RIVERSIDE, CA─Looking around, eyes sparkling, Austin, 12, sat with his mother, Lynnette Mullins on a couch in their Riverside home. Austin was born with an extremely rare disability known as Kabuki Syndrome, which can entail a number of health issues as well as learning disabilities. Now Austin, like many other disabled people in Southern California, is facing a serious situation.
In all of California, few dentists will see severely disabled patients due to the risks involved. Also, many such patients need to be put under general anesthesia before any dental work can be done, and such a procedure can usually only be done at a hospital by an anesthesiologist. Austin's dentist, Dr. Diana Zschaschel, according to Lynette, is one of only two private dentists she knows of in all of California who will see severely disabled patients. Yet recently, Dr. Zschaschel was denied access to her facilities at St. Vincent Hospital in Los Angeles, leaving Austin and many of her other patients with little hope.
Glancing at her son with a look of quiet concern, Lynette said softly, "With Austin, I've gone to like five different dentists and we were turned away. Because he bleeds and he needs certain kinds of medications, they didn't want to take on that risk."
"I don't know where to go," said Lynette. "It's scary for me, because every six months Austin needs his teeth cleaned. I don't even know who the other dentist is."
Austin's dentist, Dr. Zschaschel, is the founder of Angels' Smiles, a non-profit dental program which works with disabled patients. During a phone interview on April 13, 2008, Zschaschel said, "My biggest concern is for my patients because if they can't see me then who are they going to see? And when is this going to end? This is not the first and this probably won't be the last time something like this happens."
She continued, "These are a vulnerable part of our population who can't speak up for themselves and are we just going to let them go and not care? My primary concern is for my patients."
Discussing her current situation, Zschaschel said that she was told the reason she is being denied use of the dental facilities at St. Vincent hospital is that her patients cost the hospital too much money. From what she was told, the cost to the hospital is approximately $1,000 per patient, adding up to around $225,000 in the past 9 months. Yet Zschaschel said that she was never told before that her patients had been costing the hospital any money, and she is now looking to either raise funds to cover the costs or to look for another hospital which will allow her to continue her work.
"I understand the hospital's position that they need to cut costs. If not, there's not going to be a hospital to go to," said Zschaschel. "I'm willing to work with them. I just want to be given a chance to see if I can find funding."
Zschaschel said that her patients often tell her that they've been turned away from 5, 6, or 7 dentists before finding her. Zschaschel said that there are a number of different reasons why most dentists refuse such patients. Sometimes, the dentist might lack the proper training needed to deal with severely disabled patients, some don't have access to the proper facilities, some lack the patience, and some merely feel the reimbursement rate is too low, as Medicaid isn't always able to cover the costs. "The reimbursement rate is so low that they can't afford to see them because these patients require much more time and much more patience," said Zschaschel. "The only way people make money in Medical is by doing high volume. So if anything takes more time, they don't want to waste their time with it because that wastes money."
"I think that we as a society need to step back and look at the reimbursement rate of these public assistance programs for people with disabilities because there's going to be a point when nobody will see them," said Zschaschel.
Having started her work in the field of dentistry out of a wish to help others, Zschaschel often disregards her own profits so as to help her patients, providing dental work to those who would otherwise have difficulty finding such services. She mentioned that among the places that do offer similar services to disabled patients, such as UCLA and USC, a one or two year wait list is common, leaving patients in need of immediate dental work without much luck.
"Nobody from the hospital has ever come to see the work that I do. They don't even know what they're cutting. They just see a number and they don't see the face behind that number. It's not even my face that I care if they look at. I want them to see all of my patients who are suffering because of the decision they're making," said Zschaschel.
Pausing a moment, she continued, "My patients are like my family."
Feeds