Not only does Dr Jessica Manuela run two thriving practices in Hobart, she’s also improving the oral health of Indigenous Tasmanians. By Frank Leggett
Dr Jess Manuela, a proud Palawa and Niuean woman, was interviewed on the land of the Muwinina people of Lutruwita (White name: Tasmania). Bite would like to pay respect to the elders of the past, present and future and acknowledge that First People’s traditions, culture and connection to land is as important today as it has ever been. We also acknowledge that it is imperative to back First People’s leadership.
When Dr Jessica Manuela was attending the University of Adelaide from 2008 to 2012, she was the only Indigenous student in her year.
“It wasn’t an issue,” says Dr Manuela. “My mum’s white and I’ve grown up with lots of non-Indigenous friends, so I was pretty comfortable. Though there were a few things that needed to be addressed. Some of the students a few years below me started a group called ‘We Are The White Girls Of Dentistry’. They thought it was funny but it was obviously racist so myself and fellow classmate, Dr Scott Williams, shut that down. It just highlights the ignorance of some people and how Australia still has a long way to go to address its systemic racial prejudice. Racism is never a joke.”
After graduation, Dr Manuela worked for 18 months at a clinic in the suburbs of Hobart. Unfortunately, this experience fell far short of her expectations, motivating her to start her own practice as a recent graduate.
“There was a lot of sexism in that clinic,” she says. “I didn’t like how the young people and women were being treated. I decided I might as well be stressed from starting my own business rather than working in a clinic that made me feel morally conflicted.”
At the age of 26, Dr Manuela started Dental South in the Tasmanian town of Margate. Margate was developing quickly but didn’t have a local dental clinic. There were two schools within walking distance of her site and more schools in a 10-kilometre radius. She leased an old heritage doctor’s surgery that had been vacant for eight years. Family and friends helped renovate the decrepit space until it gleamed.
“One good thing about being raised poor is that you’re used to working hard and figuring stuff out,” says Dr Manuela. “I was happy to work until 3am for weeks to renovate the premises. I didn’t have any business background; I just jumped in the deep end.”
The risk paid off and the new clinic was immediately successful. From the day it opened in late 2014, the practice was booked out each day. Dr Manuela, the sole dentist for the first few years, took the opportunity to stamp the business with her own ethos.
“Running a business is difficult and time-consuming,” she says. “It’s easy to get lost in the day-to-day and at times I had to remind myself why I started Dental South. I wanted to provide a safe space for my staff to work but at the end of the day, they should be able to go home without thinking about work. I also made it a safe, calm space for my patients where I use high-quality materials and spend enough time with them without feeling under pressure.”
With the first clinic going gangbusters, Dr Manuela decided to expand her business empire. In August 2017, she opened a second Dental South clinic in Blackmans Bay and suddenly began to understand the hardships of business ownership. The new clinic was adjacent to the suburb of Kingston that had four dental practices so it was much slower to build a client base.
“While it’s easy to manage a business where you work, having two on your plate is a very different experience,” she says. “The second clinic grew much more slowly than my first start-up, which was very humbling. I also had a steep learning curve when the second clinic flooded in 2018 and closed for two months. I had to start again and learnt about the process of insurance claims. It took a good two years to get it where it needed to be.”
Along with running two practices, Dr Manuela volunteers her time to regularly visit eight schools in the surrounding area. She takes along a staff member to educate the children about good oral hygiene and healthy diets. She has also run information sessions at nursing homes, high schools and refugee adult learning classes.
Another passion is the dental scheme for Aboriginal adults she set up in 2017 with the assistance of the Royal Flying Doctor Service (RFDS) and the South East Tasmanian Aboriginal Corporation.
Len Crocombe, Associate Professor of Oral Health at the University of Tasmania, La Trobe University and the University of Papua New Guinea, first met Dr Manuela when he was leading her tutorial group at the University of Adelaide. Today he visits Dr Manuela for his six-monthly check-up at Dental South Margate. Professor Crocombe consults for the RFDS and was able to assist in getting them involved with Dr Manuela’s scheme.
“The scheme enabled adult Aboriginal patients to come to my clinic and get work done which was then bulk-billed,” says Dr Manuela. “The RFDS had a budget to use on rural areas and that enabled the scheme to operate. When our Aboriginal patients visited, they always saw me or an Aboriginal dentist who worked at my clinic. Seeing the same clinician every time allowed us to build a relationship. If they used the Public Oral Health Services then they would often see a different dentist every visit. It’s all about relationships and trust.”
“One good thing about being raised poor is that you’re used to working hard and figuring stuff out. I was happy to work until 3am for weeks to renovate the premises. I didn’t have any business background; I just jumped in the deep end.”
Dr Jessica Manuela, owner, Dental South
The program was very successful with patients coming from all around the surrounding area. Unfortunately, the scheme was discontinued because Dr Manuela’s clinic was not ‘rural’ enough. It seems her practice was positioned five kilometres short of an arbitrary line.
“It was devastating for the community, as the scheme was successful and we were seeing improvement in oral health,” says Dr Manuela.
Professor Crocombe is equally disappointed. “It was a case of some bureaucrat ticking boxes rather than trying to figure out what was best for the community. Dr Manuela is doing vital work as we don’t actually know the oral health condition of Indigenous people in Tasmania. When the Australian Research Centre for Population Oral Health does its national survey, they take a 500-person sample for Tasmania. The figures simply cannot be extrapolated to be representative of the Indigenous population.”
Speaking and lobbying
Dr Manuela also spent a lot of time lobbying to save the Child Dental Benefits Scheme when it was under threat of cancellation. She spoke at rallies, with politicians and on ABC radio. The scheme was under-utilised because it was advertised so poorly. People simply didn’t know it existed.
In recognition of her volunteer work and her program providing dental access to Tasmanian Aboriginal patients, Dr Manuela was awarded the 2017 Premier’s Young Achiever of the Year and the 2018 Tasmanian Young Australian of the Year. She also nabbed the 2017 Telstra Young Business Owner for Tasmania.
With two practices and a full schedule of volunteer work, she has recently re-organised her schedules for more efficiency and a better work-life balance. “I realised I needed more time off as a business owner. I’m in the practice Tuesday, Wednesday and Thursday, and I have staff meetings with my four managers once a month. Those meetings allow us to keep on top of things and discuss ways of improvement. I trust my business leaders and have always believed that building them up and sharing responsibility is crucial to success and stability. I’m now much more efficient with three days of hands-on work while having the time to plan what I want to happen in my businesses and in my life.”
While business expansion may be on the cards in the future, Dr Manuela is committed to her clinics maintaining their authenticity. They are well-regarded in the community and all the staff embrace the practice ethos—to be respectful and compassionate with integrity.
“Being a dental practitioner is a real privilege,” says Dr Manuela. “We need to keep in mind that there’s a human on the other end of what we do. Everyone should be treated with respect and be given time. Sometimes, dentistry is just too expensive and there are barriers to care for a number of reasons. As a profession, I would love to see all of my fellow colleagues volunteering a day a year to educate people about oral health that will help prevent dental disease. Drilling and filling holes is too late; it’s way too downstream.”