Shadowing Paper: Bethany Palesh

For my assignment, I job shadowed Bethany Palesh, a registered dental hygienist at Advanced Periodontics Implantology in Michigan on Monday, January 30, 2016. Precisely, the healthcare facility is located at 31636 Schoolcraft Rd Livonia, MI 48150. The business offers dental healthcare services such as Bone grafting, dental implant, gum graft surgery, gum surgery, root planning, simple tooth extraction, teeth scaling, crown lengthening, non-surgical gum treatment and teeth extraction. Bethany has a main interest in working in Periodontics. She enjoys working with patients to help them achieve periodontal health that can be maintained with good home care and continued hygiene visits. I chose to job shadow Bethany because of her good professional background, because she works in a field in which I have interest and because she is my role model. In her free time, Bethany enjoys traveling, reading and playing piano, which I also love to do.

Advanced Periodontics Implantology had the following mission statement. “Welcome to our practice website. We applaud you on taking the first step towards a better periodontal health. Your smile is our primary priority. Please use this website as a resource. The website will help you better understand your line of treatment and answer all questions related to periodontal therapy.” Regarding their staff and goals, the statement read, “Drs. Bhola, Kolhatkar, & Cabanilla Jacobs are specialists in Periodontics and Implantology. We specialize in the conservative and surgical treatment of gum disease that includes cosmetic procedures to aesthetically augment your smile, as well as dental implants that can restore single or multiple missing teeth. Even though no one likes to go to the dentist or doctor, we endeavor to make your appointments with us as comfortable and lovely as possible. We sturdily believe that our patient’s comfort is an important part of quality dental care. We work closely with your dentist, but a referral by a dentist is not required to visit our office. We are extremely proud of our staff, which encompasses caring and dedicated professionals. They make sure that the patient’s surgical and administrative needs are met as proficiently and smoothly as possible. Our goal is to make you feel contented and relaxed. We are here to listen to your questions and concerns and to help provide solutions leading to your better health. Please don’t hesitate to contact us if you have any questions regarding your care.”

The climate of the healthcare facility was friendly and conducive to physicians working. The work environment was meticulously clean, very professional and extremely organized. They perform huddles with staff and doctors every morning to have an understanding of what will transpire throughout the day and discuss treatments of every patient that day. I was delighted that all of the staffs were eager to welcome me and help out if I needed assistance. From the way I monitored the working environment, employees seemed to work well together.

My job shadowing day started at 8:30 am with Bethany explaining her professional and educational background. Bethany Palesh hold an associate’s degree in dental hygiene 2010/UDM Bachelors 2015. Her credential included CPR/Local anesthetic/Nitrous. She does not have professional association membership; however, the type of course she attended was Continuing Education, which was a four-hour class given at her place of employment. She attended the course in November 2016. Bethany is not aware of how many CE hours she has accumulated to date; however, she told me since she is from Canada they need something like 50 hours every three years more than what is expected in Michigan in 3years which is 36 hours in 3 years. So she stated she never worries because she typically surpasses the required amount. She did know she is due in 2018 that will be three years for her.

Regarding her occupational responsibilities, Bethany assesses perio condition of the patient and insure patient a painless visit. Her monetary compensation is bi-weekly. She does not receive fringe benefits. Besides, she gets no insurance because she is part time. However, she did inform me because she resides in Canada they have free healthcare. On the career background, Bethany has been practicing for 7 years. She worked in Periodontics for one year than six years with “Great Expressions” where she had recently quit in December 2016. She began at Advanced Periodontics/Implantology in October 2016 and went to both locations. Regarding her Profession, she is very knowledgeable with regards to her profession due to her seven years of experience and continuing education. Bethany was satisfied with her career. She repeatedly let me know throughout the day how much she loved what she did and her patients. She also let me know that she treats all patients as if they were family members.

I had the opportunity to see Bethany attending to patients. For perio-maintenance (4910 code), Bethany is given 1 hour to attend to the patient. In the case of Scaling and Root Planing (SC/RP), she is given 1 ½ -2 hours. If all her patients are perio-maintenance than she can see 6-7 however no more than 7 in a day. Bethany performed several injections when I shadowed, and they included IAN, Long buccal, ASA, PSA, MSA, and NP. She used only Lidocaine and Carbocaine on patients that day. She let me know that part-time was basically considered 15-24 hours a week and every patient has a general dentist and hygienist they see. The day I shadowed her she saw 5 total patients with an 8 min break! The staffs are assigned uniform colors for each day and the day I was there (Monday, Jan 30, 2016) they wore black even the doctors.

We had a fifty minutes lunch break, and I had the opportunity to eat with Bethany in the doctors’ lounge. During that time, I witnessed some interactions between physicians. Physicians in this healthcare facility have a healthy relationship. They acted like old friends and shared stories about their families and current news.

This experience brought to light some things I did not expect. However, I learned the following from my interaction with Bethany. First, the system they use is “Curve Hero” to place a patient in. “Seerpy” is what they call Scaling and root planning in Canada. Bethany has been allowed to perform in an Osseous surgery (which is a procedure done when you have a pocket around a tooth (or teeth) that has not responded to other treatments. It is done to help you retain the tooth and create an environment that is easier for you to keep clean.). She was able to work side by side with the doctor and scrub in. She places multiple Arestins throughout the day on patients. Periodontal disease is a serious infection under your gumline.

ARESTIN® (minocycline hydrochloride) is an antibiotic that kills the bacteria that cause the infection. It is placed directly in the infected areas—or “pockets”—in your gums. It is applied right after scaling and root planning, the dental procedure that disrupts stubborn plaque and bacteria below your gum line—where brushing and flossing can’t reach. ARESTIN® starts working quickly, right at the source of infection and keeps fighting bacteria long after you leave the dental office. ARESTIN® fights infection and inflammation for 30 days and provides significantly better results than scaling and root planning alone for up to 90 days. Second, they still use paper charts; however, they place notes in into Curve Hero of what transpired during each induvial patient’s visit, and then the note is emailed to their general Dentist.

Third, they also have an Advanced Periodontics/Implantology Education that is in the same building where the physicians hold Continuing Education (CE) courses for staff and doctors. This what they have scheduled for this upcoming year.

Dr. Bhola’s Speaking Engagements and Lecture Schedule

Hands-On CE Courses 

January 2017

  1. January 21- HCP Review Board Meeting, Zimmer Biomet, Palm Beach, FL
  2. January 29- Advanced Surgical Pig Jaw Course: High Level Bone and Soft-Tissue Grafting, Montreal, QC

February 2017

  1. February 10-11- The USC 42nd Annual International Periodontal and Implant Symposium, Los Angeles, CA.
  2. February 15- Implant Esthetics- New Guidelines for Grafting and Immediate Implant Placement, Chicago, IL.

March 2017

  1. March 3- Implant Esthetics- New Guidelines for Grafting and Immediate Implant Placement, Fort Worth, TX.
  2. March 10- Implant Esthetics- New Guidelines for Grafting and Immediate Implant Placement, Cincinnati, OH.
  3. March 15-17- Academy of Osseointegration, Orlando, FL.
  4. March 20-22- NYU Global Symposium, NY, NY.
  5. March 24-25- Advanced Surgical Cadaver Course-A Two-Day Hands-on Cadaver Course. Las Vegas, NV.

September 2017

  1. September 9-11- AAP Meeting, Boston, MA.

April 2018

  1. April 27-28- Rutgers School of Dental Medicine, 3rd Biennial Symposium, New Jersey

After my shadowing, my hopes of being an outstanding dental hygienist are still valid. Bethany is my role model and I have been inspired by the way she behaves when attending to patients or talking to people. I have learned a lot from her and I would like to pursue my education and build a career similar to hers. Moreover, I still have the same educational goal. My goal is to be excellent in class. Hopefully, with the skills that I have learned, I would like to be a successful dental hygienist.

 
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