Letters: System broken at Gallup Indian Medical Center Dental

Gallup Indian Medical Center Dental (where I was employed) as a whole generally prefers to extract teeth rather than to save, and when they do place fillings, these are generally substantially larger then they need to be, and often performed incorrectly.

Why? Dental schools are taught almost exclusively by dentists who have practiced their entire careers in institutional care such as the Indian Health Service or military. More than two decades I have been in the private sector, so I have a far different perspective. In the private sector we are concerned with having the best possible outcomes for our patients, and with being as productive as possible. The general policy of GIMC Dental is to do basic dentistry, and with limited resources this is viable.

By the same token, if the existing dentists at GIMC Dental were to actually perform a day’s work, and be paid the way we are in private practice, substantially better care would be the result.

I will explain this all-important point. In private practice I routinely see 20-25 patients per day with on average of four or more payable procedures per patient. While the assistant is placing and finishing several fillings in one chair, I already have at least two more patients in two other chairs, and I routinely run three to four chairs plus the hygiene.

For maximum productivity I will do as much dentistry as possible within the time frame that I have, meaning instead of restoring one tooth at a time, I will prepare every tooth in that area based on areas I must anesthetize.

At GIMC the dentists see 5-12 patients per day with at most two teeth at a time restored, and any procedure that might be spread out over multiple visits (such as root canals) they do. They then complain they are overworked, yet still believe they should be paid the same as in private practice.

Much of the time they are in their office chatting, whereas in private practice I seldom ever got to even sit in my office chair (except to do notes), as I was usually far too busy.

My better half (my wife) is a pediatrician, seeing on average 50 patients per day, often working on her notes until 9 p.m.

These dentists at GIMC are here because they could not survive in the private sector, and all they have ever known is institutional dentistry. Some seem to be allergic to work, some are borderline incompetent, and this is why nothing ever gets done in terms real patient care. The system is broken and needs to be fixed.

David McGuire
Gallup, N.M.

Happy to see trash bags along the highway

On Sunday, April 22, I was returning from a Grand Canyon Trust work weekend at Kane Ranch, near the North Rim, when I turned east at the intersection of U.S. 89 and U.S. 160, and was surprised and heartened to see trash bags bulging with roadside litter all the way from Tuba City to Shiprock.

A lot of people did a lot of work to clear the landscape of unsightly litter and I’m sure they did it in hot, windy weather. Sadly, trash is commonplace in the West and all those on Navajo who contributed to the cleanup effort are to be commended.

I hope the effort is sustained. Unfortunately, when I arrived back in San Juan County, New Mexico, litter blighted the landscape as always. Those community members along U.S. 160 clearly want to “walk in beauty,” and the land certainly is beautiful. As a neighbor in New Mexico, I wish we would follow their example and keep our roadways as clean. It makes a difference.

Thanks to those who made my drive a pleasant and scenic one.

Hart Pierce
Aztec, N.M.

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