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Family First Health

A community health care center

Meet the staff: Angel Wagner

angelTitle: Clinical Support Staff Supervisor, Lewisberry

Years at Family First Health: 10

Angel Wagner, a clinical support staff supervisor at our Lewisberry office, loves nursing and loves to serve.

“I believe everyone deserves to have the best health care possible,” said Angel. “A lot of our patients have enough barriers in their lives to overcome, and finding a health care home they can trust to get the quality care they need, is awesome. That’s why I work at Family First Health”

In her free time, Angel is involved in several outreach ministries including the Power Pak Program, Soul Food Ministry and Neighborhood Fun Night. Her work in the community also allows Angel to have a fuller connection with patients, as they benefit from many of the programs.

“I love working at Family First Health and plan to stay until my nursing career ends” Angel said.

Meet the staff: Missi Ensminger

missiTitle: RN, Nurse-Family Partnership program

Years with Family First Health: 32

Missi joined Family First Health’s medical department in 1983 seeking hours and an environment that would work for her young family. As an RN, her work allowed her to care for the same patients she had been seeing in a hospital setting, but on a schedule that worked for her new family. As part of her job, she received training in HIV testing and counseling.

She grew her role to become the nursing supervisor of the Hanover, Lewisberry, George Street and Hannah Penn centers for five years before starting work with the Nurse-Family Partnership (NFP) program.

The Nurse-Family Partnership program allowed Missi to get back into what she loves: Interacting with patients. By meeting with patients in their home environments, the program allows Family First Health to tailor care to each family in order to provide the best possible outcomes for mothers and babies.

Through her work, Missi has the opportunity to assist patients throughout the York area that may not otherwise have a voice in their health care.

In her spare time, Missi enjoys working in her garden; cruising in a 1962 MGA convertible recently restored by her husband, Tom; and bragging about her son and daughter-in-law’s photography business.

Meet the staff: Brittany Hanchett

brittany

Title: Nurse Educator
Started at Family First Health: June 2015

Brittany has always wanted to help people — it’s one of the reasons she decided to go into the field of healthcare.

“In the medical field, you see people at some of the best and worst times in their lives,” Brittany said. “Being able to be a part of those good moments and offering support in difficult times is a very special privilege.”

For her, one of the best parts about working for Family First Health is its connection to the community.

“I love the way this organization reaches out to the community to offer assistance wherever it can,” she said.

When not working at Family First Health, Brittany can be found outdoors. She enjoys everything from running and hiking to spending time at the beach. She also has an adorable 1-year-old daughter who has no trouble keeping her busy!

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.

 

Restructuring Our Team

In our most recent post, we made mention of the awesome dental team we have here at Family First Health. As dentists, hygienists and dental directors, we all know how important this team is! We also know that each team is only as strong as its weakest link: Each member plays an integral part in the success of the practice.
How do you establish a strong, effective team; maintain engagement; and promote job satisfaction? We have been asking ourselves and (and our employees!) these questions for years.
We’ve found that a lot of it has to do with one thing: Balance.
There are challenges in finding that balance when your team has multiple moving parts. We’ve found success thus far in restructuring the department and allowing everyone to function at their maximum potential. As a part of this process, each individual identified his or her strengths or areas of interest, and we came up with a plan on how those strengths could be used to our best advantage.
One way we’ve seen this play out was when two of our hygienists expressed interest in obtaining licensure that would allow them to administer local anesthetic. They presented their proposal to us with ideas on how this could benefit the practice — demonstrating initiative, fulfilling the CE obligations and obtaining licenses — and we played our part by offering feedback and encouragement and creating a supportive environment for continuing staff education. We’d already identified their ability to deliver anesthetic as a great asset, and our hygienists are happy to be using their new skill to help patients.
Adjusting your department’s structure can feel intimidating, but if there’s one thing we’ve learned, it’s that continued improvement often requires adapting as you grow!