You do not need a new specialty for any of this. You need new eyes on old instruments. Here are the five I have, and what changes when I hold them differently.
The chart
Read once, it's a snapshot. Read across visits, it's a time series. Write the change, not just the number. The person who charts is running the most consistent longitudinal biological dataset in American healthcare, and has been the whole time.
The film
Read the whole thing, condyle to corner. It holds more than the teeth. When something in a corner looks like it does not belong to the mouth, it probably doesn't, and the cost of being wrong is one referral.
The hands
Palpate. Measure the opening in millimeters. Listen. Thirty seconds, and a joint stops being a dental mystery and becomes what it is: a joint, which the rest of medicine has known how to stage for fifty years.
The hygienist's eye
She sees the tissue before I do, and she sees it every six months. Nobody in the building is support staff. Everyone is part of the instrument. Give her the first two minutes to report what moved.
The exam
Twice a year, for decades. No other clinician gets that regular a look at a living person. It was always the earliest seat in medicine. We were sitting in it the whole time.
Good. Now stay open.
These skills are good. Keep them all. But an exam that watches for damage can learn to watch for change, in both directions: the disease starting and the health starting. Recognize, refer, note it, follow up. Stay in scope; staying in scope is what makes the flag credible. We are adding perception, not procedures.
What comes next
1840 is a movement first and a platform second. The platform learns your body, and then it fights for it. It is being built for the people who read these letters, from both sides of the split, and the first cohort gets in at the start. You are already on the door.
Now we move.
Thad Connelly
Oral and maxillofacial surgeon