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.


WOHD 2014. Celebrating healthy smiles in Portugal!

March 30, 2014

The celebrations of World Oral Health Day 2014, in Portugal, were held in Cultural Centre of Belém in Lisbon.

The Portuguese Government and the Portuguese Dental Association caught the theme “Celebrating healthy smiles” and teamed up with reading through national project “SOBE”, aiming to develop actions that promote reading, happiness and oral health.

The celebrations had two moments: in the morning a playful program for children and in the afternoon an institutional session. In parallel, an exhibition was held based on the book “Articulate – Oral Health and Art.”

The celebrations in Portugal had the collaborative approach oral health/education as the main focus. This partnership was well received and should be maintained and developed in the future.

The morning session was attended by about 150 children and nearly 200 people. General Director of Health, Francisco George, interactively welcomed children. The atmosphere was full of happiness and joy.

1_WOD2014_PTOpening of the event with children.

2_WOD2014_PTGeneral Director of Health, Francisco George.

3_WOD2014_PTTheatre for children.

The afternoon session, targeted to health stakeholders, decision makers and politicians was attended by about 100 people. The results and the projects of both the National Oral Health Promotion Programme (NOHPP) and project SOBE were presented. The debate on oral cancer inclusion on the NOHPP was quite participated.

In the closing session, as President of the PDA, I presented the “FDI White Paper – Oral Health Worldwide”. The Portuguese Secretary of State for Education addressed the relationship between oral health and reading projects in this area that have been undertaken by the government.

The session was closed by the Health Minister, who praised oral health professionals and reading for the help and support they have given to this government towards the promotion of oral health of Portuguese people.

He also mentioned the extension of the National of Oral Health Promotion Programme including Oral Cancer early diagnosis; the success of oral health and reading kits which have now been extended into School Libraries of Portuguese speaking countries and the early intervention in oral cancer project.

4_WOD2014_PTMe addressing at the closing session.

5_WOD2014_PTMinister of Health, Paulo Macedo, addressing at the closing session.

6_WOD2014_PTMinister of Health, Secretary of State for Education, João Grancho, and me.

7_WOD2014_PTLast remarks for media.


President of the Portuguese Dental Association dedicates honorary doctorate to dental medicine

January 30, 2014

Photos, video and my speech (PDF) of the ceremony awarding the honorary doctorate to the dentist Orlando Monteiro da Silva, on January 15th at the Faculty of Dental Medicine, University of Porto.

The dentist and President of the Portuguese Dental Association was awarded the title of doctor honoris causa by the University of Porto, on January 15th 2014, and dedicated this tribute to those who helped the Portuguese population  become aware of the importance of oral health.

Doutoramento honoris causa de Orlando Monteiro da Silva (15 janeiro 2014, FMUP)

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Doutoramento honoris causa de Orlando Monteiro da Silva (15 janeiro 2014, FMUP)

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Doutoramento honoris causa de Orlando Monteiro da Silva (15 janeiro 2014, FMUP)

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“It is a tribute to Portuguese dentistry and all those that since the early 70s, which was when dentistry appeared in Portugal, contributed to the Portuguese population’s awareness of the importance of oral health in overall health and quality of live”, said Orlando Monteiro da Silva.

“It is itself a genius and visionary initiative of two Professors, Afonso Pinhão Ferreira , Director of FMDUO, and António Felino, president of the Scientific Council, an additional milestone of enormous significance, and most relevant to the development and consolidation of dentistry” he emphasized in his speech.

The President considered that it was “the recognition, more than fair, of the path of many in the establishment of dentistry, “having found in myself”, possibly, the best placed recipient.”

“We cannot, however, forget to mention the public policies of education, prevention and treatment, through the National Program for Oral Health and Regional Programs, articulated with OMD, which contributed decisively to the improvement of oral health indexes of populations, helping Portugal to reach, in only a few years, the average of EU countries and the OECD.” he underlined.

Biography Note

Orlando Monteiro da Silva was born in Porto and graduated from Dental Medicine in the University of Porto.

He is President of the Portuguese Dental Association since 2001, and has occupied several positions in national and international renowned institutions.

In 2003 he was elected to the board of the Council of European Dentists, CED, having later served a term as its president, between 2006 and 2009.

In 2004 he was a candidate for the council of FDI – World Dental Federation, having become the first Portuguese to assume decision-making positions within this global organization of dentistry. He promoted the affiliation to FDI of East Timor, Angola, Mozambique and Guinea-Bissau and the Lusophone Dental Association.

The importance of strengthening Portuguese dentists and dentistry at national and international level, as well as the relevance of learning and bringing experiences from outside in, have marked his work as President of the Dental Association.

In 2010 he acted as president of FDI – World Dental Federation, a position he held until the end of term in August 2013. He was the first Portuguese to become President of the most important organization of world dentistry.

In 2011, he was elected president of the National Council of Professional Bodies (CNOP) and in 2012 took over as Director of the Economic and Social Portuguese Council, for the four years between 2011 and 2015.


Orlando Monteiro da Silva receives honorary doctorate from University of Porto

January 13, 2014

Orlando Monteiro da SilvaThe University of Porto conferment of degree doctor honoris causa to Orlando Monteiro da Silva, by proposal of the Faculty of Dental Medicine. It’s the first time that a dentist is recognised in Portugal.

With origins dating back to the eighteenth century, the University of Porto is currently one the most prestigious higher education institutions of Europe.

A public institution close to 32,000 students, 2,400 teachers and researchers along with 1,600 administrative staff attend its 15 schools and 60 scientific research units, spread across three university campuses located in the city of Porto.

With 14 faculties and a business school, the University of Porto provides an exceptional variety of courses, covering the whole range of study areas and all levels of higher education. In fact, offering over 600 training programmes per year (from degrees to continuous professional training), the University of Porto has teaching solutions for everyone.

The immediately previous distinguished was Jean-Claude Juncker in 2013. See all 79 contemplated here since 1921.

Biography Note

Orlando Monteiro da Silva was born in Porto and graduated in dentistry from the Faculty of Dental Medicine, University of Porto.

President of the Portuguese Dental Association since 2001, Orlando Monteiro da Silva has occupied several functions both in national and international prominent institutions.

In 2003 he was elected to the board of the Council of European Dentists, CED, having later served a mandate as its president, between 2006 and 2009.

In 2004, he was a candidate for the council of FDI – World Dental Federation, having become the first Portuguese person to assume decision-making functions within this global organization of dentistry. He promoted the adhesion of East Timor, Angola, Mozambique, Guinea-Bissau and the Lusophone Dental Association to the FDI.

University of PortoThe importance of advocating for Portuguese dentists and dentistry both nationally and internationally, as well as for the relevance of learning and of bringing experiences from abroad, have marked his work as President of the Portuguese Dental Association, Ordem dos Médicos Dentistas, regulatory body of the profession in Portugal.

In 2011 he acted as president of FDI – World Dental Federation, a position he occupied until the end of his term in August 2013.

In 2011, he was elected president of the National Council of Professional Associations (CNOP) and in 2012 he took office as councillor of the Portuguese Economic and Social Council, for four years from 2011 to 2015.


Madrid: Current practice of Dentistry in Europe

December 29, 2013

Last 21 December, by invitation of the Spanish Dental Association, I participated at the Round Table “Current practice of Dentistry in Europe” of the XXXIV Congresso Nacional e XIV Internacional do Consejo General de Colegios de Odontólogos y Estomatólogos de España.

Other colleagues, as Stefaan Hanson, Marco Landi, Catherine Mojaïsky, Philippe Rusca, Gerhard Konrad Seeberger and Michael Sereny had also contributed with their opinion and experience. The moderator was Juan Manuel Aragoneses and Manuel Alfonso Villa Vigil, president of the Consejo, was the host of this relevant round table.

The highlight and topics that were under discussion:

  • numerus clausus: limitation in the number of incoming student at university in EU;
  • number of Dental Schools;
  • number of students that begin Dentistry studies each year;
  • percentage of population that uses dental services;
  • percentage of population that goes to the dentist without a “perceived need” annually;
  • Funds and/or supports from Governments to dental services;
  • private treatments / kind of payments
  • Advertising

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From left to right, Andrés Plaza Costa, Manuel Alfonso Villa Vigil and Juan Antonio López Calvo.

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From left to right, Enrique Llobell Palanca, Premio Santa Apolonia, my wife, Manuel Alfonso Villa Vigil, Llobell’s wife and me.

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Press conference at Santiago Bernabéu Stadium of Real Madrid. Gerhard Seeberger, speaker at the round table too, interpellating a journalist…