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Multnomah County dentists picket over proposal to increase patient numbers

Dentists at the county's safety-net dental clinics use lighter schedules one day a week to catch up on paperwork and tackle tougher cases; now they say the county wants to end that practice.
August 10, 2023

Dentists at Multnomah County’s clinics are picketing Thursday, Aug. 10 in protest of what they say is a lowball contract offer that would hurt the low-income and marginalized communities they serve.

The county employs 21 dentists at six safety-net dental clinics under its federally qualified health clinic, also known as a community health centers, under the county’s Integrated Clinical Services division. The centers are overseen not just by county staff but by an independent board — an unusual structure for a safety-net clinic.

The county wants dentists, who are represented by the Oregon branch of the American Federation of State, County and Municipal Employees, to see more patients at the expense of quality of care, said Eben Pullman, an Oregon AFCSME spokesperson.

Instead of recognizing the dentists’ grueling service as essential frontline workers during the pandemic, he said, “the county wants to instead force a contract on us. It requires dentists to increase their workload with no form of additional compensation.”

A county spokesperson released a statement commenting on the picket that did not directly address the union’s assertions.

“Multnomah County values the oral health services that Multnomah County Dentists, Dental Hygienists, Expanded Functions Dental Assistants (EFDAs) and Orthodontic Assistants (OAs) provide for people in our community, including members on the Oregon Health Plan and those who have no health insurance,” said the statement. “Our labor agreements are the result of detailed contract negotiations and bargaining by Multnomah County Labor Relations and Local 88 union members. Together, we negotiate the working conditions, rates of pay, hours of work and benefits for these dental employees and more than 3,600 other County employees. However difficult these conversations can be, they are also respectful, above-board and, ultimately productive. We are partners in public service and we are confident this process will get us to the agreement that best serves our community.”

The informational picket begins at 1 p.m. at the Mid-County Health Center at 12710 SE Division St.

“One-chair days” at issue

Pullman said dentists for the county see as many as 22 patients per day. To save time they do so by overseeing two chairs on most days, so one patient can get settled while another receives care.

But dentists typically get one day a week where they oversee only one chair, giving them time to catch up on paperwork and also focus on more challenging cases. People who migrated to Oregon from other countries, as well as people experiencing homelessness, can have problems mount due to lack of access to the health care system, making some cases more time-intensive than others.

Now, Pullman said, the county wants to eliminate the “one-chair days” citing the low reimbursement rates that he said don’t fully cover the cost of dental care.

They are “likely going to be forced to do much more of their work after hours and during lunch and meal periods rather than during their normal work day,” he said.

The county’s community health centers have racked up two straight years of hefty surpluses, he added.

You can reach Nick Budnick at [email protected] or at @NickBudnick on Twitter.