From the November, 2012 issue
A staffer called in sick, so Bonita Neighbors, blue scrubs and all, starts her day at the Community Dental Center answering the constantly ringing phones. When relief arrives, Neighbors, the clinic's director, enters her office a bit drained--she'd been trying to reassure a woman upset because her car broke down and she didn't think she'd be able to keep her appointment. Neighbors had offered to cover cab fare, but finally the patient found a friend to drive her.
Voices in distress aren't uncommon at the small, low-slung brick building on North Ashley. "Sometimes people cry on the phone," says Neighbors, when they can't afford even the clinic's modest fees (a basic cleaning costs $49). Unlike most private dentists, the center accepts Medicaid--but, Neighbors points out, many of the "working poor" don't qualify for the federal program.
Because so many patients have limited incomes, "I can't always do what I want because of the financial barrier," Neighbors, says, frustrated. But, adds the fifty-seven-year-old dentist, "I love being down and dirty in the trenches!" It's a welcome change from her twenty-three years at the Michigan Department of Corrections, where she supervised dental care at twenty-three prisons. "The [administrative] job got larger and larger," she recalls. "I didn't have time to see patients."
Neighbors moves fast and frequently flashes a wide, sunny smile. She's eloquent, but prefers action to talk--the "one thing I don't have patience for," she says, is "laziness." She treats patients about half of the day, and spends the rest of her time supervising the busy clinic, chasing outside support, and engaging with others in the county alarmed by a growing population that needs but can't afford care.
Reflecting the rough economy, the clinic treated more than 2,000 patients last year, up nearly 40 percent since 2008. Ruth Kraut, who helps track affordable dental care at the Washtenaw County Department of Public Health, says that Neighbors quickly increased the clinic's visibility when she arrived a year and a half ago,
in part by throwing a well-attended thirtieth anniversary party this past spring. "She's really special," says Kraut. Neighbors also championed what may have been the center's first designated day of free care, provided by volunteer U-M dental staff and students; she hopes to expand to three days next year.
Year-round, Neighbors and the center's other staff dentist, Anne Bibik, are backed by volunteer dentists and an ever-changing corps of U-M dentistry and dental hygiene students and Washtenaw Community College dental assistants in training. A patient who just needs a cleaning and checkup might wait three months to get an appointment, but emergencies--a broken crown, a toothache--are handled quickly. (Emergency treatment is funded by grants from various organizations, including the Ann Arbor Thrift Shop and Kiwanis; it's tougher for Neighbors to find funding for routine care.)
Started under the former federal Model Cities program, the clinic is now operated by the U-M School of Dentistry. (The city owns the building, which the dental school leases for a stipend.) Neighbors says that the dental school administration has been "very supportive" while granting her freedom to try new things. The center's budget, which typically runs $500,000-$700,000 a year, is funded by the United Way, patient fees and insurance, public assistance programs, donations, and grants from the dental school.
Community Dental can accept anyone, and some patients are middle-class bargain seekers. "I just feel I'm getting the same quality and better care than at a higher-price location," says Charlotte Payne, a retired city housing inspector. "They have a care and a concern for everybody."
But most patients, says Neighbors, are struggling financially; some are homeless, and many are visibly agitated. That can cause "culture shock," she says, for the mostly middle-class students. When she told one woman she needed several teeth pulled, Neighbors recalls, the woman shouted and swore at her, then "stormed out. Their eyes got big," she says of the students watching. Neighbors says she told them, "'Look, she's not mad at me. She's mad at circumstances.'"
She hopes the students also appreciate that good dental care raises people's self-esteem. She recalls a homeless man who'd lost his teeth, and whom the clinic was able to provide with dentures. "He was so happy! He came in wearing new clothes; he was cleaner. The last time we saw him, his hair was combed, and he was starting to go around and interview for jobs."
When Neighbors was growing up in rural North Carolina, her parents emphasized both education and service to others. Her father, whose parents were sharecroppers, became a teacher; her mother was a county home economist. Although they made better money than most of their neighbors, they refused to move to a wealthier area. They helped people study to pass the infamous "literacy tests" used to keep Southern blacks from voting. Neighbors, an only child and an excellent student, sat at the table with them and helped.
She attended Bryn Mawr, where, as a freshman, she met her future husband, Harold "Woody" Neighbors, a student at nearby Haverford. "My only boyfriend, and that was it," she says. "I've been blessed." They married when she was a senior, and she joined him in Ann Arbor, where he earned a doctorate in public health; he's now a professor at U-M. Neighbors graduated from the U-M dental school in 1986. Their son, Rashid, is an engineer in California. In a tragic development, two-and-a-half years ago, their other child, Kamillah, a grad student in public health at U-M, died suddenly, of a seizure. She was thirty-three. "Family, faith and friends, and all the things I love about my job" helped her cope, Neighbors says. The young students bring her particular pleasure. "You have an opportunity to teach them. That, to me, was what being a mother was all about."
A friendly relationship with her own childhood dentist helped inspire Neighbors' career. "Math and science was always my thing," she says. She considered engineering but picked dentistry because it provides more contact with people. And she believes that when people feel connected to a particular dentist they are more likely to keep their appointments. When passing a downtown bench where homeless people often spend time, she smiled when she heard one man tell another, "Look, there's my dentist."
[Originally published in November, 2012.]