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Family First Health

A community health care center

Kids Against Cavities takes oral health to Adams County

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Today, our Kids Against Cavities went somewhere it’s never been before — Adams County!

Our staff visited kids at VIDA Charter School to provide mandated school screenings. Also, the school decided to bring us kids who, according to their paperwork, did not have a dental home or hadn’t visited the dentist in more than 6 months.

Some even admitted that they’d NEVER been to a dentist. And we’re talking about kids up to 6th grade. We are working to change that.

20160204_084705The goal? To check on the status of their teeth AND encourage follow-ups and routine care. Papers go home with the kids whose parents can indicate they already have a dentist or ask for help in getting their kid into a dental home — maybe the Family First Health Gettysburg office perhaps!?

Our dental directors Joe and LaJuan Mountain and our new dentist Maria Fletcher saw 93 kids in only an hour and a half Thursday. That’s a lot of teeth.

Many of these kids told us they did not brush twice a day … and for many reasons. Some said they just forgot. Others said they were rushed to the car in the morning and told not to waste time doing so. Another told me that her sister threw out her toothbrush and her parents didn’t buy her a new one.

During the school screenings, our staff count teeth, check for sealants and cavities, check the overall hygiene and of course, note a need for follow ups and urgent care.

During the month of February, we’re raising money to help Kids Against Cavities reach more children. It is Children’s Dental Health Month of course.

In 23 visits to York, Pa., schools and child-care programs, Family First Health’s Kids Against Cavities program treated 1,887 kids. Dental staff identified a total of 2,351 cavities. So we want to raise $1 per cavity found.

Through these photos of our work at VIDA, you can really get your mind around EXACTLY WHERE your donations are going. It’s as simple as this:

$25 – Gets toothbrushes and toothpaste into the hands of 10 children.

$50 – Covers the cost of a dental cleaning for one child.

$75 – Covers the cost of a comprehensive oral exam for one child.

$100 – Covers a panoramic X-ray of a child’s mouth.

The work this staff does taking dental care into our schools is amazing and empowering. The help of our community enables us to keep doing this work.

Click here to donate. Community donations go directly into Kids Against Cavities to provide more screenings and cleanings.

Filling a dental need

20151027_093129Who loves teeth as much as this guy? We do.

I just wanted to share something with you guys that really reminded me of the good work that’s done here.

I was checking on other dentist offices in the Hanover-Adams County area that accept Medicaid patients. There are a LOT of dentists in Hanover-Adams. A lot. Only two in the whole area do accept Medicaid — and one of them is Family First Health.

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Why? Well, Medicaid doesn’t really offer a lot to dentists who accept Medicaid in terms of reimbursement. So it’s easier and more cost efficient for many to just say no. Many offices offer other payment plans for potential patients. Here, we do both.

We treat the whole patient at Family First Health — mouth. Because a healthy mouth is an important part of a healthy you.

Checking for other Medicaid options in the area was a frustrating experience. Say you’ve got a tooth in serious pain — I can’t imagine checking with as many places that I did today.

So don’t give up, patients. Here at Family First Health, we want to help you and your teeth.

Come and see us at our three sites that offer dental services – York, Hanover and Gettysburg. We also take our dental tools into the schools to reach kids where they learn and get them started on good oral care.

York’s dental staff sponsors family’s Christmas

It all started with a man coming in for his dental checkup with his 2-year-old grandson, Jaxyn, in tow. A photo circulated around the George Street dental staff.

A grandfather unable to walk well, still willing to get on the floor to talk teeth and play with his grandson.
A grandfather unable to walk well, still willing to get on the floor to talk teeth and play with his grandson.

Gary and Marty are raising their three grandchildren — Gracey, age 10; Carly, age 7, and 2-year-old Jaxyn. They didn’t have enough money to do Christmas this year. So that’s where dental stepped in.

Today, the family stopped by for a surprise. And boy, were they surprised. The gifts just kept on coming for all three kids, and of course — Grandma and Grandpa. The staff also got Jaxyn a new bed and mattress, which he immediately started jumping on.

20151221_123713“We haven’t had a Christmas in years,” Gary said, opening his gifts of pj pants, new shoes and more. “It’s all about the kids.”

Marty spent most of her time bouncing from grandkid to grandkid as they showed off their new dolls, nail polish, clothes and more. Each time, the girls looked up with amazement after gifts were revealed.

Our CEO couldn’t make it down, but dental staffer Rolando Nieves presented the family with a Weis gift card, which Marty says they’ll use for a turkey.

Every few seconds it seemed, Marty was thanking the staff, wiping away tears and exclaiming she couldn’t believe all they had done.

But that wasn’t all.

One of our staffer’s mother is the pastor at St. Peter Lischey’s church in Spring Grove. For all of Advent, the congregation has been collection donations for the family. Pastor Kathy presented the family $900 toward their Family First Health dental bills.

Taking slow, deliberate steps with his cane in hand, Gary made his way over to give out hugs of thanks. Marty turned to him in awe, saying maybe he can get his teeth fixed to.

Marty kept trying to clean as she went, with staffers taking trash bags and wrapping paper from her hands. She even offered to come clean our offices in thanks.

Instead, she joked the kids will give thanks by spending more time caring for their teeth.

And the staff, from the looks on their faces and tears wiped away, they had all the thanks they needed.

“Santa Claus is real,” Gary said. “I believe it now.”

Before break was over, staffers helped load up the car full of three boxes full of toys. It was likely a Christmas their family and ours will never forget.

Watch a video with photos of the whole thing below.

Busy vs. Productive: What’s the difference?

In our last blog post, we introduced the topic of the business of dentistry and the five areas we focus on to develop our business skills: budget, support staff, provider buy-in, revenue and the difference between being busy and productive. Over the next several posts, we’ll cover each topic in more detail.
First up? Busy vs. productive.
Busy is a word often used in dentistry, and it can be synonymous with working hard. Or, it can reflect full schedules with lots of unguided activity. In fact, being “busy” in a practice can be a desperate situation if the practice is not generating adequate revenue.
In our world, busy and productive have different definitions. Busy is working hard in a way that is not connected to the fiscal health of the practice. Productive is meeting the needs of all interested parties while generating adequate revenue.
It can be difficult to know the difference. To be productive you have to understand your patient demographics, the skillsets of your providers, practice overhead and how much revenue is generated by each procedure. Once leadership understands the variables that shape your practice, you can use them to set a productivity goal.
Acting with a productivity goal as a guide will help to create harmony in your practice: Staff feel as if they can manage their work load, patients’ needs are being met and providers are providing reliable care — all while the practice is generating enough revenue to cover its expenses and produce a surplus to allow for long-term planning.
How do you become productive?  View the dentistry your practice produces through a different lens.
  • How long do procedures take in your practice? 
  • What time of day do you and your patients prefer to have procedures done?
  •  Is the practiced staffed at the same level throughout the day?
  •  Do you have enough equipment to have multiple providers complete the same procedures at the same time?
  • What procedures are your providers good at? 

 

Once these questions are answered, the practice can began the journey toward productivity. Start by reviewing the monthly budget to determine how much money the practice must generate to cover its costs. Decide how many days you have to achieve that goal, then set each day’s productivity goal accordingly.
Once you have an idea of how productive your practice needs to be, decide your procedure mix for the day based on revenue potential for each procedure, demand for procedures and the skillset of your providers.  Create a template of ideal day scheduling, and direct your front desk to schedule appropriately.
At Family First Health, our goal for our dental practice is to have the day’s productivity goals met before lunch and the month’s productivity goal achieved in the first half of the month.
We’re an ambitious crew!

 

Stay tuned for upcoming posts as we dive into budget, support staff, provider buy-in and revenue.

The Business of Dentistry

Many people believe that clinicians don’t make good business people. This statement has always bothered us — we believe operating a dental practice is about teamwork, making quality decisions, knowing when to lead and understanding when to follow.  
 
Some people think operating a dental department within a federally qualified health center (FQHC) is easier than within a private practice. In reality, it depends on the FQHC and the private practice being compared. 
 
In our work, there are five areas we focus on that can help to develop your business skills in a FQHC setting: 
  1. Budget: We work closely with our CEO and CFO in developing our departmental budget. An accurate budget for the upcoming fiscal year is critical to the success of the department. If your budget is not accurate, it’s less likely you will meet budgeted expectations, leading to insufficient revenue. If you overachieve what was budgeted, that could be seen as a positive — but if this is significant, you missed the opportunity to budget for critical spending. 
  2. Support Staff: Is your current staffing at the appropriate levels? Too many or too few could be equally devastating. Too many will drain the budget and cause a level of unproductivity because the staff will be continuously idle and more difficult to supervise. Too few staff will leave the department drained and exhausted because of the workload. Understanding the appropriate staffing is a result of understanding the tasks that you are expecting your staff to achieve.
  3. Busy vs. Productive: Understand the difference, because they are not the same. Being busy but not productive is a recipe for disaster. In our world, busy means viewing the practice in terms of visits, with a disconnect as to much how much dentistry is produced. Productive is when your patients are seen, their needs are met and quality dentistry is produced.
  4. Provider Buy-in: Are your providers on board with the budget for the upcoming year? Do they understand what it will take for the year to be a financial success? Provider buy-in will improve the culture of your department while improving their dedication to their work and to your department’s mission and goals.
  5. Revenue: Understanding what and who generates revenue in your practice will help you to invest in areas where you will see the greatest return on investment.

 

This list could be tripled and still not take into account half of the decisions that are juggled by most dental directors. However, using this as a starting point can definitely give a solid foundation for quality decision-making. If you approach your CEO and CFO and let them know you want to better develop these business skills, they will eagerly help. They will see that you have the desire to learn their language.

Community Service as A Vehicle to Increase Visibility

How do you position yourself and your practice to be the local go-to resource for dental information? Networking? Making yourself available as an expert resource?
 
We believe that community service is the best vehicle.
 
 
For us, we’ve found community service to be personally rewarding and an effective professional advertisement to the community for our clinical services. More importantly, it is an opportunity to make a difference in our community.
 
We are, admittedly, busier than we sometimes realize — we can’t possibly fulfill every community request of our time. As we select service opportunities, we aim to engage our community in ways that are realistic, sustainable and rewarding.
 
Years ago, we viewed community service only through dental initiatives. This has its benefits, but it can leave you feeling limited. Over time, we made a concerted effort to diversify our community efforts. Developing our Kids Against Cavities campaign through Family First Health allows us to funnel most professional requests through that program.
 
Outside of professional community service, we volunteer at our kids’ school, assist in local sports programs and accept invitations to participate on local community boards. Engaging with our community on this level has been very rewarding for us.
 
But surprisingly, the aspect we’ve found most rewarding is when people find what we do to be inspirational. As professionals, we’ve all experienced the pleasure when a patient decides to pursue a career in dentistry because of you. That feeling is amplified when you inspire someone to pursue a healthy lifestyle because he or she encountered you on a community level.
 
In the end, it would probably be acceptable to limit our social contributions to what happens chair-side on our dental offices each day. Do we have an obligation to do more? The question provides an opportunity to reflect on the individuals that were generous with their time and contributed to our development. Now, we’re committed to passing on our expertise to future leaders.

 

Tooth decay is an avoidable agony for kids

Recently I wrote this article for a local newspaper, The Gettysburg Times, on the behalf of our local oral health task force. I wanted to post it to our blog due to the positive feedback we received from the community. If you are curious as to how we have incorporated an “under four” initiative into our practice, please reach out —we are always glad to share our experience.
Tooth decay is an avoidable agony for kids
By Dr. Joseph Mountain, Family First Health
According to the Centers for Disease Control, tooth decay is one of the most common chronic childhood diseases. But what exactly is tooth decay? Tooth decay is a carbohydrate-fed bacterial process that thrives in an acidic environment. Many of the foods we eat have carbohydrates and contribute to the acidic environment. This bacterial process results in the development of a hole in a tooth, referred to as a cavity or “tooth decay.”
 
Thankfully, tooth decay is a preventable condition. However, if left untreated, it can become painful and debilitating. Untreated tooth decay can progress to cause dangerous infections, hospitalization and even death.
 
Early in my career as a dentist, it was normal to schedule a child’s first dental visit at 4 or 5 years old. But as with many diseases, the youngest among us are the most vulnerable. We now know that focusing on prevention and early intervention is much less expensive over time, and provides better outcomes.
 
As a dental director at Family First Health, I have had the pleasure of interacting with many families in southcentral Pennsylvania. Living and practicing in this community, I have witnessed the unnecessary suffering caused by tooth decay. Older children often miss days of school and suffer with unimaginable pain. For infants and toddlers, the situation can become critical because it often goes undiagnosed until the child has a visible swelling or is unable to eat. In these cases, restoring the affected teeth often requires treatment in the operating room.
 
Education and early intervention is key in building a healthy community. Understanding this, we encourage parents to bring their infants into our dental offices before the eruption of their first tooth. We’ve also begun experimenting with medical and dental integration, in which providers work together to offer dental visits during well child visits. It is a tremendous benefit to have medical providers who can talk with parents on how to maintain their kids’ teeth in a way that is both easy and safe.
 
Family First Health is not alone in the fight to improve the oral health of children in our communities. We have combined forces with other like-minded professionals and community leaders to form the Adams County Oral Health Task Force.
 
This year, the task force will begin to distribute literature to educate families on the benefits of working with their family dentist to have their kids begin these dental visits earlier. During an infant or toddler exam, the parent sits in the dental chair while holding the child. The provider examines and brushes teeth and applies fluoride. Even this brief appointment affords the opportunity to identify problems and provide valuable education on how cavities are formed, plus how to prevent cavities and keep a child’s teeth healthy.
 
When visits are started early, the child develops a positive view of dentist visits — they view the dentist’s office as a friendly place where they get a new toothbrush and prizes.

 

In building the relationship from a young age, we hope to be able to make a difference in our community’s health and quality of life for years to come.

Loyalty

Loyalty: The quality or state of showing complete and constant support for someone or something.
What does it mean in today’s dental practice? Work — hard work!
So how do we go about establishing loyalty with your patients, dentists, hygienists and other staff?
Patient loyalty is challenging because each patient is different. Therefore, we must ask how we identify the core requirement that each patient is seeking that will guarantee his or her loyalty.
Everyone in the office was tasked with this mission. From providers (both dentists and hygienists) to staff, we all play an integral part in maintaining customer loyalty. Although there is great diversity within this group, we see two common themes: To improve oral health and increase satisfaction with services.
Where do you start?

With the providers, we started by building on the forces that drive them and their desire to help. We all agreed that it is not enough to just show up — we had to bring passion and a determination to connect with and assist our patients in obtaining and maintaining oral health.
We know: It’s not easy. But we decided the only way to accomplish our goals was to approach it on a patient-by-patient basis and focus not only on the patient’s specific needed treatment but on the entire patient. This gives each provider great autonomy to engage and treat their patients and works to ensure that each patient believes and feels we are here to help.
With the rest of our team, which consists of assistants and front desk staff, providers have focused efforts on supporting them in their roles, providing training and revamping areas identified as ineffective. This allows them to create and manage projects of improvement, all while increasing job satisfaction.
What we realized in this process was that we were building strong relationships that benefited from our hard work to earn the trust of everyone we interact with daily.
With that trust earned, we’re well on our way in the journey to loyalty.

The provider-driven practice

During the day at a federally qualified health center, there are many patient-care decisions to make. Therefore, our practice is heavily provider-driven: We rely on our dentists to lead the team and drive the decision-making process to achieve the best results.
As dental directors, we make this a conscious effort each day.

 

It would be very easy to minimize provider input and allow non-clinical employees to direct or manage the flow of the practice. But we’ve found that when non-clinical employees are tasked with managing clinical issues, the patient’s needs are often lost in the shuffle — a definite problem. The patients must know that their dentist is establishing their treatment plan based solely on their presented needs.
How does effort this look in practice?
We empowered our providers to be the primary decision-makers in the practice with issues that affect patient care. Our providers are encouraged to:
  • Share their clinical expertise: Explain to a front desk person why the swollen emergency child needs to be seen immediately, or take the time to develop a new dental assistant
  • Engage in system development: Decide how supplies are organized or how patient care schedules should be developed
  • Allow room for experimentation: Providers are intelligent and well-educated; their ideas should be considered and tested. 

 

According to feedback we receive from our providers, the provider driven practice allows for a high level of job satisfaction. Encouraging their participation in how the practice operates and involves intensifies the providers’ level of investment in the practice and ensures we’re continually moving toward of goals and vision for Family First Health.