Staffing challenges and military commitments: how to manage a dental clinic in a military environment.
Subject: Dental personnel (Practice)
Dental clinics (Management)
Author: Shahin, Marnie E.
Pub Date: 07/01/2012
Publication: Name: The Dental Assistant Publisher: American Dental Assistants Association Audience: Academic; Trade Format: Magazine/Journal Subject: Health; Science and technology Copyright: COPYRIGHT 2012 American Dental Assistants Association ISSN: 1088-3886
Issue: Date: July-August, 2012 Source Volume: 81 Source Issue: 4
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Product: Product Code: 8043800 Dental Auxiliaries; 9105215 Military Health Services; 8087000 Dental Health Centers NAICS Code: 62121 Offices of Dentists; 92312 Administration of Public Health Programs SIC Code: 8021 Offices and clinics of dentists
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 303225252
Full Text: Managing a large dental clinic has many challenges, but running one of the largest Air Force dental facilities presents even more unique challenges. For example, the Sachsel Dental Clinic at Travis Air Force Base (AFB), CA, located near Fairfield, delivers comprehensive dental services to over 7,000 active duty Air Force members. This facility has a total of 123 staff which includes 41 dentists of all specialties. The clinic also has two residency programs: a one-year Advanced Education in General Dentistry and a four-year Oral and Maxillofacial Surgery residency program. To support all the providers, we have a staff that consists of 65 enlisted members and 17 civilians. Balancing all our military commitments and managing this large staff may seem like a daunting task but it is just part of our everyday life in managing an Air Force dental clinic.

As dental assistants, we are required to train, equip, organize and deploy to support worldwide combat and peacetime contingency operations. At any given time we have two to three assistants deployed and out of the clinic for up to six months at a time. Along with meeting these requirements, there are many other military commitments that must be adhered to. All young airmen and noncommissioned officers are required to complete various levels of professional military education that take them out of the clinic for weeks at a time. They are also required to fulfill mandatory details for the base. For example, each month we have airmen participate in the Base Honor Guard or Security Forces Augmentee. These details are each a month long. This begins the first of many challenges this military dental facility faces.

The next challenge is obtaining and developing skilled employees. When it comes to dental technicians, we do not have a say in who will be working for us. There is no hiring process where we interview and choose the best person for the position. Personnel in the military move around based on the needs of the Air Force. We do not know the skills, knowledge or capabilities of any of the airmen who are chosen for an assignment to Travis AFB. Many times we receive new recruits straight out of technical school, after just nine weeks of training. So begins their year-long, on-the-job training program. Other times we may get individuals who are highly skilled in one area of the clinic but are needed to fill a position for which they are not currently trained.

This brings us to our residency programs. We must select the best possible candidates to work alongside our residents to aide in their training. These programs go into greater detail, focusing on general dentistry and each of the dental specialties. Our assistants must meet the needs of the provider not only as their assistant, but to help guide them in training as well. These assistants are required to assist in all types of specialty care and even work alongside the provider in the operating room. Without a knowledgeable and skilled assistant, the residents' training could drastically suffer.

In order to maintain the world-wide readiness of our 7,000 patients, we must complete an examination and oral prophylaxis on each member annually. The military only has a handful of active duty dental hygienists, one of whom is assigned to us. In order to care for a large number of patients, we must utilize our assistants. They must receive advanced training to become oral preventive assistants. Once they attend the three-week training program at Lackland AFB, TX, these assistants will perform oral prophylaxis under the supervision of the hygienist. It takes the right people for these positions. They must be mature, responsible and able to work independently. Our preventive dentistry section includes one hygienist and six oral prophylaxis assistants to meet the needs of our base population.

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Finally, continuity of personnel will always be a challenge. To meet military needs, airmen must continue to move from one assignment to another. Military members may volunteer to move to another assignment. If approved, they will leave within three to six months and we may not have a projected replacement. The average airmen will only remain on station for two to three years before moving on. A first-term airman's commitment is either four or six years. After he or she has fulfilled his or her commitment, there is an option to reenlist or separate.

It is important to recognize that not all our airmen chose this career field; it was selected for them by the Air Force. If they choose to separate, we may be without a replacement until the Air Force can assign one, which can be a long process. Lastly, a career airman is eligible for retirement after completing 20 years of service. Once that member retires, we may end up, once again, waiting for a replacement.

The reality is that constant change of personnel is a normal process in the military. Our clinic sees a 30 percent turnover of staff each year. As challenging as it may sound, for us managing the day to day operations is just another opportunity to train, mentor and further develop our personnel. So how can we continue to meet the needs of our patients at the same time we are meeting the needs of the Air Force? We train every assistant to the same basic level and conduct monthly refresher training. We have one-on-one mentoring, focus on flexibility and emphasize being receptive to change. We work hard and we play even harder. Our assistants continue to provide world class service to our patients. Despite all of the challenges we face, we continue to maintain a well-running, cohesive team that keeps getting better.

Senior Master Sergeant Marnie E. Shahin is the Squadron Superintendent assigned to the 60th Dental Squadron, Travis AFB, CA. She provides leadership, mentors 123 personnel and manages a 54-room dental facility. Sergeant Shahin is also the dental practice manager for a $13.1M business plan, oversees a $17M facility, $3M equipment and a $1.1M annual budget. Her career in the Air Force began as a dental assistant in 1988. Sergeant Shahin is from Tomahawk, WI and is married with three children.
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