Running a fly-in fly-out dental practice

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fly-in fly-out dental practice
Dr Prashant Krishna

It’s not easy running a fly-in fly-out dental practice but the many challenges can be overcome with creative thinking and dogged determination. By Kerryn Ramsey

The town of Nhulunbuy, situated on the Gove Peninsula in East Arnhem Land, NT, has a population of around 3300 people. It’s a remote, beautiful place, only accessible by four-wheel drive or infrequent commercial flights. This is where Dr Prashant Krishna has set up his practice, Udent Dental.

“I love the time I spend in Nhulunbuy,” he says. Dr Krishna and the other dentists at the practice are all fly-in fly-out (FIFO) professionals. Generally, they work for a week in Nhulunbuy then have a week off back in their hometown. “It’s great to get away from the hustle and bustle of the big cities. The people are very welcoming and I’ve even been invited to be a part of some cultural practices. It’s a great experience.”

After graduating from James Cook University in 2016, Dr Krishna undertook outreach work in the public sector. Employed by Top End Oral Health, he visited rural remote communities in and around Bulman, Katherine and Borroloola. 

“Witnessing the high rates of oral health comorbidities, such as oral cancers and dental infections, was alarming,” says Dr Krishna. “Too many patients were in acute pain and in need of immediate treatment. There was a massive need for a more permanent dentist.”

Reaching out

These experiences inspired Dr Krishna to set up Arnhem Dental in Nhulunbuy. The practice has recently rebranded as Udent Dental Clinic with Athi Selvanayagam joining as a business partner. Selvanayagam has extensive experience in creating self-sustainable economies for rural remote communities across Asia and Australia.

Witnessing the high rates of oral health comorbidities, such as oral cancers and dental infections, was alarming. Too many patients were in acute pain and in need of immediate treatment. There was a massive need for a more permanent dentist.

Dr Prashant Krishna, owner, Udent Dental

“Most recently I worked with the Jilkminggan community in the Roper region of Arnhem Land,” he says. “Predominantly the people have been dependent on money from the Federal Government. I saw an opportunity for them to be self-sufficient through poultry farming. I helped them secure contracts with Woolworths and Coles so it’s sustainable. This can be a sustainable business across generations.”

Many of the oral diseases rampant in remote communities are preventable by screening and early intervention. Dr Krishna’s mission is to reach out to underserved locations and provide regular dental services and education. Selvanayagam is addressing oral health disparities between remote and major cities by instituting a social model of oral health. He aims to have a population-based impact through economic advancement, health promotion, and policy change to ensure a better future for the local populations.

Outback challenges

Running a FIFO practice in a remote community offers many challenges. Everyday issues include longer turnaround time for fabrications, brownouts and blackouts, the logistics of supplying materials and equipment, and exorbitant flight costs. Extreme weather events are a constant possibility. Larger issues include finding and keeping professional staff, the availability of suitable housing, and maintaining regular openings hours.

“The recruitment and retention of support staff and clinicians is always difficult,” says Dr Krishna. “The scarcity of dentists in Australia contributes to that difficulty. At Udent, we are blessed to work with professionals who want to give back while benefiting from a positive experience and gaining personal development.”

What it takes

Dr Nishan Soomessur is one of the FIFO dentists working at Udent. He flies into Nhulunbuy on a Monday. The team work 10 to 12 hours a day until Thursday then he flies back home on Friday morning. He does this twice a month. 

FIFO dentistry is very rewarding as I’m often the only dentist for a community of 3000 people. It has put things into perspective for me clinically and has given me a new lease of life that I needed after 12 years of general practice.

Dr Nishan Soomessur, Udent Dental

“I’m now trying to commute from Bali,” he says. “I’m not sure if it’s possible but I love that my job has the flexibility to give it a try. FIFO dentistry is very rewarding as I’m often the only dentist for a community of 3000 people. It has put things into perspective for me clinically and has given me a new lease of life that I needed after 12 years of general practice. I love the community in Nhulunbuy; it has a small-town feel and I’m often stopped and asked if I need a lift home while carrying my Woolies bag. That never happens in a city.”

fly-in fly-out dental practice
Athi Selvanayagam

Of course, there are certain qualities that make a good FIFO dentist. You need to embrace change and be willing to work outside your comfort zone. Flexibility, the ability to think on your feet, patience, and open-mindedness are also great characteristics to have. 

New career

One person who knows he has what it takes is Athi Selvanayagam. Currently undertaking biomedical science at James Cook University, he intends to pursue dentistry in the near future. 

“My experiences with Udent have grown a passion for dentistry in me,” he says. “There are a lot of dental emergencies in remote practices and I can see a practical way to reduce that. Wanting to be part of the solution is leading me to a whole new career as a dentist.”

Dr Krishna and Athi Selvanayagam have also established a new dental hub at Tennant Creek that provides private and public dental services. It’s another FIFO practice working in conjunction with Top End Oral Health.

“Australia should be able to provide equal dental services to everyone, no matter where they live,” says Dr Krishna. “We’re a long way from that but we’re taking steps in the right direction. It’s going to be difficult but it’s certainly a clear goal.”  

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