Back to China!

November 30, 2014

Let me share with you some moments of my presence in Haikou, Hainan Province, China. The Hainan Province is one of the main special economic zones of the Republic of China.

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There the BIT’s 1st Annual International Congress of Dental & Oral Medicine (CODM2014), took place from 13th to 16th November, Organized by BIT Life Sciences.

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The theme of the CODM-2014 was “Bring Beautiful Smile to the Earth”, and aimed at to attracting strategies for managing prevention and control of oral diseases. The congress had several topics such as Oral Biology, Oral Diseases and Therapy, Oral Cancer, and so on.

I was one of the Keynote Speakers of this event, under the theme
Shaping the future of oral health.The moderator was Dr.Shuguo Zhenk, from the Peking University School of Stomatology.

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A statement shared with an audience of international attendees:

“Oral healthcare provision is an important industry which generates a considerable turnover. According to WHO, it is the fourth most expensive disease to treat worldwide. For example, total expenditure for dental care in the United States was estimated at more than 100 billion dollars in 2009, and the market for dental supplies in China alone is due to reach 3.1 billion dollars in 2012, with an 11% annual growth rate.”(FDI Vision 2020).

In parallel, six other events were occurring:
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Four Nobel Prizes in Chemistry participated:
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Group photo:

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I’m sure I’ll come back to continue following closely the “explosion” of dental medicine in China!


First Portuguese Oral Health Barometer!

November 27, 2014

The Portuguese Dental Association held its annual congress on the 6th, 7th and 8th November 2014, at Exponor in Porto, Portugal. The twenty-third edition of OMD’s congress had 48 speakers, 115 posters, 3110 attendances, 7250 visitors to Expo-Dentária and 130 companies with 347 booths at Expo-Dentária.

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I would like to share with you some special moments, in special the launch of the first Portuguese Oral Health Barometer and its results.

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See below a short video resuming the conclusions.

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I would like to highlight the conference Dental Medicine in Europe . Aspects of the oral health system from different European realities were shared and debated with the audience.

From left to right: Sara Roda (Council of European Dentists Policy Officer), Alasdair G. Miller (President of the British Dental Association, United Kingdom), Juan Carlos Llodra (Secretary of the Consejo General de Colegios de Odontólogos y Estomatólogos de España, Spain), me as moderator of the conference, Catherine Mojaïsky (Confédération Nationale des Syndicats Dentaires, France), Óscar Castro Reino (President of the Consejo General de Colegios de Odontólogos y Estomatólogos de España, Spain), Filipa Carvalho Marques (Director of the Legal Department of the Portuguese Dental Association).

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Meeting with Portuguese Dental Students Associations and European Dental Students’ Association.

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It is always a huge effort to yearly launch such a congress, given that the Organizing Committee is only composed of volunteers. At the end an enormous pride fills us with a feeling of mission accomplished in contributing to the continuing of education of the oral health team in Portugal.

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Thank You and keep calm, see you in Lisbon, the 12th, 13th, 14th November next year!


Thank You ADA!

October 28, 2014

Honoured with ADA’s tribute I cannot give away the present moment without a feedback to my friends and colleague’s followers of my blog through these last few years.

The ADA 2014 – America’s Dental Meeting took place in San Antonio, Texas, from 9th till 14th October.

Presentation of Honorary Membership at the Meeting of the American Dental Association by ADA President Charles H Norman III

Photo, courtesy ADA News. © 2014 American Dental Association

ADA President Charles H Norman III remarks:

…”As FDI President, he worked collaboratively with the ADA as we jointly sought to ensure the World Health Organization, United Nations and others to promote oral health as a global health priority”… (read more)

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Maxine Feinberg, ADA President-Elect at the ADA Opening Ceremony

Photo, courtesy ADA News. © 2014 American Dental Association

Source: ADA- news –Press Release …” In nominating, Dr. da Silva, then ADA President-Elect Maxine Feinberg underscored how his leadership helped transform FDI, moving the international organization in the “right direction” toward “greater financial security.”

She also addressed his efforts to expand access to care. “He has worked tirelessly to improve the oral health of underserved populations all over the world,” Dr. Feinberg wrote. “His energy is boundless. He should be an inspiration to all.”

My speech
…” My sincere thanks to the Board of Trustees, to the ADA, to those I’ve working with this last years, many of them present in this room!
A special word for my colleagues in Portugal.” (read more)

Addressing to ADA House of Delegates

Photo, courtesy ADA News. © 2014 American Dental Association

Photo, courtesy ADA News. © 2014 American Dental Association

Photo, courtesy ADA News. © 2014 American Dental Association

The opening general session had as Distinguished Speaker George W. Bush, 43rd President of the United States and Founder of the George W. Bush Foundation.

Photo, courtesy ADA News. © 2014 American Dental Association

From left to right, Greg Chadwick ADA Past President , Kathryn Kell, FDI Treasurer , Charles H. Norman III, ADA President at the “ADA International Reception”.

San Antonio, Saint Anthony (1195 – 1231) also known as Anthony of Lisbon, was a Portuguese Catholic priest and friar of the Franciscan Order.

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“San Antonio – For whom the City & River are named. Gift of Portugal”

Beautiful San Antonio River…

American Texan Style…


ADEE Riga Latvia-Emerging new approaches to dental education

August 31, 2014

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The Association for Dental Education in Europe (ADEE) was founded in 1975 as an independent European organisation representing academic dentistry and the community of dental educators.

ADEE members are European university dental schools, about 80%, specialist societies or other national dental bodies concerned with or related to dental education.

I was invited by Damian Walmsley, ADEE President, to deliver a keynote address at the 40th ADEE Annual Meeting, held this year at the Rīga Stradiņš University, in Latvia, on 28th August.

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I would like to thanks to ADEE and to Professor Ilze Akota, Chair of the Local Organising Committee, for the warm welcome and opportunity to share the strategic document Vision 2020.

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My address: “Vision 2020, Shaping the future of oral health” focused very important challenges for the future of oral health.

Current traditional models of dental education have not been yet able to adequately address disparities in oral health. Moreover, there is a growing disconnect between dental and medical education, despite wide recognition that oral health is an integral component of general health. We are working to support the reshaping of educational models to better equip members of oral health care workforce team for the challenges. (Vision 2020)

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Picture and comment from Kate Fabrikant,Professional and Scientific Relations Procter & Gamble.

“Discussion of future of oral health and barriers to overcome. Let’s focus on growing importance of health oriented dental education!”

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Tour to the Institute of Stomatology, guided by Prof. Egita Senakola

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With Damian Walmsley at the celebration Dinner at The Small Guild (the building was erected in the years 1864—66 after a project by architect Johann Felsko in Neo-Gothic style).

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Thank You ADEE, Thank you Riga!


Elected Honorary Member of the ADA!

July 10, 2014

A few days ago, I received the most pleasant surprise:

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Charles H. Norman III, ADA President wrote to me on behalf of the ADA Board of Trustees informing me of my election to the Honorary membership in the American Dental Association!

…”The honor is conferred by the Board of Trustees on those individuals who made outstanding contributions to the advancement of the art and science of dentistry”….

This honorary Membership is a tremendous joy for me.

The ADA and its efforts in promoting oral health in the United States and at global level have always been a source of inspiration for me.

I remember very well in the beginning of the past decade, applying for ADA Affiliate membership. Besides being part of the ADA organization, the possibility of accessing the most valuable information in terms of oral health promotion was of tremendous importance for me not only as a dentist in the private practice, but also for the professional organizations in which I was involved.

The ADA, being on the frontline of the defence of dentists and the profession in the US, constituted many times a source of inspiration to launch similar battles in Portugal , at an European Union level and later on at an FDI level.

I could never have imagined at the time, that one day I would be distinguished with such an honour!

This election by the ADA, one of the biggest, oldest and most respected professional organizations of the world is an enormous incentive to continue the fight to help promoting access of the populations to oral health!

My sincere thanks to the ADA! I’m looking forward to seing you all at the ADA 2014 Annual Meeting in San Antonio, Texas, 9-14 October


WHPA – Health professional regulation Geneva

May 19, 2014

By kind invitation of the WHPA, via Brenda Myers, Secretary general of the WCPT, World Confederation for Physical Therapy, I was responsible for delivering the closing summary of the Third World Health Professions Regulation Conference in Geneva, Switzerland, on 17 & 18 May.

My role was to draw together key messages from the presentations and discussion sessions.

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The World Health Professions Alliance WHPA brings together the global organizations representing the world’s dentists, nurses, pharmacists, physical therapists and physicians and speaks for more than 26 million health care professionals in more than 130 countries. WHPA works to improve global health and the quality of patient care and facilitates collaboration among the health professions and major stakeholders.

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Closing Summary
I’d been involved for about 15 years in national, regional and international regulation. So the theme for this conference was very attractive to me.

This two-day event has demonstrated a certain consensus that Governance, accountability and responsiveness should be an intrinsic part, or the DNA, permeating all regulation systems. It needs to take into account best public interest, justified and proportional in scope and perceived as legitimate.

A theme throughout the sessions has been a distinction on the one hand, between the national regulatory environment, set up to ensure quality and safety of patient care. And, on the other hand, maintaining these values in the face of new pressure exerted on regulation systems from workforce shortages, regional integration and globalization.

These is an increased focus globally on making sure regulators do not create unreasonable barriers to supply of health services under the guise of “protecting the public”. This is especially the case for systems of recognition of competencies and qualifications of foreign practitioners in their access to markets from bilateral, regional or international agreements.

Although numerous models exist, certain principles need to be observed, notably checks and balances between the different stakeholders and, between patients and professionals, an awareness of rights and duties.

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More than 200 delegates from all parts of the world attended the conference.

I think we can make sure that the goals of health professions regulation are patient-centred, involving patient care, patient rights and patient safety, taking into account social and economic welfare and professional practice.
Some of issues that stood out during the presentations and discussions of the first session yesterday were:

  • The need for a consensus among health regulators, who defines what?
  • A regulation model that takes into account interprofessional collaborative practice is likely to be more effective than a model purely “silo” one …
  • The need for sustained political commitment by the two principal actors: decision makers and professionals. This implies a leadership role in regulation for the professions themselves as guarantor of compliance.
  • The need for regulatory bodies to produce more information evidence-based examples to justify measures proposed and to create evaluation mechanisms according scientific criteria. For example, there are no studies about private and public health care services.
  • The need for the regulatory body to understand the day-to-day realities of the health professions they are seeking to regulate. These vary from country to country and, if the regulators are unaware of the reality, how can they regulate? The regulatory framework has to be fit for purpose.

Yesterday, we looked at Universal Health Coverage and its associated requirements in terms of access to affordable and quality health care services, robust workforce, and supply shortages, especially in terms of health care professions’ migrations.

We noted that, in certain areas, such as Europe, economic realities such as the single market take precedence over regulation and that regulation is frequently viewed as a brake on economic development. We also saw that regulations were deemed trade restrictive, even protectionist, in bilateral and international trade negotiations.

With these in mind, the EU provides a successful model with regards to

  • The free movement of workers;
  • A focus not on less regulation, but better regulation;
  • Non-trade-restrictive regulation, with an emphasis on EU wide applicability of European Directives;
  • Meeting the needs of citizens.

The European professional card was highlighted as a unique system at European scale in terms of health professionals’ mobility.

In addition, some concern was expressed about the role of standardization within the health care system as a means to circumvent regulation, with possible negative impacts. This type of standards was deemed well adapted to devices but doubts were expressed about how well they applied to medical or surgical procedures.

On an international level, there was concern that the migration of health professions does not always follow population needs and that there appeared to be no cross border planning or management. The danger was that, to manage shortages, there would inevitably some kind of de-skilling and de-professionalization at national level.

The conclusion was that mobility will not solve most of the problems and there is a danger that some regulations are perceived as obstacles to efficiency and expanded access to care. We need to encourage the concept of safe mobility of health professions and we need to prevent unhealthy competition.

We also looked at the challenges specific to health professions’ regulation in Africa. Regulatory issues raised included public interest versus self-interest and the need for the independence of health regulators.

In addition, there is not only the lack of knowledge about regulatory issues among professionals that would benefit from cross border sharing of information. The weakness of professional associations on the African continent was also highlighted as well as cultural and gender issues.

"Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage."

“Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage.”

This morning’s session investigated whether non-technical skills, called NTS, recognized within the context of high risk industries such as aviation, nuclear energy and offshore oil production, could be adapted to health sector in the interest of positive outcomes, team work and patient safety.

If skills such as communication, decision making, team coordination, leadership, situation awareness, as well as managing stress and fatigue were recognized, at what stage should they be introduced into the health care profession curriculum: at secondary level, at university level or during later training? And testing or examination method would increase their perceived importance by students and professionals?

We then saw three national models described. The looked at the regulatory structure in Jamaica, and what is was trying to achieve nationally and within the context of the single Caribbean market, CARICOM in terms of recognition, accreditation and common competencies.

The next focus was South Africa, and the concept of developing shared or “core” competencies among health professions, advancing the cause of interprofessional collaborative practice and enhancing health management and leadership. The five competency clusters identified were identified in professional practice, health system, public health, management, leadership and personal interpersonal skills.

We then heard details of the competence the ‘balancing act’ of the competence based approaches for professional regulation from Quebec. Inevitably, governments become more involved in the public interest debate and ask questions, for example, should we move beyond the current diploma-based approach? Are there new ways to demonstrate competence? Is current regulation too precise and comprehensive? And, in general, how to ensure that regulation remains true to its purpose.

This afternoon, we looked at research evidence and some of the overriding issues. We saw that there was no organized framework at transnational level and good information is part of good regulation. Maybe we need to work on an agreed set of definitions and terms for regulation. We need to ask ourselves “which models provide the best performance” and start research to collect evidence to invest in regulation models that deliver results.
You’ve just heard the final panel, so I don’t need to remind you in detail of its content.

A description of 3 years as a new model of health practitioner regulation in Australia. We’ve heard about core functional areas, notifications management and accreditation of education there.

We noticed how regulation has changed in the UK since 1858 to now.

From self regulation to the designated “independent professional Regulation” since 2003… Could this be a revolution ?

No value judgement…

Finally, the Israeli experience, with a Law regulating health professionals since 2008 and its impact on the physiotherapists role function.

A final note:

Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage.

We hope you all found this enlightening and, most of all, engaging. We have all been given much to think about in terms of the challenges of health profession regulation and factors we may wish to consider in addressing these challenges.

We all trust that WHPA will maintain and reinforce its role as “think-tank” in terms of health professions regulation on a global level and looking forward to the next WHPA regulation conference.

Ladies and gentlemen, I would like to leave you with the message that regulation whatever the model is a responsibility and a public duty and not an option.

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“I would like to leave you with the message that regulation whatever the model is a responsibility and a public duty and not an option.”

The discussions we have had over the last two days have enriched an ongoing process. No-one has the magic answer but we’ll get closer to finding it by getting together and exchanging views and experience.

Thank you to the keynote speakers and panellists for their relevant and constructive presentations. Thanks to WHPA and Brenda Myers for their work in organizing this exceptional event.

And most of all, thank you all for joining us here in Geneva and making the WHPA conference such an outstanding success.

 

Speakers and Session Chairs
David Benton (Switzerland)
Hazel Bradley (South Africa)
Jonh Chave (Belgium)
Niall Dickson (United Kingdom)
Gilles Dussault (Portugal)
Rhona Flin (United Kingdom)
Katrín Fjeldsted (Belgium)
André Gariépy (Canada)
Mukesh Haikerwal (Australia)
Orlando Monteiro da Silva (Portugal)
Margaret Mungherera (Uganda)
Ayala Parag (Israel)
Annabel Seebohm (Belgium)
Marlene Smadu (Canada)
Una Reid (Jamaica)
Chris Robertson (Australia)


Meeting with President of the Portuguese Republic

May 8, 2014

As President of the National Council of Professional Orders (CNOP), I had a meeting with Aníbal Cavaco Silva, President of the Portuguese Republic.

The main points addressed to the President were the European elections and its political moment; the revision of the self-regulation legislative process in course under Government initiative, and mobility of the qualified professions particularly on the European context.

CNOP represents 16 Orders and more than 300.000 qualified professionals in Portugal.

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From left to right, Pedro Biscaia (vice-president of the General Council of the Order of Layers), José Azevedo Rodrigues (president of the Order of Chartered Accountants), Carlos Pereira Martins (president of the Executive Committee of the CNOP), Carlos Matias Ramos (president of the Order of the Engineers), Alexandra Bento (president of the Order of Nutritionists), Orlando Monteiro da Silva (president of CNOP and president of the Dental Portuguese Order), and Aníbal Cavaco Silva, president of the Portuguese Republic.