Social Workers in Big Demand at Eastman Marking 30 Years of Service to Patients and Residents

When George Eastman founded the Dental Dispensary 106 years ago, he knew the importance of collaboration, and engaged social services to help young orphans receive dental care they likely wouldn’t have received without their help.

Fast forward to 1993, and the mounting evidence of domestic violence, child abuse and neglect led to the formal collaboration with URMC Social Work and Eastman Dental to improve outcomes for patients in need.

At that time, EIOH and URMC had several departmental collaborations underway before they merged in 1998. The URMC Social Work Department designated eight hours of services to dentistry, mostly for pediatric patients and families. They provided consultations to educate faculty and residents on identifying these situations as well as direct support for patients and families.

Today, it’s just two part-time social workers who cast a much wider net, helping patients and residents within 15 departments and clinics throughout Rochester. Much has changed over the last several years, including a significant increase of referrals, and the nature of patients’ needs.

“Social work support within dentistry generally exists to address barriers that impact one’s ability to comply with or complete treatment,” explained Jill DelVecchio, LMSW, EIOH social worker.

Jill

“However, patients often require much more than facilitation of care or referrals to community resources.”

Social work uses a biopsychosocial perspective to assess for social determinants of health. These assessments allow social work to better assist patients in identifying strengths, coping mechanisms, community supports and help empower the patient to continue with dental care.

Referrals range from assistance with transportation and insurance challenges, to the more complex medical, mental and social barriers. “We assist many patients with medically complex conditions like cancer, infectious diseases, craniofacial anomalies, developmental differences and those awaiting lifesaving treatment and procedures,” she explained.

For example, a patient who awaits cancer treatment first needs a dental clearance. But the patient has Medicare, which doesn’t cover dental treatment. Jill assists the patient in collaborating with medical and dental providers, as well as connecting him or her to resources for insurance or other financial support.

Or, an adult patient with autism is scheduled for dental surgery. The patient has a history of running away when anxious and can become aggressive toward others. Social work puts together a plan and facilitates communication with all parties involved in the patient’s care, including parking, public safety, group home staff, parents, operating room nursing staff and other faculty/staff to provide the most optimal outcome in the safest manner.

“In my roles as a resident, faculty member and manager, I have benefitted from having a social worker at EIOH,” said Sean McLaren, DDS, director, EIOH Quality Improvement and Compliance. “Our social workers always broadened my perspective of the situation at hand. I have learned to frame issues with a much wider lens due to these interactions.” lasting impact on oral health facilities, like seeing fewer patients due to staff shortages and new, more time-consuming cleaning and prep procedures.

“Even though Eastman Dental is seeing fewer patients for these reasons, social work continues to see an increase in the number of referrals,” Jill said about the 702 referrals her office received in 2022.

While pediatrics continues to claim the largest share of referrals, General Dentistry and Oral and Maxillofacial Surgery Departments follow close behind. Together the three departments comprise 62% of all referrals to social work. The number of patients with medical complexities, mental health challenges and other social determinants of health have increased greatly, she added.

“For more than 100 years we have been the safety net oral health provider in the region,” said Eli Eliav, DMD, PhD, director, Eastman Institute for Oral Health. “Our social workers are invaluable resources for our patients, and they are one of many examples of our commitment to patients and the community.”

Before Covid, EIOH Social Work was experiencing a pretty steady increase in the number of annual referrals. In 2018, they received 567 referrals, and a year later, 629.

Like many health care systems, the pandemic has had long-

“Jill goes above the call of duty assisting me with my dental care,” said Richard Shaw, of Utica, NY. “I have a lot of complex medical issues and she has been helping me a long time. She never hesitates to answer my questions or follow up to help coordinate everything.”

Social work participates in all resident core orientation by providing presentations on the role of social work in dentistry, identifying signs of child or adult abuse and neglect, as well as domestic violence. Jill is frequently asked by faculty to present case reviews and in-services, as well as provide lectures related to ethics and advocacy.

Now integrated into the Office of Quality Improvement and Compliance, EIOH Social Workers are part of the discussions and decisions that impact policy and procedures within the institution, including social justice and equal access.

“While it’s clear there is a need for additional social work support for patients at EIOH,” Jill said, “we’re pleased that social work has proven to be an effective component in the overall mission at Eastman, and look forward to serving for the next 30 years.”