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!