Fraundorf K C
J Health Polit Policy Law. 1984 Winter;8(4):759-81. doi: 10.1215/03616878-8-4-759.
Organized dentistry spent nearly a century laboring to obtain control over entry into the profession. The first attempt, the American Society of Dental Surgeons, failed because the issue of using amalgam so split the Society that collective action became impossible. The second attempt, state licensing during 1870-1900, gave preferential treatment (automatic licensing) to dental school graduates and appeared at first to be the solution to the entry problem, given the small number of schools in operation. However, dental school entrepreneurs recognized a profitable opportunity, and the supply of dental schools expanded rapidly. Thus, in the third and final attempt at obtaining entry control, organized dentistry attacked the for-profit schools. The dental practice acts were amended to require all candidates to pass a licensing examination, provided first that they were graduates of a school considered "reputable" by the state board of dental examiners. Moreover, rising costs generated by increased school standards took the profit out of for-profit operation, and by 1930 such schools ceased to exist. However, the competitive nature of the 1930s made altogether clear that entry control was a necessary, but not sufficient, condition for the maximization of dentist profits, and thus organized dentistry began its turn inward, focusing on the competitive behavior of existing dentists.
有组织的牙科行业花费了近一个世纪的时间努力控制行业准入。第一次尝试是成立美国牙科外科医生协会，但失败了，因为使用汞合金的问题使该协会产生了严重分歧，以至于无法采取集体行动。第二次尝试是在1870年至1900年期间实行州执照制度，鉴于当时运营的牙科学校数量较少，该制度给予牙科学校毕业生优惠待遇（自动颁发执照），乍一看似乎解决了准入问题。然而，牙科学校的创业者们发现了一个有利可图的机会，牙科学校的数量迅速增加。因此，在第三次也是最后一次获得准入控制权的尝试中，有组织的牙科行业对营利性学校发起了攻击。牙科执业法案被修订，要求所有候选人通过执照考试，前提是他们是州牙科考试委员会认可的“声誉良好”学校的毕业生。此外，学校标准提高带来的成本上升使营利性运营失去了利润，到1930年，这类学校不复存在。然而，20世纪30年代的竞争性质清楚地表明，准入控制是牙医利润最大化的必要条件，但不是充分条件，因此有组织的牙科行业开始转向内部，关注现有牙医的竞争行为。
