Dentist shortage?

Posted 2/5/09

Or put yourself in the shoes of a single parent, struggling to make ends meet, and trying to find someone to treat her child — who is eligible for Equality Care or Kid Care, both of which are state assistance programs aimed at young …

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Dentist shortage?


Local providers have different perspectives Imagine waking up with a severe toothache, a nagging pain that just keeps getting worse throughout the morning. You don't have a regular dentist, so you call a local dentist listed in the phone book, only to be told the dentist is not taking any new patients. You try the next number, and the next, only to be told the same thing.

Or put yourself in the shoes of a single parent, struggling to make ends meet, and trying to find someone to treat her child — who is eligible for Equality Care or Kid Care, both of which are state assistance programs aimed at young children.

The parent begins calling dentists, asking, “Do you take Equality Care patients?”

When the answer is affirmative, she requests an appointment, only to be told the office “isn't taking new patients.”

“That's part of the kicker,” said Dr. Larry Akin. “We tell them we take (Equality Care patients), but then that we don't accept new patients. It's a struggle.”

There are six dentists in Powell: Jason Hoffmann, Melvin Ginest, Ken and Cordelia Hoffmann, Thomas Jones and Akin.

Two of them, Akin and Jason Hoffmann, are not accepting new patients.

They both said they feel the need to take care of their existing patients, since they begin to suffer if their dentists take too many patients.

Drs. Ken and Cordelia Hoffmann, who operate a joint practice, are currently accepting new patients. However, according to Judy Walsh, from their office, “(We are) if they (the patients) are willing to wait, because they're booking so far out. The doctors are already booking into May, and the hygienists are booked until July.”

Drs. Melvin Ginest and Thomas Jones are taking new patients as well. Ginest is booking about one week out, and Jones is taking patients based on appointment availability.

“I've been here for 25 years,” Akin said. “When I first started, I worked Monday through Friday, plus Saturday morning.

After about 10 years, I thought, ‘This isn't good. I've got to make some changes' ... so I cut the number of hours I work.”

Akin now works Monday through Thursday, and until 2 or 3 p.m. on Fridays.

“If all six of us worked a full five days, we could probably handle the need. (But) we want to have good marriages, family life, be involved in the community,” he said. “If you're going to do those things, you can't work so many hours. If you live here because you enjoy the quality of life, you can't work all the time. Because of that we need another dentist.”

However, Jason Hoffmann added, “You can't just sit there and say we have a shortage of dentists because there are too many people and not enough dentists. That's an easy, pat answer, but you really need to look at what's going on in the world of dentistry — cosmetic dentistry, the economy, elective procedures, fluoride ...”

Jason Hoffmann said there has been a huge increase in pediatric patients in the last decade or so.

“In 2000 or 2001, we tried to get fluoridated water, which is a great thing for the amount of money spent. It's better to fluoridate the water than pay for the restoration of children's teeth,” he said. “But (they) didn't do fluoride, and there's been a rise in the amount of decay. Pediatric dentists are really busy.”

Of the six providers in Powell, three of them — Jason Hoffmann, along with Ken and Cordelia Hoffmann — do not accept Equality Care or Kid Care patients. According to Akin, that's another thing contributing to the shortage he perceives.

“We have seen a huge influx in Equality Care patients,” he said, adding that his office gets between three and five Equality Care and Kid Care calls per day. The programs pay reduced fees that amount to 60-75 percent of the normal fee.

“There's no way for me to work on all of them. If overhead runs you 60-70 percent, it's not viable. I think we need to go beyond the financial,” Akin said. “We got into this business to provide a service, but we all need to share the responsibility of providing services to those people.”

Akin has also talked to the state Legislature about raising reimbursement rates for the program.

“They're aware of the problem. If they raised the reimbursement schedule, probably more dentists would accept it,” he said. “If more dentists would see these young kids, it would help.”

Liz Brimmer, a spokesperson for the Wyoming Dental Association, said that the dentist-to-patient ratios are actually pretty good in Park County, especially when compared to the national numbers.

Brimmer said the national dentist-to-patient ratio is one dentist per every 1,800 patients — the Park County ratio is one dentist to every 1,694 patients. Big Horn County, on the other hand, has a ratio of one dentist to every 3,797 patients.

“We have a lot of overflow from Big Horn County,” Akin said, meaning that the numbers may not be accurate in all cases.

He also mentioned that, in his dental school, students were told that the ideal ratio is one dentist for every 1,300 patients.

Akin said he is trying to recruit dentists to come to Powell, but the “economy has put a hold on it. I bought a lot (land to build a new office), drew up plans ... We're aware of the problem, we're trying to solve the problem.”

According to Jason Hoffmann, in recent years the climate has turned more toward elective and cosmetic procedures, and away from the “nuts and bolts.”

“Now with the economy like it is, many dentists who have focused on elective, high-dollar work may find themselves with openings,” he said. “(It's also difficult because) young dentists can make more money in large, urban areas.”

“Because we get so many calls, either emergency or new patients, we were having to schedule three or four months out,” Akin added. “I got to thinking, ‘That's not fair to the people who have been loyal all these years.' Now, if I get two calls, and one is a loyal customer, I'll always give the appointment to that person. By doing that, we're only scheduling out six to seven weeks. (We try to squeeze some other emergencies in), but for others, we call other dentists to see if they can see the people. Hopefully we don't just blow them off and say, ‘That's your problem.'

“I think, for myself, along with the other dentists in town, we're just trying not to get burned out.”