A few years ago, I got this e-mail from a complete stranger. His
words made me pause and reflect on what I was doing with my
career. When I was an associate, I spent one day a month at a free
clinic in Seattle. Fast-forward to two practice purchases, the neverending
CE chase and a new baby - volunteering was the last thing
to eat on my very full plate.
I'm not sure how he got my e-mail address; I'm assuming from
my website where it mentions volunteer work. Here you have
someone who appears to be truly down on his luck and saw in the
media that someone died from a tooth infection. He was scared and
couldn't find anyone to help him.
Dear Dr. Scoles,
I am writing to you very much in desperation. I called the Union
Gospel Mission many ti mes to make a dental appointment. I t is the
only place that mentions about dental surgery and teeth restoration
and not only routine procedures. I left messages mentioning that I
am suffering. H owever, nobody ever called me. Today I read about a
man who died of dental infection and I am afraid.
After some research today, I am finding out that you are one of the
doctors w ho volunteers at the Missi on. Could you please help me get
an appointment? I can't help feeling a bit asha med of my situation
and even to show my teeth. But I can't keep on l i ving like this.
I do look forward to hearing from you.
It took one e-mail to get him an appointment; thirty seconds to
make a profound difference in someone's life. As dentists, we have
a unique ability that not many others possess: we can remedy acute
pain for another person in minutes. We do it every day. People pay
us to do it. It becomes routine. I will leave it up to the philosophers
as to whether we have an obligation to do work for free.
I still have a very full plate, but I am down to four days a week
and I am finding a bit more balance in life. I'm going to start volunteering
at the clinic again. Sometimes, it is too easy to get caught
up in your own life and stress over truly insignificant things, when
just down the road, there is someone who has a legitimate fear of
dying from a toothache. I am glad this person e-mailed me. It definitely
made me do an inventory on my life priorities.
A few weeks later, I received this e-mail:
Hi Dr. Scoles,
Just wanted to let you know Dr. Paul took care of me last
Friday. He is great! His hands are so light! He extracted two
upper teeth. I still have many teeth left to be extracted but
those were the worst and most painful ones.
I was a bit sad not to see you at the Mission. I am sure I'll meet
you one day. I have your website bookmarked. When things get
a little better for me, I want to volunteer my time at/donate to
the Mission. I've learned quite a bit through my hardships.
I just want to thank you again from the bottom of my heart.
Obviously, volunteer work benefits a lot of
people, but it can also be a very gratifying personal experience.
Unfortunately, it is not without its pit falls. I will give my perspective on
volunteer dentistry and things you should look out for when deciding
to give back.
There are several avenues to do volunteer dentistry overseas. It is a
very virtuous thing to do. If you are at the place in your career where
you can shut your office down for a week or two, this is definitely something
to consider. For me, there is so much unmet need within 10 miles
of my office that I have never seriously considered these trips.
There are all kinds of ways to find people who are in legitimate need
of services who don't have the means to come see us. Most state dental
associations have a donated dentistry program. There are numerous types
of free clinic settings, religious groups and even mobile dental vans that
rely on dentists and auxiliaries volunteering to complete their mission.
With the donated dentistry program, you are seeing the patient
through all their treatment, and in some cases, you may elect to do their
recall as well. It is cost effective in that specialists are on board, as well as
the local dental labs. Once on the provider list, they will send you a candidate
who has already been screened and you determine whether you
would like to treat him or her. On paper, it's a good system and we have
treated several very appreciative patients over the years. The down side
is no-shows. In the vein of "no good deed going unpunished," nothing
sours you more than to block out two hours of your schedule for a probono
case and have the person not show up. This has happened on a
consistent basis. Now, in our initial meeting with the patient, we stress
that one cancellation will result in their dismissal. We have had patients
demand certain procedures and they show little gratitude, and we have
had patients bring us cookies and are an absolute joy to have in the
office. Guess which ones we allowed to stay on for recall care?
My wife and I were leaving a restaurant in our town and a homeless
woman came up to us asking for change so she could go to the
University of Washington Dental School to get a tooth extracted. We
gave her a few dollars and walked away. After about 20 steps I stopped,
went back, gave her my card and told her she could come to my office
and I would help her. She was there the next morning and we extracted
two severely decayed molars. I think the staff got as much out of it as
the woman did. Bottom line, it feels good to help people and it's great
for office morale. Most patients will see you in an altruistic light when
they find out you are helping others this way. Unfortunately, having a
homeless person in your lobby during normal business hours might put
off some of your other patients.
While volunteering in the clinic setting, there is usually no shortage
of patients and you can really make great use of your time. I've
heard it from the dentists who do mission trips; they are working 12-
14 hour days just trying to keep up. I don't think you need to kill
yourself, but if you spend eight hours at a clinic, you are going to get
a workout. At the clinic where I volunteer, most of the people we see
are physically living in the building and are a phone call and a few
minutes from coming down. We also have a high volume of walk-in
patients who will sit in the waiting room all day to be seen. This is
hard work with dated equipment and materials. If you establish a
track record with particular clinics, they might be able to order specific
things you can't live without. The clinic is the first place I call
when we are upgrading or cleaning things out since most clinics are
on a shoestring budget. Things that have fallen out of favor for us are
wonderful additions for them.
I know that some people will have a free dental day and block out
a whole day for treatment of local people who are in need. I think this
is an outstanding idea and something I plan to do soon. Not only are
you helping people, it's a great team builder and potential marketing
gem. You have to advertise it to make it work, and you can get a lot of
positive press at the same time. I think it's a good idea to solicit your
product reps for donations to help defray some of the overhead.
Veterans are another population to reach out to - people who have
served our country, might have been wounded and are now out of the
military trying to find care. In some instances, VA locations are hundreds
of miles away and if they can get there, they will only get basic
treatment. You may have a perfect candidate in your office, or you
could find someone through a local veterans support group.
I don't think there should be any shame in receiving marketing
benefits from doing a good deed. If you do one day of it in your career
and advertise how you are the Mother Teresa of the dental world, that's
a different story. I spend a lot of time at the clinic in Seattle. I am
proud of it, my staff is proud of it and we share it with our patients. I
have a "giving back" page on my website, and I have received a lot of
positive comments from patients about it.
As humans, I think we can all agree there is something really heartfelt,
both for the receiver and the giver, when you help others directly.
Writing a check cannot elicit this feeling, nor does it have the same
value. As dentists, we have a unique skill set that can provide a profound
impact on other people's lives. As responsibilities pile up, it is
harder and harder to make time to do charitable dentistry. My suggestion
is try to set some time aside. Give volunteering a shot and see how
you feel about it. It is great for gaining perspective on what is truly
important in life, and it is good for your soul.
| The Pros and Cons of Pro-Bono Cases
The Dentaltown.com message boards
are teaming with discussion about the
ups and downs of offering free dentistry.
Here's some of what Townies are saying.
Search: Pro Bono
We do cases through donated dental each year. The patients are
very appreciative and it's so easy. It costs really nothing more than
your time as the lab does the work for free. If every dentist did
just one case a year, it would make a huge difference. Check out
www.nfdh.org for more information about Donated Dental Services.
I recommend you only offer pro-bono work outside of your own
office. You should only do free dentistry when it's on your schedule
and not have clients walk into your office trying to talk you into
doing work for free. Go on a dental outreach trip to a third-world
country. There is a time and place to offer free care, but during
business hours, you need to concentrate on your business. You do
not want a packed schedule with people who can't afford any
dentistry but heard you offer work for free.
The no-shows killed treating needy patients in our office. Los
Angeles is a big place and we now have the opportunity to volunteer
our services, with medical services for the needy at large
organized free clinics. Dentistry is the most requested service and
now that we have it wired (we take two bags, one with our special
setups, the other for bringing the used stuff back), we can easily see
30-40 patients per day (thank goodness for amalgam). All the
patients are extremely thankful and the staff is so excited, they
have even been known to drive back to the office to run instruments
Be careful with clergy and shelters. I did work for a women's
abuse shelter. Let's just say, more women needed work than I really wanted to spend time doing. Half a day a
month turned into two full days, turned into late-night
calls, turned into patients starting to ask for (almost
demand) veneers and cosmetic work, turned into starting to
affect my normal practice. I only got a thank you a handful of
times for the more than 200 people I treated. I no longer offer it
in my practice - best decision I could have made. Work in a county
clinic. Go on a trip to a third-world nation. This will be more
enjoyable, trust me. I am not saying every patient was ungrateful,
just that not enough were happy.
Jordan "skibum" Pilling
I have done a few missions and love every second of them. I
also do some charity case-by-case in my office. Just depends on
I had a local charity call and ask if I was willing to help out a guy
who lost his job and was in pain; I said sure, send him over. He
broke off an upper lateral and had severe perio. The tooth was
hopeless. The guy comes in late, smells of booze, with several missing
teeth. I tell him he needs an extraction and I will do it for no
charge. He says he won't do it unless we replace the tooth, so now
we need a full-mouth debridement in order to make the flipper.
Long story short, he pretty much expected it to be free and didn't
show up for his debridement and I got burned. Never again. How
much is enough? We donate and support so many causes, employ
people with decent jobs, work on people with transmittable diseases,
give to every school fundraiser. Enough of this entitlement;
learn how to say no.
We ran a free dental day out of our clinic at the start of the month.
It was run on a Saturday when we normally aren't open. It was a
great experience and the staff donated their time. The local paper
ran an article on it and we were overwhelmed by the response.
Sadly, we couldn't fit everybody. We plan to run one every three-tofour