The Real Access to Care by Trevor Lines, DDS

The paradigm shift
For me, the shift was a long time coming and it happened along with a wholesale change in my worldview—also known as a midlife crisis. As with every good midlife crisis, the question “Why?” was central and weighed heavily on my mind. Why am I here in life? Why did I go to dental school? Why am I a dentist?

I started my practice in 2006 and have been working there ever since. Like you, I always tried to be the best dentist I could be. Like you, along the way I saw many successes and my share of failures. Why does most treatment succeed and some fail? Technical skill is an important factor, but not nearly as important as the oral environment in which we work.

What I found, over time, was that most of my patients who got the work done—who filled the teeth that had cavities, who crowned the teeth that had structural weakness, who got the appropriate perio treatment, and who came back for regular recare visits—those patients got healthy and stayed that way.

With our help, they changed their oral environments and then they worked hard at home to preserve the work we had undertaken together. Together, we achieved health. A realization slowly dawned on me that we, dentists, were there to heal.

At our office, we no longer speak in terms of “needs” for any procedure. We now speak in terms of health. The term “pending treatment” is painful to our ears. Instead, we have concerns for our patients, we have sick teeth and unhealthy mouths that we have the opportunity to make whole if only we can provide our patients with the access to care that they need.

Access to care
When I was in dental school, the phrase “access to care” held little meaning to me. Access to care was something that the disadvantaged had to worry about, and certainly none of my patients—people like me. If people didn’t have healthy mouths, it was their own fault. Not mine.

What I discovered is that everyone wants a healthy mouth, but many people cannot cross the barriers that are in their way of having one. As far as I can tell, there are three unique obstacles people face in getting the care they need: time, money and fear.

For many people, getting in front of a dentist is the biggest challenge of all. Most people simply cannot afford to take time out of their busy work and school schedules between 8 a.m. and 5 p.m., Monday through Thursday, to get in for a cleaning. It’s just a cleaning, after all, and missing work or missing school has a high cost, so they put it off. Wouldn’t you? And if a patient can’t make it in for a hygiene appointment, then how can any disease be diagnosed? How can we manage the patient’s caries or perio? How can we care for a patient who can’t get to our office during the week?

We can’t.

Solutions to the dollar problem and the fear problem—while very difficult or even impossible for some to overcome—do not require us to make much of a change to the way we practice. The problem of restricted hours is easily solvable, and it is our moral imperative to solve it, but it requires a solution that will cause us to shift the way we work. We have to be available when the patients are. People aren’t available on bankers’ hours, but they are available on pharmacists’ hours. Those are the hours we need to embrace.

Patients will repay you in dollars, they will repay you in referrals, and they will repay you with the opportunity to bring them health, to serve them and to fulfill your calling as a dentist.

The answer is time
Despite what your team might tell you when you try to expand or alter your hours, patients can and will come to the dentist at all hours of the week. They will come on Saturdays. They will come on Sundays.

They will come at 7 and 8 o’clock at night. And they will be grateful for it. They will be grateful that you are there to care for them. They will be grateful that they can afford to have a healthy mouth because the cost—not in dollars, but in time—is one they can afford.

They will be grateful and they will repay you. They will repay you in dollars, they will repay you in referrals, and they will repay you with the opportunity to bring them health, to serve them and to fulfill your calling as a dentist.

Whether we want to acknowledge it or not, our profession is in a state of upheaval. We are being challenged by corporate dental offices that often boast better systems, more access to capital, cheaper supplies and expanded hours. They are open on Saturdays and they will be open on Sundays. They are—or will be—open early in the morning and late into the evening. We have to be, too, if we want to stay in business.

The giant advantage we hold is that we care. We care more about our patients and our teams than we do about dollars. And if we can offer the same hours, our patients will come to us rather than the office down the street where the team may not be as happy or caring, where they have “pending treatment,” and where our patients never felt quite comfortable with the sales pitch.

Serve, heal, expand
The answer to The Big Why is now written on our hearts and on the front door of our office: “Here to Serve.” Let’s never forget that our job is to improve people’s lives—that we are only as successful as our patients are healthy, and our patients are only as healthy as their access to care.

Our patients need us to be there and they need us to serve them when they are available. Let’s give them the access they need by banding together and expanding our hours. Let’s change our paradigm before it is changed for us by the evolution of the dental marketplace.

We are healers, you and I.

Let’s serve. Let’s heal. Let’s expand.

Trevor Lines, DDS, graduated from the University of the Pacific in 2003 and is a member of the ADA and ASDA. After a couple of years working as an associate, Lines purchased his own practice. He has recently purchased a practice in Gilbert, Arizona, which he named BlueDot Dental, and has plans to expand and hire an associate.