Stephen J. Seder, DDS, MS
Program Director, General Practice Residency
Michael E. DeBakey VA Medical Center
Department of Veterans Affairs
I never considered a career working in public health. When I was in dental school I always imagined hanging a shingle and starting up a small town dental practice. Maybe you can relate to those dreams? I envisioned working long hours Monday through Thursday while saving time for a golf game on Friday. My practice would be the perfect balance between work and family. Before I graduated, l felt like all that was in my cards, however, like many other things in life, plans change.
At the end of the last year of a two-year AEGD residency at the University of Connecticut Health Center, it was time for me to make some career decisions. Not quite ready to open my practice and still in the academic mindset, I put my private practice aspirations on hold and chose a prosthodontic residency.
When I arrived in Houston at the Michael E. DeBakey Veterans Affairs Hospital to start my residency, I received my first introduction to public health.
Public health meant sometimes seeing patients who had never had easy access to care. Some patients arrived to the clinic with poor dental health and a misunderstanding of how their dental situation relates to overall health. There are patients with very compromising health conditions, and I had to learn to work with other specialties across the hospital to affect a good outcome. The patient population numbers are often large, and there is a balance to do the most good for the most patients.
From a prosthodontic learning standpoint, it was a gold mine. I developed the advanced clinical skills necessary to replace missing teeth both by removable and fixed means. I never had to modify my treatment plans based on what the patient could or could not afford; that is I could develop my treatment plans by what is best for the patient, and not be influenced by their monetary situation.
As I got more and more comfortable in this public health setting, I started to rethink that small town private practice career vision. I wondered if I could see myself working for the government in a hospital setting. A hospital setting would mean limiting my patient population to mainly medically compromised adults.
The benefits and salary would be comparable to that of private practice. A plus is that I would be practicing without the headaches of running a small business. My sister, a busy orthodontist in private practice, will tell you what grief she had after a water leak. She had to close her practice for several weeks but she still had to pay all her bills, pay her employees, and still worry about insurance reimbursement. Not only could I avoid this type of problem working for the government at the Veterans Administration, but I could give back to those individuals who unselfishly gave so much to serve our country. A career with the Veterans Administration was looking better and better the more I thought about it.
Fortunately for me a staff dentist retired and so I accepted a position at the Houston Veterans Administration. I was also given the opportunity to become the program director for the general practice residency. I now could practice the dentistry that I love, prosthodontics, while teaching dental school graduates those skills that helped me to be a better dentist.
For those dental students and graduates considering a career in public health, let me give you some of our VA demographics courtesy of the Department of Veteran Affairs website and Dr. Patricia Arola, Assistant Under Secretary of Health for Dentistry, Department of Veterans Affairs. As of September 2010 there were 22.7 million veterans with roughly 8% being eligible for dental benefits. With 210 outpatient and inpatient dental clinics staffed by approximately 850 dentists and many more supporting personnel, we are one of the largest dental public health settings within the nation. With 78 AEGD, GPR, endodontic, periodontic and prosthodontic residency programs, there are no shortage of programs to have a formal, invaluable educational experience (http://www.va.gov/dental/residency.asp).
For more information on VA dental careers and our mission, please visit us at http://www.va.gov/dental/. I would also love to answer your questions, so please do not hesitate to contact me via email at StephenJ.Seder@va.gov, through our residency link http://www.houston.va.gov/about/dentalresidency/ or by phone at 713-791-1414, extension 4337.
Looking back over my past sixteen years within Veterans Administration, I have no regrets—that small town dental practice is not even on the radar screen! Good luck on your future dental pursuits.