Keith Phillips, DDS
Every dentist has encountered this problem. A patient arrives in desperate need of dental care, but has no insurance. He can pay very little since he needs every cent he earns just to meet basic housing, food, and transportation needs. You must decide between sending the person away without much hope for treatment and giving away costly dentistry. Unfortunately, due to hard economic times, dwindling public health budgets, and the rising cost of quality dental care, this dilemma will become more common.
Dr. Tom Underwood, a Nashville general dentist, envisioned a nonprofit dental clinic to serve low-income, working families with no dental insurance. Dentists could refer any patient unable to afford dental care to the clinic, where the staff would handle paperwork and income verification. Patients would pay on a sliding fee scale according to income and family size. When Dr. Underwood joined forces with the Nashville Dental Society and the Outreach Commission of the West End United Methodist Church, the dream became a reality. Interfaith Dental Clinic opened in November 1994 in the church basement with two dental chairs and one staff member.
Today, the clinic owns its own building with six operatories, state-of-the art equipment, administrative offices, a staff lounge, and a spacious waiting room. The staff sees an average of 20 patients a day and restores about 300 people a year to optimum oral health, while freeing hundreds of others from pain and disease. More than 120 volunteer dentists, hygienists, and specialists contributed more than $120,000 worth of hours during the 2001/2002 fiscal year.
Dr. Rhonda Switzer was hired as the clinic's first staff member and only executive director to date. She wanted a place to do quality dentistry for people in need without dealing with the bureaucracy and limitations of a public health clinic. The Interfaith Dental Clinic provides comprehensive care through collaborations with area endodontists, orthodontists, periodontists, oral surgeons, and the Vanderbilt University Department of Oral Surgery.
At the clinic, several hours are devoted to each patient to improve oral hygiene skills. Plaque scores are taken at every appointment, with compliance required to remain in the program. Patients are enrolled for a 12- to 18-month period, when they can have their mouths restored to optimum health. Then, they are discharged to seek cleanings and maintenance in private practices.
Dr. Switzer believes every patient should contribute financially to his care, even if it is a modest amount. In this way, the patient has a vested interest in the result, is committed to maintenance, and dignity does not suffer. Patients pay on a sliding fee scale based on income and family size. The average is 20 percent of usual and customary prices. The philosophy is that if a person has set aside $500 for dental care in a year's time, he can afford to budget the cost of regular cleanings and X-rays.
Interfaith has to work hard to keep revenue coming in. With a diversified revenue stream from patient fees, individual donors, United Way, churches, government funding, and local foundations, the clinic has increased its services each year. To make such a clinic work, you must communicate your vision not only to the dental community but to the community-at-large. Both segments have to believe in you to offer long-term support.
Although the clinic can't reach everyone in need, its focus is on the life-altering changes that can be made in the lives of hundreds by giving back smiles and the tools to maintain them. For more information, call Dr. Rhonda Switzer at (615) 329-4790 Ext. 19.
The author wishes to thank Melissa Hutcheson for her contribution to this column.
Dr. Keith Phillips maintains a private practice in Winston-Salem, N.C. He is president and founder of The Giving Hand Foundation, a nonprofit organization committed to the start-up and development of free medical and dental clinics. Dr. Phillips also serves as a teaching associate at the L.D. Pankey Institute and is on the faculty of the University of North Carolina School of Dentistry.