Thursday, January 26, 2006

Hug-a-Dentist Day

Tis the wee hours of the morning now so expect some rambling. You have been forewarned !

We came back at 1:30 am from mick and debs place, the traditional place where we hang out on the eve of public holidays. In the past we have stumbled home at about 4 am after PS2 sing star comps and eye toy comps :) We have been doing this for the past 3 years since we have gotten to know them well. Richard had lots of stuff to do and we almost didn't go but we decided to go because we realised that this will probably be the last public holiday we live in Cowra. Our planned move is at Easter time so that will probably be full of moving stuff.

Yes its 2:20 am and I'm still up. Its bad sleeping habits yadda yadda but there is so much stuff you want to do after work and so little time. I usually only need 6 hours of sleep a night but Richard needs about 8-10. I just read in January's Australian Readers digest that this may be due to the amount of chilli I eat! This may explain our observations of asians being awake to late at night and still being able to function the next day. When I told my best friend in S'pore that they put kids to bed here at 7:30 pm, she said," Who on earth goes to bed at 7:30??" Over there kids sleep around 9 or 10 pm, yet awake full of energy at 7 am.

The main point of my post tonight is actually to reflect what got my goat today and how thinking about positive stuff helped me. Today, one of the public patients came in with pain and the tooth was loose with gum disease and she wanted it out. (There was no other option as it had a hopeless prognosis). She asked if I could give her a check up and see what other work needed to be done. I explained that as a public patient ( as I explained before, they don't need to pay a fee for emergency work. We have a schedule of items we can do, mostly fillings and extractions, attach the x-ray, write out a voucher for a nominal fee that the government gives private clinics for providing the service, get the patient to sign it and send it away. It is about half of what the Australian Dental Assoc. has as average fees, and in some cases does not even cover our cost of the nurse, sterilizing the instruments etc. etc.) there was only a limited amount of funding allocated so she would have to pay for a check up herself. She demanded to know exactly what could be done and she wanted to make as much use of the service as possible. She then proceeded to say," how about all the stuff on my teeth, can't you clean it off too?" I explained, trying to keep my cool, with as much patience that I could, that it was only meant for emergency work, there was a limited amount of funding and cleans were not included, only extractions and fillings. She then started to argue that her friend came here and got a clean done for free. Oh lordy! They are just scheming amongst themselves to rort the system as much as they can!

This town is extremely lucky that my boss has agreed to do this service because only one other dentist in this whole area does it. Hence we get public patients driving 200 kms just to see us as there is a drastic lack of dentists working in the public sector. Actually, Australia is lucky full stop as they are only 1 of 3 countries that provide free dental service to low income earners and pensioners. On the whole, I have mixed feelings about public patients. I pity them but I also feel that they could do a lot more to help themselves. One of my classmates at uni said that the funding could be better spent elsewhere because dental disease is the only one that is actually preventable. If people were honest about how much they brushed and flossed, there is a linear co-relation between that and the number of holes people get in their teeth. I tend to agree with that to a certain extent, barring people who were invalids, had brain damage etc. However, don't even get me started on people claiming to be low income earners and getting free dental, medical and pharmaceutical yet give their kids a brand new Playstation for Christmas. My nurse even observed that the above mentioned patient drove a nicer car than she did.

So I was feeling really made used of. Here I was trying my best to provide a public service yet this person was not only ungrateful, she was trying to get as much of out the service as possible.
Another type of patient that gets me down is the sort that you say hello and they just say, " I hate being here, I hate the dentist." And I think hang on, I'm that person, you don't even know me and you're telling me that you hate me. Its really an emotional drain as you need to work extra hard to make that person comfortable. No wonder it is the job with one of the highest suicide rates!

Then, along came a patient in the afternoon who was also a public patient. I had known her for a few years now, as she had a few problems having been on too many medications etc. We were coming to an end of an era as a few months ago, she was tired of having repeated treatments and after some discussion about pros and cons, decided to have all her teeth taken out and have a full set of dentures. This was approved by the regional head public dentist and so this drastic decision was done. Today was the day she was getting her dentures and apart from a few adjustments, she would probably not need any treatment again. (However, it would be hard for her to eat normal food as lower dentures are notoriously uncomfortable.) Before I could say anything, she gave me a hug and said she was really grateful I had organised everything for her and she was really happy with my treatment. That really changed everything and made my day. The whole day of stress from phobic patients and dealing with demanding ones just melted away with a hug. It also made me think of patients who had written me cards and letters, brought me produce from their farms (yes one of the great perks of living in the country) and one elderly lady even knitted me a teddy bear.

Hence,I declare it offically hug a dentist day. If you haven't done so lately, hug your dentist. It will really make a difference in their life.


At 3:48 AM, Blogger Clare Eats said...

I would hug ya Rach if you wereclose enough! ou are close enough for a virtual Hug *O O* LOL, BUT I willgiveyou a hug next weekend and your chrissy presant YAY!!

At 3:50 AM, Blogger Dr. Mommy, D.D.S. said...

so right on, rachel, i have so much to say about your post and i can't even get the words out, so bear with me on my ramble.

it's very frustrating coping with that type of situation. when i practiced in new york and my husband practiced in new jersey, we both had lots of experience with public assistance patients. the funding was issued by each state and was called medicaid. each state had it's own schedule of fees, which were about a fifth or less of what "normal" or what we called UCR (usual, customary, reasonable) fees are. for example, a dentist received $150 for a molar root canal, obviously not fair compensation at all.

in the US, dental schools are located in "underserved" areas because the fees are markedly reduced and the school doesn't lose any money by treating medicaid patients (look at how much they score from our tuition alone and how pathetically clinical instructors are paid!) medicaid doesn't cover a crown or molar endo on a patient over 21, so patients usually opt to "pull it out", long term consequences be damned. doesnt' matter that half these people have better cell phones and wear nicer clothes than i do. of course they can afford to do that, i'm footing the bill for housing and free medical insurance with my tax dollars! never mind that in the US, i didn't even have health insurance for my own family (a whole other topic of discussion...)

it's a struggle, really. not all patients are like that and you genuinely get a sense of satisfaction when we reach someone and they are truly grateful for all you've given them. at the same time, i'm not going to lie and say that in private practices that treat these patients, you don't have to see a large volume of patients to break even, let alone make a decent living to pay off your debt and put food on the table. as a result, you spend less time with each patient and the quality of your work suffers. that's why both my husband and i both agree, we will not work in an office that takes that kind of insurance ever again. when we have enough money and built up enough resources, we will give back to the community in volunteering and donations of materials and services, hey i don't need a lot to survive or to even be happy. but for now, it's all about making money and doing quality work on people that really want it and are willing to make that investment in themselves.

you obviously seem like a caring and dedicated individual to do what you're doing. i know what i'm saying might sound a bit selfish, but i think it's all about finding the balance between serving your community and being able to support your family while making a good living. i've invested soooooo much money ($200K that i have to pay back to the US government) that right now, that's where my priorities lie. i know that somewhere down the line, in a few years from now, i'm meant to do something more, something special that makes a difference. and when i do, i'll hopefully be in a position where i can give it my all.

sorry again about the rambling. i hope i got my point across. kudos to you for all your hard work, rachel! you rock!

At 1:53 PM, Blogger RON said...

when you get bombarded with ingratitude, it would make just about anyone start to wonder if ingratitude is the norm. I would dub ungratifulness as a poor attitude that's just part of human nature. And it really is. But you know something, when anyone reaches a certain age, they fully aware when they're should be conducting themselves way better than they are. We've all had our own share of that experience. You fared a lot better than me to say the least.

At 10:54 PM, Blogger Rachel said...

Thank you clare! Where have both of you ventured to this weekend? Lucky you spending nice weekends away :)

I'm so glad you understand Dr Mommy !! Even some of my peers don't understand as they work in private full fee paying patient clinics only. Over here it is usually either one or the other. Public dental hospitals or private clinics. A hybrid is rare. Thanks for listening and I'm glad I have someone to confer about stuff with :)

Hi Ron, your observations are interesting and true about human nature. There are somepeople though, no matter what age, they still don't feel it is important to better themselves. Lol prehaps your cynicism is rubbing off ;)

At 6:05 PM, Blogger KirkK said...

Hi Rachel - Situations like you describe can often make Healthcare workers cynical and quite jaded. The Missus often gets this way when she works shifts in the ER. Often there is the apathetic sense that one should take as much advantage of what is deemed as free(someone else is paying, but it's not them!), sometimes creating a sense of entitlement....oh, and I could go on! But we send you our most sincere hugs!!! I just think it's sad when People show such lack of pride, but hey that's me.

At 6:54 PM, Blogger Rachel said...

Dear Kirk and Missus,

I am so glad you guys understand too :) I am sure you and the missus have a few tales of good and bad incidences to tell yourself as well !

At 7:59 PM, Blogger milgwimper said...


HUGZ COMFORT I am so sorry you have to deal with the stress. When I worked at a hospital lab, we would be treated like such crap by the nurses, doctors, and the patients. So, I can understand your stress, but try not to let it get you down, and it is nice to have a person or two (maybe more, but I wish they would speak up) that appreciates the hard work. :)

At 12:06 AM, Blogger Rachel said...

Thank you Milly ! Just knowing you care made a crappy day better :)

At 3:06 PM, Blogger Lawrence said...

As a dental patient, I certainly believe that most dentists only want the best for their patients. Our dentists in Collierville are known to not only give the best dental care, but also known to connect to their patients on an emotional level, thereby thwarting any anxiety related to dentists and dentistry.

In particular, the dentist I'm visiting obliged to give me advices after my check-up. I'm with you for hugs to dentists. Collierville residents should feel lucky they have dentists who actually care for them.

At 9:10 PM, Blogger Mark Gel said...

I believe all dentist always aim to give better services to their patients. My dentist in Norfolk Village dental always willing to serve and give better options for patients needs to help them have a better smile again.
The dentist will never forget to give an advice for better results and satisfactions to their patients. A million hugs to Norfolk Village dental.


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