Brady, Michelle

Chambers, David

Cuny, Evelyn

Ojcius, David M.

English

Pacific McGeorge School of Law

Making it easier to be a patient in times of a pandemic

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Scholarly Commons

University of the Pacific Scholarly Commons Dugoni School of Dentistry Faculty Articles Arthur A. Dugoni School of Dentistry 1-1-2021 Making it easier to be a patient in times of a pandemic David Chambers University of the Pacific, dchamber@pacific.edu Michelle Brady University of the Pacific, mbrady1@pacific.edu David M. Ojcius University of the Pacific, dojcius@pacific.edu Evelyn Cuny University of the Pacific Follow this and additional works at: https://scholarlycommons.pacific.edu/dugoni-facarticles  Part of the Dentistry Commons Recommended Citation Chambers, D., Brady, M., Ojcius, D. M., & Cuny, E. (2021). Making it easier to be a patient in times of a pandemic. Journal of Dental Education, , DOI: 10.1002/jdd.12588 https://scholarlycommons.pacific.edu/dugoni-facarticles/507 This Article is brought to you for free and open access by the Arthur A. Dugoni School of Dentistry at Scholarly Commons. It has been accepted for inclusion in Dugoni School of Dentistry Faculty Articles by an authorized administrator of Scholarly Commons. For more information, please contact mgibney@pacific.edu. brought to you by COREView metadata, citation and similar papers at core.ac.ukprovided by Scholarly CommonsReceived: 13 November 2020 Revised: 23 February 2021 Accepted: 27 February 2021DOI: 10.1002/jdd.12588ADVANCING TH ROUGH INNOVATIONMaking it easier to be a patient in times of a pandemicDavid Chambers EdM, MBA, PhD1 Michelle Brady DDS1 David Ojcius PhD2Evelyn CunyMS11 Diagnostic Sciences Department, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA2 Department of Biomedical Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USACorrespondenceMichelleBrady,DDS,Diagnostic SciencesDepartment,ArthurA.Dugoni School ofDentistry,University of thePacific, 155Fifth Street, SanFrancisco,CA94103,USA.Email:mbrady1@pacific.edu1 PROBLEMWhat responses are needed when a public health crisis,the COVID-19 pandemic, disrupts continuity of care ina dental school clinic? To what extent do fears regard-ing safety during treatment deter patients from attendingappointments in dental school clinics and can the schoolcontrol these factors to ensure educational experiences?Much attention has been paid to the precautions for pro-tecting students, faculty, staff, and patients during treat-ment, including triage and procedures and barriers thatensure safe distancing.1–3 The University of the Pacific,Arthur A. Dugoni School of Dentistry has adhered to strictstate and county guidelines and informed patients of theseprotocols as shown in Table 1. Nevertheless, we observeda 40% disruption in mid-treatment for endodontic, fixed,and removable prosthodontic care. We asked patients howreceiving dental care under these circumstances appearedfrom their point of view.2 SOLUTIONThis project received IRB exempt approval 2020-15. Thefirst author attempted to contact the 16 patients who hadnot attended a scheduledmid-treatment appointment dur-ing the first week of June 2020. Twelve were reached byphone after up to three attempts and gave verbal con-sent to be interviewed in English or Spanish for approx-imately 10 min each. Semi-structured guided interviewswere conducted with the only standardized question being“Describe where you are in your dental treatment.” Allsubsequent discussion consisted of follow-up on patients’comments. Patients were not asked about perceived barri-ers to care, although they all mentioned some. Interviewswere not recorded, but notes were taken and transcribedand coded for themes.3 RESULTSPerceived value of the care and trust in the school remainedhigh. No respondent expressed fear of contracting coron-avirus during dental treatment.Factors outside of the dental clinic were blocking careseeking. These included uncertainty regarding protocol fortesting by the county and fear of contracting COVID-19 onpublic transportation on the way to dental appointments.Other personal concerns assumed greater salience thancompleting nonemergency oral care. “I’m 87 years old. Iget out of the apartment once every two weeks, and thatis for food. I don’t understand what all I have to do nowfor dentistry. New hassle. I will wait until things get easier.A phone reminder isn’t going to make any difference. Thetemporary crown is good.”This project highlighted the fact that patients place oralhealth care behavior in the context of their other needs,some of which may not be directly influenced by informa-tion or protocol under the control of dentists. Stanford’sAlbert Bandura4 called this a self-efficacy mechanism,which influences thought patterns, actions, and emotionalarousal on the patients’ part. Harvard Business School Pro-fessor Michael Porter5 argues that health care profession-als tend to define care in terms of what happens betweenputting on and taking off the gloves or what staff do toencourage patient attendance. Patients, by contrast, defineJ Dent Educ. 2021;1–2. © 2021 American Dental Education Association 1wileyonlinelibrary.com/journal/jdd2 CHAMBERS et al.TABLE 1 Measures taken to improve communication withpatients regarding COVID-19 protocols during the pandemicCommunication initiatives Date implementedUpdated patient website March 2020–PresentGroup practice virtual huddleson patient communicationApril 2020–PresentPatient information lettersfrom student providersMay 2020–August 2020Patient information videoadded to websiteAugust 2020Community outreach topatients via social mediaAugust–October 2020Student/receptionist scriptregarding COVID-19 testingJuly 2020PPE video displayed on patientwaiting room monitorsOctober 2020health in the entire context of their personal daily lives.The pandemic has shown that improvements in the for-mer may have limited influence when the latter becomeslarger problems.CONFL ICT OF INTERESTThe authors declare no conflict of interest.ORCIDDavidOjcius PhD https://orcid.org/0000-0003-1461-4495REFERENCES1. Wang C, Miao L, Wang Z, Xiong Y, Jiao Y, Liu H. Emergencymanagement in dental clinic during the coronavirus disease 2019(COVID-19) epidemic in Beijing. Int Dent J. 2021;71:32-39.2. Manuballa S, Abdelmaseh M, Tasgaonkar N, et al. Managing theoral health of cancer patients during the COVID-19 pandemic:perspective of a dental clinic in a cancer center. J Clin Med.2020;9(10):3138.3. Long RH, Ward TD, Pruett ME, Coleman JF. Modifications ofemergency dental clinic protocols to combat COVID-19 transmis-sion. Spec Care Dentist. 2020;40(3):219-226.4. Bandura A. Self-efficacy mechanism in human agency. Am Psy-chol. 1982;37(2):122-147.5. Porter ME, Teisberg EO. Redefining health care: creating value-based competition on results. Boston: Harvard Business SchoolPress; 2006.How to cite this article: Chambers D, Brady M,Ojcius D, Cuny E. Making it easier to be a patient intimes of a pandemic. J Dent Educ. 2021;1-2.

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