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ADA – Can You Hear Me Now?

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The Sounds of Institutional Silence 

[By Darrell K. Pruitt DDS]

pruitt2

Hey you, American Dental Association.

What do you have against talking with us members?

Do you fear the questions we might ask, or something?

Who I Am 

I am one of a growing number of dentists who believes that our profession, as well as all US health care, urgently needs transparency through communications – hair and all – bottom to top.  That means accountability from leadership.

Government Similarity 

President-elect Barack Obama has the same idea about government. Over a year ago, candidate Obama promised that all his Cabinet Secretaries would maintain weblogs to promote two way communication with all citizens. Even before he takes office, his website has been busy for weeks with interactive conversations with average citizens … yet I cannot get an official from my own professional association to respond to me online at all. I pay dues to the non-profit organization. How good is that?

The Naked Conversations 

Over two years ago, I read about weblogs in “Naked Conversations,” written by Robert Scoble and Shel Israel. I quickly became a fan of networks. A few months later, I offered to help start an ADA weblog – in a conversation with ADA Senior Vice President Dr. John R. Luther. I suggested that if ADA members could interact online with ADA officials or their representatives in real time, the transparency would empower the organization like never before in history. He was not interested.

An ADA Weblog 

Dr. Luther dismissed my idea outright and refused to discuss it further. He specifically told me that when the ADA was ready for a weblog, “the ADA leadership would let me know.” If you don’t recognize it, his was a variation of a typical conversation-ending response often used by leaders of traditional top-to-bottom, command-and-control business models like the ADA’s. Other door-closers are “Just because,” and “Anyway, it’s mandated so we have no choice.”  In my opinion, the ADA and in turn, the dental profession, are hobbled by an archaic model that no longer works and is recently vulnerable to trouble-makers like me who not only don’t play by their self-serving rules – but have a hell of a good time flaunting them. 

So-Called Authoritarian Dismissals 

By the summer of ’06, I was already accustomed to authoritarian dismissals from Dr. Luther.  On a separate issue I had raised earlier concerning the NPI number, he used a nuclear door-closer when he suggested that I write a letter to the editor if his committee-approved non-answer didn’t satisfy me … which he knew didn’t come close. If I had gone through my ADA publications with my question, the turnaround – if it were even considered for publication – would have been at least six weeks. 

Chain of Command 

That is how the leaders of the ADA used to conveniently handle those who didn’t respect proper chain-of-command representation, which normally shelves tricky questions on local dental society levels long before they reach Headquarters in Chicago. Very soon, officials in the ADA will be demanded to explain what’s wrong with responding to members immediately, or their silence will look more and more suspicious. It is not a good time in history to be a dinosaur. Barack Obama’s team finds the time to talk to underlings. What makes the leaders of the American Dental Association so special?

Internal Rules

Oh yea! Here is another internal ADA rule. “Let’s not wash our laundry in public.”  That means laundry never gets washed. Now, Dr. Luther isn’t the only ADA official who won’t venture onto the Internet.  I have tried to attract past Presidents, current Presidents and future Presidents as well.

For example, when one Google searches “Dr. Ron Tankersley,” who will be our next President of the ADA, my article on the PennWell forum titled “An invitation to Dr. Ron Tankersley, President-elect of the ADA” – appears on his first page.

http://community.pennwelldentalgroup.com/forum/topics/an-invitation-to-dr-ron

Here is the invitation that has been ignored for two months

Dear Dr. Tankersley,

I too am a member of the ADA. Congratulations on your election to the highest post in our professional organization. It is an esteemed compliment when so many colleagues put so much faith in a fellow professional, especially in these challenging times for dentistry.

As a dentist, I am excited about the miracles of discovery that will become possible when we begin applying Evidence-Based Dentistry to a vast network of interoperable computers in dentists’ offices across the nation – creating real-time research.

  • How soon do you foresee this happening?
  • Can we expect to see the beginning of it during your reign?

Your response is appreciated by dentists and patients alike.

Assessment

Does anyone else found institutional silence odd these days? Or, am I unprofessional to demand information that I consider is owed me?

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Conclusion

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On Financial Sector Failings

Understanding the Debacle

[By Staff Reporters]56371606

Did you know that Michael Lewis and David Einhorn recently gave a nice review of the financial system catastrophe, and its devastating flaws, causes and effects, in the January 3rd 2009 New York Times?

Exposing the Flaws

In review of How to Repair a Broken Financial World, they said:

1. Wall Street CEOs won’t self-incriminate or blow the whistle on their own companies [Think: thin-blue line]. And, they receive bonuses and are on peer-compensation committees. Perhaps they might even be fired if they self-accuse of irresponsibility.

2. The credit-rating agencies, which are supposed to carefully measure the amount of risk that companies take, dropped the ball.

For example Fannie, Freddie, GE and AIG all had triple-A ratings; remember Enron? But, they disguised the risk, rather than expose it. Why? Because they would have to re-rate tens of thousands of credits tied to them, as well as increase their own cost-of-capital; integrity and reputations be damned! And, did the big financial firms contribute to those very same credit-rating agencies [pay-2-play]?

3. Was Chris Cox and the Securities and Exchange Commission [SEC] competent enough, or motivated enough, to do its job and investigate the Madoff scheme even after being warned about it?

Assessment

Can you cite some other, even more pernicious, flaws? For example; how did the mortgage industry’s engorgement of commission-driven sales, and the consumer sentiment to “own a home – at all costs” factor into the fault-line?   

Link: http://www.nytimes.com/2009/01/04/opinion/04lewiseinhornb.html?_r=1

Conclusion

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Healthcare Economics Stimulus

The $100-B Question

Staff Reporterscapital

Reporting in a January 6, 2009 article in Politico, Chris Frates says the healthcare industry could potentially gain more than $100 billion from the $775 billion economic stimulus plan that President-elect Obama and congressional Democrats are now assembling.

 

Insiders Speak

Frates reports that some pundits opine the vast majority [$80 billion] will be earmarked for state Medicaid programs. Apparently, President-elect Obama now realizes that many states have been put into a bad financial position, with failing budgets and increasing pressure on Medicaid programs, and massive layoffs across the country.

Health IT Earmarks

The other $20 billion would likely go to updating medical care delivery with health information technology. The money probably will be distributed as pay-for-performance [P4P] rewards, with some of it being used as grants to hospitals and healthcare systems that need help building IT infrastructures.

Assessment

Link: http://www.politico.com/news/stories/0109/17119.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Can Obama achieve his stated healthcare goal of complete eMR adoption within five years?

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