The new president of ADA NSW is certain that working in Wagga Wagga as a public sector dentist has made her a better healthcare professional. By Frank Leggett
Having been based in the regional NSW town of Wagga Wagga for nearly 30 years, Dr Kathleen Matthews, the new president of ADA NSW, understands the challenges facing rural dentists. The biggest problem is still the tyranny of distance—communities are simply unable to access specialist care. There is also a lack of dentists willing to live and work in regional communities.
“We know there’s a mal-distribution of dentists rather than a shortage of dentists,” says Dr Matthews. “There are high concentrations in metro areas and not enough in rural areas. Getting dentists to work in smaller communities is difficult. Unfortunately, they don’t always understand how wonderful it can be to be part of a community. I came to Wagga Wagga for a year and I’m still here 28 years later.”
While Dr Matthews has lived in many different rural and metro cities across Australia, Wagga Wagga is her home. Soon after moving to the area, she fell in love, married and had a baby. It was at this point, Dr Matthews decided it was time to take control of her professional destiny.
“I wanted to own my business and have some flexibility around my family life,” she says. “I purchased Peter Street Dental in 1995 and ran it for the next 16 years. After I sold it in 2009, I was lucky to score a job as the senior dentist at the Wagga Base Hospital Public Dental Clinic. I was also working for NSW Health and the Murrumbidgee Local Health District.”
For the past decade, Dr Matthews has been a public sector dentist. During her time as a business owner and while working at the public health clinic, she embraced a service mentality. She is well experienced in how effective communication can help negotiate with patients.
As the new president of ADA NSW, Dr Matthews believes her experiences as a public sector dentist from rural Australia will be a real advantage. “Although I’ve mainly pursued dentistry within one location, Wagga Wagga, I’ve worked in very diverse areas,” she says. “I understand the significant challenges and opportunities of the dental profession.”
NSW Health has a hospital located on the grounds of Wagga Wagga Base Hospital. This clinic is also a part of a wider network with Dr Matthews managing clinics in Tumut, Junee, Cootamundra and Young.
“NSW Health has a great work ethic and capacity to deliver care,” she says. “It’s a bit hamstrung by the lack of funding that a large health organisation needs.”
All of these public sector clinics have an eligibility criteria around which patients can access the service. The main clinic in Wagga can treat children under 18 years of age with an address in the local health district and who have a current Medicare card. Adults must have a pension or healthcare card. The dental treatment is essentially safety net and emergency treatment, although there is some comprehensive care.
Growing up with a father in the army meant Dr Matthews moved around a lot as a child. She attended five different primary schools and never spent very long in one town. Eventually, she went to high school in Canberra where, just before finishing Year 12, a visit to the dentist would dramatically change her life.
“I was having my regular check-up and chatting with my dentist who was a lovely fellow,” recalls Dr Matthews. “When I told him about my plans to study science, he suggested I think about dentistry. So, a conversation and a little bit of a think as a 17-year-old and here I am—35 years into my career as a health professional.”
While studying at the University of Sydney, she found dentistry to be a bit of a challenge. Naturally an introvert, she needed to overcome her reticence with people to fully embrace the learning environment and dentistry as a career choice.
“The ability to communicate is a real gift,” says Dr Matthews. “To this day, I think the biggest challenge of dentistry is communication.”
The power of three
After graduating in 1986, Dr Matthews was initially based in the ACT where she worked three days a week at a family practice in Belconnen, one day a week at an inner-city practice and one day a week in a public sector job.
“The three jobs gave me five days a week of work,” she says. “I thought I was just filling up my dance card, so to speak, but it also allowed me to observe different styles of practice with different styles of management and staffing techniques. The patient cohorts were as varied as the practices.”
In the early ’90s, a move to Wagga Wagga, three hours’ drive west of Canberra, saw her employed as a dentist for the Government Employees Health Fund. There was plenty of opportunity to hone her skills as she had access to visiting dental specialists and was able to observe their work.
“At that time, in the ’90s, this health fund had no co-payments for patients,” she explains. “The patient had no extra to pay above their health insurance. This meant people were able to visit the dentist without extra financial burden and I saw a wide variety of cases.”
Joining the ADA
Attending university at a time when there was no Higher Education Contribution Scheme (HECS) is directly responsible for Dr Matthews becoming involved with the Australian Dental Association (ADA).
“I felt it was an honour to have been educated by my country, so I thought I should pay it back,” she says. “I wanted to help dentists do dentistry better and become an advocate for them. I signed up for local committee membership of the ADA, attended study groups, listened to lectures, met people and built a network of like-minded individuals.”
In 2014, Dr Matthews made an application to be a council member of the New South Wales branch and was voted in. She became a board member in 2015 and had been vice-president for the past two years. Last month, the dental practitioner became president of ADA NSW.
“It’s an honour to represent the profession,” says Dr Matthews. “It’s also wonderful being a public sector dentist because I feel I bring a broad knowledge to the role.”
During her time as president of ADA NSW, Dr Matthews plans to undertake advocacy work in a number of different areas. She is particularly passionate about improving dental access for older Australians and patients with disabilities.
“Working as a public sector dentist, I know that access to health services can be very difficult,” she says. “Older people have significant barriers around mobility, frailty and finances. The same barriers often apply to people with disabilities. I want to advocate via professional bodies such as the ADA, along with government and like-minded organisations.
“Some people think the solution is simply adding dental work to the Medicare schedule. However, developing a universal scheme needs careful thought and planning. At the same time, it’s odd that we have a Medicare system that treats every part of the body except the mouth. I think there’s a good case for medically necessary dental treatment for pain and infection to be added to the schedule. Further discussions and planning could create a more inclusive plan that’s sustainable into the future.”
Another area that Dr Matthews wishes to explore is a sugar tax. She sees it as a possible solution to Australia’s sugar addiction. However, many commentators claim that a sugar tax is just another example of the nanny state gone mad.
“Not at all,” says the dentist. “We simply need to acknowledge how processed foods and changing lifestyle has impacted on the health of our population. It’s not just sugar in drinks; it’s everywhere and it’s extremely complicated.
“In Mexico, the UK and Finland, a sugar tax has seen manufacturers lower levels of sugar in products to earn a health rating. They are also seeing significant improvements in the population’s BMI [body mass index]. In dentistry, increased sugar volume usually means an increase in decay presentation. A sugar tax may not solve all the problems but there’s an evidence base that says it impacts in a positive way.”
Reclaiming expert status
These days, in the era of ‘fake news’ and social media experts with answers to everything, Dr Matthews would like to see the status of the expert reclaimed. “People are not critically thinking or looking at the source of their information,” she comments. “They seem to think their uninformed belief is unassailable.
“In dentistry, we’re seeing the rise of home whitening, DIY aligners and conspiracy theories about fluoride in the water or even toothpaste. There needs to be respect for dental professionals—dismissing me as part of a conspiracy that’s designed to hurt people is very distressing. Dentists are caring health professionals who are striving for the best, healthiest results for their patients.
“Listening to recommendations from influencers and people on social media is a poor choice compared to the advice of a dental professional. Unfortunately, an endorsement by someone popular ranks higher than Dr Matthews, who actually knows what she’s talking about.
“Dentists are amazing primary health caregivers who deliver safe, quality procedures every day. At the very least, their expertise and advice should be respected.”