusive Health Conference
By Rick Rader, MD FAAIDD, FAADM
Photos by Karen Tiu
Charles Scharf, the CEO of Wells Fargo, summed up my own feelings about meetings with, “Meetings should have as few people as possible, but all the right people.”
It was apparent that the American Academy of Developmental Medicine and Dentistry (AADMD) subscribed to this axiom in creating a milestone historic meeting at their annual meeting on June 14th in Orlando, Florida.
To the best of our knowledge, this was the first (and only) time the Presidents of the American Medical Association (AMA) and the American Dental Association (ADA) met to discuss the state of healthcare for people with intellectual and developmental disabilities and the role of organized medicine and dentistry.
The AADMD knew the conversation had to be focused, revealing and impactful, and they certainly recruited the right person to serve as the facilitator. The Honorable Neil Romano is a respected advocate for people with disabilities with over 40 years of experience working for five presidents in the area of employment for people with disabilities, healthcare promotion and human rights. He received a Presidential appointment as the Chairperson at the National Council on Disability (NCD, www.ncd.gov), and continues to serve as a council member, as well as a Presidential appointment as the Chair of the President’s Committee on People with Intellectual Disabilities (www.pcpid.gov). Neil was a former Assistant Secretary of Labor in the Division of Disability Employment. He was the creator of Oral Health America’s National Spit Tobacco Education Program (NSTEP) which, at the time, was the largest and most successful program promoting oral healthcare in the world. Neil is fluent and well versed in the long standing and shameful health disparities experienced by people in the disability community.
As luck would have it, both the ADA and AMA Presidents came from the primary care trenches, where healthcare for patients with intellectual and developmental disabilities are either derailed, neglected, undertreated, or begin a pathway to appropriate comprehensive and collaborative healthcare.
Dr. Cesar Sabates, President of the American Dental Association, was a general dentist and had numerous patients with disabilities. He was the first Cuban-American dentist to be elected as the President of the American Dental Association and has a keen appreciation of the struggles inherent in belonging to marginalized populations.
Dr. Gerald Harmon has a Family Medicine practice in South Carolina and understands how patients with disabilities have been historically stigmatized, devalued, and often considered a burden by medical practitioners.
As stated at the beginning of this article, “…all the right people.”
Dr. Sabates and Dr. Harmon acknowledged the historic shortcomings of both physicians and dentists in not having the skills, training and experience that is required to provide access to competent care for people with (all) disabilities across the lifespan. Mr. Romano reminded the audience that of the 192 medical schools and 66 dental schools in the United States, few offer any standardized curriculum in the clinical treatment of patients with disabilities. Research has demonstrated that the overwhelming majority of medical and dental school graduates personally feel they do not have confidence in their ability to provide competent care. Interestingly enough, those same students overwhelmingly would like to treat patients with complex needs.
Several significant concerns that contribute to healthcare disparities were discussed and included poor reimbursement, problems with communication, high turnover of support staff, clinician bias and negative attitudes about people with disabilities, lack of knowledge of disability syndromes, erroneous belief that care requires “specialization”, and time constraints dictated by managed care organizations.
The questions posed during the Presidents’ fireside chat took aim at the history of disregarding people with disabilities, in both the medical and dental profession. Dr. Sabates and Dr. Harmon acknowledged the historical shortcomings of physicians and dentists who were under-educated, ill-equipped, and unwilling to treat people with disabilities. They renewed their commitment to move both the ADA and AMA towards addressing this national disparity of care.
The AMA and ADA Presidents outlined plans to provide clinical competency training to both medical and dental students, and assured people with intellectual disabilities would be appointed to the committees that develop those plans.
The fireside chat with Dr. Sabates and Dr. Harmon was hosted at the AADMD’s One Voice Conference, the only conference that brings all health disciplines together for IDD. This year’s 20th Anniversary conference, held in Orlando, FL, was held directly before the Special Olympics USA Games. The conference theme “The Way Forward: How to Live Well” explored how to pick up the pieces following the pandemic and allow the IDD patient population to live well – especially during times of crisis.
“Today is the beginning of equitable healthcare. The AADMD is proud to host major leaders to make major changes for the future. These leaders listened and understood the problems that exist and are committed to moving the needle forward, including changes in interdisciplinary care for the whole healthcare system, reimbursement access education and individualized care plans,” said Dr. Allen Wong, AADMD President 2020-2022.
The AADMD looks forward to continued conversations, and commitment from the AMA and ADA, and will hold both organizations to their promise. To take this historic discussion and put it into action, the AADMD will invite additional healthcare partners, IDD industry leaders, insurance companies, IDD advocates and self-advocates to work together to create a successful new model of care.
Historians have acknowledged the 1945 Yalta Conference as being one of the most famous conferences ever held. It was the meeting of the heads of the Allied powers following World War II in order to reorganize post war Europe. Attended by the three heads of state of the Allied powers – President Franklin D. Roosevelt, Prime Minister Winston Churchill and Premier Joseph Stalin – the conference aimed to create a post-war period of peace and stability in Europe.
One could argue that the AADMD Orlando Conference could be considered the most significant conference ever held to reorganize and promote access to competent healthcare for millions of Americans with complex disabilities. And like the Allied powers at the Yalta Conference, we had our own powers, The American Medical Association, The American Dental Association, and the American Academy of Developmental Medicine and Dentistry.
“Meetings should have as few people as possible, but all the right people.” To that I might add, “All the right, committed and determined people.”
Like the ones we had in Orlando.
About the Author
Rick Rader, MD, FAAIDD, FAADM, DHL (hon) is Director, Habilitation Center, Orange Grove Center; President, American Association on Health and Disability; Member, National Council on Disability; Board, American Academy of Developmental Medicine and Dentistry; National Medical Advisor, National Alliance for Direct Support Professionals; Board, National Task Group on Intellectual Disabilities and Dementia Practices.