Not a month goes by that a patient doesn’t bring a flowering plant, doughnuts, or other such present to the staff at the Bucksport Regional Dental Center. It’s just another way of thanking the secretaries at the front desk: Alta Clapper and Lisa Gross, dentist: George Quitmeyer, dental assistant: Judy Davis, and dental hygienists: Beth Bunker, Susan Kirkpatrick and Aimee Lanpher.
“One patient brought a huge cake,” Lisa said, with Alta chiming in, “That you and I couldn’t eat ourselves.” Lisa said, “Another made a cake for us and decorated it real fancy,” explaining, “she does wedding cakes.” It’s almost as if Alta and Lisa were family friends. “If they have a pet, they bring it in to show us,” Alta said; “We do families and we get to know families.”
That attitude at the Dental Center prevails partly because of Alta and Lisa’s personalities, but also because Executive Director John M. Corrigan insisted on warm, friendly behavior from the beginning. (He says John is the baptized name, but that it’s obligatory to call a John who’s Irish, Jack.) He said, “My job was to put together a group of people who had never worked together and train them to be a team.”
He met with them every Wednesday for about two years starting in late 2000. Now they meet by themselves. They discuss problems when they come up rather than letting them fester. In the beginning he told them, “We are serving people who are disadvantaged and under no circumstances are we to treat them as if they are economically unlike us.”
Corrigan, who grew up in an inner city neighborhood of Providence, Rhode Island, knows what being disadvantaged is all about. He also knows how to work with people and how to work the system. He’s been dealing with the federal government since the early 1980s, when he started working at the Bucksport Regional Health Center, which, Potter said, opened in 1974 on Main Street in the Alamo building. He’d helped start up two such centers in the 1960s in Providence and said, “I was the bodyguard. The nurses and doctors were afraid to come into the neighborhood.” He said of Bucksport’s Health Center, “This is the rural version of those neighborhood health centers of the 1960s.”
“I’ve been banging on doors since 1995,” he said, meaning the doors of the federal government because it funds the Health Center. “The federal government kept saying we should have dental services.” But the catch was, he said, “The Project Officer in Washington in charge of [funding] wasn’t releasing money to rural places. Their priorities were inner cities.” They told Corrigan to write grants, but Corrigan needed technical assistance. He found a dental specialist from Washington State who wrote a plan for the budget part of a dental center, and that worked. Corrigan got one grant, enough money to provide equipment and to hire personnel, but none to run the center. (The Town of Bucksport added $38,000 to the federal grant.) And he didn’t even have a dentist or a site. As he said of dentists, “They’re not walking around. They’re few and far between and there’s hardly any of them coming to Maine.”
But in the summer of 2000, he found his dentist in George Quitmeyer, who spent his childhood in Africa, the son of missionaries, and hired him without having a dental facility to offer him; there was no space to spare at the Medical Center. Corrigan had just found the building next to Rosen’s Department Store on Bucksport’s Main Street and said to the incoming dentist, “Your job is to make sure the thing looks like a dental facility,” giving Quitmeyer the pleasure of designing his own dental office within the budgetary constraints of the grant.
The Bucksport Regional Dental Center opened in January 2001 and was instantly busy. “Then we were really in trouble,” Corrigan said. “The government never came through for the Dental Center.” He had to make sure the Center paid for itself and supplied services. With no money to keep it going, he was stuck until he had the ingenious idea that he could change the sliding fee at the Medical Center to make it less liberal, thus freeing up funds to provide the sliding fee for the Dental Center. In other words, he borrowed from Peter to pay Paul with the approval of his board of directors, explaining, “It was all I had left.”
The sliding fee system is an income-based discount program. If patients meet the government poverty guidelines by providing income tax and Social Security information, a telephone bill and electric bill, they’re accepted. The minimum charge is $3. At the Dental Center a crown costs $770 before the sliding fee kicks in; a private dentist would usually charge $1,000 and up. A child’s cleaning costs $37 before the sliding fee, an adult’s cleaning costs $56, x-rays cost $24, and a comprehensive exam is $45. A root canal is $450 for a front tooth. The Dental Center does not do root canals on molars.
“After we got [the Dental Center] going,” Corrigan said, “it wasn’t a burden because of the great people who work there. They know there are budgetary things and that they’re there to serve people. And it’s worked.”
In addition to his Wednesday staff meetings, every Thursday he holds a meeting of the licensed clinical personnel, made up of Corrigan, assistant director and business manager Carol Potter, the dentist, dental assistant, and dental hygienist. Potter, who has been with the Health Center since 1985 and who schedules monthly meetings with the dental team, said of the Dental Center, “I have seen continuous growth every year.”
Of the 3,000 patients served by the Bucksport Regional Dental Center, only 700 or fewer than 25 percent come from what Corrigan calls the Declared Service Area. It serves 144 towns in the state.
“When we started,” he explained, “no one took MaineCare (Medicaid).” Perhaps the patients that move them the most, according to Clapper and Gross, are those from area group homes. They’re young adults, troubled kids from broken families. Alta said, “Some of them have never had dental care, and they’re so happy to have care, to have somebody care, treat them as individuals. A boy the other day said, `Thanks for being so kind to me.’ ”
One thing in particular that has made the Dental Center work is that Corrigan made it separate from the Medical Center. He had seen that when dental centers are physically located as part of community health centers with the medical team, it never works out well for the dental team because the entire system is geared towards the medical side of things. Corrigan gave the dentist and his team the freedom to be dentists and supported them. He even gave them a different name. And, like that less traveled road, it has made all the difference.
Corrigan is proud of what the Dental Center has achieved. He said, “Our efficiency and our productivity as measured as units of services rendered per full-time licensed clinician is in the top 2 percent of the country.” He began with a start-up fund of $190,000; the Center now gets $699,000 per year. Although Dr. Quitmeyer will retire next May, Corrigan has already found a replacement in Dr. Elizabeth Archer, who will start practicing with Quitmeyer in August. Archer, now in her 30s, started as a dental assistant. She went on to become a dental hygienist before going to dental school to become a dentist. So for nine months starting in August, the Bucksport Regional Dental Center will have two dentists to cover its 3,000 patients. Judging from the success of the Dental Center, Corrigan may have to hire a second dentist after Quitmeyer retires.