Suanne
Well-known member
First, thank you to Guy who posted just recently about RAM (Remote Area Medical) and their upcoming schedule here https://vanlivingforum.com/showthread.php?tid=25162&pid=311301#pid311301. The timing couldn't have been better as I had developed a tooth ache and no extra funds or dental insurance to get it looked at in the US.
I did have dental insurance up until this year, but didn't enroll in a replacement policy after my divorce. I thought I'd be safe for a while as over the last 4 years my twice-yearly check ups and cleanings found no problems. And, my long-term plan was that, when I did have a dental problem, I'd go to Los Algodones and get it fixed much cheaper than the cost of a dental policy which doesn't fully cover major dental costs anyway.
I was in Washington State ready to head south for the season when I started to experience pain. Soon I realized it was an infection from a bad tooth. Gratefully, I had gone to Los Algodones in previous years and picked up some Amoxicillin antibiotic. (To learn more about Los Algodones and its services, read Bob's blog post here http://www.cheaprvliving.com/budget...co-for-dental-glasses-and-prescription-drugs/.) The Rx and ibuprofen knocked out the pain. So, I decided I would go to Pahrump's RAM dental clinic while visiting friends there in a few weeks. But, by the time I got to northern California, the pain had returned. I increased the dosage of Amoxicillin and changed course for Reno where RAM had a clinic this weekend, one week before Pahrump's. I got my tooth extracted there yesterday.
Basically RAM is a bunch of volunteers of professionals and lay folks who serve un- and under-insured people with dental (cleanings, xrays, restorative, extractions), basic medical (blood pressure, medical history, check-ups, immunizations), and vision (check up, prescriptions, eye glasses within an hour). They move from town to town. It's all free, no questions asked, regardless of who you are or where you are from.
The one in Reno was at the Boys and Girls Club's super large gym which was partitioned off into a registration/triage area, and a service area. Within the service area, the large grouping of dental stations were hidden from view with curtains, as were the individual exam "rooms" in the basic medical section. The vision exam and service area was darkened, but wide open to everything else. Sets of chairs were set out in front of each service area. Everything is first-come-first served. Patients do a sort of musical chairs, moving up to the front seats as their turn draws near.
As someone who is a traveler, a minimalist, and somewhat of a perfectionist, I was astounded at how RAM had transformed a large open building into a full-service medical facility. For example, I was familiar with regular dental offices' cushy adjustable chairs, big hanging x-ray machines, water pumps and overhead operating lights. In comparison, the set-up in this gym wasn't so fancy, yet still fully practical, functional and sterile. Everything was made to travel from one place to another -- sturdy metal folding exam chairs/loungers, a hand-held x-ray "gun," water pumped from 5-gallon buckets, and bright strap-on head lights worn by the dentists (like we use as campers). They even had air suction. The other bit I liked seeing yesterday that I never saw in a regular dental office, is the process of sterilization and re-packaging of the instruments. This was all behind the curtains in the big dental area. I was impressed.
I was also impressed with the volunteers; there had to be at least 100 of them there yesterday. Every volunteer that I observed was friendly, fair-minded, compassionate, kind and respectful. And a few provided extremely outstanding service, advocating for me, comforting me before and during a very difficult extraction, then congratulating and cheering me for making it through successfully. Dr. Powell is probably the best dentist I've ever had both in skill and bed-side manner.
To get to the point of finally sitting in that dentist chair at 2:00 PM was a bit of a journey that started at midnight. That was when they opened the gates to the Health Administration's parking lot about 15 minutes away from the Boys and Girls Club's Gym where the clinic was located. I crossed the gate just as the clock struck 12 as I knew it was first-come-first-served. I got ticket #14 then was told to follow the car in front of me to the parking lot. The attendant directed us with red glowing sticks, like we were airplanes on a runway, to our parking spaces. We were told where to catch the bus to the clinic, and to be in line by 4:45 AM. I got, maybe, an hour of sleep.
I was in line by 4:30 AM. In the cold, I stood, waited and chit chatted with the other patients while local news crews filmed and interviewed for the News at 5. I was glad it wasn't windy, rainy or worse weather. Finally, at 5:15, two chartered city buses came to take the first group to the clinic which was to begin at 6. Once at the Boys and Girls Club, we lined up outside in our numerical order. We stood and waited outside the gym for the volunteers and technical systems to finish getting set up, again more news crews, cameras, and interviews.
At 6 they started letting groups of 5 through the door. Those still waiting outside were offered water, a banana, and a large fig bar. Once inside you told the attendant if you wanted dental or vision; you can only get one or the other at each visit. But, you could combine either of those with any basic medical need that you had. Then, you went to get registered. My mistake here was I got out of line to use the restroom which means I dropped well below my original #14 spot.
The registration process was pretty impressive. Every station, about 40 of them, was equipped with a networked laptop and label printer. The interview was oral with the attendant typing your answers onto their online form. Once completed, a label with your basic information was attached to your paper form and you walked across the room to a triage nurse who took your blood pressure, then collected your vital stats, medical history, and medications.
At that point you were escorted and directed to sit in your designated chair in first-come-first-serve order for the service you were there to receive. I was in about 25th place in the area for fillings and extractions. Then I waited. There was only one dentist who showed up. Rumor was that there were three no-shows. As a result, they had too many patients, and too many support staff volunteers for just the one dentist. As we waited, some patients switched to getting vision services, a few left to return on Saturday (today) as there were suppose to be six dentists then. I waited. Another dentist showed up. I waited. We were told that if we still weren't served by 6 PM, then we would be first to receive service the next morning. I waited.
We were instructed not to get out of our chair so we didn't lose our spot in line. So, they had volunteers that would sit in your chair for you if you needed to get up for any reason. Thankfully, I had nice folks around me who willingly saved my empty spot, moving me up in line with them, when I needed to get up. I even stepped outside for a lunch snack at one point.
I could tell some folks were in pain. We were all sleep deprived. The gym was a hubbub of activity and noise, accompanied by dental drills ... and more news crews with cameras. Yet, the interactions among the patients were friendly, with a few laughs here and there. The volunteers managing the flow of patients to services were also good at keeping us up-to-date and informed as to what our options were.
With all of the sitting and waiting, I was very glad that they provided wifi on their RAM network. I was a bit too stressed to do any meaningful online activities, but I did make it up a few levels in Candy Crush
This is my experience for this one initial visit as a patient.
I would certainly go to a RAM clinic again should I need one of the services they offer and I can't afford it otherwise. The worst was the standing and waiting, the second worst was the sitting and waiting, and the third worst were the news crews with their cameras all day. I complain, but do understand the need for the waiting processes when serving so many, and the reasoning for the media coverage to get community support. Astonishingly, for the hundreds of patients served yesterday, I feel like my service was as singularly personal as any I have receive by any other medical office or facility.
I hope to volunteer at Pahrump's RAM, a small token of gratitude and pay back. Thanks again to Guy who described his experience volunteering for RAM here https://vanlivingforum.com/showthread.php?tid=21090&pid=246318#pid246318
Suanne ... grateful and recuperating back in nature
I did have dental insurance up until this year, but didn't enroll in a replacement policy after my divorce. I thought I'd be safe for a while as over the last 4 years my twice-yearly check ups and cleanings found no problems. And, my long-term plan was that, when I did have a dental problem, I'd go to Los Algodones and get it fixed much cheaper than the cost of a dental policy which doesn't fully cover major dental costs anyway.
I was in Washington State ready to head south for the season when I started to experience pain. Soon I realized it was an infection from a bad tooth. Gratefully, I had gone to Los Algodones in previous years and picked up some Amoxicillin antibiotic. (To learn more about Los Algodones and its services, read Bob's blog post here http://www.cheaprvliving.com/budget...co-for-dental-glasses-and-prescription-drugs/.) The Rx and ibuprofen knocked out the pain. So, I decided I would go to Pahrump's RAM dental clinic while visiting friends there in a few weeks. But, by the time I got to northern California, the pain had returned. I increased the dosage of Amoxicillin and changed course for Reno where RAM had a clinic this weekend, one week before Pahrump's. I got my tooth extracted there yesterday.
Basically RAM is a bunch of volunteers of professionals and lay folks who serve un- and under-insured people with dental (cleanings, xrays, restorative, extractions), basic medical (blood pressure, medical history, check-ups, immunizations), and vision (check up, prescriptions, eye glasses within an hour). They move from town to town. It's all free, no questions asked, regardless of who you are or where you are from.
The one in Reno was at the Boys and Girls Club's super large gym which was partitioned off into a registration/triage area, and a service area. Within the service area, the large grouping of dental stations were hidden from view with curtains, as were the individual exam "rooms" in the basic medical section. The vision exam and service area was darkened, but wide open to everything else. Sets of chairs were set out in front of each service area. Everything is first-come-first served. Patients do a sort of musical chairs, moving up to the front seats as their turn draws near.
As someone who is a traveler, a minimalist, and somewhat of a perfectionist, I was astounded at how RAM had transformed a large open building into a full-service medical facility. For example, I was familiar with regular dental offices' cushy adjustable chairs, big hanging x-ray machines, water pumps and overhead operating lights. In comparison, the set-up in this gym wasn't so fancy, yet still fully practical, functional and sterile. Everything was made to travel from one place to another -- sturdy metal folding exam chairs/loungers, a hand-held x-ray "gun," water pumped from 5-gallon buckets, and bright strap-on head lights worn by the dentists (like we use as campers). They even had air suction. The other bit I liked seeing yesterday that I never saw in a regular dental office, is the process of sterilization and re-packaging of the instruments. This was all behind the curtains in the big dental area. I was impressed.
I was also impressed with the volunteers; there had to be at least 100 of them there yesterday. Every volunteer that I observed was friendly, fair-minded, compassionate, kind and respectful. And a few provided extremely outstanding service, advocating for me, comforting me before and during a very difficult extraction, then congratulating and cheering me for making it through successfully. Dr. Powell is probably the best dentist I've ever had both in skill and bed-side manner.
To get to the point of finally sitting in that dentist chair at 2:00 PM was a bit of a journey that started at midnight. That was when they opened the gates to the Health Administration's parking lot about 15 minutes away from the Boys and Girls Club's Gym where the clinic was located. I crossed the gate just as the clock struck 12 as I knew it was first-come-first-served. I got ticket #14 then was told to follow the car in front of me to the parking lot. The attendant directed us with red glowing sticks, like we were airplanes on a runway, to our parking spaces. We were told where to catch the bus to the clinic, and to be in line by 4:45 AM. I got, maybe, an hour of sleep.
I was in line by 4:30 AM. In the cold, I stood, waited and chit chatted with the other patients while local news crews filmed and interviewed for the News at 5. I was glad it wasn't windy, rainy or worse weather. Finally, at 5:15, two chartered city buses came to take the first group to the clinic which was to begin at 6. Once at the Boys and Girls Club, we lined up outside in our numerical order. We stood and waited outside the gym for the volunteers and technical systems to finish getting set up, again more news crews, cameras, and interviews.
At 6 they started letting groups of 5 through the door. Those still waiting outside were offered water, a banana, and a large fig bar. Once inside you told the attendant if you wanted dental or vision; you can only get one or the other at each visit. But, you could combine either of those with any basic medical need that you had. Then, you went to get registered. My mistake here was I got out of line to use the restroom which means I dropped well below my original #14 spot.
The registration process was pretty impressive. Every station, about 40 of them, was equipped with a networked laptop and label printer. The interview was oral with the attendant typing your answers onto their online form. Once completed, a label with your basic information was attached to your paper form and you walked across the room to a triage nurse who took your blood pressure, then collected your vital stats, medical history, and medications.
At that point you were escorted and directed to sit in your designated chair in first-come-first-serve order for the service you were there to receive. I was in about 25th place in the area for fillings and extractions. Then I waited. There was only one dentist who showed up. Rumor was that there were three no-shows. As a result, they had too many patients, and too many support staff volunteers for just the one dentist. As we waited, some patients switched to getting vision services, a few left to return on Saturday (today) as there were suppose to be six dentists then. I waited. Another dentist showed up. I waited. We were told that if we still weren't served by 6 PM, then we would be first to receive service the next morning. I waited.
We were instructed not to get out of our chair so we didn't lose our spot in line. So, they had volunteers that would sit in your chair for you if you needed to get up for any reason. Thankfully, I had nice folks around me who willingly saved my empty spot, moving me up in line with them, when I needed to get up. I even stepped outside for a lunch snack at one point.
I could tell some folks were in pain. We were all sleep deprived. The gym was a hubbub of activity and noise, accompanied by dental drills ... and more news crews with cameras. Yet, the interactions among the patients were friendly, with a few laughs here and there. The volunteers managing the flow of patients to services were also good at keeping us up-to-date and informed as to what our options were.
With all of the sitting and waiting, I was very glad that they provided wifi on their RAM network. I was a bit too stressed to do any meaningful online activities, but I did make it up a few levels in Candy Crush
This is my experience for this one initial visit as a patient.
I would certainly go to a RAM clinic again should I need one of the services they offer and I can't afford it otherwise. The worst was the standing and waiting, the second worst was the sitting and waiting, and the third worst were the news crews with their cameras all day. I complain, but do understand the need for the waiting processes when serving so many, and the reasoning for the media coverage to get community support. Astonishingly, for the hundreds of patients served yesterday, I feel like my service was as singularly personal as any I have receive by any other medical office or facility.
I hope to volunteer at Pahrump's RAM, a small token of gratitude and pay back. Thanks again to Guy who described his experience volunteering for RAM here https://vanlivingforum.com/showthread.php?tid=21090&pid=246318#pid246318
Suanne ... grateful and recuperating back in nature
