By Bhakti Desai, UAB School of Dentistry, Class of 2020 —
As I progress in my education as a dental student, I often feel farther not closer to the career goals that led me into the field. School–with assignments, exams, and a desire to succeed–becomes a distraction from remembering that we entered the healthcare profession to help people. We learn about the existing disparities and issues plaguing our healthcare system, but we push it off as a future endeavor for when we are more qualified or have lived our lives and have time to give back to our communities.
I was afraid of losing sight of my altruistic goals of affecting change and impacting the lives of those in my community. I applied for the Albert Schweitzer Fellowship last year with the hope that this fellowship would help keep the bigger picture in sight. This fellowship allowed me to create a project that would address an unmet health-related need in my community. I partnered with Cahaba Valley Health Care, a clinic that provides free dental care (extractions and fillings) for patients. Because of the high demand, individuals are only able to be seen once every 2 years. My role is to provide oral health education for the patients, specifically teaching them about preventive oral health care. From brushing habits to diet and fluoride intake, my goal was to teach patients information that I often take for granted.
I have loved my time as an Albert Schweitzer Fellow. Multiple clinic sessions were required for me to finally find a natural rhythm with presenting the information and finding a time to speak to patients individually without overwhelming them. After speaking with each patient, we would work together to set a goal that could be accomplished in a month’s time. This would be a step towards better oral health and, therefore, better overall systemic health. However, it is difficult to teach patients the value of maintaining their oral health as they would their overall health when we live in a society that does not place equal value on these two types of care. As of 2016, Alabama is one of four states that does not provide any dental coverage to Medicaid adult beneficiaries, while most states provide either emergency benefits, limited coverage, or extensive benefits.1 According to a study published in Health Affairs, 74% of “low-income beneficiaries…received no dental care.”2 While teaching patients about preventive oral healthcare is important, it’s vital that people receive regular cleanings and maintenance at the dentist. It is difficult to hold patients accountable for their oral health without giving them the resources necessary for them to achieve this basic level of care.
I often feel like I am not making much of a difference in the grand scheme of things, because institutional policies which perpetuate healthcare disparities are still in place, and I am simply operating within that framework. I am always taken aback when patients thank me for just taking the time to actually listen to them and explain treatment options. Without a change in the institutional framework and reform in our healthcare legislation these issues will continue to plague patients. We cannot remain complacent bystanders. One of my favorite college professors put it best when she stated that focus on private benefit “could lead to non-existence in the deprivation of the public good.” We must hold ourselves accountable to a higher standard of citizenship and advocacy. I have hope, and I have faith.