Where It Really Works | Rural Colorado

Fewer than 10,000 people live in Craig, Colo.

Steamboat Springs, some 40 miles away, boasts just 12,000.

There’s little in between.

The two towns sit along the Yampa River, just west of the Continental Divide.

Elk are plentiful. Healthcare providers are not.

This is where Malea Johnson DHS ’14 has recently made her home.

After earning her bachelor’s degree in the Pacific University dental hygiene program, Johnson set out to travel by taking three-month jobs around the country, filling in for other hygienists on family leave.

She was in Steamboat on a temporary job when she saw a posting for a new kind of position: the first dental hygienist working with the Northwest Colorado Visiting Nurses Association.

The organization provides broader care than its name might imply. Physician assistants, nurse practitioners, MDs and others offer a range of primary care, public health, home health, hospice care, and assisted living in the two rural counties of Northwest Colorado.

Last year, the NCVNA received a federal grant to add oral health to that mix.

Johnson was the first hygienist hired by the group and has spent nearly a year working on the process of integrating dental care into two medical clinics.

“I was excited, because this was so foundational in school at Pacific: treating patients comprehensively. It’s something I’m really passionate about as well, building a culture where oral health is valued, by patients and organizations,” Johnson said. “I remember reading the job description and it was like, ‘I did every single one of these things in school!’”

Not all hygienists could say that — and in fact, her employers were surprised she wasn’t more nervous about the integration. But at Pacific, Johnson worked with the Interprofessional Diabetes Clinic, went on an interprofessional service trip to Nicaragua, and participated in interprofessional case conferences routinely.

“It made me confident with dental as part of the care team,” she said.

Johnson spent June to December 2015 just setting up the system. She purchased the necessary equipment, developed policies and procedures, offered trainings, and helped figure out how she would fit into the flow of care at the two clinics in Craig and Steamboat Springs.

"I remember reading the job description and it was like, 'I did every single one of these things in school!'"

Since January, she’s been actively working with patients. Each day starts with a team meeting, where all providers get together to talk about their patients’ comprehensive needs. Then, Johnson might see patients who were referred to her while she was at another site, or she’ll take part in the actual medical appointment.

“After the primary care appointment finishes, I’ll go in and introduce myself, and we’ll go to the dental room, just a few doors down the hall,” she said.

To her, the system just makes sense, because oral health is closely linked to so many other medical conditions — diabetes, pregnancy health, and more.

“Oral health just really belongs in primary care, because there are so many different conditions in systemic health that affect oral health,” she said. “It is just so silly to address one isolated part of the body.” ■

This story first appeared in the Spring 2016, Special Healthcare issue of Pacific magazine. For more stories, visit pacificu.edu/magazine.