By Alli Regan, MD, SOM ’14
Family medicine resident, Baystate Medical Center
While working alongside the dental hygienist on the UMass Memorial Ronald McDonald Care Mobile during her oral health elective, Alli Regan, MD, had an opportunity to witness a reconnection to the health care system that was unexpected. She also learned the nuances of making people feel comfortable no matter what background they are coming from—lessons that are no doubt serving her well in her internal medicine residency.—Hugh Silk, MD
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| Alli Regan, MD, SOM '14 |
When “Sonia” first walked into the UMass Memorial Ronald McDonald Care Mobile she did not anticipate that she would be visiting the dental hygienist. Instead she had an appointment with the nurse practitioner at the other end of the bus for a pre-employment physical. However she had to wait in line to see her, whereas the dental hygienist, Jamie, had an empty chair and offered Sonia a dental assessment and cleaning.
“Do I have to pay?” She asked. She was reassured that the service was free to patients without insurance. Her next statement was one I had heard before from patients who were afraid of disappointing their health care providers. “Oh no, I haven’t visited a dentist since I was six. Things might look really bad in there.” Again, she was reassured that we were not there to judge, just to help get her started on establishing dental care and referring her to a dentist.
As she slipped into the chair she chatted nervously about her situation. “I moved from out west this past year and had recently found a job. I have a friend here who I have been staying with.”
Jamie took this opportunity to have Sonia elaborate on her social history and asked Sonia if she used any illicit substances. Sonia hesitated before answering, “No.”
“Have you ever used drugs in the past, like pot?” she asked again, nonchalantly.
“Well, I use pot sometimes to take the edge off . . . not every day though. I used to use meth.”
“When did you last use meth?”
“I am six months clean. I haven’t used it since coming here. I’m glad that I gave it up and besides it is harder to get here,” Sonia explained. Jamie just nodded her head as she draped Sonia. I nervously looked at Jamie and copied her cool composure and managed to mask my shocked facial expression. As Jamie readied her tools I took the chance to study Sonia more closely. She was dressed in baggy jeans, a hoodie, and her hair was held back in a tight pony tail. Her eyes met mine and I smiled. “That’s great news about giving up meth—keep it up!” She smiled in return.
“Okay, open up and let’s take a look.” Jamie inspected Sonia’s dentition with her tools while explaining to me what she was doing. “It is common to get small cavities in these areas,” she stated as she pointed in between Sonia’s teeth. After she was done she gave Sonia a break and explained to her. “You have two small cavities, but overall everything looks pretty good.”
Sonia looked relieved and stated she thought she might have “meth mouth.”
“There is some pretty nasty stuff in my mouth . . . I didn’t want to know how bad it was . . . ,” Sonia started. Jamie nodded but again reassured Sonia. Jamie continued with the cleaning. At the end of the cleaning Sonia was given information on the next steps to restorative care and counseled by the coordinator to ensure she would be covered by Medicaid. I was surprised by Sonia’s story and couldn’t imagine another way that she would have re-established her dental care without the Care Mobile.
