There are over 1,400 community health centers in the U.S., and these centers serve 31.5 million patients a year at more than 15,000 service sites. [1] What is it like to work at one of these clinics? Is this a valid career choice that both new and experienced practitioners should consider?

To gain insight into this question from the viewpoint of a practicing dentist, we spoke with Dr. Khushbu Shah. Early in her career Dr. Shah chose to leave private practice to work in a community health center. She enjoys it so much that she convinced her husband to do the same!

Public vs. private practice: How do they differ?

Having practiced in both the private and public sectors, Dr. Shah has seen that some of the biggest differences between the two are in the following areas:

· Dental school debt – The cost of dental school has skyrocketed, and many dentists graduate with a tremendous amount of debt.

“One of the wonderful things about being in public health,” Dr. Shah shares, “is that they provide a public service loan forgiveness. That’s a program that I believe is in all states. In Illinois, if you dedicate 10 years to public health, they help you forgive your student loans. Also, while you’re working in public health, they have national health scholarships that help you throughout. So either it is subsidized or the scholarships will help you pay off the student loans.”

Those who choose to go into private practice earn more, but do not receive this assistance for retiring their debt.

· Mindset – “In private practice it was a different experience,” Dr. Shah recalls, “because it was more production based. It was just a different mindset. Over in public health, I realized the biggest change was I can focus more on patient care, and fully be indulged in just patient care, without having to worry so much about everyday production.”

· Specialty care – A challenge with practicing at community health centers, Dr. Shah points out, is trying to provide comprehensive dental care, as they do limited procedures at these clinics.

“Many patients present with very difficult cases and have years of dental neglect,” she says. “So sometimes we find ourselves performing what we call heroic dentistry. A big challenge that comes to mind is referring to specialty care. So, in turn, this requires us providers to manage a broader range of dental issues.” For example, she takes on more surgical extractions than she would have in private practice.

This difficulty in referring to specialists, coupled with the high volume of patients that seek care at community health clinics, also means that patients do not get comprehensive treatment as quickly as they would in a private practice setting.

· Budget constraints – Many community health centers face severe budget constraints, which forces doctors to think in terms of how to provide the best care possible in the most cost-effective ways. Dr. Shah has found that choosing the right products can make a big difference in this area. For example, Dr. Shah likes to use a single shade composite.

“Single shade composites are often more affordable than alternative restorative materials,” she asserts, “so it allows us to stretch the budgets further and provide care to a larger number of patients.”

Dr. Shah’s go-to single shade composite is Tokuyama’s OMNICHROMA, the first universal composite to shade-match any tooth color, from A1 to D4. “I love that single shade composites can be used for conservative repairs of chipped, fractured or decayed teeth, avoiding the need for more extensive and costly procedures.”

· Patient education – While patient education is important in any practice, it is especially vital in a public health setting. At the clinic where Dr. Shah works, patients come from all over the world.

“I see so many families,” she reports, “and I want to make sure that I’m starting when they’re young. We tell them to bring them as soon as their babies are one year old. They’re surprised. They’re like, ‘Oh, you go to the dentist every six months?’ They just don’t have that concept, because in their countries, they only used to go when there was pain.”

· Rewards – “Where do I start?” asks Dr. Shah. “There are so many rewards, one of them being the opportunity to make meaningful differences in the lives of underserved individuals and communities. We have medical, dental and behavioral health, allowing the patients to take care of all their medical needs in one building. It gives you a very wonderful, overall better health outcome.”

Dr. Shah also likes the flexibility she enjoys, including paid time off and other benefits you may not get in private practice.

[blogad]

Things to consider before committing to public health

For anyone who is considering a career in public health, Dr. Shah recommends first researching different areas within public health to gain a better understanding, whether it’s a clinical setting or working for the Department of Public Health.

“If there’s a specific clinic or state you want to work in,” she advises, “research the clinic. Look up demographics in that zip code, how the clinic receives funding, the location of the clinic and, most importantly, provider turnover.”

Dr. Shah also recommends that you connect with other professionals to network. “In public health,” she explains, “there’s a lot of information you can get just by talking to people who are in the field through networking events, informational interviews or professional organizations. Building relationships with individuals who are working in public health can really provide valuable mentorship, advice and potential career opportunities.”