Day 24 - Hoonah wrap-up

Today was my last day in Hoonah, AK. The day started off right as I finally got a chance to eat Pat’s famous french toast. She took extra good care of me and gave me a few slices for the road. Her reputation as Hoonah’s best cook is definitely well deserved.

Unfortunately, we had a few more cancellations in the morning. As each day passes I am starting to see the chasm between the front office workers in Hoonah (SEARHC employees, but not dental specific employees) and the dentists who make the village trips. The front office staff takes names from the patient list and places them on the appointment blocks, but then they do not call the patient until the day before their appointment. If you were going to be out of town on June 7th but you had a dental appointment on that day you wouldn’t know that you weren’t going to be able to make it until June 6th. This is despite the fact that you have likely been penciled into that June 7th appointment since the beginning of April. For those in a major city this is an inconvenience but may not be a huge problem as the dentist is always a quick car or bus ride away. But in Hoonah, AK, patients have access to a dentist only once every two months. The front office staff makes no effort to accommodate patient’s schedules or the dentist’s time. Yesterday the woman who works the front desk in the Hoonah clinic took the day off, however, she neglected to call any of the dental patients to remind them of their appointments today. What happened? We had no patients at 7 AM, 8 AM, or 9 AM until we realized that people were not skipping their appointments intentionally – they had no idea they even were on any sort of schedule.

Not only is this a poor use of resources for SEARHC but, on a larger scale, the United States government. The federal government funds the Indian Health Services which then redirects the funds to SEARHC. So as Dr. Nascimento and Cindy sit and stare at the clock all morning they are being paid by the government for not doing any work. It’s very, very troubling and a hugely inefficient use of funding.

Once we called our patients to confirm their appointments they began to come in and visit the clinic. I got a chance to do some more waiting room interviews and am really learning a lot about the mindset of the Alaskan natives.

I went out to lunch with Cindy and Dr. Nascimento again today. Dr. Nascimento was so nice and picked up the tab for everyone. It’s great to be around genuinely nice people all the time. After lunch I said my goodbyes and headed back to the Hoonah airport for my flight to Juneau. There were only four people in the small Wings of Alaska plane when it took off. The flight was short again and the sky was blue and clear as far as the eye could see. We saw whales in the water below us and marveled at the beautiful spruce trees that are now almost entirely green and devoid of snow.

Once the plane landed I took the bus to the SEARHC clinic in Juneau. I met with Dr. Hort to debrief her on my experiences in Hoonah. I then spent some time talking to Chris, the DHAT, so we could plan for my first day in the OB clinic tomorrow. Things are really starting to get rolling now and I can’t wait to see what trends we start to see from our patients.

I had a nice treat for dinner tonight – a family friend was in town on a cruise ship and took me out to dinner. I ate with the Kwiatek family at The Twisted Fish for dinner right on the Juneau harbor. I had an awesome salmon filet served on a cedar plank. The Kwiateks told me all about the Alaskan cruise experience and where they were headed. Today the got to go dog sledding and said it was just an incredible experience. I have added it to my list of things to do before I leave Alaska. I took them back to the dock and then headed back to the Ray house. I’m thankful that Dr. Dee agreed to take care of the house and dog for me while I was gone. Again, just speaks to the quality of person I get to spend my summer with.

Big day tomorrow as I will finally put my OB survey into use. I am nervous and excited to hear what our patients have to say. Until tomorrow…