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The Basics

Help a budding doctor and save

Schools for future dentists, optometrists, counselors and therapists offer low-cost care under an instructor's watchful eye.

By Karen Aho

More than 150 million Americans lack dental insurance. I'm one of them.

But rather than put off care for my aching tooth, I found relief for about half the price from a source you might not have thought of: students.

In fact, students represent a ready cadre of health-care workers to soothe many types of ailments, not just bad teeth. Dentists, optometrists, psychological counselors and practitioners of alternative therapies -- from naturopathic doctors to massage therapists -- routinely do their practicums in designated student-training clinics.

This is treatment at licensed health centers run by universities and professional schools for student training. The centers provide thorough evaluations to the public at half the price, or less, of a standard clinic and guarantee high-quality care overseen by licensed supervisors.

These clinics give faculty the opportunity to oversee training, expose students to a diverse clientele and further the educational mission to serve the community, often filling a gap in services for the underinsured.

Time is money

In every field of health care, student trainees are eager listeners and observers. They are constantly being evaluated and are required to do lengthy medical histories and meticulous physical or psychological exams. Their work is double-checked -- and the patient re-examined -- by a doctor, who discusses the case with the trainee and, at times, additional trainees and faculty experts.

If pain is a concern, don't worry. Dental students have to put in hundreds of hours on mannequins and other students before they are allowed to hold a metal instrument anywhere near patients.

So, you ask, with all this, and at half the price, what's the catch? Well, there are some limitations, and they depend on the field.

With dental work, the most significant drawback is time. A cleaning and exam could take three hours instead of one ($50 instead of $100). A crown might require a commitment of nine hours instead of two or three ($600 instead of $1,200). These are samples; times and prices vary.

In any case, dental schools are not the place for a quick fix. To prevent any irreversible mistakes, students are required to get the instructor's approval before each step. Because instructors circulate among students, it makes for a lot of downtime in the chair.

That said, the waiting isn't all bad. Your mouth need not remain open. And the dental student is there with you, a captive prisoner to any and all questions.

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I became a patient at the Tufts University School of Dental Medicine in Boston. On my first day, I got tips on preventing tea stains, learned that I had two extra bones in my mouth and discovered in detail why, despite a mouthful of fillings, I am not destined for an old age in dentures.

On the second day, though, I was forced to calculate the exact value of my own time. My student dentist informed me that the two crowns and a root canal I needed would require 15 three-hour appointments. She started to list each of the steps on a piece of paper but ran out of room. It became clear why many of the people in the lobby looked like retirees or students.

I did a quick analysis. The student clinic would cost me 39 hours more and $1,600 less than a private dentist, for a savings of $41 per hour. So it pays. It's just difficult to fit into a work schedule.

Your body is a textbook

The time discrepancy is far less stark in other health-care fields.

A comprehensive eye exam at one of the nation's 15 optometry schools might take 90 minutes, as opposed to 45 at a private clinic, and still offer a significantly reduced rate.

Edward Revelli, the University of California, Berkeley, School of Optometry associate dean of patient care, said most of the patients are insured and could go anywhere. They come to the student clinic for the multiple layers of care. Patients are seen by a student, and again by an instructor, sometimes more than once.

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