The Roanoker - July/August 2017 - 58
DENTISTRY | LOOKING BACK
again, not a clue on how to be a boss. Managing a growing staff was the challenge. As
a practice owner we wear all of the hats. We are the chief provider of services, the HR
department, equipment manager and quite often the maintenance staff. Every dentist
I know who has built a practice has probably scrubbed a toilet at some time-with
gloves on of course. Taking continuing education courses on management matters
became as important as taking courses on new materials and techniques.
I attended the Roanoke Valley Dental Society monthly meetings. This organization
has been around since the 1950s and provides a community for local dentists to get
together to learn. Face-to-face meetings were valuable to develop relationships with
colleagues. I believe that this is something that cannot be replaced with the online
groups of today. I remember attending my first meeting and being the only woman
present. When I introduced myself to a truly lovely wife of a veteran dentist, she
greeted me and said "and your husband is...?"
After clearing that up, I found the group to be completely open and supportive.
At our last meeting I noticed there were as many women as men in attendance.
Ab ove : A thorough examination with
a patient occurs before developing a
comprehensive dental-health plan.
Righ t: Sandra Andrew spends about one
week each year teaching at the Pankey
Institute, an advanced dental-education
center in Florida.
WHICH BRINGS ME TO A MAJOR demographic shift in dentistry. According to the ADA, in 1980 less than 1 percent of practicing dentists were female.
In Virginia that number has grown to 32 percent. Dental schools are almost
50/50 in gender split.
In 1983, there were just Dr. Robinson and myself. Now there are over 30 women
dentists in the Roanoke Valley area. Of all practicing female dentists, 56 percent are
under the age of 45. Some of these women have their own practices and some have
joined a group practice.
In the 1980s, the Valley had two group practices. One was located in Salem and
one in Roanoke. Everyone else was in a solo practice. In Virginia at present, 67 percent of dentists are in solo practice. Twenty percent are in group practices. The rest
work in education facilities, hospital-based clinics or government-supported clinics.
EQUAL ACCESS TO CARE
The valley has several clinics that service the populations that have dental needs but do not have the means for private care. Some area dentists
In Virginia there are rural areas with a very limited number of dentists. The
and clinics accept Medicaid which provides treatment for children. Benefits
eastern region and southwest region each have 2 percent of the dentists
for adults with Medicare or Medicare are very limited.
practicing in the state. In Northern Virginia and Richmond, there are several
Local nonprofit facilities:
on every street corner. In fact, 41 percent of all Virginia dentists are located
The Bradley Free Clinic: Serves the working uninsured and temporarily
in Northern Virginia. Distribution of dentists is a problem. According to the
unemployed; there are eligibility requirements; coverage area is Roanoke
Virginia Department of Health, there are at least 60 localities that have no
City, Roanoke County, Town of Vinton, Salem, counties of Craig and Bote-
dental safety net. That means there are no community-based clinics to
provide care to those unable to afford private services.
As noted elsewhere, young dentists come out of school with an overload of debt. The chance of them succeeding to support themselves, their
family and a practice in a rural county is low. Recruiting dentists to these
areas is a challenge.
In cities like Roanoke, with an adequate number of dentists for our
G. Wayne Fralin Free Clinic: Part of The Roanoke Rescue Mission, the
clinic provides care to the homeless individuals who are unemployed and
Christian Free Clinic in Botetourt: Provides limited dental services to Botetourt County residents without private insurance or government-provided
population, what we should really say is patients need access to affordable
New Horizons Healthcare: Community based health care center providing
care. As Bernie Saunders said, everyone has access to a million dollar home
basic dental care for the underserved and uninsured. Accepts Medicaid
but that doesn't mean we can afford it. Dental care is not a million dollars
and has a sliding scale fee schedule available.
but good quality care comes with cost. Dental insurance provides some
All dentists provide some type of care to needy patients in their own
support but only if you have the policy. Most dental insurance is part of a
offices. It may not be a formal program and they may not talk about it but
work benefit. Individual policies are more expensive with limited coverage.
much is being done behind the scenes. -SA
58 | JULY/AUGUST 2017