title: Holding up the oral health safety net: the role of National Health Service Corps alumni dentists in North Carolina.
abstract: BACKGROUND
  Access to oral health care among low income populations is a growing problem. The National Health Service Corps (NHSC) might increase the supply of dentists motivated to provide services for this population.
  
  
  OBJECTIVE
  To determine if North Carolina dentists who began a service obligation with the NHSC in 1990-1999 continued to provide care for underserved populations and if they differ from non-NHSC alumni primary care dentists who started practice in the state during that same period.
  
  
  METHODS
  All 19 NHSC alumni and 50 comparison dentists were surveyed by mail. NHSC alumni also responded to selected items in a telephone follow-up interview. The two groups were compared using difference of means tests and multivariate contingency tables.
  
  
  RESULTS
  National Health Service Corps alumni were more likely to be African-American (38%vs. 10%), work in safety net practices (84%vs. 23%), and see more publicly insured patients (60%vs. 19%) than comparison dentists. Yet their job satisfaction was comparable to non-NHSC alumni dentists. Analyses suggested that current practice in safety net settings is affected by dentists' race, altruistic motivations and previous NHSC participation. CONCLUSION AND POLICY IMPLICATION:  Targeted recruitment of African-American dentists and others wanting to work in underserved communities could amplify the effectiveness of the financial incentive of NHSC loan repayment and induce dentists to remain in 'safety net' settings.
authors.affiliation: School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. drneel1@gmail.com
authors.forename: Neel B
authors.initials: NB
authors.lastname: Bhatavadekar
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Konrad
mesh_terms: D001741:Black or African American; D000533:Altruism; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003729:Dental Care; D003815:Dentists / Q000191:economics / Q000523:psychology* / Q000600:supply & distribution*; D005792:General Practice, Dental; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008484:Medicaid; D008507:Medically Underserved Area; D009657:North Carolina; D009909:Oral Health; D011331:Private Practice; D011636:Public Health Dentistry; D012189:Retrospective Studies; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D018401:Sample Size; D011795:Surveys and Questionnaires; D014146:Training Support; D014481:United States; D000078329:Workforce