by John D.B. Featherstone
Dean John D.B. FeatherstoneWhat exactly do we mean when we talk about “access to care?” In simple terms, the availability of care for the underserved, the underprivileged.
Some countries have health systems, funded by the government, that provide care for all with satisfactory reimbursement or payment for physicians and dentists. Here in the United States, there is federal funding; there is state funding — which varies from state to state — that to some extent provides access to care for the underserved, but is largely inadequate. Many pontificate on “how we’re going to solve this problem” without actually suggesting solutions.
Some of our alumni have taken it upon themselves to create those solutions — largely motivated by the values imparted here at the School of Dentistry. I’d like to share some of their stories.
Last month, I visited an alumnus, a pediatric dentist, in Florida. He decided that his mission in life is to solve the access-to-care problem for as many people in his area as possible. I visited one of this three practices; they’re beautifully set up. No matter what one’s background is, patients feel as if they’re coming to the Ritz Carlton of dentistry. That’s the way he wants it: Patients — many of whom are on Medicaid — all receive the same level of quality, enthusiasm, atmosphere. It’s a large practice, but set up and operated quite efficiently. Other providers in the practice (including another UCSF School of Dentistry alum) share his philosophy about treatment, of helping the underserved, of putting prevention ahead of restoration.
If we could replicate nationwide what he’s doing, we could make huge inroads in access to care.
On more than one occasion, I’ve visited with another of our alumni, in the New York area. He has done the same as our alum in Florida, but in a different way. Also a pediatric dentist, he likewise has dedicated his life to serving the underserved, primarily Medicaid patients, in a lower socioeconomic area of New York City. It is truly spectacular what he too has done.
And last year, I met with yet another alumnus, a general dentist in Southern California, who treats patients of all ages and of all incomes.
These three alumni are like many of our graduates, who leave here with the hope of serving the underserved as well as making a good living. They are putting into practice both the philosophy and methodology they’ve learned here.
Part of that is owed to the success of our externship program, a nine-week program all our DDS students take part in. The importance of this program is such that we’ve recently brought on board a new faculty member, Leon Assael, whose task is to grow and expand the externship program and make it even more successful. We’re not only providing opportunities for our students to work in outside practices — particularly in community centers and the like — but also to instill in them the philosophy of serving the underserved. They’re able to see first-hand the difficulties many patients have in gaining access to care and in turn, we hope, experience great satisfaction in doing dentistry for people in that situation. Looking ahead, we plan to extend that philosophy into interprofessional practice, involving other health care providers, at our externship sites.
I must also mention the impact of our Community Dental Clinic, which many of our students volunteer in, serving for many hours during their time with us. That experience also colors their way of thinking in a big way. I could quote many alums whose lives have been changed by the experience of volunteering in the CDC — alumni who have gone on to do wonderful work serving the underprivileged.
Public service is part of the mission of the University of California. We, perhaps, have taken that charge to the next level: not just providing care, but providing excellent care, no matter who seeks it.
And the numbers of those needing financial assistance for care are growing. In our predoctoral clinics, the share of our DentiCal patients grown from 30 percent 10 years ago to 52 percent now. In our pediatric dentistry clinic, more than 90 percent of our patients are on DentiCal. We are we one of the biggest DentiCal providers in the state. Why? Because most private providers don’t take DentiCal. Fortunately, the three alumni I cited have made a conscious decision that they will make a living serving the underserved. They are making a difference, and so are we.
