Virginia dentist’s compassion stands out in a state that won’t expand Medicaid

Dr. Gerald Frank leans against reams of neatly organized patient files as he waits with receptionist Dayra Vargas for the after-school rush at his Alexandria, Virginia, office.
J. Lawler Duggan | The Washington Post
Dr. Gerald Frank leans against reams of neatly organized patient files as he waits with receptionist Dayra Vargas for the after-school rush at his Alexandria, Virginia, office.
By Petula Dvorak, The Washington Post
Posted June 20, 2014, at 9:29 a.m.

WASHINGTON — For more than half a century, kids in Virginia with bad teeth and poor families have had somewhere to go.

Their parents — immigrants, minimum-wage laborers, the unemployed — usually found Gerald Frank through the grapevine, and they spread the word about his modest dental office. At 75, he has been an oasis of compassion in a state that refuses to expand Medicaid to 400,000 Virginians who desperately need health care insurance.

“I think it’s terrible that they did that,” said Frank, who drives a Honda and vacations in Pennsylvania.

When he opened his own practice 37 years ago, on the ground floor of a plain, gray apartment complex in Alexandria, Virginia, he knew he was going to be the dentist who treated everyone. The exam rooms are cheerful, but not fancy. He has one of those old-school X-ray machines, with the aqua color and sleek lines of a ’57 Chevy.

“Hello, Kevin,” he says, when 15-year-old Kevin Alvarado comes into the office. “What are you doing this summer?”

Kevin has been coming to Frank since he was 2 years old. His mom, Miriam Alvarado, is a cashier. They have Medicaid — as do about 75 percent of Frank’s patients — but she had a difficult time finding a dentist who would take Kevin when was young.

“Other people, friends, told me about him,” Alvarado said.

Even with the mirror and probe deep in his mouth, Kevin tried to talk to Frank.

“Awlintow cowny,” he tried to say.

Frank takes the instruments out of his mouth long enough for Kevin to explain he got a summer job helping run an Arlington County moon bounce.

“That’s good, Kevin. Good for you,” Frank said.

The Medicaid patients don’t generate a ton of money for dentists. The percentages are pretty low, so few offices accept them. When they find Frank, they stay. Some of his patients keep coming to him after they’ve reached adulthood, had their own kids.

“I have one who’s still coming to me, and she’s a grandmother. Or maybe a great-grandmother,” he said.

He likes kids — that’s one reason he does this. His wife is a social worker, so his partner is sympathetic to helping others. But what probably stuck with him the most were his early years in his parents’ corner store in Portsmouth, Virginia.

“If a mother came in and couldn’t afford milk, my parents would always give it to her,” he said. “No one should go without.”

When you talk to Frank, you’ll eventually notice he’s missing half of the pointer finger on his right hand. Essential for a dentist, right?

“Oh, I make do,” he demured, sticking tape on the floppy end of his blue, rubber glove.

His assistant, Vicki Artola, helps with the things his hand can’t do. She has been with him for 20 years. When she was a student from Chile working for him and her student visa expired, Frank sponsored her work visa. She’s funny, cheerful, bilingual, efficient and loyal. She refuses to work for any other dentist.

It’s Artola who tells me the story of her boss’s missing finger. “A child bit him,” she said, and MRSA bacteria from the bite infected his finger, landed him in the hospital for a week and took part of his finger.

Afterward, he got right back to work. He continues to take the kids without insurance who come to him in desperate shape. It’s not unusual for him to get calls from the emergency rooms of local hospitals, where children whose parents couldn’t afford dental care show up with rotten teeth, swollen mouths, bleeding gums, writhing in pain.

“‘Send ‘em over,’ I tell them,” Frank said. “I don’t turn anyone away.”

If only all dentists were like him. Instead, many turn down Medicaid patients because, they say, reimbursement rates are too low and administrative hurdles are too high.

That never stopped Frank. He has never forgotten Deamonte Driver, the 12-year-old from Prince George’s County, Maryland, who died from a toothache in 2007. An $80 extraction would have prevented the infection that spread to his brain.

Congressional hearings, research panels and reports by The Pew Charitable Trust have slowly begun to fix Maryland’s dental health care system. When Deamonte died, only a third of the state’s children covered by Medicaid had been to a dentist. Five years later, 42 percent of kids have had their teeth checked.

Across the Potomac River, kids have Dr. Frank. But this is Frank’s last week as the owner of his practice. He sold it and cleaned out his shelves. He’s not completely retiring. He’ll continue to see his current patients a few days a week. He isn’t sure that he’ll take new patients.

Just as he said that one day this week, the front door opened and six bouncy, chattering children spilled in. They were two families and a friend who came to help translate Aramaic. They had been to another dentist, but that man said he couldn’t treat the children.

Frank directed the bouncing gaggle to the aquarium in his office. He introduced himself to the 6-year-old boy and led him into the exam room. The boy calmed down, quietly climbed into the chair and said “aah.”

“We’ll do his teeth,” Frank told his assistant. “Won’t turn anyone away. The buck stops here.”

Petula Devorak is a columnist for The Washington Post, where this piece first appeared.

http://bangordailynews.com/2014/06/20/opinion/virginia-dentists-compassion-stands-out-in-a-state-that-wont-expand-medicaid/ printed on September 30, 2014