Wanted: Medicaid Dentists
By David Bruce, Erie Times-News, Pa.
Jun. 23–Erie oral surgeon Joseph Bukowski planned to retire in 2008.
Instead, he’s checking wisdom tooth extractions at the Martin Luther King Center’s new dental clinic.
“I was going to retire at the end of the year when I heard about the new clinic,” said Bukowski, 60, between seeing patients at the center, 312 Chestnut St. “I know the need for dental care is great, so now I’m working here.”
Even with the new MLK Center clinic, Erie County has a critical need for dentists and oral surgeons who accept Medicaid patients. Many of them must wait six months or longer to see a dentist, and travel to Pittsburgh to have a tooth pulled.
The federal government estimated that the county needs an additional 12 full-time dental providers to meet demand. It has designated Erie and Crawford counties as low-income Dental Health Professional Shortage Areas.
“What it means is that dental providers in Erie (or Crawford) County can apply for grants to pay for start-up costs, equipment and first-year salaries,” said Stacy Kriedeman, a spokeswoman for the Pennsylvania Department of Health, which provides grant funding. “Dental students can locate there after graduation and have a portion of their student loans repaid.”
Erie County doesn’t have an overall shortage of dentists and oral surgeons, so why do so few of them treat low-income patients?
Reimbursement is a problem, said John Alonge, an Erie oral surgeon and president of the Erie County Dental Society. The state reimburses dental providers at a lower rate than private health insurers do, and it requires far more time-consuming paperwork.
“It’s a nightmare,” said Alonge, who doesn’t accept Medicaid patients at his office but treats them as an on-call oral surgeon at Hamot Medical Center and Saint Vincent Health Center. “It requires additional staff, time and money, and you get less reimbursement.”
Another problem is that Medicaid patients as a group are not as compliant as other patients, said John Schultz, chief executive of Community Health Net, which operates the MLK Center dental clinic and two others in Erie.
“You see a high no-show rate, patients don’t always listen to what the dentists tell them, they don’t always follow treatment plans,” Schultz said.
Community Health Net is actively recruiting dentists and oral surgeons. A new dentist is expected to begin working in August, and Schultz said he hopes to hire another one in the fall.
The new dentist is foreign born and is locating in Erie as part of the federal government’s J-1 visa waiver program.
“The program allows foreign-born dentists to remain in the country by working in a Dental Professional Shortage Area,” said David Bowman, a spokesman for the Health Resources and Services Administration, which oversees DPSAs.
There is no quick solution to Erie County’s shortage of dental professionals, but low-income patients can improve their dental health by following a few simple directions, Alonge said.
“The bulk of tooth decay and gum disease is due to a lack of brushing and flossing, and poor dental nutrition,” Alonge said. “They need to brush and floss, and avoid high-carbohydrate foods and soda pop.”
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