In some California counties, finding a dentist is like pulling teeth

In some California counties, finding a dentist is like pulling teeth

Several areas in the state have dire shortages. In Alpine County there are no dentists, and Inyo County has one for 5,000 people, according to a report by the UCLA Center for Health Policy Research.

Have a toothache in Alpine County? Tough luck. There are no active dentists there, making it the most underserved dental population in California, according to a report released Thursday by the UCLA Center for Health Policy Research.

The 700-square-mile mountainous region is one of several counties with severe dentist shortages. San Benito and Inyo counties have less than one dentist per 5,000 people; Imperial and Colusa counties have less than one dentist per 4,000. Even some poorer parts of Los Angeles County are considered underserved, said Nadereh Pourat, director of research planning at the UCLA School of Public Health and the report's primary author.

"In some areas, particularly when they're rural, you're talking about having to travel a long way before you can find a dentist," Pourat said. "And if you don't have dental insurance, you have to pay out of pocket in order to find a dentist willing to accommodate you."

In Hollister -- located in San Benito County, where the UCLA data show only five working dentists serving nearly 58,000 residents -- Dr. Mark Stephens said he's been able to handle the demands on his practice, so far.

"If someone calls with a toothache, we try to see them the same day, but some offices don't see them for a week or two," Stephens said. "If I have to work through lunch or stay late, I will."

Stephens said he thought there were more than a handful of dentists still practicing locally, but added that in the last several months, his brother, who is also a dentist, sold his practice and another dentist died.

Like many dentists, Stephens does not accept Denti-Cal, the state's dental insurance for the poor. He said he knows of only one dentist in Hollister who does.

The shortage situation may worsen in some already-underserved areas because new dentists are not keeping pace with those retiring.

Because dentists often leave school with between $200,000 and $300,000 in loans, setting up practice in areas where patients rely on government-sponsored insurance that pays only 30 to 40 cents on the dollar can be hard, said Cathy Mudge, chief administrative officer of the California Dental Assn.

"They need to be able to repay that loan," she said.

To encourage new dentists to move to needy areas, Mudge said, the association's foundation offers a loan repayment program. In exchange for a three-year commitment in an underserved population, the foundation covers their loan payments during that time.

For Dr. James Forester, who works at La Clinica de Tolosa in Paso Robles, that equals about $35,000 a year in loan payback -- a hefty sum, particularly when he's working at a clinic that pays significantly less than what he could be making elsewhere.

"For me to be able to work in a population where people really need me is ideal," he said. "Who else would be here if I wasn't here? It's a great opportunity, but also a responsibility. These people are here. They need care too."

Begin With Patients In Mind

by Ryan

The life of a dental student is rather selfish, isn’t it?
Seriously, think about it. After countless hours of your day spent in classrooms and clinics, the remainder of your time is usually allocated to studying and lab work. With so much of your schedule and energy monopolized, the most important people in your life get the short end of the stick—a version of you that’s devoid of energy and propped-up just long enough to make an appearance. Home life suffers during an exam-heavy week as dirty laundry and dishes pile up. Plants and pets are lucky to survive a finals week! Though you may not realize it, your decision to pursue a dental degree obligated those around you to years of sacrifice and compromise toward your cause.

I’m a dental student…and it’s all about me!

Now, please don’t take this the wrong way. The nature of the “dental school” beast demands a level of selfishness. It’s a reality all dental students share, and my story was no exception. Like you, my success as a dental student was defined by my ability to improve and advance my skills. It was a system that legitimized self-mindedness, and even rewarded it. For a long time, the primary mission was simply to work on me. Then I entered the private practice world, and all the rules changed.
As associateship interviews approached, I began nailing down a few priority items I was looking for in a prospective practice. The list included a great staff, a boss interested in mentorship, a thriving business with ownership opportunity, and an overall compatibility with the practice philosophy and style. The criterion that rose to the top of my list, however, was “the patient experience”. Thinking about my own experiences as a patient, I wanted to work for an office that, without question, kept its patients as the primary focus.
During the course of interviews, I encountered practices that ran the gamut— a few were more staff-centered or money-centered, and some were, well, “my most recent vacation”-centered. I did find, however, a few offices that seemed to concentrate on the patient experience first and foremost. Fortunately, the opportunity to join one such office arose. In the whirlwind of my transition from residency to private practice, I almost overlooked the true significance of what I had discovered.

There’s only so much a manikin can teach about customer service.

I was beginning a new game, with new rules. In order to succeed in this new system, I would need a whole new mindset. Unlike the student experience, success would no longer be a function of things I did for me. Success, from this point forward, would depend on my ability to be patient-centered.A patient-centric practice philosophy positions the patient as a singular center, and then derives all aspects of the practice from that center. In other words, consideration for the wants and needs of the patient permeates every aspect of practice behavior. A patient-centric philosophy is a simple concept, but “simple” and “easy” are two completely different things. The challenge to “think like the patient” can be formidable for an emerging practitioner. The new dentist’s mind is already quite busy just trying to “think like a dentist”! Making that critical shift from a self-focused to a patient-focused mindset is not easy. However, I believe it is the most impactful way to squarely position yourself on a path to successful practice, and to get moving down that path. The sooner you overcome this mental hurdle, the better!


Part 2 will be POSTED later