Maine dentists do more free work than most people will ever know
Dr. John C. Frachella
Mobile dental vans have never worked, regardless of gas prices, hard economic times, shortages of dentists or low MaineCare reimbursement rates. Vans simply aren’t cost effective especially in northern climates.
I was the director of the Bangor Children’s Dental Clinic for 32 years as well as the state dental consultant in the 1980s. It was my job to study the successes and failures of dental van delivery systems in New England. After many years of research, I concluded (along with the state, the city of Bangor and the Maine Dental Association) that dental vans have never been successful in the northern U.S. or Canada.
In 2003, I was invited along with the Health Department director, the late Maryanne Chalilla, to visit the Penobscot Community Health Center dental clinic. We also got a tour of their new dental van, partially funded by Anthem-Blue Cross as well as by federal tax dollars. Despite what looked like changing times, we upheld the belief that public funds are better spent using older, donated equipment instead of using new stuff like expensive mobile dental vans. I liked the idea of going on the road in rural areas, but preferred a lower cost approach. Ms. Chalilla proposed using new, but low cost, portable dental units, a utility van for transportation, and a system that would set up clinics in schools, hospitals, community centers or hotels to get the work done inexpensively.
It’s been five years since the PCHC van first saw patients. Now it’s for sale and the dental equipment’s been stripped from it.
There’s no perfect system for the delivery of dental care to the indigent. I recently accepted a job as the dental director of a rural health clinic in Oregon. There’s not one practicing dentist in our county. Money’s tight. It always is for projects like this, so we’re proceeding on the cheap. Our model is the Bangor Children’s Dental Clinic, where, for over 30 years, we treated thousands of children for a very low cost. Maine dentists helped by providing political and financial support. Oregon dentists will do the same.
For those who think that dentists in Maine don’t care about poor people, please think again. Many dentists contributed thousands of dollars to the Children’s Dental Clinic Trust Fund so Bangor kids on MaineCare could be treated by a specialist in pediatric dentistry (namely myself). Even before the Children’s Dental Clinic closed (when I semiretired two years ago), various dentists in Maine treated poor kids in their private offices without submitting claim forms because the state makes the reimbursement process so demeaning. Maine dentists do more free work than most people will ever know.
What breaks my heart is that so many of the patients I left behind are no longer being treated anywhere. A public health dental clinic for needy children should be able to treat at least 1,000 patients a year. This is no longer happening in Bangor.
I wish PCHC all the luck. These days, they’re the only game in town. I hope, now that the dental van’s been put aside, they can hire a pediatric dentist who will work locally (if not regionally) to restore what’s been lost.
Dr. John C. Frachella is the former director of the Bangor Children’s Dental Clinic.
On 9/4/08 at 6:15 AM,
Johninphilippines wrote:
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Dr. Frachella, your article is excellent. So is the concept of mobil dental vans. So, also, is the concept of treating children and other patients that are financially-stressed. We, in the Philippines must perform a similar service to people who are indigent, and who are living in the remote environs of the Province (Isabela) where I reside on Luzon. We have no "mobil clinics", per se. What happens here is that medical and dental supplies are requested, then donated by pharmacutical companies, hospitals and by some physicians. Once a (on a rotational basis) site has been selected to treat the people in need, we recruit some dentists and physicians to accompany us, along with the crated medical and dental supplies packed into our vans, cars and pickup trucks and head off out into the province. This creates a "medical mission". Of course, as I said, the entire project is preplanned, and occurs once every three months in a different township. The town mayors always accept this "mission", and offer their indigent listing, so these people will have free treatment, whatever their case is. Who are the principals? The Masonic Lodges. Rotary Clubs, Knights of Columbus, and a couple of other associations participate. However, in the State of Maine and the US, there may be certain statutes that have to be considered in this type of "medical mission" concept. I'am sure you could find a dentist or two or a physician or two to participate, but if these medical professionals are working for a hospital concern or dental group, insurance and corporation laws may prevent them from doing it; maybe or maybe not. In any instance, if you want to take a look at a low-cost way to do things, this is the way. It's the only way to do it here, when people cannot get to a medical government-sponsored medical or dental facility nor has the money to get there or to pay for treatment.
On 1/23/09 at 6:30 PM,
dentist wrote:
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Your article raises the point of being able to deliver dental care to remote areas where there is no dental service around for miles.
A fellow dentist friend of mine, recently launched a dental directory so that Dentists could have better exposure and that people located in rural areas might be able to easily find the dental treatment they seek.
Here is a link to the site:
Children Dentists
On 1/23/09 at 6:33 PM,
dentist wrote:
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On 1/23/09 at 11:53 PM,
hrdwkngmom wrote:
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Dr. John was an asset to this community. The children's Dental Clinic was a great loss to this area. My children were treated By Dr. John for many many years, although we were not low income, we remained with the clinic for the excellent care that was given. When my son suffered severe dental injuries from a Skateboard Dr. John did all he could do to help me in the reimbursment process for the thousands of dollars it cost to just place his teeth back in is gums and wire them in place for months, We were petrefied he would lose his teeth, we weren't sure if they were even able to be saved. Dr. John made an amazing smile on my son's face, with the damage that was done I wasn't sure he would ever smile again..
An amazing man with a heart of gold for all, low income, middle class, he paid no mind.
Unfortunatly we have been left with a Dental Clinic that is rude, belligerant and full of cocky rules, they have made a mess of my child's teeth, they treat you like a child, they go so far as to book you 4 appointments in one week to get as much money as they can..This is only my opinion...
We have decided to travel to New Hampshire to try and save the smile Dr. John created...
It is a total shame that PCDC is pretty much the only place you can go for childrens dental needs, I cringe when I walk through the doors for I know I will be treated like a child, my youngest is petrefied for they force him to go to the back ALONE with STRANGERS sticking oblects into his mouth. They make appointments, you call to confirm, you get there and they tell you its the next day, or even the next month...They give you a card with an appointment date and time, they then send you a "fired" notice for the date they gave you was wrong and you didn't show up! Then they make you speak to a Social Worker and be scolded like a freaking 5 year old when they are the one in the wrong!
Why does this happen? Because they book so many appointments in one day they can't keep track, they have you come on on Monday for one thing, Wednesday for another and Friday for another..Who the hell wants to sit at the dentis 3x in one week??
Dr. John ran a Smooth office, friendly courteous girls, pleasant conversations, and never a mixed up appointment, as well as he would do as much as he could in one day so you didn't have to come back and forth...
I refuse to bring my children back to them, I will drive the xtra miles to have my children recieve the care they deserve...
I would rather take my children to a Dental Clinic of cheap, pre used antique equiptment in a ripped dental chair in a dirty old city building than I would go to PCDC and be treated like a child and my children treated like guinea pigs for a few bucks to pay for their high priced equiptment and too much staff!
Dr. John ran his office with 2 young ladies, they were his dental assistants as well as his secretaries, they made all the appointments and did all the billing and paperwork...PCDC..Well let's count how many secretaries they have making appointments....2 to answer phones, 2 to schedule, one to walk you in, one to walk you out, one to clean the teeth, one to check the cleaned teeth...It just goes on and on and on..So many staff in there they are bumping into eachother...Wonder what the cost is to employ so many people???? No wonder they make you return 3x in one week...
Dr. John and the closing of the BCDC was a HUGE loss to this community...It's really a shame.
Oregon residents have been blessed....
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