I am exhausted. Today was a very busy day. I had to do laundry, straighten up the Ray's house, get a haircut, go grocery shopping, pack for UAS, and pack for Sitka, AK. Fortunately for me, I have a car and my own washer and dryer this week. Not to mention, a dental assistant from the office works at a hair salon and agreed to cut my hair. Throughout the day I was able to accomplish each of these things. Keeping up with a house and a dog is harder than it looks.
Didn't do much of substance today. The weather cleared a bit so I was able to go on a run down near the Mendenhall Glacier. I also went over to Dr. Dee's house for some dinner and to watch the NBA finals.
Tomorrow I leave for Sitka and I am very excited. I will be taking the 8:00 AM ferry (I'm on the Fairweather) that arrives in Sitka around 12:30. Dr. Hort agreed to lend me her bicycle so I will carry that onto the ferry and use it to get around Sitka. Sitka has a lot of neat totem poles and musuems about the Tlingit culture. I'm going into the dental clinic in the afternoon and then after work I hope to explore the city. Tuesday I am going to interview OB patients at the hospital in Sitka and then I have a meeting in the afternoon with Martha Pearson and Litia Garrison. It should be a really fun and enjoyable trip.
Sorry for the short and rushed blog posts from the weekend, but I haven't had a lot of time to sit and reflect today. I'm going to take some time on the ferry tomorrow to collect some thoughts and post a nice, insightful article on Monday night.
Thanks for reading!
Monday, June 14, 2010
Day 27 - Typical Juneau weather
It appears my stretch of good weather has officially ended. For the last three or four days it has been cold and rainy - quite the contrast to the weather I had during my first few weeks in Juneau. Everyone that I work with has been laughing at me as they all knew this stretch of rain and cold was coming while I was blindly optimistic. Oh well.
I woke up early this morning because the inspector came to look over the house. Of all the Saturdays to wake up early this was a good one because the World Cup was on early. I watched the first half amidst a series of fire alarms, smoke detectors, and lights flashing on and off as the inspector did his thing. At halftime, I met the Wilkinsons and Dr. Dee for dinner at Paradise Cafe in downtown Juneau. The restaurant was really, really good. It's a tiny little cafe with one cook. She asks you what you want and then makes it for you. Combined with the good company and the endless cup of coffee I'd say it was a pretty good morning.
The afternoon was a bit slow and lazy as the rain once again prevented me from going outside. It's a good thing I've got the dog to hang out with or else I might get a little stir crazy. Either way, it's nice to just have time to relax and not have to worry about an upcoming test or assignment.
I went over to Dr. Marcotte's house for dinner tonight. She and her husband made Indian food. They really like Indian food but since Juneau is not brimming with quality restaurants they have adapted and learned to cook it on their own. We played cards and hung out late into the night.
That's about it for today. Weekends have been very easygoing lately. Tomorrow I have to pack all of my things up as I will be moving out of the Ray's house and back to UAS early next week...
I woke up early this morning because the inspector came to look over the house. Of all the Saturdays to wake up early this was a good one because the World Cup was on early. I watched the first half amidst a series of fire alarms, smoke detectors, and lights flashing on and off as the inspector did his thing. At halftime, I met the Wilkinsons and Dr. Dee for dinner at Paradise Cafe in downtown Juneau. The restaurant was really, really good. It's a tiny little cafe with one cook. She asks you what you want and then makes it for you. Combined with the good company and the endless cup of coffee I'd say it was a pretty good morning.
The afternoon was a bit slow and lazy as the rain once again prevented me from going outside. It's a good thing I've got the dog to hang out with or else I might get a little stir crazy. Either way, it's nice to just have time to relax and not have to worry about an upcoming test or assignment.
I went over to Dr. Marcotte's house for dinner tonight. She and her husband made Indian food. They really like Indian food but since Juneau is not brimming with quality restaurants they have adapted and learned to cook it on their own. We played cards and hung out late into the night.
That's about it for today. Weekends have been very easygoing lately. Tomorrow I have to pack all of my things up as I will be moving out of the Ray's house and back to UAS early next week...
Saturday, June 12, 2010
Day 26 - Friday, the best day of the work week
Friday not only means the weekend right is around the corner, but it's also a day where I can sleep in and go to work a little later than usual. Today I woke up around 8 and took my time getting ready in the morning. It's great having a car because I am not bound by the Capital Transit bus schedule. I got into work around 9:45 ready to do some telephone surveys. Friday is the perfect day to do surveys because both Dr. Bornstein and Dr. Hort have Friday off. I can use their offices and telephones without disturbing anybody else. I have stopped counting the number of death stares I have gotten from the other dentists in my office as I repeat my survey script over and over and over.
The survey started pretty slowly initially, but I have found a bit of a rhythm. At first it was very disheartening when I would call and not get an answer or begin the survey only to be told that the person was not interested in participating or hung up in the middle of a question. I worked for a week to research past dental anxiety surveys and edit my questions. I also pretested with members of the dental staff so I felt I had prepared a very polished product. It's always discouraging to have someone not be interested in something you have spent a lot of time on. However, since the first few days, I have learned to shrug off these roadblocks and keep plowing through my growing list of phone numbers.
It's extremely rewarding to get some constructive feedback that I think will help the dental staff in the future. I have done so many surveys that I have kind of lost track of the trends, but I can't wait to compile all of the data in a few weeks and see what the patients are saying about their dental anxiety and why they are continually missing or breaking appointments. One positive thing that I know has come out of the survey is the discovery of many wrong or out of service phone numbers. To me, this is just as important to the dental staff as getting someone to take the full five minute survey. If the front office workers do not have working phone numbers they cannot call and confirm patient appointments. If they don't confirm appointments that lessens the chance that a patient will remember they were scheduled and actually show up to the clinic at the appropriate time.
After work I had to walk the dog in the rain. The typical Juneau weather has set in - cold with a constant rain. My rain jacket is my new favorite article of clothing and the windshield wipers on my car are permanently on the highest setting. I don't mind the rain while I am in the office, but it really affects my ability to go out and explore the city and the trail systems in Juneau.
Last night I went out to dinner and to the movies with some people from the clinic. We ate Chinese food (who would have thought I would eat Chinese just as much as I would eat seafood in Alaska?) and went to the movie theater downtown. It's a pretty neat theater. There are two screens - one on the lower level and one on the upper level. You walk up a few flights of stairs just to reach the theater.
Tomorrow I will be up early to watch the World Cup (USA! USA!) and to go out to breakfast with the Wilkinson's. We are going to Paradise Cafe downtown. I hope it's good...
The survey started pretty slowly initially, but I have found a bit of a rhythm. At first it was very disheartening when I would call and not get an answer or begin the survey only to be told that the person was not interested in participating or hung up in the middle of a question. I worked for a week to research past dental anxiety surveys and edit my questions. I also pretested with members of the dental staff so I felt I had prepared a very polished product. It's always discouraging to have someone not be interested in something you have spent a lot of time on. However, since the first few days, I have learned to shrug off these roadblocks and keep plowing through my growing list of phone numbers.
It's extremely rewarding to get some constructive feedback that I think will help the dental staff in the future. I have done so many surveys that I have kind of lost track of the trends, but I can't wait to compile all of the data in a few weeks and see what the patients are saying about their dental anxiety and why they are continually missing or breaking appointments. One positive thing that I know has come out of the survey is the discovery of many wrong or out of service phone numbers. To me, this is just as important to the dental staff as getting someone to take the full five minute survey. If the front office workers do not have working phone numbers they cannot call and confirm patient appointments. If they don't confirm appointments that lessens the chance that a patient will remember they were scheduled and actually show up to the clinic at the appropriate time.
After work I had to walk the dog in the rain. The typical Juneau weather has set in - cold with a constant rain. My rain jacket is my new favorite article of clothing and the windshield wipers on my car are permanently on the highest setting. I don't mind the rain while I am in the office, but it really affects my ability to go out and explore the city and the trail systems in Juneau.
Last night I went out to dinner and to the movies with some people from the clinic. We ate Chinese food (who would have thought I would eat Chinese just as much as I would eat seafood in Alaska?) and went to the movie theater downtown. It's a pretty neat theater. There are two screens - one on the lower level and one on the upper level. You walk up a few flights of stairs just to reach the theater.
Tomorrow I will be up early to watch the World Cup (USA! USA!) and to go out to breakfast with the Wilkinson's. We are going to Paradise Cafe downtown. I hope it's good...
Thursday, June 10, 2010
Day 25 - OB Clinic
Today was my first day in the OB clinic. I got to work early and met Chris to go set up our table in the waiting room. Chris has lots of dental posters and facts dedicated to newborn dental care that she lent to me today. It was very helpful as I not only had the chance to interview the women, but also to teach them a little bit about caring for their newborns. Once the patients started rolling in things got really fun and exciting. I had bags filled with toothbrushes, toothpaste, and dental floss that I handed to each person who took the survey. It was really interesting to take note of the ages of some of the women who were there in the OB clinic. Many were in their twenties or thirties, but I saw my fair share of teenage mothers. This just speaks to the mindset of the Native Alaskan and the cultural differences between some of those living in Alaska and the rest of the United States.
Each woman I interviewed was very thoughtful and helpful in filling out the survey. Some of the early trends that I am noticing between my surveys from Hoonah and my surveys today are that many people want two things: 1) To have access to dental information in a technologically savvy way, and 2) To have access to dental information in a way that does not require them to spend lots of extra effort outside of their scheduled appointments or visits to the dental clinic. Also, I am noticing that there is a huge push for more information on preventative care. This is great as it is already a goal of the SEARHC dental team to make dentistry a more preventative profession so this will give me the most support and backing as I begin to actually develop the patient education material.
I spent the day in the clinic and interviewed 17 women. It was a great experience and one that I am looking forward to repeating over the next two Thursdays. Before I went back to my home I spoke with Dr. Hort about Sitka. We booked my rooms in the Mount Edgecumbe Hospital Short-term Housing and I purchased a ticket for the ferry. I also got in contact with Martha Pearson and Litia Garrison to confirm that we would be meeting next Tuesday to discuss how they revamped their old patient education materials.
After such a beautiful day yesterday the weather today was a bit more typical of Juneau in early June. The clouds hung in the sky and a light drizzle fell throughout the day. Like I posted a few weeks ago, I don't feel bad skipping out on some work afternoons in early May as I will now be stuck in the office for the rest of June. I am still trying to shake my cold so I did not do much tonight. The Alaskan Time Zone is great as I am able to watch East coast sporting events (like the NBA finals) and still get to bed at a reasonable hour.
Tomorrow will be a pretty uneventful day as I will dedicate it entirely to calling my patients who missed an appointment over the past week. Since I was out of town and in the OB clinic today I have quite a few phone calls to make!
More to come tomorrow...
Each woman I interviewed was very thoughtful and helpful in filling out the survey. Some of the early trends that I am noticing between my surveys from Hoonah and my surveys today are that many people want two things: 1) To have access to dental information in a technologically savvy way, and 2) To have access to dental information in a way that does not require them to spend lots of extra effort outside of their scheduled appointments or visits to the dental clinic. Also, I am noticing that there is a huge push for more information on preventative care. This is great as it is already a goal of the SEARHC dental team to make dentistry a more preventative profession so this will give me the most support and backing as I begin to actually develop the patient education material.
I spent the day in the clinic and interviewed 17 women. It was a great experience and one that I am looking forward to repeating over the next two Thursdays. Before I went back to my home I spoke with Dr. Hort about Sitka. We booked my rooms in the Mount Edgecumbe Hospital Short-term Housing and I purchased a ticket for the ferry. I also got in contact with Martha Pearson and Litia Garrison to confirm that we would be meeting next Tuesday to discuss how they revamped their old patient education materials.
After such a beautiful day yesterday the weather today was a bit more typical of Juneau in early June. The clouds hung in the sky and a light drizzle fell throughout the day. Like I posted a few weeks ago, I don't feel bad skipping out on some work afternoons in early May as I will now be stuck in the office for the rest of June. I am still trying to shake my cold so I did not do much tonight. The Alaskan Time Zone is great as I am able to watch East coast sporting events (like the NBA finals) and still get to bed at a reasonable hour.
Tomorrow will be a pretty uneventful day as I will dedicate it entirely to calling my patients who missed an appointment over the past week. Since I was out of town and in the OB clinic today I have quite a few phone calls to make!
More to come tomorrow...
Wednesday, June 9, 2010
Pictures
I have added all pictures taken through June 9th. I am not sure if they all show up in the slideshow on the blog, however, if you click on the slideshow and go to the album they are all there.
Check them out and try not to get too jealous!
Check them out and try not to get too jealous!
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…
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…
Day 23 - Hoonah, AK Day 2
I had an early wake-up call this morning because our first patient at the clinic was at 7 AM. Pat was upstairs bright and early cooking breakfast. She prepared eggs, sausage, and pancakes this morning. She loves to cook so, as long as you sit at the table, she’ll continually feed you juice, coffee, and breakfast. I told her I had been looking forward to the French toast so she promised that it would be on the menu tomorrow morning.
The walk to the clinic took about 5 minutes. I interviewed the first patient in the waiting room and then headed to my makeshift office to organize some things for the day. At the beginning of each day I have to update my list of people to call for my telephone survey. I go through Eaglesoft and look for patients with the 09130 code next to their names. I can then sort them by clinic and isolate the ones from the four clinics I am calling – Prince of Wales, Haines, Sitka, and Juneau. The list is growing quickly (25% missed appointment rate adds up!) and I am getting a bit behind because some of these patients are hard to get a hold of. I am in a precarious position because I don’t want to keep pestering patients who don’t answer, however, if not enough patients answer to take the survey the results will not be as meaningful. Good thing I am here for another month and a half.
The rest of the morning in the clinic ran really smoothly. I interviewed each patient as they came into the waiting room. I am getting some really great responses. One of the questions on the survey is an open-ended question that allows patients to tell me what dental information is most important to them. The responses have been quite surprising. Most don’t really care about anything more basic than how often to brush, when to make appointments, or whether or not flossing is important. Sometimes it’s hard to believe that this is the mindset of some patients in the United States in the 21st century.
Cindy, Dr. Nascimento, and I headed to a local restaurant for lunch. The restaurant is known for their halibut pizza so I tried a slice. It was actually pretty good. It must be hard to serve bad fish when it’s caught fewer than 50 feet away. During lunch I had an interesting conversation with Dr. Nascimento about the scheduling process for these clinic trips. Since the dentists obviously cannot see every patient every time they are in the clinic there is a bit of a rotating schedule. Ideally, the patients should rotate through the system to give everyone an equal opportunity to see the dentist at least once per year, however, it often does not work that way. The dentists are met with a lot of opposition from the full-time staff at some of the smaller clinics. There is a combative mindset between the dentists and the administrative employees in places like Angoon, Hoonah, and Haines. Many in these smaller villages appreciate what the dentists do for their communities, but others fell upstaged by the dental village trips. As a result, the front desk does a poor job of scheduling appointments for the most urgent patients. There is a lot of favoritism and discrimination by the administrative workers as they prepare the clinic schedules. This turns out to be unproductive for everyone as the most critical needs of patients are not met and the minimal time the dentists are spending in the clinics is not used efficiently.
I also learned about treatment planning today. There is simply no penalty for patients who skip out on appointments and that leads to a lack of commitment from the patients towards the dentists. There is little the dentists can do as the patient base is covered under the Indian Health Services and Medicaid programs, however, the one way in which dentists can fight back is through treatment planning. The dentists often start with the back teeth and work their way towards the front of the mouth. The patients, frustrated by the aesthetics of their front teeth that are visible when they smile, are forced to come back to get treatment on their back teeth. Dr. Nascimento agreed to fix a black decay spot on a front tooth for a patient only after the patient agreed to let her fix an infected tooth in the posterior of the mouth.
I just got back from the clinic and am about to go on a run. Cindy is going to meet me at the Historic Canner and we are going to grab a burger and watch the Zipriders from the beach. There are two cruise ships in port tonight so the area should be busy and fun.
Tomorrow is my last day in Hoonah and then it’s back to Juneau for the rest of the week. I have my first OB survey day on Thursday and a boatload of phone interviews waiting for me on Friday. Things are really starting to pick up and get exciting…
The walk to the clinic took about 5 minutes. I interviewed the first patient in the waiting room and then headed to my makeshift office to organize some things for the day. At the beginning of each day I have to update my list of people to call for my telephone survey. I go through Eaglesoft and look for patients with the 09130 code next to their names. I can then sort them by clinic and isolate the ones from the four clinics I am calling – Prince of Wales, Haines, Sitka, and Juneau. The list is growing quickly (25% missed appointment rate adds up!) and I am getting a bit behind because some of these patients are hard to get a hold of. I am in a precarious position because I don’t want to keep pestering patients who don’t answer, however, if not enough patients answer to take the survey the results will not be as meaningful. Good thing I am here for another month and a half.
The rest of the morning in the clinic ran really smoothly. I interviewed each patient as they came into the waiting room. I am getting some really great responses. One of the questions on the survey is an open-ended question that allows patients to tell me what dental information is most important to them. The responses have been quite surprising. Most don’t really care about anything more basic than how often to brush, when to make appointments, or whether or not flossing is important. Sometimes it’s hard to believe that this is the mindset of some patients in the United States in the 21st century.
Cindy, Dr. Nascimento, and I headed to a local restaurant for lunch. The restaurant is known for their halibut pizza so I tried a slice. It was actually pretty good. It must be hard to serve bad fish when it’s caught fewer than 50 feet away. During lunch I had an interesting conversation with Dr. Nascimento about the scheduling process for these clinic trips. Since the dentists obviously cannot see every patient every time they are in the clinic there is a bit of a rotating schedule. Ideally, the patients should rotate through the system to give everyone an equal opportunity to see the dentist at least once per year, however, it often does not work that way. The dentists are met with a lot of opposition from the full-time staff at some of the smaller clinics. There is a combative mindset between the dentists and the administrative employees in places like Angoon, Hoonah, and Haines. Many in these smaller villages appreciate what the dentists do for their communities, but others fell upstaged by the dental village trips. As a result, the front desk does a poor job of scheduling appointments for the most urgent patients. There is a lot of favoritism and discrimination by the administrative workers as they prepare the clinic schedules. This turns out to be unproductive for everyone as the most critical needs of patients are not met and the minimal time the dentists are spending in the clinics is not used efficiently.
I also learned about treatment planning today. There is simply no penalty for patients who skip out on appointments and that leads to a lack of commitment from the patients towards the dentists. There is little the dentists can do as the patient base is covered under the Indian Health Services and Medicaid programs, however, the one way in which dentists can fight back is through treatment planning. The dentists often start with the back teeth and work their way towards the front of the mouth. The patients, frustrated by the aesthetics of their front teeth that are visible when they smile, are forced to come back to get treatment on their back teeth. Dr. Nascimento agreed to fix a black decay spot on a front tooth for a patient only after the patient agreed to let her fix an infected tooth in the posterior of the mouth.
I just got back from the clinic and am about to go on a run. Cindy is going to meet me at the Historic Canner and we are going to grab a burger and watch the Zipriders from the beach. There are two cruise ships in port tonight so the area should be busy and fun.
Tomorrow is my last day in Hoonah and then it’s back to Juneau for the rest of the week. I have my first OB survey day on Thursday and a boatload of phone interviews waiting for me on Friday. Things are really starting to pick up and get exciting…
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