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One of the advancements that SCFHC

March 5, 2013

One of the advancements that SCFHC

 

Genevieve Filmardirossian, SCFHC Chief Operations Officer, estimates that more than 60 percent of the patients the clinic sees are uninsured, and the remainder are either insured, under insured or receive Medi-Cal or some other type of assistance. Martha and Rafael Munoz, who sell hardware supplies at a local swap meet, rely on Medi-Cal. Filmardirossian emphasized the clinic’s focus on prevention and education.

 

“Our model is to heal, to empower and to educate the community,” Filmardirossian said, echoing the clinic’s motto. “We empower these patients to take care of themselves so they are healthy and they have better outcomes. If you take care of yourself and are able to control the illness that you suffer, you will not be a frequent user of the ER. We believe that staying healthy and prevention is the key to being healthy.”

 

South Central Family Health Center has been able to increase services thanks to a number of federal grants. In recent years, the clinic received Recovery Act assistance through the Health Resources and Services Administration, including $1.3 million in a New Access Point grant, $304,000 for an Increased Demand for Services grant and $1.6 million for additional construction, renovation, equipment and health IT.

 

With the added funding, SCFHC opened the Huntington Park Family Health Center in 2010, remodeled and expand its main location; added mammography and radiology rooms; added staff; and extend hours. The primary location is now open from 7 a.m. to 7 p.m. Monday through Friday and from 7 a.m. to 6 p.m. on Saturday.

 

More recently, SCFHC received Affordable Care Act funds through Health & Human Services. The $500,000 grant received in May will go to the Huntington site and allow the clinic to provide dental care. “It’s just allowed us to meet the expanding need,” Ferguson said. “We have to grow to meet that growth in the community. There’s challenges that come along with that and we’re continuing to do what we can to try and meet those challenges.”

 

One of the advancements that SCFHC has made is in the department of medical records. Each exam room includes a computer terminal, where providers can enter updates, go over medication, schedule appointments and more.“The fact that a patient can call me and ask me a question about his labs, I can just look it up in the computer in a manner of a couple of minutes,” Dr. Aguilar said.

 

South Central Family Health Center also runs two school-based clinics at Jefferson High School and The Accelerated School, both in South Los Angeles. Ferguson stressed the relationship between education and health care, from primary care to addressing sexually transmitted diseases and teen pregnancy. While the clinic works to keep up with demand, South Central Family Health Center leadership wants to learn what it can do better and to get the word out about its services. To do so, the clinic has formed a Patient Advisory Committee.

 

“The main purpose for this is to have the patients be the voice of the clinic and to bring any concerns,” Filmardirossian said. “They volunteer to do work in the clinic. They provide information in the front office. They are all volunteers for the clinic. They are basically the voice of the community.” Fanny Ramirez, 58, has been a patient at SCFHC for approximately six months now. She works part-time as a housekeeper and does not have insurance. Ramirez lives in the area and heard about the clinic from a friend.

 

“I wasn’t being attended very well in the other place I was attending,” Ramirez said through a translator. Ramirez sought treatment for her an irregular heartbeat, as well as arthritis, poor blood circulation and cholesterol. She plans to join the Patient Advisory Committee. Rafael and Martha Munoz are also both on the Patient Advisory Committee. “There is something important for why we are in the committee,” Rafael Munoz said, with translation from his wife. He emphasized keeping the community healthy and out of the emergency room. “If the community is receiving good medical service, they won’t be in the emergency rooms of the hospitals. If there are people not getting sick it’s going to be more productive to the country.”

Many of our members have expressed frustration

March 5, 2013

Many of our members have expressed frustration

 

Even when Mexicano had coverage under Denti-Cal she was only using it for emergencies because she didn’t know she was eligible for cleanings and other preventative services. “That’s the big failure with Medi-Cal, they don’t communicate effectively with beneficiaries,” Marcus said. Another program for low and middle income kids in the county is the Healthy Kids Program. It takes families who wouldn’t have previously qualified for Denti-Cal because their income is too high. Healthy Kids beneficiaries have incomes below 300 percent of the federal poverty level, $69,000 for a family of four.

 

The Central California Alliance for Health, a locally operated public health plan administers Healthy Kids which is funded by the county as well as hospitals, nonprofits and foundations. But its capacity is limited. Currently 1,246 children in the county are enrolled in that program and 430 are on a waiting list, said Maria Love, an administrative analyst for the Santa Cruz County Health Services Agency. Like Marcus, she says even with Healthy Families there were already thousands of children in the county not receiving dental services.

 

“The dental part of the Healthy Families transition to Medi-Cal] will be one of the biggest challenges for sure,” she said. Typically the Healthy Families Program provides a higher rate of compensation to dentists than Denti-Cal. Medi-Cal is matched 50-50 with federal funds while federal funds provide two thirds of the funding for the Healthy Families Program, Williams stated.

Anthony Wright, Executive Director for Health Access California, a nonprofit consumer advocacy coalition in Sacramento, said his organization doesn’t think Medicaid is an awful program. He said there’s clear evidence that a majority of people with Medicaid coverage are satisfied and appreciative of it.

 

But in the scenario with Healthy Families, the fact that beneficiaries will be moved from a dental program with a higher reimbursement rate to a program with a lower one will have a significant effect, he said. “At the end of the day it’s a cut and will inevitably have an impact on the access,” he said. “The rates paid in the Denti-Cal program are well below the cost of providing care, this has a tremendous impact on the number of dentists that can participate in the program,” stated the California Dental Association in an e-mail response to questions.

 

“Many of our members have expressed frustration with the Denti-Cal program, including exceptionally low rates, the cumbersome process needed to become an approved Denti-Cal provider and the challenges in ensuring a pediatric specialist can see children when needed,” the Association reported. In terms of Medicaid reimbursement levels to providers, California is almost at the bottom, ranking 46th in the country, Williams wrote.

 

“Fees have just gotten so ridiculously low it’s easier for me to convince dentists to take patients paying nothing than to do Medi-Cal,” said Hugo Ferlito, Associate Chief Operating Officer of Salud Para La Gente, a Watsonville-based federally qualified health center. It’s a nonprofit safety net clinic like Dientes that cares for patients regardless of their ability to pay. Salud operates three physical clinics as well as 14 school-based clinics and is in the process of opening clinics at Cabrillo and Live Oak Elementary Schools and in Seaside. Last year Salud had an operating budget of $13 million and did an additional $4 million in uncompensated care, Ferlito said.

 

“If someone is in pain, we take care of them,” he said. So Salud employs a full-time grant writer, gets money from the cities of Watsonville and Santa Cruz and Santa Cruz County. “It’s just a scramble,” he said. “Many of our members provide a great amount of work pro bono rather than trying to maneuver through the financial and administrative barriers to providing Denti-Cal services, the California Dental Association stated. But that’s not a workable replacement for a functional statewide dental system. “California must develop a true dental system of care that meets the needs of its citizens,” the association contends.

Health care reform helps L.A. clinic meet rising demand

March 5, 2013

Health care reform helps L.A. clinic meet rising demand

 

South Los Angeles, maybe best remembered as ground zero for the 1992 Rodney King riots, now boasts an unexpected draw. Patients are traveling from other parts of Los Angeles to seek care at the South Central Family Health Center, a clinic that provides health care to the uninsured – and is using grants from the Recovery Act and the Affordable Care Act to innovate and grow. When seeking treatment for her hemophilia and his Guillain-Barre Syndrome, Martha and Rafael Munoz made what was for them an easy decision. Despite living in Hawthorne, the husband and wife chose to receive healthcare at South Central Family Health Center, twelve miles away.

 

“We’d been going to a lot of clinics and hospitals like Harbor and we didn’t like how they treated us as patients,” Martha Munoz, 51, said during an interview on a busy Wednesday afternoon in September at the South Central Family Health Center. “I feel that they treat us as a file number.”

That wasn’t Martha and Rafael’s experience at the South Central Family Health Center. In addition to a familiar doctor in a familiar location, the Munoz family walked into a comprehensive primary health care facility focused on prevention, exercise and nutrition. More recently the clinic has implemented electronic medical records, more exam rooms, student-age outreach and dental care. The center also boasts comprehensive prenatal care.

 

Founded in 1981 as a small clinic at the corner of San Pedro Place and South Main Street, the non-profit moved into its current location – a vacated meat market – early last decade. The mission of the federally qualified health center is “to provide quality healthcare services for the uninsured and to the under insured population of Los Angeles County, specifically South Los Angeles,” according to Jerra Ferguson, South Central Family Health Center’s Development Director. Dr. Aguilar said the clinic sees between 250 and 300 patients on a given day, but still has to turn away between 20 and 50 people. He said he talks to a number of patients who were once insured.

 

“The demand is much greater than the medical resources that we have,” Dr. Aguilar said. “We just don’t have enough providers. We just don’t have enough resources to be able to take care of them. We wish we could. As time goes by we have new services, but the demand for healthcare services is great.” South Central Family Health Center boasts 11 providers and more than 20 exam rooms.

 

“Every day we turn people away,” Dr. Aguilar continued. “We try to do our best. A nurse checks them out to make sure it’s nothing serious that cannot wait, but it’s something that’s a daily occurrence here. We’re always looking for ways to innovate, to find new manners of service to augment and do more.”

Inflammation links periodontal and systemic diseases

January 24, 2013
Inflammation links periodontal and systemic diseases

By Rabia Mughal, Contributing Editor

December 17, 2008 -- The importance of the oral systemic link got another nod when a recent Columbia University study found that people with periodontal disease are more likely to have increased levels of inflammation, which is also a risk factor for cardiovascular disease (CVD).

Periodontal disease and CVD are both caused by inflammation, explained John Grbic, D.M.D., M.M.Sc., a professor at the Columbia University College of Dental Medicine and one of the study authors, in a DrBicuspid.com interview.

"The bacteria that cause periodontal disease elicit an inflammatory response in their periodontium. The cytokines produced by inflammatory cells in the periodontium can enter the circulation and cause increased inflammation in other parts of the body," he said. "These bacteria can also enter the circulation and deposit themselves in areas of atheroma formation such as coronary arteries. Periodontal pathogens have been found in arterial plaques. The presence of these bacteria can cause inflammation, leading to the formation of more atheromas."

Although this hypothesis suggests that the treatment of periodontal disease should reduce the risk of CVD, it has never been proved in an interventional trial. However, studies have shown that treatment of periodontal disease may lower levels of circulating inflammatory mediators, Dr. Grbic said.

Also, patients with increased generalized systemic inflammation may be vulnerable to diseases caused by inflammation, including CVD and periodontal disease, he added.

"Of course, the relationship may be a combination of both of these possible mechanisms," Dr. Grbic said.

The Columbia University Medical Center study involved 421 individuals who did not have heart disease but were family members or cohabitants of patients with heart disease. They were screened for traditional CVD risk factors and also answered questions about their oral health (American Journal of Cardiology, December 1, 2008, Vol. 102:11, pp. 1509-1513).

Researchers noted that, in a diverse population of individuals eligible for the primary prevention of CVD, a history of periodontal disease was associated with significantly higher levels of Lp-PLA2, an inflammatory marker, when compared to those without periodontal disease. The data indicates a possible association between oral health and inflammation, which in turn means that inflammation could be a factor in the relation between oral health and CVD, the authors noted.

"It is not possible to conclude from these data that oral health is a risk marker for CVD or CVD outcomes or that any therapy based on oral health status will be effective," the authors concluded. "Our data suggest that 'at-risk' individuals who may otherwise not be identified by traditional CVD risk screening might be identified through oral health screening."

Another recent study corroborated the link between inflamed gums and periodontal disease. Researchers from the University of Milan looked at 35 healthy people who had mild to moderate periodontal disease. They examined the subject's carotid arteries at baseline and at several points over the course of periodontal treatment. One year after treatment, they observed a reduction in oral bacteria, immune inflammation, and the thickening of the blood vessels associated with atherosclerosis, the chronic inflammatory response in artery walls (Journal of the Federation of American Societies for Experimental Biology, December 12, 2008).

"It has been long suspected that atherosclerosis is an inflammatory process and that periodontal disease plays a role in atherosclerosis," said Mario Clerici, M.D., a senior researcher on the study, in a press release. "Our study suggests that this is the case and indicates that something as simple as taking good care of your teeth and gums can greatly reduce your risk of developing serious diseases."

More aggressive perio treatment?

For dentists, this discovery means they can play a key role in screening patients for potential cardiovascular problems and referring those at risk for a more through evaluation with their physician, said Dr. Grbic while discussing the results of the Columbia University study. Also, these findings indicate that physicians can determine which patients need to be screened for CVD by asking relatively simple questions about their oral health.

Does it also mean the treatment of periodontal disease should change?

"No, although it makes diagnosis of periodontal disease more important," Dr. Grbic said.

Michael McGuire, D.D.S., who addresses the inflammation link in another recent article (Journal of Periodontology, November 2008, Vol. 79:11, pp. 2016-2020), feels the link between periodontal disease and inflammation does warrant some changes in treatment, however.

Dr. McGuire warned that gingival inflammation cannot be viewed as a simple problem, especially in high-risk patients -- such as heavy smokers, diabetics, and interleukin-1 genotypes -- and those with systemic inflammatory conditions who do not respond to debridement.

These patients should be treated more aggressively, he advised. He recommends shortening their recall intervals, reinforcing home-care techniques, recommending toothpastes or essential oils with anti-inflammatory properties, and prescribing local delivery drugs, systemic antibiotics, or subantimicrobial dose doxycycline as part of the recall regimen.

"Because inflammation is associated with systemic events, why take a chance?" he wrote.

Solid links seem to exist between periodontal diseases and systemic inflammatory diseases, but it may take many years before the systemic therapeutic benefits of periodontal treatment are established, he noted.

If these benefits are established, there may be changes in the way dentists practice, such as an increase in referrals of periodontal patients with systemic conditions, inclusion of periodontal evaluation in medical protocols, and more collaboration with medicine in both patient care and research, Dr. McGuire concluded.

Georgia dental school gets $3 million grant

January 24, 2013
Georgia dental school gets $3 million grant

By DrBicuspid Staff

December 16, 2008 -- The Robert W. Woodruff Foundation has pledged $3 million toward construction of a new Medical College of Georgia (MCG) School of Dentistry building, according to the school.

Construction is slated to begin this summer and last two years, MCG said.

The MCG School of Dentistry is the only dental school in Georgia. The school said it is increasing its class size incrementally from 63 to 100 and its residency positions from 44 to 72. Only 13 of the country's 57 dental schools now have a class size of 100 or more, according to the ADA.

Georgia currently issues about 200 dental licenses annually, the MCG noted. The school expansion should help alleviate the shortage of dentists in Georgia, which has 41.4 dentists per 100,000 citizens.

The approximately $112 million new facility will have five floors, 220,000 sq ft, and new equipment, including dental chairs, simulation technology, and distance learning and teledentistry capabilities. The school expects patient visits to increase from 50,000 a year to nearly 100,000 once the facility is complete.


Copyright © 2008 DrBicuspid.com

Survey: U.S. women prefer dental visit to money talk

January 24, 2013
Survey: U.S. women prefer dental visit to money talk

By DrBicuspid Staff

December 16, 2008 -- More than two in five women (41%) find going to the dentist less excruciating than talking to their spouses about their daily finances, according to a survey of U.S. women conducted by State Farm.

The State Farm survey revealed that while 74% of U.S. women feel anxious about their retirement and financial futures due to the recent economic decline, only 15% have made major changes to their financial plans, the company noted.

The survey also found that when women look for financial guidance, they don't always seek out expert advice. The survey showed many women turn to their parents (16%) or friends (13%) for financial advice, while fewer are likely to turn to insurance agents (12%) or accountants (7%).

State Farm's survey was conducted by Kelton Research from November 7-13, 2008 using random digit dialing of listed and unlisted numbers. Quotas were set to ensure reliable and accurate representation of the total U.S. female population ages 25-65.

U.K. dentists prohibited from using 'Dr.'

January 23, 2013
U.K. dentists prohibited from using 'Dr.'

By DrBicuspid Staff

November 4, 2008 -- All over the world, a dentist is a doctor. All over, that is, except in the U.K., where regulators recently ordered a dentist to stop using "Dr." in his ads because he has neither medical qualifications nor a Ph.D., according to the Daily Telegraph.

The order came from the Advertising Standards Authority (ASA), a commission of U.K. advertisers that pressures advertisers to comply voluntarily with truth-in-advertising rules and can also refer violators to government enforcers.

The ASA says dentists may sometimes use "Dr.," but only if they make it obvious that they are not medical doctors, according to the newspaper.

The case has pitted dentists against medical doctors, the newspaper said. It quoted Peter Ward, chief executive of the British Dental Association, as saying, "We believe that dentists should be permitted to use the courtesy title 'Dr.' should they wish and provided that it is not done in a way which might mislead patients as to their qualifications.... The General Dental Council has no objection to the title and its use is becoming widespread."

But Dr. Jonathan Fielden, chairman of the British Medical Association's consultants committee, said banning dentists from the "Dr." honorific protects patient safety, according to the Daily Telegraph.


Copyright © 2008 DrBicuspid.com

Nobel Biocare profits plunge 62% in Q3

January 23, 2013
Nobel Biocare profits plunge 62% in Q3

By DrBicuspid Staff

November 3, 2008 -- The economic downturn is being blamed for a 62% drop in net profits for dental implant maker Nobel Biocare in the third quarter of 2008 (end-September 30). The Swiss company reported net profit of 13.5 million euros ($17 million U.S.) for the quarter, compared to 35.5 million euros ($45 million) for the same quarter a year ago and well below analyst estimates, which had called for 22.8 million euros ($28.6 million).

Nobel Biocare does not expect the downward trend to reverse itself in the current quarter. In the company's latest interim report, issued November 3, CEO Domenico Scala said, "In view of the increased economic uncertainty and discretionary nature of some of the company's products, Nobel Biocare expects a further slowdown in growth for the remainder of 2008. Nobel Biocare anticipates that its growth will underperform the market average this year due to its geographic and business mix, which is weighted toward large-case treatments, as well as several country-specific issues."

While the company is confident in the long-term fundamentals of its business, Scala added "given the current economic environment, it is not possible at this time to provide any reliable quantitative guidance."

CE course focuses on role of stem cells in dental therapy

January 23, 2013
CE course focuses on role of stem cells in dental therapy

By DrBicuspid Staff

October 31, 2008 -- StemSave is partnering with Hu-Friedy's online dental hygiene community, Friends of Hu-Friedy (www.friendsofhu-friedy.com), to offer a new continuing education (CE) course on the role dental professionals can play in both the recovery and future use of stem cells.

The CE class, "Stem Cells: Emerging Medical and Dental Therapies and the Dental Professional," was developed in collaboration with StemSave's president, Dr. Gregory Chotkowski, D.M.D., O.M.S.

"The class is essential for anyone in the field and is yet another example of how Hu-Friedy strives to offer the most state-of-the-art education classes to its members," Dr. Chotkowski stated in a press release. "Stem cells are driving an array of emerging medical and dental therapies, and it is important that the dental community understand the role it can play."

Dentists featured in new movie and TV show

January 22, 2013
Dentists featured in new movie and TV show

By Laird Harrison, Senior Editor

September 16, 2008 -- "What a great job, to be able to shove wads of cotton in people's mouths." The thought reportedly occurred to David Koepp, director of the new film "Ghost Town," as he was walking down a New York street "feeling crabby about people in general."

From that eureka moment came one of the few feature films offering a dentist as the main character. "Ghost Town," starring Ricky Gervais as dentist Bertram Pincus, starts September 19.

And "Ghost Town" is not the only new fictional dentist popping up in popular culture. Next year, Nickelodeon will launch "Glen Martin, DDS," a stop-motion children's TV show with a dentist as a main character.

The simultaneous appearance of fictional dentists on the small and big screens is apparently a coincidence. But conversations with the creators suggest some ways in which the mass media view of the profession is changing.

Thirty-two years ago, "Marathon Man" -- which featured dentistry literally as torture -- created the most memorable image of a dentist in the movies.

Perhaps because of progress in caries prevention and anesthesia, pain is the not the major theme in either "Ghost Town" or "Glenn Martin, DDS."

Rather, a different stereotype figures into "Ghost Town" -- the notion that dentists themselves are depressed about their work, said Casey Stone, a Paramount publicist. "He is definitely a snarly character," she said. "There is the statistic that dentists are an unhappy profession."

 

The trailer from "Ghost Town," which opens this weekend.

The Ricky Gervais character, much like Ebenezer Scrooge in Charles Dickens' A Christmas Carol, is a chronically crabby man who is brought to a sunnier outlook by the visitation of ghosts.

Stone is quick to point out that another dentist in the film, who shares an office with Gervais' character, is naturally a cheerful man.

(The choice of Gervais -- who won fame as the star in the original British version of "The Office" TV show, carries with it a small irony: news accounts have sometimes focused on his crooked teeth.)

The inspiration for the Nickleodeon dentist Glenn Martin comes from a very different view of dentists, said Steven Cohen of Tornante, the production company behind the new show. "We wanted to portray an upper middle class working man and wanted to pick a profession that was very identifiable, very visual, and also a bit demanding," he wrote in an e-mail toDrBicuspid.com.

 

"Glenn Martin, DDS," image courtesy of Tornante.

Since the show was pitched to kids, the creators thought it would be funny to portray Dr. Martin traveling in a mobile dental clinic, which he calls the Molar Express.

 

"As far as a feeling a dentist evokes to our target audience, we feel that a dentist has a certain warmth compared to other professions," Cohen explained. "Kids remember going to the dentist, getting the toys at the end, and Glenn is that kind of dentist, very warm, friendly."

The opening scene of the first episode shows Dr. Martin working with a child who won't open his mouth. "There is a certain personal touch a dentist must give each and every patient, so that also made it an attractive and rich profession for a show like this," Cohen wrote.

Not all episodes will depict Dr. Martin at work, however. "The show is really about this family that decides to live on the road and see America, it's not specifically about being a dentist, although that will certainly come into play in episodes," he wrote.

So do dentists at last have their answer to the legion of fictional medical doctors -- from Marcus Welby to Dr. McDreamy -- who have flaunted their stethoscopes on large screen and small? Stay tuned.

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