Small Smiles Temp Dentist Speaks-Reposted From A Dental Forum

I just returned from a 6 week assignment from a temporary agency to a small smiles clinic. (Assignment cut short because FORBA decided not to use doctors that were not credentialed with medicare) In any event, The biggest question I had was....Why mom or dad were not back here learning how to care for the children's teeth. Then I find they are not allowed back there. I was disgusted with the way the children were treated. I wouldn't take a dead snake to that place.

While my office is being built, I decided to make a little money in the interim. I happened to use a temp. service that put me in a small smiles clinic. I was informed by the lead dentist that this was the last place many of the patients could go for dental services, "that we had to do what was necessary to get the job done." This sort of tugged at my heart to see these kids with so much decay and infection. Out of the five doctors that where available, I had the most experience with respect to years practiced. Most were recent grads.

We probably averaged 20 -25% usage of the papoose. It was a screaming frenzy for those few patients that did get the papoose. I did inquire "why oral sedation was not used" and was told that it was not a covered event for the Medicaid patient. From a business view point, they make a lot of cash. Even with the new doctors, it gave me the impression that it is sort of like an uncontrolled residency and a quick way of bringing your skills up to par before entering the "outside world".

They train their own assistants for the most part, because of the high turnover rate. Compensation to them is minimal. They do get enticed with a monthly bonus. I was told that they average 16K production a day. From what I saw, they must do most of that in Hygiene. I do not know what Assistants can or can not do with respect to polishing in that state, but that is used a lot. They work the assistants to the ground and they frequently have 10 hour exhaustive days. One day we saw 137 patients.

I have mixed emotions at the present time. It is obvious that a great deal of money is being made utilizing the government handout of these funds. I was told that not all states pay as well as others and that is why they are not in some of the states.

Whether or not this is true I have not investigated. They have apx. 80 offices with goals of close to 100 or so by 2009. I am not opposed to anybody making a profit. If this truly is the last stop for many of the patients, than they are performing a needed service.

Overall, you have the most inexperienced team, working on probably the hardest portion of the population. It is going to attract media attention at any given opportunity. What is the answer to the problem at hand? I can not tell you. Once again, I am grateful I am able to refer out any pediatric case.

Perhaps, instead of going to Africa, or South America all the time, we doctors can just stay home and donate our time and talents to the local community. I know that is not as glamorous as the "out of country" trip, but it certainly would be just as beneficial. Sorry, I guess I rambled at bit too much.