Juneau, AK essentially is an 18 mile stretch of land that is only accessible by ferry, boat, or airplane. The 18 mile stretch goes from the downtown harbor where tourists arrive on Carnival cruise ships to the Mendenhall Valley, a suburban area that includes the University of Alaska - Southeast. There is one main road that stretches the entire length of the city which makes car travel inside of Juneau very easy. Even those addicted to their GPS can't get lost!
Today, I had my first experience "out the road". "Out the road" is an expression used by the locals to describe the area beyond the Mendenhall Valley on the Glacier Highway. The area is basically a series of trails, glaciers, and mountains. For those who spend an extended period of time in the city it is definitely worth a visit. This morning Dr. Dee picked me up and we headed out to Boy Scout Beach which is about 20 miles beyond the Mendenhall Valley. On the drive out there was some excitement - I saw my first bear. It was a big black bear that ran across the highway right in front of the car. After seeing how big it was and how quickly it moved I must say I am rather thankful I have yet to run into one on a hike. I also saw a porcupine hiding on the shoulder of the road - and this was all before we even got to the beach.
Dr. Dee and I met Dr. Hort, Cindy (a dental assistant), Dr. Newton, Dr. Marcott, and various boyfriends, husbands, and children to start our walk to the beach. The walk along the trail was nice and flat and it took about 35 minutes before we saw water. Since we left fairly early this morning the tide was very low which exposed lots of sand bars. We spent most of the morning walking from sand bar to sand bar in what was essentially the middle of the channel. Eventually we reached a point on the beach to set up camp. By this point the sun was pretty high in the sky and it was beginning to get hot. We listened to music, played pickle ball, and skipped rocks all morning. Every 20 or 30 minutes we had to move back to accommodate the rising tide. Eventually we all settled in and began to, I can't believe I'm going to say this again, soak up sun. I'm going to have a difficult time convincing the Ingram Scholars staff that I actually used my stipend to go back to Alaska because, at this point, I am bright red from a sunburn! It was amazing to sit on the sun-filled beach and stare across the channel at snow covered mountains.
After a few hours we headed back to the car and visited the Jensen-Olsen Arboretum. It just opened yesterday and there were lots of interesting flowers and plants that were just starting to bloom. Normally I would not have enjoyed such an activity but on a day like today I would have done just about anything to be outside. For lunch, we headed to a restaurant called The Sand Bar. They served fried halibut and chips that were pretty incredible. Apparently, this restaurant is so popular with the locals that the Alaskan Fishing Company makes sure to send only the whitest halibut to the restaurant. By extension, I think this means I stumbled across the best fish and chips in town. This is definitely another restaurant I will be frequenting again in the near future.
The day in the sun was pretty exhausting so I didn't do much tonight. It was nice to just sit outside and relax, especially since I get tomorrow off for Memorial Day. Looking forward to taking advantage of the last day of my three day weekend...
Sunday, May 30, 2010
Day 13 - Thane, BBQ, and Bonfire
The weather this week has been absolutely incredible. It has been in the high seventies and eighties all week, and I don't think I've seen a cloud in quite some time. I woke up and had a picnic right outside of my dorm room today. I brought my computer outside and watched the Cardinals game while soaking up the sun - no better way to start a Memorial Day weekend.
In the afternoon I went hiking with Dr. Dee and Lexi. Lexi is a dental health aide therapist so it is interesting to hear her approach to dentistry and her patients as compared to Dr. Dee who went the traditional dental school route. The three of us went past downtown Juneau to an area of the city called Thane. Thane is a small little town with hiking trails and residential homes. We took a nice, flat 2 mile walk through the woods to a small beach. You could see the Gastineau Channel during the entire walk. The beach was great - small, private, and sunny. I never thought that I would spend an afternoon suntanning in Juneau, AK.
After the hike, Dr. Dee and I went over to Dr. Marcott's home on Douglas Island. We grilled steaks and enjoyed the beautiful weather. Dr. Marcott lives right next door to Dr. Sohonage, and he too was having a party with some of the people I work with. Eventually the parties combined and we enjoyed each others company long into the night. Once the sun went down, we went down to the beach and built a giant bonfire. It was great sitting on the beach and watching the tide slowly creep back in. The night was so clear that we even saw faint streaks of the Northern Lights. At last, the tide came in and washed away our fire which meant the party was over and it was time to go home.
Tomorrow I am going to Boy Scout Beach with a large group of people I work with. Hopefully the weather is as nice tomorrow as it was today...
In the afternoon I went hiking with Dr. Dee and Lexi. Lexi is a dental health aide therapist so it is interesting to hear her approach to dentistry and her patients as compared to Dr. Dee who went the traditional dental school route. The three of us went past downtown Juneau to an area of the city called Thane. Thane is a small little town with hiking trails and residential homes. We took a nice, flat 2 mile walk through the woods to a small beach. You could see the Gastineau Channel during the entire walk. The beach was great - small, private, and sunny. I never thought that I would spend an afternoon suntanning in Juneau, AK.
After the hike, Dr. Dee and I went over to Dr. Marcott's home on Douglas Island. We grilled steaks and enjoyed the beautiful weather. Dr. Marcott lives right next door to Dr. Sohonage, and he too was having a party with some of the people I work with. Eventually the parties combined and we enjoyed each others company long into the night. Once the sun went down, we went down to the beach and built a giant bonfire. It was great sitting on the beach and watching the tide slowly creep back in. The night was so clear that we even saw faint streaks of the Northern Lights. At last, the tide came in and washed away our fire which meant the party was over and it was time to go home.
Tomorrow I am going to Boy Scout Beach with a large group of people I work with. Hopefully the weather is as nice tomorrow as it was today...
Saturday, May 29, 2010
Day 12 - Motivational Interviewing and Blackerby Ridge Trail
I woke up early this morning because I had my Motivational Interviewing seminar at 8 AM. Luckily, Dr. Dee agreed to pick my up so I didn't have to take the 6:50 AM bus to SEARHC. I got there a little early to take advantage of the free breakfast - bagels from Silverbow. I think I have officially joined the workforce - short hours, long lunches, and making sure to take advantage of any and all free food around the office!
The Motivational Interviewing workshop was run by Dr. Steven Cole from Stony Brook. Dr. Cole is a physchiatrist and, along with a few others in his practice, has been working to develop the concept of Motivational Interviewing (MI). MI is a way of developing brief action plans with patients who wish to adjust a certain aspect of their lifestyle. This could be something as simple as cleaning out a car or something as complicated as quitting smoking or starting a weekly exercise regimen.
The main concept of MI is for the patient to recognize an issue they wish to address and for the patient to verbalize how they are going to fix it. This is not just a doctor rambling off statistics and lecturing an unhealthy patient. The doctor asks simple, open-ended questions that allow the patients to formulate their own responses and plans. For example, a doctor would not say, "You are obese, I think you should start walking 3 times a week". Instead, the doctor would say, "What is something you would like to do to address your issue of obesity?". This is important because it allows the patient to come up with their own solutions and create ways in which to hold themselves accountable. Instead of just being accountable to the doctor, patients can create action plans in which they are accountable to spouses, friends, or co-workers. The doctor will then write up a detailed action plan that patients can hang on their refrigerator or keep in their wallets.
The reason that I find MI to be interesting is because the patient base at SEARHC dental is not receptive to many of the suggestions or ideas of the dentists. All of the patients who visit the clinic are Native Alaskan, so many still feel they are being experimented on or simply being used as practice. As a result, they refuse to listen to much of the advice the dentists offer and end up with severe dental disease. With MI, dentists in the clinic can transition from a lecture style to a style in which they allow patients to come up with their own solutions to their dental problems (with dentist supervision, of course!).
After the workshop, I met Dr. Bornstein at the dental clinic. We went to the Juneau Market to pick up sandwiches and then headed off the Blackerby Ridge Trail. Dr. Bornstein warned me the trail was steep right before we began, but nothing could have prepared me for what I was about to experience. The elevation change from where we started to the top of the ridge was over 2,000 ft, but let me say, it was well worth it.
We hiked for about 2 hours until we reached the alpine portion of the ridge. It was really neat to be standing on snow while in shorts and a t-shirt. At one point we were hiking up the ridge and noticed a bird off in the distance. Before we knew it, a bald eagle flew about 3 feet over our heads. I'd say that beats the zoo any day! The view from the top of Blackerby Ridge was incredible. In one direction you could see the Juneau Icefield which was filled with glacier runoffs. In another direction you could see the city of Juneau. In a third direction, if you looked close enough, you were looking into Canada. There was a tiny pond on top of the ridge which is apparently a prime picnic spot in the summer. Since we went 2,000 ft up that meant we had to go 2,000 ft back down. I'm fairly surprised that my calves and knees did not simply revolt and stop working midway through the hike.
For dinner, the Bornstein family invited me to come to a Friday night potluck Shabbat dinner. The temple is on Douglas Island and is extremely different than anything I have ever experienced before. It is essentially a small wooden building with one giant room. We all gathered around on folding chairs as we ate and conducted a small Friday evening service. I think there may have been about 12 people there, and that was most of the Jews of Juneau.
After the service, a professor from Brandeis named David Sachs came to speak about Taglit - Birthright. Dr. Sachs recently wrote a book about how the Birthright experience affects young Jewish adults. He spoke about some of the data and how it shows the experience is extremely meaningful to young adults in terms of recognizing their Jewish identity. This is something I can vouch for as I was a Birthright participant through Vanderbilt last summer. While Dr. Sachs was interested in telling the parents and adults about the results of his data, many were more interested in hearing my stories about hiking Masada, laying out on the beach, and experiencing Tel-Aviv's vibrant nightlife. At one point I said I went on the trip with 30 Jewish friends from Vanderbilt and a mother sitting next to me gasped. She said she can't wait for the day her son can too say that he has 30 Jewish friends. I guess being Jewish in a place like Juneau, AK is just that different.
That's about it for today. I'm hoping that I will be able to walk tomorrow after my strenuous hike today, but I'm not making any promises. Good thing it's the beginning of a 3-day weekend (and a Cards/Cubs weekend at that!).
**I added pictures to the album from my hike on Blackerby Ridge so be sure to check them out!**
The Motivational Interviewing workshop was run by Dr. Steven Cole from Stony Brook. Dr. Cole is a physchiatrist and, along with a few others in his practice, has been working to develop the concept of Motivational Interviewing (MI). MI is a way of developing brief action plans with patients who wish to adjust a certain aspect of their lifestyle. This could be something as simple as cleaning out a car or something as complicated as quitting smoking or starting a weekly exercise regimen.
The main concept of MI is for the patient to recognize an issue they wish to address and for the patient to verbalize how they are going to fix it. This is not just a doctor rambling off statistics and lecturing an unhealthy patient. The doctor asks simple, open-ended questions that allow the patients to formulate their own responses and plans. For example, a doctor would not say, "You are obese, I think you should start walking 3 times a week". Instead, the doctor would say, "What is something you would like to do to address your issue of obesity?". This is important because it allows the patient to come up with their own solutions and create ways in which to hold themselves accountable. Instead of just being accountable to the doctor, patients can create action plans in which they are accountable to spouses, friends, or co-workers. The doctor will then write up a detailed action plan that patients can hang on their refrigerator or keep in their wallets.
The reason that I find MI to be interesting is because the patient base at SEARHC dental is not receptive to many of the suggestions or ideas of the dentists. All of the patients who visit the clinic are Native Alaskan, so many still feel they are being experimented on or simply being used as practice. As a result, they refuse to listen to much of the advice the dentists offer and end up with severe dental disease. With MI, dentists in the clinic can transition from a lecture style to a style in which they allow patients to come up with their own solutions to their dental problems (with dentist supervision, of course!).
After the workshop, I met Dr. Bornstein at the dental clinic. We went to the Juneau Market to pick up sandwiches and then headed off the Blackerby Ridge Trail. Dr. Bornstein warned me the trail was steep right before we began, but nothing could have prepared me for what I was about to experience. The elevation change from where we started to the top of the ridge was over 2,000 ft, but let me say, it was well worth it.
We hiked for about 2 hours until we reached the alpine portion of the ridge. It was really neat to be standing on snow while in shorts and a t-shirt. At one point we were hiking up the ridge and noticed a bird off in the distance. Before we knew it, a bald eagle flew about 3 feet over our heads. I'd say that beats the zoo any day! The view from the top of Blackerby Ridge was incredible. In one direction you could see the Juneau Icefield which was filled with glacier runoffs. In another direction you could see the city of Juneau. In a third direction, if you looked close enough, you were looking into Canada. There was a tiny pond on top of the ridge which is apparently a prime picnic spot in the summer. Since we went 2,000 ft up that meant we had to go 2,000 ft back down. I'm fairly surprised that my calves and knees did not simply revolt and stop working midway through the hike.
For dinner, the Bornstein family invited me to come to a Friday night potluck Shabbat dinner. The temple is on Douglas Island and is extremely different than anything I have ever experienced before. It is essentially a small wooden building with one giant room. We all gathered around on folding chairs as we ate and conducted a small Friday evening service. I think there may have been about 12 people there, and that was most of the Jews of Juneau.
After the service, a professor from Brandeis named David Sachs came to speak about Taglit - Birthright. Dr. Sachs recently wrote a book about how the Birthright experience affects young Jewish adults. He spoke about some of the data and how it shows the experience is extremely meaningful to young adults in terms of recognizing their Jewish identity. This is something I can vouch for as I was a Birthright participant through Vanderbilt last summer. While Dr. Sachs was interested in telling the parents and adults about the results of his data, many were more interested in hearing my stories about hiking Masada, laying out on the beach, and experiencing Tel-Aviv's vibrant nightlife. At one point I said I went on the trip with 30 Jewish friends from Vanderbilt and a mother sitting next to me gasped. She said she can't wait for the day her son can too say that he has 30 Jewish friends. I guess being Jewish in a place like Juneau, AK is just that different.
That's about it for today. I'm hoping that I will be able to walk tomorrow after my strenuous hike today, but I'm not making any promises. Good thing it's the beginning of a 3-day weekend (and a Cards/Cubs weekend at that!).
**I added pictures to the album from my hike on Blackerby Ridge so be sure to check them out!**
Thursday, May 27, 2010
Day 11 - A nondescript day
A really uneventful day today. The weather reached the 80's so I tried to spend as much time outside as possible. I went running with Dr. Sohonage and Dr. Bornstein over lunch. We went all the way to the top of the Salmon Creek Dam which was about a 7 mile round-trip. The residents and dental assistants know that Dr. Sohonage and Dr. Bornstein talk about office related stuff during the runs so they all run to me for any good gossip as soon as I come back.
Early this morning I went to the OB clinic to scout the area and see where the best place to conduct my survey would be. Chris, a dental health aide therapist for SEARHC, works in the OB clinic so knowing her should make the patients less hesitant to speak to me. Also, my friend Patricia from orientation is a nurse in the OB clinic so I will get to see her at least once a week. The rest of my day was pretty relaxing and uneventful. I spent the afternoon outside listening to the Cardinals game on the radio - it was too nice of a day to spend in a clinic office.
Tonight I went to dinner with the residents - Anne and Ryan. They have both been really good friends to me and I enjoy hearing their stories about residency and dental school. We went to a Thai restaurant right near the UAS campus that was really good. It was probably the best dinner I've had since I've been in Juneau - and definitely a place I will be writing about again.
Tomorrow I am going to a conference on Motivational Interviewing which is a method of patient communication that we are considering using for the distribution of our patient education material. I will write more about it tomorrow.
Off to bed...
Early this morning I went to the OB clinic to scout the area and see where the best place to conduct my survey would be. Chris, a dental health aide therapist for SEARHC, works in the OB clinic so knowing her should make the patients less hesitant to speak to me. Also, my friend Patricia from orientation is a nurse in the OB clinic so I will get to see her at least once a week. The rest of my day was pretty relaxing and uneventful. I spent the afternoon outside listening to the Cardinals game on the radio - it was too nice of a day to spend in a clinic office.
Tonight I went to dinner with the residents - Anne and Ryan. They have both been really good friends to me and I enjoy hearing their stories about residency and dental school. We went to a Thai restaurant right near the UAS campus that was really good. It was probably the best dinner I've had since I've been in Juneau - and definitely a place I will be writing about again.
Tomorrow I am going to a conference on Motivational Interviewing which is a method of patient communication that we are considering using for the distribution of our patient education material. I will write more about it tomorrow.
Off to bed...
Wednesday, May 26, 2010
Day 10 - An unexpected surprise
A fun and relaxed day today. The weather here continues to be amazing - it's a shame I can't wear shorts to the clinic! The bus ran a little late this morning so my office mates who tease me for my 4 day a week, 6 hour a day work schedule added a little fuel to their fire. They may get to tease me while I'm in the clinic, but I'm the one laughing when I get to run or hike while they are still seeing temperamental patients on days like today.
I spent the majority of the day pretesting my telephone survey on members of the dental staff. They all had a great time making up funny names and outlandish excuses about why they had "missed" recent dental appointments. Even though the pretesting ended up being fun and lively it was actually very helpful. If there is one thing I have learned in my week and a half here it is that the patient base here is very difficult to deal with. I know broken appointments are a problem but, based on some of the stories I hear, I wonder if some of the dentists don't secretly wish the 25% missed appointment rate was even higher. The dentists and dental assistants who took my survey really did an excellent job of simulating some of the types of people I will be talking to over the next few weeks. It appears as if the telephone survey is done so tomorrow will be my first day calling actual patients.
I went to the medical building on the SEARHC campus to have lunch today. There was a fundraiser for a sick nurse and they served fish tacos and fry bread. We waited in line for 20 minutes only to get to the front and realize there was no more food! We had paid $10 (some donation, some for the food) so we were disappointed that all we got out of the experience was a Pepsi. The woman working the money table sensed our disappointment and offered to send food up to the dental clinic when more arrived. We headed back to the dental building and waited. And waited. And waited. And waited. No food. In the end my lunch consisted of half of Dr. Dee's turkey sandwich - at least the donation was for a good cause.
This afternoon was pretty uneventful. I sent a few emails and began pretesting my waiting room survey. I hope to finalize that survey by tomorrow so that I can plan my trips to Sitka and begin seeing OB patients in the medical clinic starting next Thursday.
It's amazing how, no matter what situation you are in, interesting things always seem to happen. I got a call late last night from Dr. Sohonage asking me if I would be interested in house-sitting for friends of his from June 1st-June 14th. It was a great offer. Not only could I move out of UAS housing and save some money, but I would be closer to work and in an actual home. I was hesitant about packing and unpacking and moving in and moving out until I learned that the couple had a Husky that I would also get to care for. That sealed the deal for me. I called them late last night and agreed to meet them after work today. The house is beautiful - surrounded by woods and right on the Mendenhall River. My new best friend, Sky, is also very cute. She is very playful and enjoys scaring off bears which should make my hikes much more enjoyable. The couple who own the house is very nice. The Ray's, Sara and Jimmy, just moved to Alaska from Oregon last year. They are both professors at UAS - Sara teaches English and Jimmy is a fish biologist (Jimmy is also British which I think puts him in an even smaller minority in Juneau than me as a Jew). I move in on Memorial Day and the house is officially mine starting June 1st.
Tomorrow is supposed to be another beautiful day so I will probably spend the afternoon running and hiking. I'll post pictures and keep you updated.
On another note, thanks to everyone who reads and comments on the blog. As cool as my experiences are here in Alaska, it means even more to me that people are with me every step of the way. Thanks for the support!
I spent the majority of the day pretesting my telephone survey on members of the dental staff. They all had a great time making up funny names and outlandish excuses about why they had "missed" recent dental appointments. Even though the pretesting ended up being fun and lively it was actually very helpful. If there is one thing I have learned in my week and a half here it is that the patient base here is very difficult to deal with. I know broken appointments are a problem but, based on some of the stories I hear, I wonder if some of the dentists don't secretly wish the 25% missed appointment rate was even higher. The dentists and dental assistants who took my survey really did an excellent job of simulating some of the types of people I will be talking to over the next few weeks. It appears as if the telephone survey is done so tomorrow will be my first day calling actual patients.
I went to the medical building on the SEARHC campus to have lunch today. There was a fundraiser for a sick nurse and they served fish tacos and fry bread. We waited in line for 20 minutes only to get to the front and realize there was no more food! We had paid $10 (some donation, some for the food) so we were disappointed that all we got out of the experience was a Pepsi. The woman working the money table sensed our disappointment and offered to send food up to the dental clinic when more arrived. We headed back to the dental building and waited. And waited. And waited. And waited. No food. In the end my lunch consisted of half of Dr. Dee's turkey sandwich - at least the donation was for a good cause.
This afternoon was pretty uneventful. I sent a few emails and began pretesting my waiting room survey. I hope to finalize that survey by tomorrow so that I can plan my trips to Sitka and begin seeing OB patients in the medical clinic starting next Thursday.
It's amazing how, no matter what situation you are in, interesting things always seem to happen. I got a call late last night from Dr. Sohonage asking me if I would be interested in house-sitting for friends of his from June 1st-June 14th. It was a great offer. Not only could I move out of UAS housing and save some money, but I would be closer to work and in an actual home. I was hesitant about packing and unpacking and moving in and moving out until I learned that the couple had a Husky that I would also get to care for. That sealed the deal for me. I called them late last night and agreed to meet them after work today. The house is beautiful - surrounded by woods and right on the Mendenhall River. My new best friend, Sky, is also very cute. She is very playful and enjoys scaring off bears which should make my hikes much more enjoyable. The couple who own the house is very nice. The Ray's, Sara and Jimmy, just moved to Alaska from Oregon last year. They are both professors at UAS - Sara teaches English and Jimmy is a fish biologist (Jimmy is also British which I think puts him in an even smaller minority in Juneau than me as a Jew). I move in on Memorial Day and the house is officially mine starting June 1st.
Tomorrow is supposed to be another beautiful day so I will probably spend the afternoon running and hiking. I'll post pictures and keep you updated.
On another note, thanks to everyone who reads and comments on the blog. As cool as my experiences are here in Alaska, it means even more to me that people are with me every step of the way. Thanks for the support!
Tuesday, May 25, 2010
Day 9 - Making progress
I forgot that Tuesday morning is administrative time for the office and that I am not required to go in until 10 AM. I paid the price as I had to sit through the staff meeting. Needless to say, I will not be making that mistake again.
I had another great talk with Dr. Bornstein this morning. We discussed the ADA (American Dental Association) and the role it played in the DHAT legislation. It is a very long story but, essentially, about 10 years ago the Indian Health Services (which funds tribal clinics like SEARHC) was having a difficult time filling their available dental positions. At the lowest point, over 33% of the dental positions were unfilled. As you might imagine, this initiated a chain reaction in which the clinics could not meet the demands of their large patient bases. This is the main difference between public health and private practice dentistry. There is a saying that "20% of the patients have 80% of the problems". A dentist in private practice would be thrilled with this problem as he or she could raise rates or simply tell some of the needy patients to go find other providers. A public health dentist, on the other hand, must serve all patients that qualify for their care so the shortage of dentists affected the quality of care and the amount of care they were able to administer.
In response to this problem, Dr. Bornstein and others suggested using Dental Health Aides (DHATs) to perform basic procedures such as fluoride varnishes and antimicrobial rinses to free up the dentists to perform the more complex procedures. The ADA was none to happy with non-dentists administering dental care so they traveled to a Alaskan Tribal Health Council meeting to threaten a lawsuit. Little did they know that nothing fires up Alaskan tribal members more than being threatened by white men in fancy suits. Eventually the lawsuit was dropped, the legislation passed, and the DHAT program has evolved into its current state. (On another note, with the sagging economy in the United States, many are reconsidering private practice and the Indian Health Services now has no problem filling all of their positions.)
After my talk with Dr. Bornstein, I met Dr. John Sohanage. Dr. Sohanage oversees the village clinics and just returned from a trip to Angoon, AK. Dr. Sohanage gave me access to Eaglesoft, which is the patient records and scheduling program for the Juneau dental clinic. For my telephone survey I will be looking for patients in Eaglesoft with a specific code that indicates they missed their appointment without a reason. Dr. Sohanage and I went over the basics of the program and then I got to work writing down patient names and phone numbers that I will eventually call to take my telephone survey. The program is pretty cool as I can check patient records from all 18 Southeast clinics from my desk in Juneau.
Before lunch Dr. Sohanage, Dr. Bornstein, and I went running up to the Salmon Creek Dam. It was a beautiful day outside (bordering on hot!) and the 5 mile run was quite enjoyable. I'm still getting used to the running up here - all uphill in one direction and all downhill in the other. It leads to strange looking splits (11 minutes up the hill, 7 minutes down the hill).
When I got back from my run I noticed I had a response from Sara Fujioka - she had finally gotten a chance to look at my surveys. I found Dr. Hort and we looked over Sara's edits and made the changes. In addition to her edits, Sara also suggested that we email a few women from WISEWOMAN, a SEARHC organization that specializes in woman's cardiac health. Some of the staff members there have extensive histories in developing patient education materials so hopefully they can give us some extra input. Tomorrow we will begin our pretesting by administering our survey to members of the dental staff. We should get even more good feedback so we can begin giving the survey to patients starting next week.
Just finished watching the Suns and Lakers so I'll now turn my undivided attention to the Cards game. Let's get some hits!
Another day, another Gallant birthday. This time it's Mom! Happy Birthday, hope you enjoyed it!
I had another great talk with Dr. Bornstein this morning. We discussed the ADA (American Dental Association) and the role it played in the DHAT legislation. It is a very long story but, essentially, about 10 years ago the Indian Health Services (which funds tribal clinics like SEARHC) was having a difficult time filling their available dental positions. At the lowest point, over 33% of the dental positions were unfilled. As you might imagine, this initiated a chain reaction in which the clinics could not meet the demands of their large patient bases. This is the main difference between public health and private practice dentistry. There is a saying that "20% of the patients have 80% of the problems". A dentist in private practice would be thrilled with this problem as he or she could raise rates or simply tell some of the needy patients to go find other providers. A public health dentist, on the other hand, must serve all patients that qualify for their care so the shortage of dentists affected the quality of care and the amount of care they were able to administer.
In response to this problem, Dr. Bornstein and others suggested using Dental Health Aides (DHATs) to perform basic procedures such as fluoride varnishes and antimicrobial rinses to free up the dentists to perform the more complex procedures. The ADA was none to happy with non-dentists administering dental care so they traveled to a Alaskan Tribal Health Council meeting to threaten a lawsuit. Little did they know that nothing fires up Alaskan tribal members more than being threatened by white men in fancy suits. Eventually the lawsuit was dropped, the legislation passed, and the DHAT program has evolved into its current state. (On another note, with the sagging economy in the United States, many are reconsidering private practice and the Indian Health Services now has no problem filling all of their positions.)
After my talk with Dr. Bornstein, I met Dr. John Sohanage. Dr. Sohanage oversees the village clinics and just returned from a trip to Angoon, AK. Dr. Sohanage gave me access to Eaglesoft, which is the patient records and scheduling program for the Juneau dental clinic. For my telephone survey I will be looking for patients in Eaglesoft with a specific code that indicates they missed their appointment without a reason. Dr. Sohanage and I went over the basics of the program and then I got to work writing down patient names and phone numbers that I will eventually call to take my telephone survey. The program is pretty cool as I can check patient records from all 18 Southeast clinics from my desk in Juneau.
Before lunch Dr. Sohanage, Dr. Bornstein, and I went running up to the Salmon Creek Dam. It was a beautiful day outside (bordering on hot!) and the 5 mile run was quite enjoyable. I'm still getting used to the running up here - all uphill in one direction and all downhill in the other. It leads to strange looking splits (11 minutes up the hill, 7 minutes down the hill).
When I got back from my run I noticed I had a response from Sara Fujioka - she had finally gotten a chance to look at my surveys. I found Dr. Hort and we looked over Sara's edits and made the changes. In addition to her edits, Sara also suggested that we email a few women from WISEWOMAN, a SEARHC organization that specializes in woman's cardiac health. Some of the staff members there have extensive histories in developing patient education materials so hopefully they can give us some extra input. Tomorrow we will begin our pretesting by administering our survey to members of the dental staff. We should get even more good feedback so we can begin giving the survey to patients starting next week.
Just finished watching the Suns and Lakers so I'll now turn my undivided attention to the Cards game. Let's get some hits!
Another day, another Gallant birthday. This time it's Mom! Happy Birthday, hope you enjoyed it!
Monday, May 24, 2010
Day 8 - The waiting game
I eagerly ran into the clinic this morning hoping that either Sara Fujioka or Jeannie Monk had responded to the first draft of my survey questions but, unfortunately, neither had. This put me into a bit of a waiting pattern, however, I have quickly learned that Dr. Hort is rarely without a small task or interesting project to tackle. I spent the majority of the morning planning my travel schedule to Sitka, Hoonah, and Haines. I had to research flight schedules, ferry fares, and housing. Here's what I came up with...
Hoonah - June 7th, 8th, and 9th. I will be flying into Hoonah via Wings of Alaska. Oftentimes the clinic sends a group of dentists from Juneau to the smaller villages that do not have full time dental staff for a week at a time to see as many patients as possible during that stretch. I will be traveling to Hoonah with Dr. Nascimento and her dental assistant, Cindy. The flight is literally less than twenty minutes and there are about six flights out of Juneau each day. I've been told that the plane has 6 seats and, if you're lucky, you can sit in the co-pilots seat. While in Hoonah I will be staying in a Bed and Breakfast called Sportsman's. The owner, Pat, is apparently well-known around the clinic for her legendary french toast.
Haines, AK - June 20th, 21st, 22nd, 23rd. I will be taking the ferry to Haines. I will be making this trip on my own to work with Dr. Barnes, a full-time dentist in Haines. This trip will give me an opportunity to take a ferry in Alaska for the first time. The hardest part of my morning was deciphering the ferry schedule. The .pdf was filled with colors, numbers, and letter codes that all corresponded to somewhere or something different. Normally I would be able to handle such a thing, but there did not appear to be any rhyme or reason to the colors or letters. After about 20 minutes of frustration I finally realized the letter codes were referring to the name of the ferry boat and not the name of the city it was traveling to (it made a huge difference!). I am going to be doing a homestay with the hygienist from the Haines clinic. She hosts all of SEARHC's dentists and is supposed to be very friendly and welcoming.
I will also be traveling to Sitka, AK, but was unable to confirm any dates because that trip is more dependent on the survey than the other two trips. The ferry travles to Sitka almost daily so that will be my mode of transportation. I did find out that the hospital in Sitka does offer short term housing for medical personnel so I sent off a few emails to explore that option. Sitka has a large hospital with a huge population of OB patients so I will likely be traveling there two separate times since OB patients are only scheduled on Tuesday.
During lunch I took a nice hike back up to the Salmon Dam with Dr. Newton. As we were walking up the hill Dr. Hort and some others were walking down to return to the clinic. While Dr. Newton and I were coming down I noticed a buzzing in my pocket and saw I had a new voicemail. I thought nothing of it and we continued to converse casually. When I got back to the clinic all the dentists, including Dr. Hort, were more excited than usual to see us. Why the excitement? Apparently Dr. Hort had seen a black bear mother and her cub on the trail right before we walked down it. The voicemail was her calling me to warn me to stay on the trail for a few extra minutes before coming back down. Lucky for me, the bear and cub had disappeared back into the woods long before we reached the point where it was spotted. Dr. Newton told me the first thing he packs on his hiking trips is an extra pair of underwear - just in case he happens to come across a bear.
Today was another beautiful day - sunny and rain free. Dr. Hort literally ordered me out of the office to enjoy this gorgeous day. She says I should not feel bad about working shorter hours during the month of May because, come June, the rain will arrive and I will be stuck inside. I spent the afternoon on the UAS campus reading some articles and studies about varying dental topics.
One of my goals for this week is to narrow in on a topic or series of topics that will be the focus of my dental curriculum. The general focus will be on preventative dentistry and nutrition, but Dr. Hort and I both think it would be a much more meaningful guide if it were pointed towards a specialized topic within that general focus. My other goal is to utilize comments from Jeannie and Sara to tighten up my survey questions. After this week the technical, administrative aspect of the project should be over and I will be able to begin administering the survey and interacting with patients on a more consistent basis.
That's about it from here...
On a separate note, a special happy birthday to my Paw Paw, who turns 77 today! I'll be sure to do an extra three hours of celebrating for you to make sure your birthday lasts as long as possible.
Hoonah - June 7th, 8th, and 9th. I will be flying into Hoonah via Wings of Alaska. Oftentimes the clinic sends a group of dentists from Juneau to the smaller villages that do not have full time dental staff for a week at a time to see as many patients as possible during that stretch. I will be traveling to Hoonah with Dr. Nascimento and her dental assistant, Cindy. The flight is literally less than twenty minutes and there are about six flights out of Juneau each day. I've been told that the plane has 6 seats and, if you're lucky, you can sit in the co-pilots seat. While in Hoonah I will be staying in a Bed and Breakfast called Sportsman's. The owner, Pat, is apparently well-known around the clinic for her legendary french toast.
Haines, AK - June 20th, 21st, 22nd, 23rd. I will be taking the ferry to Haines. I will be making this trip on my own to work with Dr. Barnes, a full-time dentist in Haines. This trip will give me an opportunity to take a ferry in Alaska for the first time. The hardest part of my morning was deciphering the ferry schedule. The .pdf was filled with colors, numbers, and letter codes that all corresponded to somewhere or something different. Normally I would be able to handle such a thing, but there did not appear to be any rhyme or reason to the colors or letters. After about 20 minutes of frustration I finally realized the letter codes were referring to the name of the ferry boat and not the name of the city it was traveling to (it made a huge difference!). I am going to be doing a homestay with the hygienist from the Haines clinic. She hosts all of SEARHC's dentists and is supposed to be very friendly and welcoming.
I will also be traveling to Sitka, AK, but was unable to confirm any dates because that trip is more dependent on the survey than the other two trips. The ferry travles to Sitka almost daily so that will be my mode of transportation. I did find out that the hospital in Sitka does offer short term housing for medical personnel so I sent off a few emails to explore that option. Sitka has a large hospital with a huge population of OB patients so I will likely be traveling there two separate times since OB patients are only scheduled on Tuesday.
During lunch I took a nice hike back up to the Salmon Dam with Dr. Newton. As we were walking up the hill Dr. Hort and some others were walking down to return to the clinic. While Dr. Newton and I were coming down I noticed a buzzing in my pocket and saw I had a new voicemail. I thought nothing of it and we continued to converse casually. When I got back to the clinic all the dentists, including Dr. Hort, were more excited than usual to see us. Why the excitement? Apparently Dr. Hort had seen a black bear mother and her cub on the trail right before we walked down it. The voicemail was her calling me to warn me to stay on the trail for a few extra minutes before coming back down. Lucky for me, the bear and cub had disappeared back into the woods long before we reached the point where it was spotted. Dr. Newton told me the first thing he packs on his hiking trips is an extra pair of underwear - just in case he happens to come across a bear.
Today was another beautiful day - sunny and rain free. Dr. Hort literally ordered me out of the office to enjoy this gorgeous day. She says I should not feel bad about working shorter hours during the month of May because, come June, the rain will arrive and I will be stuck inside. I spent the afternoon on the UAS campus reading some articles and studies about varying dental topics.
One of my goals for this week is to narrow in on a topic or series of topics that will be the focus of my dental curriculum. The general focus will be on preventative dentistry and nutrition, but Dr. Hort and I both think it would be a much more meaningful guide if it were pointed towards a specialized topic within that general focus. My other goal is to utilize comments from Jeannie and Sara to tighten up my survey questions. After this week the technical, administrative aspect of the project should be over and I will be able to begin administering the survey and interacting with patients on a more consistent basis.
That's about it from here...
On a separate note, a special happy birthday to my Paw Paw, who turns 77 today! I'll be sure to do an extra three hours of celebrating for you to make sure your birthday lasts as long as possible.
Sunday, May 23, 2010
Day 7 - A lazy Sunday
Nothing much going on today. I slept in after going out with some of my co-workers last night. Woke up and watched the Cardinals game while eating breakfast (still can't get over that concept!). I spent most of today cleaning up my apartment - taking out trash, doing dishes, etc. I decided to give my legs a rest after 6 straight days of running and hiking.
Just got back from Fred Meyer where I replenished some of the groceries I had eaten over the course of the week. About to watch the Suns and Lakers play and then waste some time until it's an appropriate bedtime hour.
Back to work in the morning...
Just got back from Fred Meyer where I replenished some of the groceries I had eaten over the course of the week. About to watch the Suns and Lakers play and then waste some time until it's an appropriate bedtime hour.
Back to work in the morning...
Saturday, May 22, 2010
Day 6 - Maritime Festival and Perseverance Trail
I got to sleep in on my first weekend day, although I am still having trouble adjusting to the constant brightness. Of the 6 days I have been in Juneau I think I have seen dark sky for maybe a combined 17 minutes. The first thing I did this morning was turn on the Cardinals game. Nothing like a bowl of cereal, eggs, and some Saturday baseball.
I decided to go to the Maritime Festival in Downtown Juneau with Sarah and Sam Bornstein today. It was nice meeting them yesterday as they are both around my age. It wasgreat to be able to be a kid again, that is, not always having to be around adults in the office setting. We drove downtown and arrived just in time to see the mock U.S. Coast Guard rescue on Juneau Harbor. There were lots of booths set up in the downtown Marine Plaza for a lot of local excursions. I got some good ideas for dog sledding, hiking on a glacier, and other helicopter tours. We took a ride to Douglas Island on an old-fashioned steamboat. There was nothing fake about it - from the oil cannister to the original piston, to the actual fire that had to be tended to during our trip around the harbor. Even Captain John looked like he was stuck in 1842.
After the steamboat tour I went to lunch in a place that, according to the Bornsteins, "no tourist would ever find". It was a little deli called Silverbow and was pretty good. The bagel I had was excellent and I'm disappointed it is out of my way in the mornings.
Following lunch we went back to the harbor to tour some boats. We had the chance to explore a U.S. Coast Guard Rescue Boat, a 70 ft. yacht, and a Tugboat. The 70 ft. yacht was pretty impressive. There were three cabins (each with it's own bathroom and plasma T.V.), a kitchen, a washer and dryer, and that was just on the lower level. The main level had a giant bar and T.V. room that was filled with a giant T.V. and nice leather couches. The top deck had lots of scuba equipment and some great places to sit and enjoy the sun. All of that can be yours for just $31,000 per week! The Tugboat and Rescue Boat were a bit more modest but interesting nonetheless. The tugboat captain bragged on the fact that his tiny tugboat could drag around some of the giant cruise ships docked right across the harbor.
The festival wound down and I met Dr. Bornstein at the trailhead of Perseverance Trail. We ran 3 miles until we reached snow on the trail and then we ran the 3 miles back. Running hiking trails is a different experience than running on the streets of Nashville or St. Louis - lots more hills and you have to constantly look down to make sure you aren't running over rocks.
I just got back to my apartment to get ready for dinner tonight. It is somebody's birthday in the office and we are going to the Island Pub on Douglas Island. It will be nice to be with everyone while they aren't wearing scrubs and surgical masks...
I decided to go to the Maritime Festival in Downtown Juneau with Sarah and Sam Bornstein today. It was nice meeting them yesterday as they are both around my age. It wasgreat to be able to be a kid again, that is, not always having to be around adults in the office setting. We drove downtown and arrived just in time to see the mock U.S. Coast Guard rescue on Juneau Harbor. There were lots of booths set up in the downtown Marine Plaza for a lot of local excursions. I got some good ideas for dog sledding, hiking on a glacier, and other helicopter tours. We took a ride to Douglas Island on an old-fashioned steamboat. There was nothing fake about it - from the oil cannister to the original piston, to the actual fire that had to be tended to during our trip around the harbor. Even Captain John looked like he was stuck in 1842.
After the steamboat tour I went to lunch in a place that, according to the Bornsteins, "no tourist would ever find". It was a little deli called Silverbow and was pretty good. The bagel I had was excellent and I'm disappointed it is out of my way in the mornings.
Following lunch we went back to the harbor to tour some boats. We had the chance to explore a U.S. Coast Guard Rescue Boat, a 70 ft. yacht, and a Tugboat. The 70 ft. yacht was pretty impressive. There were three cabins (each with it's own bathroom and plasma T.V.), a kitchen, a washer and dryer, and that was just on the lower level. The main level had a giant bar and T.V. room that was filled with a giant T.V. and nice leather couches. The top deck had lots of scuba equipment and some great places to sit and enjoy the sun. All of that can be yours for just $31,000 per week! The Tugboat and Rescue Boat were a bit more modest but interesting nonetheless. The tugboat captain bragged on the fact that his tiny tugboat could drag around some of the giant cruise ships docked right across the harbor.
The festival wound down and I met Dr. Bornstein at the trailhead of Perseverance Trail. We ran 3 miles until we reached snow on the trail and then we ran the 3 miles back. Running hiking trails is a different experience than running on the streets of Nashville or St. Louis - lots more hills and you have to constantly look down to make sure you aren't running over rocks.
I just got back to my apartment to get ready for dinner tonight. It is somebody's birthday in the office and we are going to the Island Pub on Douglas Island. It will be nice to be with everyone while they aren't wearing scrubs and surgical masks...
Thursday, May 20, 2010
UPDATE: Pictures!
I have finally figured out how to upload pictures to the blog! The slideshow right below the giant picture is a slideshow of pictures I have taken. I realize the pictures are small, but I think that if you click on them you can view them in Picasa Web Albums at a much bigger size.
Also, once you are in Picasa there is a panel on the right-hand side. There is a heading that says "Photo Information" and then a small blue link that says "more info" right under it. If you click "more info" you should see the name of each file. The name of each picture is a description of the picture so you know what you are looking at!
I will continue to post pictures as I take them...
Also, once you are in Picasa there is a panel on the right-hand side. There is a heading that says "Photo Information" and then a small blue link that says "more info" right under it. If you click "more info" you should see the name of each file. The name of each picture is a description of the picture so you know what you are looking at!
I will continue to post pictures as I take them...
Day 5 - Playing hookey
Most of the dentists and hygienists on the SEARHC staff work a 4-10 schedule (4, 10 hour workdays as opposed to 5, 8 hour workdays), so each staff member gets one day off per week. Dr. Hort happened to be off today and, by extension, that means I got the day off too!
Instead of going into the clinic today, Dr. Hort, her husband, Dr. Bornstein, and I went hiking today on the West Glacier Trail. This morning Dr. Bornstein called and asked if I was prepared to go hiking. I said sure - I have shoes, clothes, a little drawstring backpack - I'll be fine. When we met up this morning he took one look at me and laughed. He was critical of all but my rain jacket and underwear. He did lend me a pair of hiking boots which turned out to be very helpful. In my defense, I made the 4 hour hike without a word of complaint. Not bad for a Midwestern boy with cotton clothes.
We started out on the traditional trail when we suddenly began walking directly into the unmarked woods. Apparently Dr. Bornstein is an avid hiker and knows his way around most trails so he took us the scenic route towards the glacier. We hiked up and down ridges and rock seams until we finally reached the Mendenhall Glacier. The glacier has receded a lot in recent years so what used to be an hour long hike has turned into a two hour hike. We got a chance to walk on the glacier and explore some ice tunnels on it as well. I can't even describe how cool it was.
We had lunch right near the glacier overlooking the Mendenhall River. There were icebergs floating at the base of the glacier and Nugget Falls Waterfall (which is runoff from the Nugget Glacier) was in the backdrop. We hiked another two hours back to the trailhead. As Dr. Bornstein dropped me off he invited me over to dinner to meet his wife and children since his son, Sam, is attending Washington University in St. Louis.
For dinner I finally had my first seafood since arriving in Juneau - sockeye salmon. The best part about eating the salmon was that during the entire meal I was staring directly at the source of water where it came from. The Bornstein household overlooks Auke Bay. There are mountains in the distance and the harbor is right near their home. At one point during dinner a humpback whale appeared in the harbor. Not a bad view...
It was great to meet Dr. Bornstein's family, especially his kids since they are around my age. His son was really interested in learning all about St. Louis and cool things to do in the city. I gave him my Albert Pujols jersey and told him if nothing else, at least he'd look good wearing red. I told him he would be the most knowledgeable freshman on campus (at least the most knowledgeable freshman from Juneau, AK!). Dr. Bornstein's daughter, Sarah, is in graduate school at Simmons College in Boston. She is studying to be an Archiver and is home for a few weeks during the summer.
The Bornstein family is Jewish so it was really interesting to hear about the Jewish lifestlye in Juneau. They joked that, with me in town, the Jewish population has expanded to 7 people. The one synagogue in town is on Douglas Island. There is no rabbi so services are run by whoever takes the initiative that particular week. There will be a Bar Mitzvah in June that will be the first Bar or Bat Mitzvah in Juneau in nearly 2 years! Apparently, regardless of your birthday, you have your Bar or Bat Mitzvah in the summer to ensure that out of town relatives will want to visit.
I am pretty worn out after my long hike today. Tomorrow there is a maritime festival downtown so I am going to head to that with Sarah and Sam. After the festival I am going to take a run of Perseverance Trail. Should be a busy day and a great start to my first weekend in Juneau...
Instead of going into the clinic today, Dr. Hort, her husband, Dr. Bornstein, and I went hiking today on the West Glacier Trail. This morning Dr. Bornstein called and asked if I was prepared to go hiking. I said sure - I have shoes, clothes, a little drawstring backpack - I'll be fine. When we met up this morning he took one look at me and laughed. He was critical of all but my rain jacket and underwear. He did lend me a pair of hiking boots which turned out to be very helpful. In my defense, I made the 4 hour hike without a word of complaint. Not bad for a Midwestern boy with cotton clothes.
We started out on the traditional trail when we suddenly began walking directly into the unmarked woods. Apparently Dr. Bornstein is an avid hiker and knows his way around most trails so he took us the scenic route towards the glacier. We hiked up and down ridges and rock seams until we finally reached the Mendenhall Glacier. The glacier has receded a lot in recent years so what used to be an hour long hike has turned into a two hour hike. We got a chance to walk on the glacier and explore some ice tunnels on it as well. I can't even describe how cool it was.
We had lunch right near the glacier overlooking the Mendenhall River. There were icebergs floating at the base of the glacier and Nugget Falls Waterfall (which is runoff from the Nugget Glacier) was in the backdrop. We hiked another two hours back to the trailhead. As Dr. Bornstein dropped me off he invited me over to dinner to meet his wife and children since his son, Sam, is attending Washington University in St. Louis.
For dinner I finally had my first seafood since arriving in Juneau - sockeye salmon. The best part about eating the salmon was that during the entire meal I was staring directly at the source of water where it came from. The Bornstein household overlooks Auke Bay. There are mountains in the distance and the harbor is right near their home. At one point during dinner a humpback whale appeared in the harbor. Not a bad view...
It was great to meet Dr. Bornstein's family, especially his kids since they are around my age. His son was really interested in learning all about St. Louis and cool things to do in the city. I gave him my Albert Pujols jersey and told him if nothing else, at least he'd look good wearing red. I told him he would be the most knowledgeable freshman on campus (at least the most knowledgeable freshman from Juneau, AK!). Dr. Bornstein's daughter, Sarah, is in graduate school at Simmons College in Boston. She is studying to be an Archiver and is home for a few weeks during the summer.
The Bornstein family is Jewish so it was really interesting to hear about the Jewish lifestlye in Juneau. They joked that, with me in town, the Jewish population has expanded to 7 people. The one synagogue in town is on Douglas Island. There is no rabbi so services are run by whoever takes the initiative that particular week. There will be a Bar Mitzvah in June that will be the first Bar or Bat Mitzvah in Juneau in nearly 2 years! Apparently, regardless of your birthday, you have your Bar or Bat Mitzvah in the summer to ensure that out of town relatives will want to visit.
I am pretty worn out after my long hike today. Tomorrow there is a maritime festival downtown so I am going to head to that with Sarah and Sam. After the festival I am going to take a run of Perseverance Trail. Should be a busy day and a great start to my first weekend in Juneau...
Day 4 - Meeting my first deadline
Despite the fact that today was another beautiful day, I did manage to keep myself busy in the office until 3:00 PM. Well... maybe until about 2:30 PM. I got right to work this morning to finish the survey questions, and apparently all of my background research from earlier this week really paid off as I had no trouble at all coming up with an ample amount of questions.
Dr. Hort and I went over my survey questions and, in all honesty, my survey writing is a bit verbose. Dr. Hort mentioned that studies have shown that health surveys are most effective when written at a sixth grade reading level. I'll tell you what - it's tough to write on a sixth grade level after completing a semester at Vanderbilt. Fortunately for me, Dr. Hort has two young children and has grown quite accustomed to helping with 2nd grade reading and writing. In the end we wrote two separate surveys - one conducted over the phone and one conducted in waiting rooms of various medical and dental clinics.
The telephone survey is written to address the 25% missed appointment rate for the dental clinics all throughout the Southeast. We are seeking to see why people are missing their appointments, and if the high percentage of missed appointments can be attributed to dental anxiety. We included questions from Norman Corah's Dental Anxiety Scale and Kleinknecht's Dental Fear Survey to gauge some of the anxiety issues that patients face when coming into the clinic. If the missed appointments are attributed to anxiety then this is something we can address in our final product.
The waiting room survey will be given to OB patients in Juneau and all patients in the smaller village clinics. This survey asks about the number of children OB patients have, whether or not current educational material distributed by SEARHC has been effective, and which method of media would be most effective for distributing oral health information in the future. In addition, since I will have personal interaction with those who are completing this survey, we included an open ended question asking patients about what dental information is most important to them. This question will give patients a platform to express anything they want about their oral health and dental care in the clinic.
Today during lunch we walked across the street to the DIPAC hatchery. It is still a bit early for the salmon to begin to spawn, but we did see an entire tank of baby King Salmon. There was also a large aquarium inside with various fish, crabs, and urchins. If you stand at the hatchery you can see Douglas Island, which is connected to Juneau via a bridge over the Gastineau Channel.
After lunch I went to the big map of Juneau trails to see where I would head for my daily adventure. What started out as me silently looking at a map ended up as a ten person debate between 2 dentists, 3 hygenists, 4 dental assistants, and a resident as to whether Herbert Glacier or Mendenhall Glacier offered better hiking trails. Both of the glaciers are a bit far for a run, so I decided to head to John Muir Cabin at the end of Spalding Lake Trail.
Four days in and I am loving every minute of my experience. I am finding my summer project experience to be about more than community service - something I really stressed in my project proposal. I am always sure to work hard while I am at the dental clinic, but I have also found a healthy amount of time to just be me.
Off to John Muir Cabin...
P.S. Nothing cooler than a 10 AM first pitch for the Cardinals vs. Marlins game today - what a way to start my morning!
Dr. Hort and I went over my survey questions and, in all honesty, my survey writing is a bit verbose. Dr. Hort mentioned that studies have shown that health surveys are most effective when written at a sixth grade reading level. I'll tell you what - it's tough to write on a sixth grade level after completing a semester at Vanderbilt. Fortunately for me, Dr. Hort has two young children and has grown quite accustomed to helping with 2nd grade reading and writing. In the end we wrote two separate surveys - one conducted over the phone and one conducted in waiting rooms of various medical and dental clinics.
The telephone survey is written to address the 25% missed appointment rate for the dental clinics all throughout the Southeast. We are seeking to see why people are missing their appointments, and if the high percentage of missed appointments can be attributed to dental anxiety. We included questions from Norman Corah's Dental Anxiety Scale and Kleinknecht's Dental Fear Survey to gauge some of the anxiety issues that patients face when coming into the clinic. If the missed appointments are attributed to anxiety then this is something we can address in our final product.
The waiting room survey will be given to OB patients in Juneau and all patients in the smaller village clinics. This survey asks about the number of children OB patients have, whether or not current educational material distributed by SEARHC has been effective, and which method of media would be most effective for distributing oral health information in the future. In addition, since I will have personal interaction with those who are completing this survey, we included an open ended question asking patients about what dental information is most important to them. This question will give patients a platform to express anything they want about their oral health and dental care in the clinic.
Today during lunch we walked across the street to the DIPAC hatchery. It is still a bit early for the salmon to begin to spawn, but we did see an entire tank of baby King Salmon. There was also a large aquarium inside with various fish, crabs, and urchins. If you stand at the hatchery you can see Douglas Island, which is connected to Juneau via a bridge over the Gastineau Channel.
After lunch I went to the big map of Juneau trails to see where I would head for my daily adventure. What started out as me silently looking at a map ended up as a ten person debate between 2 dentists, 3 hygenists, 4 dental assistants, and a resident as to whether Herbert Glacier or Mendenhall Glacier offered better hiking trails. Both of the glaciers are a bit far for a run, so I decided to head to John Muir Cabin at the end of Spalding Lake Trail.
Four days in and I am loving every minute of my experience. I am finding my summer project experience to be about more than community service - something I really stressed in my project proposal. I am always sure to work hard while I am at the dental clinic, but I have also found a healthy amount of time to just be me.
Off to John Muir Cabin...
P.S. Nothing cooler than a 10 AM first pitch for the Cardinals vs. Marlins game today - what a way to start my morning!
Wednesday, May 19, 2010
Day 3 - Finding my way
Dr. Hort was seeing patients all day today so I truly had a research/brainstorming day all to myself. I spent the morning reading online articles and studies pertaining to prenatal health and oral health as well as brainstorming methods to distribute the curriculum and information we eventually develop. I also had the opportunity to read some documents that Sara Fujioka sent over that were very helpful in formulating survey questions that will maximize the effect of the survey.
I got to spend some time with Dr. Tom Bornstein today as well. Dr. Bornstein is the Director of Dental Services for all 18 of SEARHC's clinics. We discussed the structure of the organization and how it is run. I find it really interesting that the majority of the dentists in the office are NOT from Alaska. Dr. Bornstein told me that generally a dentist must get re-certified to practice in each state if they wish to set up a private practice in that state, however, since SEARHC is federally funded by the Indian Health Services, dentists can come to work for the organization without getting certified to practice dentistry in the state of Alaska. We also discussed the role of DHAT (Dental Therapists) that work alongside the dentists in smaller villages such as Hoonah and Haines. The DHAT program spawned off of the CHAP program. The CHAP program is similar to the Dental Therapist program, except it is more related to medicine. Some of the trained CHAPs get to do some very interesting things. Dr. Bornstein mentioned a digital pharmacy in which a CHAP in Pelican, AK can video conference with a trained pharmacist in Sitka, AK in order to prescribe medicine to a patient. In Pelican, there is a digitally controlled box of medicine that will only dispense medicine if the pharmacist in Sitka authorizes it. There are also similar techniques in which CHAPs can examine patients in real-time while being supervised via video camera from SEARHC's main hospital in Sitka. Dr. Bornstein was excited to learn I am from St. Louis as his son will be attending Washington University in St. Louis in the fall. I think I have been hired as his official liaison to the city.
Yesterday I learned that some of the men in the office like to run during their lunch breaks, so I brought a gym bag with shoes, shirt, shorts, etc. I was disappointed to find out that Dr. Pinney had "forgotten" his shoes and wasn't going to be running today. I think he felt guilty enough that I am guaranteed a running partner from now until July 18th! I continued to get to know the people who work in my office - Dr. Dee, Dr. Pinney, Dr. Nascimento, and Dr. Newton. Pinney and Dee are young residents, Reeve (Dr. Newton) is an older man (expert trail guide!), and Dr. Nascimento is interesting because she is a native Alaskan. I enjoy working with them and have been invited to countless softball games, hiking outings, and dinners.
Today during lunch I took a hike to the Salmon Dam Reservoir. I saw the dam as well as a salmon hatchery right across the street. The salmon hatchery is a neat place this time of year as the King Salmon are coming to spawn during this season.
I left work early since it was a perfect 65 without a cloud in the sky today. I decided to go for a run (since Dr. Pinney left me hanging this morning!). Dr. Hort and other members of the office have been talking up a place called Bullwinkle's Pizza Parlor so I decided I would run there and take the bus back to UAS. I went over 7 miles - through Auke Bay, Auke Lake, across the Mendenhall River, and down Mendenhall Loop Road until I finally reached Bullwinkle's. It was well worth the run!
I mistimed the bus route (apparently after a certain time of day they only run once every hour, who knew?), but did end up meeting two really neat Americorps volunteers. Nate and Mel are both in Alaska for a year clearing nature trails on the Mendenhall Glacier. They both plan to get their degrees at University of Alaska - Southeast and will begin taking classes there in January.
Tomorrow will be a busy day as Dr. Hort wants to have a rough draft of the telephone and in-person surveys completed by the time I leave the office tomorrow - As much fun as I had exploring today I'm not sure what time that will be!
I got to spend some time with Dr. Tom Bornstein today as well. Dr. Bornstein is the Director of Dental Services for all 18 of SEARHC's clinics. We discussed the structure of the organization and how it is run. I find it really interesting that the majority of the dentists in the office are NOT from Alaska. Dr. Bornstein told me that generally a dentist must get re-certified to practice in each state if they wish to set up a private practice in that state, however, since SEARHC is federally funded by the Indian Health Services, dentists can come to work for the organization without getting certified to practice dentistry in the state of Alaska. We also discussed the role of DHAT (Dental Therapists) that work alongside the dentists in smaller villages such as Hoonah and Haines. The DHAT program spawned off of the CHAP program. The CHAP program is similar to the Dental Therapist program, except it is more related to medicine. Some of the trained CHAPs get to do some very interesting things. Dr. Bornstein mentioned a digital pharmacy in which a CHAP in Pelican, AK can video conference with a trained pharmacist in Sitka, AK in order to prescribe medicine to a patient. In Pelican, there is a digitally controlled box of medicine that will only dispense medicine if the pharmacist in Sitka authorizes it. There are also similar techniques in which CHAPs can examine patients in real-time while being supervised via video camera from SEARHC's main hospital in Sitka. Dr. Bornstein was excited to learn I am from St. Louis as his son will be attending Washington University in St. Louis in the fall. I think I have been hired as his official liaison to the city.
Yesterday I learned that some of the men in the office like to run during their lunch breaks, so I brought a gym bag with shoes, shirt, shorts, etc. I was disappointed to find out that Dr. Pinney had "forgotten" his shoes and wasn't going to be running today. I think he felt guilty enough that I am guaranteed a running partner from now until July 18th! I continued to get to know the people who work in my office - Dr. Dee, Dr. Pinney, Dr. Nascimento, and Dr. Newton. Pinney and Dee are young residents, Reeve (Dr. Newton) is an older man (expert trail guide!), and Dr. Nascimento is interesting because she is a native Alaskan. I enjoy working with them and have been invited to countless softball games, hiking outings, and dinners.
Today during lunch I took a hike to the Salmon Dam Reservoir. I saw the dam as well as a salmon hatchery right across the street. The salmon hatchery is a neat place this time of year as the King Salmon are coming to spawn during this season.
I left work early since it was a perfect 65 without a cloud in the sky today. I decided to go for a run (since Dr. Pinney left me hanging this morning!). Dr. Hort and other members of the office have been talking up a place called Bullwinkle's Pizza Parlor so I decided I would run there and take the bus back to UAS. I went over 7 miles - through Auke Bay, Auke Lake, across the Mendenhall River, and down Mendenhall Loop Road until I finally reached Bullwinkle's. It was well worth the run!
I mistimed the bus route (apparently after a certain time of day they only run once every hour, who knew?), but did end up meeting two really neat Americorps volunteers. Nate and Mel are both in Alaska for a year clearing nature trails on the Mendenhall Glacier. They both plan to get their degrees at University of Alaska - Southeast and will begin taking classes there in January.
Tomorrow will be a busy day as Dr. Hort wants to have a rough draft of the telephone and in-person surveys completed by the time I leave the office tomorrow - As much fun as I had exploring today I'm not sure what time that will be!
Tuesday, May 18, 2010
Day 2 - Coming into focus
Still adjusting to the time change so I was up early this morning. Wanted to go back to bed, but it's difficult when the sun is already high in the sky at 5 AM! I made breakfast this morning, and fortunately I found an old newspaper in the dental clinic on Monday so I was able to complete the crossword puzzle and read the comics. I took the 8:06 AM bus from DeHart's to SEARHC.
Dr. Hort and I immediately went from the dental clinic to the administrative building to speak with Jeannie Monk and Sara Fujioka. Sara was in SEARHC's clinic in Sitka, Alaska so we used the organization's Polycom system to set up a video conference. There is a Polycom center at each of the 18 Southeast clinics so at any time some in Kake can speak with someone from Juneau while simultaneously video-conferencing with someone from Prince of Wales. This keeps the clinics (particularly the smaller, more remote ones) all connected and aware.
Jeannie Monk is a grant writer and Sara Fujioka is a biostatistician. It was so helpful to pick their brains and use their experience to help me develop my own survey. The most interesting part of the meeting came when Sara suggested we focus on a specific subgroup of patients within the patient population. It made sense - why would a 65 year old man in Kake, AK want to receive dental care information in the same manner as a 22 year old woman from Juneau, AK? We decided to focus on OB women. This is interesting to me because I will now have the opportunity to interact with women in the OB clinic on Thursdays. This will add a new dimension to the project.
This afternoon, Dr. Hort and I got sidetracked focusing on the nutritional aspect of my summer project. Recently, there has been a lot of study conducted on Xylitol, a sugar found in many of the foods we eat daily. Xylitol is important to SEARHC for many reasons. First, it is completely organic which is vital to the lifestyle of many of the native Alaskans. Second, studies have shown that it can reduce plaque and prevent cavities (at least finish reading before going to buy a pack of Orbitz or Icebreakers gum!). Dr. Hort convinced the SEARHC board of directors to purchase a vending machine for the clinic and stock it completely with products that contain high concentrations of Xylitol. My job this afternoon was to research products that would work well in the vending machine. We went to Blockbuster and Wal-Mart to check out the candy aisles and huddle over nutritional facts and ingredient information. I'll keep you posted on what we settle on!
The drive around town was a great chance to get to know Dr. Hort and a little bit about life in Alaska. One of the most interesting things she said was that high school sports in Alaska suffer because parents are often required to pay extensive travel fees so the athletic teams can compete with teams all over the state. Sometimes the closest softball or water polo team can be a day long ferry ride away! These costs add up and, as a result, sports suffer in the area.
I spent the rest of the afternoon researching dental caries, prenatal health, and dental anxiety to build a strong base of information for my survey. Dr. Hort is really trusting me to take the reins on this project and I am excited to immerse myself in the information to make it mine.
I took the bus to downtown Juneau to explore the harbor and Main Street. I saw lots of cruise ships, bush planes, and plenty of tourists. Main Street and the historic downtown district were buzzing with people coming off the ships. I walked around and saw the state capitol, Supreme Court, and Governor's house (no Sarah Palin!). I have now seen all of Juneau from the Mendenhall Valley (where I am living) to downtown Juneau. It is about an 18 mile stretch. On the bus ride back home I got a little excited after Ryan Ludwick homered to put the Cardinals back on top. I forget I am not in the baseball-crazed Midwest anymore.
Just finished dinner and probably headed for another early night - I have been going non-stop since I got here. Not that I am complaining - each day brings a new challenge and a new set of tasks. I am enjoying what I am doing and who I am doing it with. Let's see what tomorrow has in store!
Dr. Hort and I immediately went from the dental clinic to the administrative building to speak with Jeannie Monk and Sara Fujioka. Sara was in SEARHC's clinic in Sitka, Alaska so we used the organization's Polycom system to set up a video conference. There is a Polycom center at each of the 18 Southeast clinics so at any time some in Kake can speak with someone from Juneau while simultaneously video-conferencing with someone from Prince of Wales. This keeps the clinics (particularly the smaller, more remote ones) all connected and aware.
Jeannie Monk is a grant writer and Sara Fujioka is a biostatistician. It was so helpful to pick their brains and use their experience to help me develop my own survey. The most interesting part of the meeting came when Sara suggested we focus on a specific subgroup of patients within the patient population. It made sense - why would a 65 year old man in Kake, AK want to receive dental care information in the same manner as a 22 year old woman from Juneau, AK? We decided to focus on OB women. This is interesting to me because I will now have the opportunity to interact with women in the OB clinic on Thursdays. This will add a new dimension to the project.
This afternoon, Dr. Hort and I got sidetracked focusing on the nutritional aspect of my summer project. Recently, there has been a lot of study conducted on Xylitol, a sugar found in many of the foods we eat daily. Xylitol is important to SEARHC for many reasons. First, it is completely organic which is vital to the lifestyle of many of the native Alaskans. Second, studies have shown that it can reduce plaque and prevent cavities (at least finish reading before going to buy a pack of Orbitz or Icebreakers gum!). Dr. Hort convinced the SEARHC board of directors to purchase a vending machine for the clinic and stock it completely with products that contain high concentrations of Xylitol. My job this afternoon was to research products that would work well in the vending machine. We went to Blockbuster and Wal-Mart to check out the candy aisles and huddle over nutritional facts and ingredient information. I'll keep you posted on what we settle on!
The drive around town was a great chance to get to know Dr. Hort and a little bit about life in Alaska. One of the most interesting things she said was that high school sports in Alaska suffer because parents are often required to pay extensive travel fees so the athletic teams can compete with teams all over the state. Sometimes the closest softball or water polo team can be a day long ferry ride away! These costs add up and, as a result, sports suffer in the area.
I spent the rest of the afternoon researching dental caries, prenatal health, and dental anxiety to build a strong base of information for my survey. Dr. Hort is really trusting me to take the reins on this project and I am excited to immerse myself in the information to make it mine.
I took the bus to downtown Juneau to explore the harbor and Main Street. I saw lots of cruise ships, bush planes, and plenty of tourists. Main Street and the historic downtown district were buzzing with people coming off the ships. I walked around and saw the state capitol, Supreme Court, and Governor's house (no Sarah Palin!). I have now seen all of Juneau from the Mendenhall Valley (where I am living) to downtown Juneau. It is about an 18 mile stretch. On the bus ride back home I got a little excited after Ryan Ludwick homered to put the Cardinals back on top. I forget I am not in the baseball-crazed Midwest anymore.
Just finished dinner and probably headed for another early night - I have been going non-stop since I got here. Not that I am complaining - each day brings a new challenge and a new set of tasks. I am enjoying what I am doing and who I am doing it with. Let's see what tomorrow has in store!
Monday, May 17, 2010
Arriving in Juneau, AK/Day 1 - Orientation
I got into Juneau late last night. I gave up my aisle seat on the flight from Anchorage to Juneau to a man so he could sit next to his wife (and I did this despite the fact he was wearing a Cubs jersey!). I ended up sitting next to a man who is the superintendent of the Kake, AK school district. He is originally from Detroit, MI but retired from his school there to move to Alaska with his wife. His school district has 85 kids, K-12 (7 in the class of 2010!). We discussed the issues of truency and overprotecting parents and tribal leaders and how this can lead to complacency amongst some of the smaller villages in Alaska.
I got to the University of Alaska - Southeast (Go Spikes!) around 11:30 PM. I am going to be living in a four person apartment. The lower level has a living room with couches, chairs, and a kitchen table, as well as a fully equipped kitchen. The upper level has four, single bedrooms and a bathroom. Lucky for me - I am the only one currently living in this huge apartment!
As promised, I took the 8:22 AM bus from DeHart's to SEARHC. After months of email correspondence and phone tag I finally met Dr. Kim Hort. She gave me a quick tour of the clinic before we headed over to human resources to start my orientation. I completed orientation with two other women. Both women were in their fifties and were in Alaska to take a break from the grind of city life to offer their medical services to SEARHC. There women were so much fun to be around - we laughed and joked all day.
One, Rosalind, works for a company called Comforce. She is a medical coder (issues pertaining to patient billing) and she gets sent to small clinics all over the Northwest United States to train employees on newer, advanced billing systems. The other, Patricia, is retired Navy. She decided she wanted to become a nurse following her tour of duty - and here she is today. I really enjoyed meeting these women and am glad we will all be in the same building.
The three of us suffered through a HIPAA video (well, technically, they suffered through the video while I read Peter King's MMQB) before we actually got to meet some of SEARHC's employees. We discussed the mission, values, and ideas of SEARHC and learned about proper medical safety. It was a very basic orientation, but I did learn a few interesting things. One of the coolest things is that I have access to SEARHC's physical training facility and locker rooms = I can lift weights and use the stationary bikes and treadmills before or after work each day.
At the end I got my badge and swipe card and returned to speak with Dr. Hort. We set up a meeting for tomorrow morning and I headed to Wal-Mart to do some grocery shopping. I bought lunch meat, frozen dinners, and a bunch of snacks. One thing that I will never take for granted again is using my car to transport groceries. This morning I had a nice, 10 minute walk down a trail to the bus stop. Well... the afternoon walk was uphill while holding six bags of groceries.
I decided to get out and explore Auke Bay (the picture at the top of the blog is a a view I get to see every single day). I used my Garmin watch and began to run. I found a nice trail along the bay and eventually made my way to the other side of the University of Alaska campus. Vanderbilt may have finally manicured lawns and imposing Magnolia trees, but nothing can compare to the two large totem poles right in front of the dining hall here. Pretty neat.
It was an eventful day. I am now officially unpacked, settled in, oriented, and ready for the fun to begin! I'm sitting in bed typing (9:15 PM) and as I look out of my window the sky is still blue and bright. What a cool place!
I got to the University of Alaska - Southeast (Go Spikes!) around 11:30 PM. I am going to be living in a four person apartment. The lower level has a living room with couches, chairs, and a kitchen table, as well as a fully equipped kitchen. The upper level has four, single bedrooms and a bathroom. Lucky for me - I am the only one currently living in this huge apartment!
As promised, I took the 8:22 AM bus from DeHart's to SEARHC. After months of email correspondence and phone tag I finally met Dr. Kim Hort. She gave me a quick tour of the clinic before we headed over to human resources to start my orientation. I completed orientation with two other women. Both women were in their fifties and were in Alaska to take a break from the grind of city life to offer their medical services to SEARHC. There women were so much fun to be around - we laughed and joked all day.
One, Rosalind, works for a company called Comforce. She is a medical coder (issues pertaining to patient billing) and she gets sent to small clinics all over the Northwest United States to train employees on newer, advanced billing systems. The other, Patricia, is retired Navy. She decided she wanted to become a nurse following her tour of duty - and here she is today. I really enjoyed meeting these women and am glad we will all be in the same building.
The three of us suffered through a HIPAA video (well, technically, they suffered through the video while I read Peter King's MMQB) before we actually got to meet some of SEARHC's employees. We discussed the mission, values, and ideas of SEARHC and learned about proper medical safety. It was a very basic orientation, but I did learn a few interesting things. One of the coolest things is that I have access to SEARHC's physical training facility and locker rooms = I can lift weights and use the stationary bikes and treadmills before or after work each day.
At the end I got my badge and swipe card and returned to speak with Dr. Hort. We set up a meeting for tomorrow morning and I headed to Wal-Mart to do some grocery shopping. I bought lunch meat, frozen dinners, and a bunch of snacks. One thing that I will never take for granted again is using my car to transport groceries. This morning I had a nice, 10 minute walk down a trail to the bus stop. Well... the afternoon walk was uphill while holding six bags of groceries.
I decided to get out and explore Auke Bay (the picture at the top of the blog is a a view I get to see every single day). I used my Garmin watch and began to run. I found a nice trail along the bay and eventually made my way to the other side of the University of Alaska campus. Vanderbilt may have finally manicured lawns and imposing Magnolia trees, but nothing can compare to the two large totem poles right in front of the dining hall here. Pretty neat.
It was an eventful day. I am now officially unpacked, settled in, oriented, and ready for the fun to begin! I'm sitting in bed typing (9:15 PM) and as I look out of my window the sky is still blue and bright. What a cool place!
Arriving in Anchorage, AK
I got lucky in the Seattle airport - thought I was going to have to settle on Burger King but ended up finding a Great American Bagel Company for lunch.
Just touched down in Anchorage, AK. As we began our final descent, I saw snow-capped mountains on the right, and water on the left - I think I may like this place. I walked off of the plane and the first thing I saw was a huge glass wall and an endless mountain range. I have been walking around the airport looking for something to do, and I stumbled upon an observation deck with tribal artifacts and another view of the mountains and water. I bet this is the only airport in the country with an "observation deck"
I'm now sitting at a Starbucks in the Anchorage airport waiting on my 7:45 PM flight to Juneau. It's only 5:00 PM here but I can tell that the 3 hour time difference will catch up with me very quickly. I rented Inglorious Bastards off of iTunes so that should keep me busy for my 3rd and final plane ride of the day.
Both the Seattle airport and the Anchorage airport have free Wifi (take notes, everyone else!) so I have had some time to check out my bus schedule and housing situation. I think I am going to take the 8:22 AM bus from DeHart's Convenience store tomorrow morning which will put me at work by 9 AM. I have two days of orientation at SEARHC until the real fun starts.
Just touched down in Anchorage, AK. As we began our final descent, I saw snow-capped mountains on the right, and water on the left - I think I may like this place. I walked off of the plane and the first thing I saw was a huge glass wall and an endless mountain range. I have been walking around the airport looking for something to do, and I stumbled upon an observation deck with tribal artifacts and another view of the mountains and water. I bet this is the only airport in the country with an "observation deck"
I'm now sitting at a Starbucks in the Anchorage airport waiting on my 7:45 PM flight to Juneau. It's only 5:00 PM here but I can tell that the 3 hour time difference will catch up with me very quickly. I rented Inglorious Bastards off of iTunes so that should keep me busy for my 3rd and final plane ride of the day.
Both the Seattle airport and the Anchorage airport have free Wifi (take notes, everyone else!) so I have had some time to check out my bus schedule and housing situation. I think I am going to take the 8:22 AM bus from DeHart's Convenience store tomorrow morning which will put me at work by 9 AM. I have two days of orientation at SEARHC until the real fun starts.
My personal interest in dentistry and how I ended up in Juneau, AK
Ever since my first retainer, I have known that dentistry would be an integral part of my life. Throughout the years, it seemed I was always at the dentist's office - whether it was for a routine cleaning, a new retainer, a puffy gumline, or eventually, my dental implants - I always seemed to be drawn to smell of mint toothpaste and latex gloves. While others dreaded their annual visits to the dentist, I embraced the uniqueness of the profession. When I was a senior in high school, I had the opportunity to do an eight-week internship with a professional in the St. Louis area. I elected to work with varying dental specialists to explore each aspect of the multi-layered profession.
My eight-week internship was a unique learning experience. I studied all aspects of the dental profession – from patient appointments to filling to billing and, of course, patient care. One thing that struck me was that, despite the difference in specialties, all of the dental offices followed the same basic model of care. Patient comes, patient leaves, and patient makes another appointment. Repeat as needed. While this system works well for large metropolitan areas such as St. Louis, I could not help but wonder how it would differ for a part of the world where technology and medicine were not only not as advanced, but also not as readily available.
I was working with Dr. Samuel McKenna in the Vanderbilt Oral Surgery Clinic last semester when we began discussing my Ingram Scholars Summer Project. I described the summer project and how I wanted to focus my project around an issue pertaining to dentistry. I explained I was convinced that the best way to work with dental care was to leave the United States and work in a third world country where dental care must be an absolute novelty. Little did I know that there was a similar situation right here in the United States. Dr. McKenna explained that dentistry in Alaska differed entirely from most other models in the continental United States.
I found this compelling for multiple reasons. First, it would be interesting to compare health delivery systems in the United States and further, the opportunity to work with those with a different set of cultural beliefs than me would be interesting as well. I began to research dental clinics through Indian Health Services (Continuing Dental Education), and eventually found SEARHC – a consortium of dental and medical clinics in Southeast Alaska.
My eight-week internship was a unique learning experience. I studied all aspects of the dental profession – from patient appointments to filling to billing and, of course, patient care. One thing that struck me was that, despite the difference in specialties, all of the dental offices followed the same basic model of care. Patient comes, patient leaves, and patient makes another appointment. Repeat as needed. While this system works well for large metropolitan areas such as St. Louis, I could not help but wonder how it would differ for a part of the world where technology and medicine were not only not as advanced, but also not as readily available.
I was working with Dr. Samuel McKenna in the Vanderbilt Oral Surgery Clinic last semester when we began discussing my Ingram Scholars Summer Project. I described the summer project and how I wanted to focus my project around an issue pertaining to dentistry. I explained I was convinced that the best way to work with dental care was to leave the United States and work in a third world country where dental care must be an absolute novelty. Little did I know that there was a similar situation right here in the United States. Dr. McKenna explained that dentistry in Alaska differed entirely from most other models in the continental United States.
I found this compelling for multiple reasons. First, it would be interesting to compare health delivery systems in the United States and further, the opportunity to work with those with a different set of cultural beliefs than me would be interesting as well. I began to research dental clinics through Indian Health Services (Continuing Dental Education), and eventually found SEARHC – a consortium of dental and medical clinics in Southeast Alaska.
Who, What, When, Where, and Why
Southeast Alaska Regional Health Consortium, SEARHC (and no, it's not spelled wrong!), is a non-profit tribal health consortium of 18 Native communities which serves the medical needs of the Native people of Southeast Alaska. In 1976, SEARCH partnered with the Indian Health Service programs in an effort to turn over the day to day operations of all clinics to tribal leaders. The consortium is made up of 18 Native communities spanning all of Southeast Alaska.
SEARHC has the ultimate goal of recognizing and responding to the glaring needs of tribal members. As it is run by the Indian Health Services, SEARHC incorporates traditional Native cultural practices and values into their health care delivery system (SEARHC –Southeast Alaska Regional Health Consortium).
Throughout the course of the summer I will be working with Dr. Kim Hort and other dentists in the SEARHC clinics. My experience this summer will involve many different steps that will eventually culminate in the completion of a summer project that encompasses many different aspects. Initially, my role at SEARHC will be as an investigator.
I will be involved in patient interaction to determine how effective SEARHC has been in promoting the idea of preventative dentistry to Native Alaskans. Further, I will analyze what methods of communication have worked well and which have not – essentially, how Alaskans learn best when it comes to the complex dental profession. I will work with members of SEARHC (namely, Jeanie Monk, Grants Professional, and Sara Beaber-Fujioka, Biostatistician) who have previously constructed surveys and completed research to ensure that my efforts are thorough and complete.
After the completion of the survey I will work more closely with Dr. Hort to create a program and curriculum that would highlight the importance of preventative dentistry. This program would be distributed to school systems as well as become a learning tool for SEARHC’s web of medical clinics. The program will be completely based on the information gathered from the survey so as to maximize the effect it will have on the patients taking the course.
During both of these processes I will be traveling around the state of Alaska visiting different clinics that are run by the Southeast Alaska Regional Health Consortium. Some of the specific clinics that I will be visiting in addition to the clinic in Juneau, AK will be in Hoonah, AK and Haines, AK. This will give me the opportunity to include many different types of opinions and learning styles into my curriculum. In addition, a portion of the summer will be spent working in dental offices – shadowing and observing how dental care in Alaska varies from the traditional mold that I have observed in Nashville and St. Louis.
My summer project is very diverse and multi-tiered. There are many components to my project – cultural exposure, research, survey development, patient interaction and, of course, community service. While the impact of my service will be realized once I am gone, I will still have the opportunity to provide meaningful, hands-on service.
As part of each day I will have the opportunity to serve as a dental and administrative assistant at varying dental clinics. Since SEARHC falls under the large umbrella of Indian Health Services, there is often not enough funding to support all of their exploits. As a result, I will be working daily to maximize administrative efficiency and help with the day-to-day operations of the dental clinics. This will be particularly important at the smaller dental clinics in Hoonah, AK and Haines, AK.
SEARHC has the ultimate goal of recognizing and responding to the glaring needs of tribal members. As it is run by the Indian Health Services, SEARHC incorporates traditional Native cultural practices and values into their health care delivery system (SEARHC –Southeast Alaska Regional Health Consortium).
Throughout the course of the summer I will be working with Dr. Kim Hort and other dentists in the SEARHC clinics. My experience this summer will involve many different steps that will eventually culminate in the completion of a summer project that encompasses many different aspects. Initially, my role at SEARHC will be as an investigator.
I will be involved in patient interaction to determine how effective SEARHC has been in promoting the idea of preventative dentistry to Native Alaskans. Further, I will analyze what methods of communication have worked well and which have not – essentially, how Alaskans learn best when it comes to the complex dental profession. I will work with members of SEARHC (namely, Jeanie Monk, Grants Professional, and Sara Beaber-Fujioka, Biostatistician) who have previously constructed surveys and completed research to ensure that my efforts are thorough and complete.
After the completion of the survey I will work more closely with Dr. Hort to create a program and curriculum that would highlight the importance of preventative dentistry. This program would be distributed to school systems as well as become a learning tool for SEARHC’s web of medical clinics. The program will be completely based on the information gathered from the survey so as to maximize the effect it will have on the patients taking the course.
During both of these processes I will be traveling around the state of Alaska visiting different clinics that are run by the Southeast Alaska Regional Health Consortium. Some of the specific clinics that I will be visiting in addition to the clinic in Juneau, AK will be in Hoonah, AK and Haines, AK. This will give me the opportunity to include many different types of opinions and learning styles into my curriculum. In addition, a portion of the summer will be spent working in dental offices – shadowing and observing how dental care in Alaska varies from the traditional mold that I have observed in Nashville and St. Louis.
My summer project is very diverse and multi-tiered. There are many components to my project – cultural exposure, research, survey development, patient interaction and, of course, community service. While the impact of my service will be realized once I am gone, I will still have the opportunity to provide meaningful, hands-on service.
As part of each day I will have the opportunity to serve as a dental and administrative assistant at varying dental clinics. Since SEARHC falls under the large umbrella of Indian Health Services, there is often not enough funding to support all of their exploits. As a result, I will be working daily to maximize administrative efficiency and help with the day-to-day operations of the dental clinics. This will be particularly important at the smaller dental clinics in Hoonah, AK and Haines, AK.
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