UAB School of Dentistry ends contract with local dental clinic
by John Fleming
Star Editor at large
Apr 05, 2010 | 9675 views |  70 comments | 180 180 recommendations | email to a friend | print
The University of Alabama at Birmingham School of Dentistry on Monday ended a five-year relationship with the Anniston-based Sarrell Dental Clinic, the statewide nonprofit organization that has served more than 130,000 indigent children. [Read the Alabama Dental Meeting transcript]

The move will have ill effects on the well-being of the state’s children, said Jeff Parker, CEO of the Sarrell Clinic. Parker said it is the culmination of an effort by some for-profit dentists to curtail Sarrell’s work statewide.

Parker said a UAB official phoned him Monday at noon to say, “Due to intense pressure from UAB alumni who have threatened to withdraw funding, [the UAB School of Dentistry] would be terminating the relationship with us.

“Obviously,” Parker said, “this heavily impacts access to care for children in Alabama.”

In an e-mail to a Star reporter Monday, Dale Turnbough, the associate vice president of public relations at UAB, wrote, “We believe Sarrell has a laudable mission and is doing a great job, and we are grateful for the partnership we have had to date. But our primary consideration has to be how to best prepare our students, and what is the best learning environment for them.

“For example, we need a setting where our students can be mentored by our full-time faculty.”

In response to a question about Parker’s assertion of “intense pressure” from UAB alumni, Turnbough noted the school “did hear from some alumni and dentists in the communities with their opinions.”

Dr. John Thornton, the associate dean of UAB’s School of Dentistry, was working at the Anniston Sarrell Clinic on Monday when Parker received the news.

“Well, I wasn’t totally surprised,” Thornton said. “I knew something was brewing.”

Thornton would not elaborate on what “was brewing,” but he did say the quality of work at Sarrell, in his opinion, was not in question.

“After working here for four years, I can tell you I have been very pleased with the quality of health care we provide,” he said. “My concern now is for the children. I have encountered some of the neediest cases I have ever seen here.”

“There were no issues whatsoever related to quality of care or payment for services,” Turnbough wrote in an e-mail Monday.

The Sarrell Clinic has succeeded, Parker said, in reducing its per-patient cost from more than $328 three years ago to $131 today.

Parker declined to say if low cost was undercutting for-profit dentists in the state and whether this was perhaps an issue.

The decision by UAB is perplexing since Sarrell is a benefit to the School of Dentistry, Parker said. Every UAB School of Dentistry senior since 2007, he said, has rotated through the Sarrell Clinic, and residents from the school have worked there since 2005.

Also, Parker added, “our contract provides around $400,000 to UAB. No other nonprofit dental clinic in the state provides money to UAB. But they want to end their relationship with us.”

According to Parker, UAB gave the clinic two weeks notice.

In January, the Sarrell Clinic was singled out by members of the Alabama Dental Association (ALDA), a body that includes UAB School of Dentistry faculty.

A transcript from a Jan. 31 ALDA meeting made available by Sarrell Dental Clinic officials details how a number of members discussed ways to curtail the operations or close the clinic, as well as other similar ones.

Sarrell is the largest dental clinic in the state, with offices in seven other locations. It serves children aged 1 to 20, the overwhelmingly majority of them low-income, with most payments being paid by Medicaid.

In an interview with The Star in March, Parker claimed than that for-profit dentists represented by the Alabama Dental Association were a threat to the Sarrell Clinic and other Alabama nonprofit dental clinics in Alabama. He said the meeting transcript supported the assertion.

“They are coming after us,” Parker said in March, “because Sarrell is the biggest in the state. But their action will also endanger other nonprofit dental operations.”

Parker went on to say, “There is and has long been a lack of adequate dental care in Alabama. For-profit dentists have chosen not to see these [low-income] children, and this is why we are in business.”

Dr. Zack Studstill, the interim executive director of ALDA, rejected Parker’s accusation.

“No one wants to take Medicaid away from children; that’s crazy,” said Studstill, who was at the January ALDA meeting. “And we are not in the business of putting people out of business. We just want to make sure nonprofits are conducting business in the right way.”

Studstill said concerns include the quality of health care at the clinics and how the business was being operated.

He added that a committee of members of ALDA, including Gadsden dentist Edward Lindsey, a Sarrell employee, had been formed to look into the operations of nonprofit dental clinics in the state.

“We’ll have more answers after the committee reports,” Studstill said. “I see the creation of this committee as an opportunity to learn, not as a threat to anyone.”

Parker told The Star that officials at ALDA provided a copy of the recording after one of his staff members requested it. Parker later had the recording transcribed by a company in Birmingham and forwarded to The Star.

When asked if the criticism of the Sarrell Clinic by members of ALDA’s board were because of health concerns or because of worries about competition, Parker responded by saying, “We have served some 130,000 children since we opened in 2005. During that time, not a single complaint has been brought against us. That should answer your question.”

Dr. Gaines Thomas, president of ALDA, who was also present at the meeting in January told The Star, “If Mr. Parker is implying that the members of the Alabama Dental Association are not concerned with the quality of health care, then I disagree with that.”

Members of ALDA argue, according to the transcript, that nonprofit dental clinics in Alabama enjoy an unfair advantage because of low or no taxes, cheap rent, cheap labor and the low cost of supplies. Other dentists, including members of ALDA, have higher costs for running their for-profit businesses.

Members also discussed working through the Legislature to force additional restrictions on the clinics.

The transcript shows that a number of dentists questioned whether the Sarrell Clinic and others like it could be closed or their operations curtailed, while others cautioned the group to be careful in how it approached the issue because of a possible backlash from the public.

EDITOR'S NOTE: The following is a transcript from a Jan 31. meeting of the Alabama Dental Association. The Sarrell Dental Clinic, which was discussed during the meeting, provided The Star with this transcript.
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