ADA Mission Creep

31 Responses

Dr. Pruitt, on February 1, 2009 at 8:37 PM said:

More on Dental Quality Control and Low Bids,

Delta Dental representative Ari Adler complains that it is unfair to his boss to have to mail payments to dentists out of network – even if they are dentists who Delta’s clients prefer over the providers Delta prefers. Delta customers’ preferences of out-of-network dentists are clearly understandable in a market that unfairly favors managed care dentistry like Delta Dental’s – performed by the lowest bidders without quality control.

But now, Delta’s good ol’ boys can no longer ignore Adam Smith and basic principles of economics, even equipped with the best PR squad. And Ari Adler is not the best. So, he’s a part-timer.

Adler reasons that making payment convenient for their clients, who pay the insurance premiums, cheats Delta because dentists who refuse to sign a contract with Delta reap unfair benefits from Delta’s network without following cost guidelines and adhering to quality control measures – like those demanded of Delta’s preferred providers.

Such nonsense makes it surprising that Ari Adler’s alter-ego maintains a reasonable and progressive blog called 5Ws.

http://aribadler.wordpress.com/.

That is why I find it stunning when the part-time Delta employee confidently says, “We put our dentists thorough a credentialing process and provide quality assurance.” I’ll get to Delta’s level of quality in a moment.

Adler blunders on: “That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.”

Please note that Mr. Adler does not offer exactly how long fillings should last. Delta Dental hires experts who do, though. They are called dental consultants.

Quality control – Is that Why Consumers buy Dental Insurance?

Some dentists think so, and they invariably belong to the American Association of Dental Consultants (AADC), and are hired by dentistry brokerage firms like Delta Dental and UnitedHealthcare Dental to maintain the highest quality in dentistry in the nation for the lowest possible price – and still maintain profits for those who sign their checks. Not an easy job.

I’ll introduce you to Dr. Robert S. Laurenzano, immediate past-president of the AADC later, and I’ll let him describe to you what he likes most about his job. But first, let us look at Delta’s success at promoting quality dentistry.

DR. Oogle and Delta’s Dentists

Do you think continuity of care is important to dental patients’ health? If so, you have to agree that dentists’ popularity is the most important measure of quality available. Dental patients can sometimes recognize bad dentistry even as it is being performed.

In November of 2007, I performed a study of Delta Dental PPO participating dentists in Austin, Texas using DR. Oogle’s dentist popularity rankings on the Internet.

http://austin.doctoroogle.com/dentist_ratings.cfm/pageID/2

From Delta’s PPO website, I chose 50 preferred dentists whose practices are located in or near the 78704 zip code in Austin, and simply compared the dentists’ DR. Oogle rankings with other dentists in the area.

SUMMARY

* 76% had no listing on DR. Oogle.
* 12% had no review.
* 12% were ranked, averaging a rank of 206 out of 297.

The study is so easy to repeat that I will not waste your time with my proof. The important result to note: Delta’s preferred providers were in the bottom third of patients’ preferences in Austin a little over a year ago. Is that quality?

Here is something more current: On November 9, 2008, I posted an article on PennWell titled “Transparency and managed care dental plans” which describes another study based on preferred providers and their popularity ranking on DR. Oogle. This time it was for Phoenix, Arizona.

http://community.pennwelldentalgroup.com/forum/topics/transparency-and-managed-care?page=1&commentId=2013420%3AComment%3A19577&x=1#2013420Comment19577

In all fairness, I must reveal that according to the grading system I designed, of the twenty most common discount dental plans available in Phoenix a few months ago, Delta’s Premier was the managed care plan most likely to be accepted by a popular dentist, as rated by DR. Oogle. Even so, Delta’s plan still only scored a 5.5 on a scale of 0 – 10, so the chances of picking out an unpopular dentist was about the same, with or without Delta’s list. Is that quality? Yes. That is average quality, and the best that Phoenix has to offer in managed care dental plans. Surprised?

Here is something else I learned about the dental market in Phoenix: From the data available for UnitedHealthcare, if one purchased their plan, he or she would be much more likely to be sent to a dentist in the bottom 4% of popularity than in the top 4%.

Did I mention that UnitedHealthcare, also the owner of Ingenix, is the largest contributor to the American Association of Dental Consultants? The AADC will be meeting again in Scottsdale, Arizona this spring – not far from Phoenix.

I wonder if Gordon Christiansen will be addressing the group this year like he did last May. The crowd fits in well with his repeated criticism of dentistry in the US, doesn’t it? They soak it up.

D. Kellus Pruitt; DDS

LikeLike
Darrell, on February 3, 2009 at 11:10 AM said:

Parasites and Stoic Individualism,

In contrast to the health insurance industry’s attractive corporate successes with micro-management of physicians’ careers – causing physicians to no longer encourage their children to follow in their paths – only a few CEOs seek to control dentistry.

Of those fifty or so, I bet not a single executive in the nation grasps why dentists have traditionally proven to be unusually difficult to domesticate. And if Ari Adler is the best PR person Delta Dental can muster, my goal of bringing Delta’s good ol’ boys down a notch or two for my readers’ entertainment (for starters) could be easier than I thought it would be.

From Delta’s silence, I learned long ago that the sleazy company is aware that its business model is defenseless. Otherwise someone might have attempted to defend the honor of Delta Dental. And that, of course, would mean that we would have us some real fun, friends.

Here is something that would-be healthcare parasites will forever stumble over: Did you know that 85% of dentists in the nation are sole proprietors of solo dental practices? That means that there are well over 150,000 different characters in 150,000 separate offices, completely independent of each other – especially in personalities. For those who are up for the world’s most difficult management challenge, they should know that each dentist represents a brand new unpredictable battle in a resilient, quiet neighborhood. Yea; too quiet!

Even though the profession may consist of an exceedingly vast assortment of über-individuals, I know of one characteristic that seems to be common among my colleagues who have also endured dental school. When it comes to public forums, dentists are stoically quiet from their freshman year forward in life. Almost every one of us learns to be reticent like those outside the profession would never believe. I am an anomaly at the extreme end of a long tail of a bell curve.

Over the last three or four decades that began with the seemingly benign arrival of dental insurance, followed by progressively worse interference in the dentist-patient relationships by dental consultants hired to save insurers money, it was easy for lots of people to temporarily forget who rightfully should be in charge of dental care in the nation. Until universal healthcare is forced onto dentistry – and as long as American small businesses can thrive in a free-market economy where competition controls quality efficiently – it will from this time forward be informed consumers who determine dental treatment in the land of the free – not dental consultants like Dr. Robert S. Laurenzano, the immediate past-president of the American Association of Dental Consultants (AADC).

On March 5, 2007, Dr. Laurenzano shared with ADA members not only the reasons that he likes his job working for dental insurance companies as a dental consultant, but also his desire to be welcomed as part of the dental team.

The title of the article he posted as a “ViewPoint” on the ADA News Online pleads “Is collegiality between dentists and benefit consultants possible?”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2390

Personally, I don’t give collegiality much chance on ethical grounds. But, don’t take my word for it, please read Dr. Laurenzano’s plea for respect and judge for yourself! I could be unfairly biased against dental consultants. Perhaps they have been more honest with other dentists’ patients than they have been with mine.

I studied the viewpoint. From what I determined, here is the list of dental consultants’ obligations according to UnitedHealthcare’s AADC as mentioned by the organization’s former President, Dr. Robert Laurenzano:

– Validate treatment quality and appropriateness (mentioned 2 times)
– Reduce fraud (4 times)
– Increase profit for dentists (1)
– Increase trust from patients (1)
– Assure ethics (6)
– Prevent mistakes (1)
– Save money on healthcare (1)
– Assure professional ideals and reputation of dentistry (4)
– Assure evidence and science-based dentistry (7)
– Assure best practices (3)
– Improve record keeping (2)
– Improve accessibility (1)
– Improve globalization of dentistry (1) [(?)]

So how involved is the ADA?

Dr. Laurenzano writes, “Last year [2006] the AADC invited Dr. James Bramson, ADA executive director, to speak at one of our meetings. He called for cooperative action by and between the ADA and the AADC in his keynote speech, and the AADC welcomes the opportunity to do just that.”

From the number of times Dr. Laurenzano mentions his desire to enforce other dentists’ ethics (6); it is obvious what he likes about his job. My question is who is enforcing Dr. Laurenzano’s ethics? UnitedHealthcare!

But look what dental consultants like most. “Assure Evidence-based and otherwise science-based dentistry.”

He makes Evidence-Based Dentistry sound like it favors Delta Dental, like his ethics perhaps?

D. Kellus Pruitt; DDS

LikeLike
Dr. Pruitt, on February 9, 2009 at 11:16 PM said:

Community of Gossip,

Since I learned my accountability lessons growing up in a small town (Panhandle, Texas, population 2000) that has always hosted a vast network of intricate communications, both seen and unseen, it was easy for me to recognize the neighborhood-enhancing qualities of Internet communications – online and off.

In Panhandle, bad news would beat you home from school every time. In fact, if it was really spectacular, many of your classmates’ parents and a tattle-tale sibling would know about something stupid sooner than Mom. Dad would hear about it when he got home. Even though it was nothing but gossip, it almost always proved sufficiently accurate for their purposes.

Do you want to see how neighborhood gossip is started? I’ll show you. Let’s fire off some.

As Medical Executive-Post and other readers may know, Dr. Robert Ahlstrom is the designated ADA healthcare IT representative who gave testimony to HHS concerning HIPAA in July 2007.

Click to access 070731p08.pdf

Anyone who reads the document can see that Ahlstrom simply misrepresented dentistry when he provided lawmakers with eleven rationalizations for electronic dental records instead of reasons. I have posted my long, critical opinion of Dr. Ahlstrom’s testimony, item by item, in a few places on the Internet.

Here is something interesting I have noticed in the last week or so. On two separate websites, here on the PennWell forum and the Medical Executive-Post, my criticism of Ahlstrom’s ideas has mysteriously gained in popularity. Why are so many people suddenly researching testimony about dentistry and electronic health records?

If you recall, I could not explain why “Dental managed Care Survey” rose in popularity out of the blue in mid-November. I still don’t know the answer. In trying to discern a reason for change, sometimes one is left with only guesses which if left unattended, can occasionally grow legs and become high-quality gossip. Does it matter if the gossip is accurate? Not in the end. Even baseless gossip is beneficial. When communities are confronted with traditionally nonresponsive leadership, gossip has natural fail-safe
features.

First of all, for gossip to travel any distance, the information must sport credibility. Once the rumor is on the move, if it gains a threshold amount of momentum, the target will eventually have to step forward to debunk it – if the truth suits the target better than suspicion.

So who would be interested in the ADA’s testimony to HHS only a few weeks into the new administration? It must be a significant number of people, and it appears that they are taking the time to not only click on the comments I posted, but to also actually read the long opinions. You can bet that it is not the ADA, and if there were significant news in the nation about Ahlstrom or HIPAA in dentistry, I would have seen it. The media is silent.

Here is the hot news as I imagine it. Workers in the Obama administration, perhaps HHS, and/or or people from CCHIT, have been shamed in the last week into finally including dentists in their plans for IT interoperability, and are desperately looking for information about a healthcare profession someone in charge overlooked.

That could also mean that someone else, perhaps from Congress, is suddenly pushing for answers for themselves. Or, it could also be the media, I suppose. These are only guesses – rumor buds.

Consider this: What if I had not challenged Ahlstrom’s testimony? Imagine how well our shoes would feel if designed according to an imaginative description of our feet by someone who sells shoestrings by the yard.

See how well gossip works? Had I not said a thing, where would we be? Grab a voice. Who cares if it is gossip, as long as it is salient?

D. Kellus Pruitt; DDS

Note: Dr. Pruitt blogs here and at others sites. He posted this today as part of a PennWell Community College course that he is teaching that started this fall (not for credit).

http://community.pennwelldentalgroup.com/forum/topics/social-networking-advanced

The Editors

LikeLike
Dr. Pruitt, on February 18, 2009 at 10:49 PM said:

A couple of weeks ago, our next ADA President, Dr. Ron Tankersley, spoke to constituent dental society leaders from across the nation who gathered at ADA Headquarters in Chicago. Yesterday, Karen Fox reported on the meeting in an article titled “From Washington to workforce, presidents-elect share information.”

Link: http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3445

Like a seasoned politician, Dr. Tankersley sounds promising:

“The increased availability of information through electronic communications can lead to misunderstandings. In order to increase transparency, it’s essential that leadership proactively provides information that members need.”

Is Dr. Tankersley sincere, or is he just the next in a seemingly endless streak of unresponsiveness at the top of the ADA whose image is good? You judge.

Over three months ago, I politely invited him to provide urgently needed information about electronic health records and dentistry – first as a comment on the http://www.dailypress.com website following an article that featured him, written by Alison Johnson (no longer available), and later on the PennWell forum.

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

When I failed to get a response, I repeated my invitation a couple of times. Nothing happened. In my opinion, his disrespect foreshadows more of the same weak leadership for US dentists at a time when our patients need our strength, not good ol’ boys’ sweet words and irrelevance.

I suspect Tankersley is so naïve about what it is really like out here in the real world that he completely fails to appreciate the humor in his use of “increasing transparency” and “proactively providing members information they need.” It gives the appearance that a dentist, who should really know better, doesn’t quite understand the meaning of the words “transparency” and “proactive.”

I would think that a straightforward and reasonable question left unanswered on the Internet, could be embarrassing to the ADA’s next president if he is concerned about his image like most politicians. It is not like the invitation will somehow just go away. Months following its posting, there are still many PennWell forum visitors who are evidently interested in Dr. Tankersley’s reply to my questions from a few months ago. For example, when one googlesearches “Dr. Ron Tankersley” the invitation to conversation pops up as his fourth hit. If Dr. Tankersley has not yet come across it, he is simply out of touch with technology, and therefore marginally suitable as a national leader of dentists. If on the other hand, Dr. Tankersley has read the invitations and refused to respond, he is obviously out of touch with membership and abysmally unsuitable as a leader. Which is it?

Yep. It looks like more of the same old bureaucratic stuff from the ADA. Are these the skills ADA leaders learn through the Hillenbrand Fellowship? Get rid of it.

Oh well, there is always the chance that the next president-elect will have the courage to respond to members. If we still have a profession and an ADA by then.

D. Kellus Pruitt; DDS

LikeLike
Rex, on March 6, 2009 at 1:03 AM said:

Dr. Pruitt,

So, just how many dentists are in the ADA, and is it still relevant?

For example, only about 25% of MDs are in the AMA. Their folks have deemed a formerly august body as un-responsive to contemporary concerns! Yet, about 85-90% of the nation’s podiatrists are in the American Podiatric Medical Association [APMA]?

So, how many practitioners are in the American Osteopathic and Optometry Associations? Are any of these associations relevant any more; or are they all dinosaurs?

Rex

LikeLike
Jane, on March 6, 2009 at 1:08 AM said:

Rex,

Great point; and here is another.

I am hounded by the AARP to join; yet why should I? Two or three decades ago AARP had a legitimate purpose to advocate for senior citizens. But now, with the doctor baby-boomer generation emerging; we are the defacto marketplace, so why join at all?

I think Gen Xers and Gen Yers will continue to run away from the medical associations; as well they probably should.

After all, fifty is the new thirty.

Jane

LikeLike
Darrell, on March 7, 2009 at 5:43 PM said:

Dear Rex and Jane;

Rex, your first two questions, “[1.] So, just how many dentists are in the ADA, and [2] is it still relevant?” led me to these answers: (1.) I don’t know because (2.) no.

On the Merriam-Webster Online website, I discovered that “relevant” comes from Medieval Latin relevant-, relevans, from Latin, present participle of relevare to raise up “ – as in the modern phrase, “stand up (for).”

No. Even though good ol’ boys stand up for each other (up to a point), for the most part, the ADA is not relevant outside the self-perpetuating bureaucracy.

For example, if the ADA were relevant, within an hour or so, I could have found your answer on an ADA website. While some consumer-oriented dental practices of today assign a staff member to periodically check for email that might arrive from any of a few thousand patients, ADA members who request information over the Internet are left to assume that staff in Chicago Headquarters are just too busy to mess with emails. More likely though, because nobody wants to be the first in the organization to be held accountable for what they say, members like me are left with no representation at all. The unresponsive organization is worse than irrelevant. It is dangerous.

It would be wonderful if the ADA provided a live person to respond to questions like yours dependably, accurately and immediately – at least during business hours. Yours is an easy, safe question. Imagine if one presents the good ol’ boys a question with hair on it.

I have been trying for years to persuade ADA officials to answer some questions I have concerning HIPAA, the NPI number and the reason why Dr. James Bramson was suddenly fired from his job as executive director about a year ago. After all, since it was my dues money that funded part of his severance pay, I think I deserve an explanation. The ADA won’t even recognize the question, much less answer it. That is simply deceitful and clearly inexcusable. Such malfeasance is an embarrassment in situ to every ADA member, however many that might be.

My questions have been routinely ignored for years. I get better service at Wal-mart. How good is that? Even though I have not yet found purchase in the hard surface of the organization, I’m still looking for leverage. Eventually, I will win, and crack the sucker wide open. Silent ADA leaders know this, and I guarantee it. Just sit back and watch.

Just to be sure that I am giving you accurate information about the unresponsiveness of my professional organization, I visited the ADA homepage and posted “ADA statistics” in the search box. I was lead to the “Dental Organizations” page.
http://www.ada.org/ada/organizations/orgdetail.asp?OrganizationID=817

I found an email address that looks as promising as any I have seen, so I sent your question to online@ada.org at 11:22 AM, yesterday (March 6). Personally, I don’t think my question will ever be answered. Someone with a different name might have better luck, but by now I think it is clear that whoever controls communication in Chicago Headquarters knows who I am, and he or she also knows that I have openly promised to take advantage of any opportunity to turn the organization on its head, and all it takes is an opening for conversation.

The changes will be painful, but once the dust settles and the ADA is much smaller than it is today, I foresee a networked organization more transparent and more powerful than we have ever seen in the history of medicine. Who can dare say this cannot happen? Who can dare say that it should not happen? Bring it on.

The ADA reminds me of a dysfunctional family that fearfully and vehemently guards taboo issues until everything blows up – always causing innocent people to get hurt. Yet following senseless harm, nobody can be found with the confidence of character to hold himself or herself accountable for the mistakes, and the harm will be repeated again and again. It is my opinion that this pervasive unaccountability has caused rot in not only professional organizations like the ADA, but also Wall Street. I think it leads to an innovation-stifling bailout mentality for those in power.

So why not just abandon the ADA? Because dental patients need me and you and the ADA to accept the responsibility to watch out for their welfare at a time when they are vulnerable to lies. It’s the Hippocratic thing to do, as well as the golden rule. The ADA is renegade, and can no longer be trusted to do the right thing. I have shown that its leaders conspire to hide information on behalf of a non-profit entity that has no possible reason to be less than 100% transparent with members who own the organization. The ADA is not the National Security Council, and the leaders do not deserve insulation from consumers.

Today, the ADA is worse than irrelevant. It is actively dangerous. I think I read somewhere that 75% of American dentists are ADA members. That means that when ADA representatives visiting Washington promote good ideas as well as bad, they are accorded the respect and credibility that comes with power, even if they misrepresent the profession to perpetuate and grow the bureaucracy for the sake of the bureaucracy – what I call, “mission creep.” As an example of inexcusable harm the ADA continues to cause dental patients, in July 2007 Dr. Robert Ahlstrom, the ADA’s representative for healthcare IT was sent to Washington to promote HIPAA, no matter what he had to say. Dr. Ahlstrom obliged, and told HHS Secretary Michael Leavitt eleven false reasons why HIPAA is wonderful for dentistry. (See “HIPAA and Dentistry,” January 8, 2009).
https://healthcarefinancials.wordpress.com/2009/01/08/hipaa-and-dentistry/
Every single one of his selling points is so obviously lame that even naïve healthcare IT cheerleaders won’t touch them.

Where will misrepresentation and no representation lead? All one has to do is watch disgusted MDs retire early over the next few years to understand how badly dental patients of tomorrow will be treated. With insurance paying the bills, and thereby making the rules, MDs will not regain bargaining power until they are scarce and hardly know English. Then there will be very sudden and painful market corrections in the healthcare industry that insurers will no longer be able to control. That is what I think.

Dentists, on the other hand, will generally prosper even in these bad economic times, but only because we still accept cash, and sometimes chickens.

Jane, I know in this very long response, I failed to directly address your point concerning joining the AARP, and I assume you mean as a preferred provider for an AARP-sponsored insurance plan. Make no mistake. Discount healthcare brokers trick doctors into abandoning control of the doctor-patient relationship any way they can. They have no soul. That is why I think it is unethical to sign a contract with anyone other than a patient. I hope this answered your question.

This has been fun. Thanks.

D. Kellus Pruitt; DDS

LikeLike
Darrell, on March 23, 2009 at 5:06 PM said:

On ADA Transparency,

In the last four weeks, I have sent six questions to various email addresses for the ADA. The only one to be answered so far is a soft question to “E-Mail Evidence-Based Dentistry” link from two weeks ago (17% success).

Last week’s test:

A week ago, I sent this question to the “E-Mail Science” link, “Can you tell me if there been any published studies that have investigated whether managed care dental patients receive more treatment than fee-for-service dental patients?” It is still unanswered.

My successful email to the EBD department asked if they had made their selections of this year’s attendees for the EBD Conference in May, which I attended last year. Within a day I received word that they would be finalizing the selection soon, and sure enough, a couple of days later, I received a PDF informing me that I had not been selected to attend this year, but said that if I wanted to be put on a reserve list, I should let them know.

I posted more about the rejection in an article on ME-P titled “Reflections on Evidence Based Dentistry.”

https://healthcarefinancials.wordpress.com/2009/03/23/reflections-on-evidence-based-dentistry/

New Tests

Since we now know that there is a human on the other side of the EBD link, Test 1 is a probing follow-up question. If nobody in the department has read “Reflections on Evidence Based Dentistry,” in which I call both EBD and Dr. Robert H. Ahlstrom stakeholder “tools,” the question is no big deal. However, I think it is safe to say that if someone does not respond to this week’s question within a day or so – just like they did a couple of weeks ago – that could mean that someone in the department is frightened into silence. Sweet.

Test 2 is a real stinker to a new department – the Department of Dental Practice. Last night, I warned head ADA lobbyist Michael Graham, who is responsible for the Advocacy page, what is coming. I suggested that he call in sick today.

Test 1 Follow-up to E-Mail Evidence-Based Dentistry
http://www.ada.org/ada/contact/email.asp?link=51

“This week I received notification that because of intense competition for seats at the EBD Champions Conference in May, my application didn’t make the cut. Before I put my name on a short-call list, can you tell me if Dr. Robert H. Ahlstrom will be speaking at this year’s meeting?

Thanks, D. Kellus DDS”

Test 2 To E-Mail Dental Practice
http://www.ada.org/ada/contact/email.asp?link=9

“I noticed that on the ADA Advocacy page that one way the ADA intends to reduce the cost of dental care is with health information technology.
http://www.ada.org/prof/advocacy/agenda.asp

Is that true? Does HIT decrease the cost of dental care?

D. Kellus Pruit; DDS

LikeLike
Dr. Pruitt, on April 6, 2009 at 6:43 PM said:

ADA transparency experiment

Results

Summary: In the last six weeks, I have sent 10 questions to various email addresses in the ADA. So far, three have been answered and seven are left unattended (30% success).

The remaining question from last week to Patrick Cannady, “I am trying to find out how many dentists in the nation have NPI numbers. Can you help me with this?” failed to earn a response.

This week’s new tests

Test 1: On Tuesday, six days ago, I asked my previously reliable contact at the ADA Library Services, “LS, can you give me an approximate number of the dentists in the nation? I have heard estimates of around 160,000.” So far; no response

Test 2: This morning, I sent a question to the “E-mail ADA News” and asked: “Dear ADA News: As I understand it, May 1 is the enforcement date for the FTC Red Flags Rule. Can you tell me when we can expect to see some guidance posted on the ADA News Online? Sincerely, D. Kellus Pruitt DDS”

Discussion

ADA Library Services

Why did I run out of luck with LS? Mine was a simple question. “How many dentists are there in the US?” I should tell you that there is more to the test than I have said so far. I cc’d my correspondence with LS to Patrick Cannady in the Department of Dental Informatics. That may have made the difference.

I interpret the silence from LS to mean that at some point, the attention of a superior was notified about my questions, perhaps even about this forum thread, and both Cannady and LS were told to ignore my email. It appears to me that the ADA Department of Dental Informatics was ducking for cover even before the Red Flag Rule. Which brings me to …

E-mail ADA News

This morning, I posted an alert on the PennWell forum concerning dentists and the Red Flag Rule titled, “Mayday! – Red Flags Rule in Dentistry.”

http://community.pennwelldentalgroup.com/forum/topics/mayday-red-flags-rule-in

The FTC deadline for compliance is a little over three weeks away. The ADA News has been silent about the topic for months. Why? I think the ADA is too heavily invested in healthcare IT, and the Red Flags Rule will bring the nation’s attention to things that cheerleaders would rather not discuss – such as, “What should a dentist do if a computer is stolen from his or her office?” We’ll take that up soon.

Conclusion

A good question, posted in the right place, is a cost-effective fire-and-forget missive.

LikeLike
Editorial staff, on April 6, 2009 at 6:49 PM said:

Darrell,

Although I am not sure why; our tacit assumption is that there are about 300,000 dentists in these United States. Right or wrong, this mean about 53% are in the ADA [160,000/300,000].

Compare this to about 25%, or less, for allopathic physicians in the AMA.

Ann Miller; RN, MHA
[Executive Director]

LikeLike
Dr. Pruitt, on April 6, 2009 at 7:55 PM said:

Ann,

I honestly don’t know that number. I think 300,000 is a little high.

In addition, I was under the impression that 75% of US dentists belong to the ADA. These are legitimate questions, and someone (other than me) should ask the ADA. Where else should one look to obtain information about dentistry in the nation?

Maybe someone will do society a favor and pose these questions while pretending to be a high school student who is interested in dentistry and is enthusiastically preparing a report for speech class. Or use your imagination. After all, even though the ADA Library Services found it simple to just a trouble-making member, I bet someone in Chicago is a sucker for ambitious future dentists.

Darrell

LikeLike
Darrell, on April 6, 2009 at 7:57 PM said:

Correction:

After all, even though the ADA Library Services found it simple to just IGNORE a trouble-making member, I bet someone in Chicago is a sucker for ambitious future dentists.

LikeLike
Dr. Pruitt, on April 14, 2009 at 8:02 PM said:

ADA transparency experiment

Results

Summary: In the last seven weeks, I have sent 12 questions to various email addresses in the ADA. So far, three have been answered and nine are left unattended (25% success).

Neither of the two questions from last week attracted a response. The first unanswered question was to the ADA Library Services, asking how many dentists are in the nation. The second one was to the ADA News, asking when guidance for the Red Flags Rule will be posted on the ADA News Online.

This week’s new tests

On Tuesday, a week ago, I posted the following question on (1) the “E-mail Dental Practice” link for ADA members and in an email to (2) Trajan King, CEO of Intelligent Dental Marketing – a direct mail advertisement company for dentists that is in business with ADA membership.

“Dear Dental Practice Department and IDM CEO Trajan King: According to a recent article by Arlene Furlong in the ADA News Online, the ADA is an investor/owner of ADA/idm. Can you tell me if the ADA members’ dues are at risk if IDM goes under?”

D. Kellus Pruitt; DDS

Today, I emailed a request to the ADA Legal Division: (3) “Dear ADA Legal Division: Could you please email me the guide for compliance with the Red Flags Rule and the sample identity theft detection and response program.”
Thank you.

D. Kellus Pruitt; DDS

Discussion

I discussed the lack of accountability of the previously reliable ADA Library Services department in last week’s report. Nothing has changed, and my suspicions grow.

An interesting coincidence happened concerning the unanswered question to the ADA News about preparing members for Red Flags Rule compliance. The deadline is May 1, yet leadership is betting our fines that the ADA’s legal division, led by Tamara Kempf, can force an indefinite delay for dentists. Within hours of emailing my question to the ADA News on April 6, Arlene Furlong posted an article titled, “ADA seeks exclusion from Red Flags Rule for dentists.”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3525

That was just in time. I stated somewhere last week that if the ADA legal department waited until April 7 to make compliance information available for membership, that would simply not allow dental offices enough time to prepare.

The ADA is still seeking exclusion for dentists, but nevertheless, they have made available compliance information if one has the inclination to ask for it, and as one might expect, I am so inclined (See question 3, above).

Here are the last two paragraphs from Furlong’s just in time article:

“While awaiting FTC response, the ADA has prepared a guide for compliance with the Red Flags Rule and a sample identity theft detection and response program, in case the FTC persists in its position that dentists are covered by the rule. These documents can be obtained by contacting your state association, or by sending an e-mail to legaldivision@ada.org. The April 20 ADA News will provide an update on developments related to Red Flags Rule compliance and dentists.”

That will give the dentists who don’t request the information ten days to prepare if the negotiations somehow fall through for the ADA legal team.

Looking ahead at a precipice

I will give you a preview of my follow-up question to the legal department of the ADA, if they respond to my request for Red Flags Rule information:

“Can you tell me how many ADA members emailed requests for the Red Flags Rule information like I did? I’m just curious …”

Is that not ornery?

What if the answer is something like “22”, out of 160,000 or so dentists in the nation? Will that draw the attention of the FTC and/or Fox News? I find this earthly exciting.

D. Kellus Pruitt; DDS

LikeLike
Dr. Pruitt, on April 21, 2009 at 5:13 PM said:

ADA transparency experiment

(Red Flags will Rule on Mayday)

Results

Summary: In the past two months, I have emailed 15 questions to various addresses sponsored by the ADA. Four elicited responses and 11 remain unattended (27% success).

One of the three questions I posted last week received a response. The first two questions were to the “E-mail Dental Practice” link for ADA members and to Trajan King, CEO of Intelligent Dental Marketing. I asked both if ADA dues were at risk in their (our) business partnership. No responses were offered.

The third question was to the ADA Legal Division requesting a guide the department put together for compliance with the FTC Red Flags Rule. Two pdfs and a word document were sent almost immediately attached to an email thanking me for contacting the Legal Division.

This week’s new test:

I sent the following in an email to the ADA Legal Division this afternoon:

Dear ADA Legal Division:

In an effort to find ways that the ADA can better serve membership, I am performing a study on dentists’ preparedness for the Red Flags Rule – including the effectiveness of the ADA reaching membership with important and urgent information.

If it is possible to mine such data from your e-records, I am requesting that you assist in this study by telling me how many ADA members have sought information from your Legal Division concerning the Red Flags Rule. I would be thankful for data from both before and after an ADA News Online article was posted on April 6 mentioning the availability of compliance information from your division. I would also like to know if any members requested such information offline, if it is not too much trouble.

I think you can easily understand how this information will ultimately help the ADA to be a more responsive organization.

D. Kellus Pruitt

Discussion

The lack of a response from either the Department of Dental Practice or Intelligent Dental Marketing is not a surprise. They were given a very difficult question involving accountability to membership. By the same standard, I would be remiss if I failed to note that it is commendable that the ADA Legal Division responded to my request with a generous amount of useful information about the Red Flags Rule almost immediately. However, since I was responding to an invitation posted by the Legal Division, their first test was hardly a challenge.

The new question I sent to the Legal Division yesterday is much more difficult to handle. I think everyone recognizes that the right thing for the ADA employees in the legal department to do is obvious: They simply must provide me with the information I request concerning ADA members’ preparedness for compliance with federal laws. Their two other options of either ignoring me or telling me why that information cannot be shared, both work well for my purposes also. But they only delay the inevitable.

Even though Evidence-Based Dentistry Champions are meeting next month in ADA Headquarters, the ADA itself does not always allow Evidence-Based principles when it comes to more effectively serving the needs of membership. I have learned that some issues are intentionally kept hidden from members – especially the subject of data breaches in dentistry. In fact, the approaching bad news for computerization in dentistry is the real reason that the ADA fears the FTC’s Red Flags Rule much more than HHS and HIPAA. Whereas there have only been two or three convictions under the HIPAA Privacy Rule in 13 years, and none involved dentists, the FTC and the ADA share a long history of enforcement battles, and the ADA generally loses against them. Anyone can see that the FTC naturally welcomes more contact with the ADA for budgetary reasons as well as raw bureaucratic power.

An eye-opening warning about this very issue appeared yesterday in an article that was posted on ModernHealthcare.com, written by Joseph Conn titled, “FTC’s hard-line enforcement may shock industry.” The title says it all.

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090420/REG/304209941/1153&nocache=1

E-discovery and the ADA

The underlying challenge in the question I sent to the Legal Division involves aiding a critical analysis of ADA policy by a member whose conclusions cannot be controlled. That requires confidence from a department head, if not a respect for the Federal Rules of Civil Procedure – Rule 26.

http://www.law.cornell.edu/rules/frcp/Rule26.htm

This is also known as the “e-discovery law,” and legally establishes the need for business entities like the ADA to carefully maintain email records to and from members.

See you next week, which will be four days from the compliance deadline for the Red Flags Rule – unless Tamara Kempf’’s team from the Legal Division can buy us more time. Meanwhile, the ADA promised to post more information about the Red Flags Rule on the ADA News Online. It was to appear yesterday. It didn’t.

That’s just one more reason why somebody in the ADA needs to start a string of confessions, and accept their punishment. Or; they can wait until the stakes are even higher.

D. Kellus Pruitt; DDS

LikeLike
Darrell, on April 28, 2009 at 12:52 AM said:

ADA transparency experiment – week nine

(“Image is everything” – ADA/idm slogan)

Results

Summary: In the past nine weeks, I have emailed 16 questions to various ADA addresses. Four were welcomed with responses, and 12 were a waste of time. This ADA member has a one in four chance of experiencing responsiveness from the ADA. (25% success). What’s your rating?

The question I sent to the ADA Legal Division requesting hard data concerning responsiveness, as expected, did not attract a response.

This week’s new test:

I just posted an easy question, followed by a more difficult one, on the modern-sounding “ADA E-mail Discussion Forum.” (It’s a notorious black hole for information).

“Are any employees and officers of the ADA planning on opening Twitter sites? If so, could those names be provided to ADA members?”

D. Kellus Pruitt; DDS

Discussion

I think it has been clearly proven that the image of solidarity with dentists across the nation is more important to those in charge of the ADA than actual responsiveness to even one member’s questions about responsiveness. This organizational fault of the ADA blocked an answer from the Legal Division for an indefinite period of time. Perhaps I don’t have the right to demand membership data from an ADA department, just like I do not have the right to ask why Bramson and Logan, the two top ADA employees, were suddenly fired a year ago this month, without any preparation for the leadership vacuum that will persist until a new executive director is finally chosen. Is that any way to run a business?

If the ADA were a government entity, I could file a FOIA request that the ADA Legal Department could officially ignore. “Dear ADA: How many members requested information about the Red Flag Rules, before and after the ADA article on April 21?”

For an ADA department to disregard my non-apologetic demands is not unprecedented. After three years of asking, the ADA Department of Dental Informatics still refuses to share with me how many ADA members they were able to talk into applying for NPI numbers. It was my dues money that paid them for their unsuccessful effort that has been abandoned.

As for the question about the ADA and Twitter … Ah, now that friends, is a clever and captivating stinker. Let’s look at the possible answers that the ADA can give.

(a) Yes, we intend to start a Twitter account, and yes, we’ll share employees’ account information with you as well.

(b) No, we do not intend to open a Twitter account, but yes, we will nevertheless share employees’ accounts with you.

(c) Yes, we’ll start account, no share employee information.

(d) No open account and no share nothin’.

(e) None of the above

I predict their non-response will fall under the category, (e) None of the above. That is why I also posted this on Twitter: “Today I asked the American Dental Association if they have plans to open a Twitter site. I have some questions for them.”

They call me Proots

Today’s inescapable business transparency caused by social platforms like Twitter and the next generation, was predicted long ago by four dudes with nothing better to do.

Please allow me share with you Theses 63 – 67 from the “Cluetrain Manifesto,” by Levine, Locke, Searls and Weinberger, from nine years ago.

63. De-cloaking, getting personal: We are those markets. We want to talk to you.

64. We want access to your corporate information, to your plans and strategies, your best thinking, your genuine knowledge. We will not settle for the 4-color brochure, for web sites chock-a-block with eye candy but lacking any substance.

65. We’re also the workers who make your companies go. We want to talk to customers directly in our own voices, not in platitudes written into a script.

66. As markets, as workers, both of us are sick to death of getting our information by remote control. Why do we need faceless annual reports and third-hand market research studies to introduce us to each other?

67. As markets, as workers, we wonder why you’re not listening. You seem to be speaking a different language.

As one can imagine, marketplace transparency doesn’t leave much wriggle-room for executives.

Drawn in by the dreams and enthusiastic voices of cluetrain’s authors, I also feel the euphoric sensation of inevitable grass-roots hope for the ADA, as well as for the very fabric of business in our nation. Let’s try e-transparence and eliminate wasted motions in health care from the ground up.

Here is “Cluetrain Manifesto” Thesis number 48: “When corporate intranets are not constrained by fear and legalistic rules, the type of conversation they encourage sounds remarkably like the conversation of the networked marketplace.”

Conclusion

Only you can stamp out talking points.
See you next week.

Darrell K. Pruitt; DDS

LikeLike
Dr. Pruitt, on April 29, 2009 at 10:05 AM said:

I like Twitter

So now that I’ve tried it for ten days, those who have not joined me on newest social network phenonemononym (bet you can’t find that term in the Medical-Executive Post Dictionary) are probably itching to ask me, “Proots, what does Twitter taste like anyway?”

It tastes a lot like chicken.

For sports fans that have not yet visited Twitter and witnessed the empowerment potential in this new application, I’ve been there and have already used the tool to advance my personal goals involving multiple issues – like multiple warheads.

I copied for you the exchanges that occurred at my Proots site in the past ten days (newest on top). You may recognize some of the characters that I also recognized from various venues. I have about as many foes following me as friends and possibly a cousin.

Here is one of the last Tweets I posted today lifted from below:

“Look who joined us: ‘ADA News Today follows 1 person: Proots / Darrell Pruitt. That’s you!’ Twitter’s got legs … about 7 hours ago from web”

We’ll have us some real fun now.

That’s right, sports fans. I discovered from a notice posted on my own profile page that not only does the ADA have a peek-a-boo site on Twitter, but that I was the only (maybe the first?) Tweeter in the world that the ADA was following. A couple of hours later, the ADA started following their second site on Tweeter – the CDC. Good damn call. I find it reassuring that the swine flu is one of the top two most important contemporary concerns for the ADA. Need I say that I find their priorities flattering as well?

If you need an invitation to join me, this is it, friends …. or not. I still call both the PennWell and the Medical-Executive Post home, so you’ll continue to be an important part of the expanding adventure. However, I doubt that I will continue to share detailed action like tonight.

There’s one more thing I would like to point out. It’s sort of a house-keeping issue with me and my office staff. About half-way down, you will see that Melanie, an employee of BCBSTX, tried to call me at work yesterday rather than risk responding to an NPI question online for all to see.

I respectfully and seriously ask everyone not to do that. If someone calls my office, they had better need a dental appointment. Otherwise, nobody online has any desire to get me on the phone. (Googlesearch “Trajan King.“ He is the CEO of ADA/idm). Yesterday, I showed Melanie mercy when I refused to accept her call.

Twitter suddenly opens multiple silos while conventional forums lumber along much more measured and deliberately – laden with information and boring. People like action, and Twitter will be remembered as clearing wide paths to make way for more efficient, horizontal business connections on open-source platforms. Then again, I sometimes get carried away.

Thanks, everyone for supporting my habit

Darrell

———————————————————–

@helainesmithdmd Have you caught the conversation about EDRs on DrBicuspid? Dr. Hamm is taking the techies apart.
7 minutes ago from web in reply to helainesmithdmd

I’m working on Episode 2, “web, TweetDeck and friends” – a reality show on the PennWell Forum.
about 7 hours ago from web

Look who joined us: “ADA News Today follows 1 person: Proots / Darrell Pruitt. That’s you!” Twitter’s got legs.
about 7 hours ago from web

Welcome to my adventure, new followers. Especially you, BCBSNM. All friends and foe are welcome.
about 9 hours ago from web

Adler elected not to post my question. It was, after all, very off-subject. I’ll meet him on Delta ad some day.
about 9 hours ago from web

I found an Ari Adler article on Digital Pivot http://bit.ly/7qqiE. I asked him about Delta Dental’s guarantee.
about 10 hours ago from web

…. or the Fort Worth District Dental Society?
about 24 hours ago from web

The National Association of Pediatricians has a twitter address, why not the Texas Dental Association?
about 24 hours ago from web

The National Association of Pediatricians has a twitter address. Why not the American Dental Association?
about 24 hours ago from web

Is it possible that Twitter and BCBSTX are an imperfect match?
about 24 hours ago from web

@tressalynne Interested in following me? We have a common interest in public relations.
about 24 hours ago from web in reply to tressalynne

Today I asked the American Dental Association if they have plans to open a Twitter site. I have some questions for them.
3:03 PM Apr 27th from web

@BCBSTX Melanie, do not call me at work again. Can BCBSTX patients use dentists who do not have NPI numbers. Y or N.
1:21 PM Apr 27th from web in reply to BCBSTX

@Tassy0416 Are you the Kathy Kincaid who works for DrBicuspid? If not, pardon my intrusion. Otherwise: Hello, Kathy. Darrell
12:43 PM Apr 27th from web in reply to Tassy0416

@mlkaiser good to see you, Meg, and all my friends to follow. Darrell
11:04 AM Apr 27th from web in reply to mlkaiser

@vlcheeseman good to see you, Vicki. Darrell
11:02 AM Apr 27th from web in reply to vlcheeseman

It appears that Ari Adler has a problem with junk mail. That is probably why he hasn’t responded yet.
10:07 AM Apr 27th from web

@BCBSTX Thanks for the reply. What happens if I don’t get an NPI number?
9:50 AM Apr 27th from web in reply to BCBSTX

I guess Ari Adler did’nt notice my question. He’s really busy.
4:31 PM Apr 26th from web

I’m waiting for Ari Adler to reply. He said that Delta Dental guarantees its dental work. That’s a bargain!
10:30 AM Apr 26th from web

@aribadler Does Delta dental guarantee fillings done by its preferred providers?
8:22 AM Apr 26th from web in reply to aribadler

@jvlwines Did BCBSTX solve your problem? Just curious.
7:15 AM Apr 26th from web in reply to jvlwines

@BCBSNM Are BCBSNM Dental members limited in choice to only dentists with NPI numbers?
7:07 AM Apr 26th from web in reply to BCBSNM

I’m trying to find other BCBS sites to follow
6:43 AM Apr 26th from web

@BCBSTX Six days, no answer. I have no NPI number. Can BCBSTX clients use their dental insurance in my practice? Simple question.
6:20 AM Apr 25th from web in reply to BCBSTX

@sarasmatic Did BCBS resolve your problem? Just curious.
3:30 PM Apr 24th from web in reply to sarasmatic

@BCBSTX Do dentists have to have NPI numbers to use your dental insurance?
9:58 AM Apr 18th from web in reply to BCBSTX

D. Kellus Pruitt; DDS

LikeLike
Dr. Pruitt, on May 5, 2009 at 10:07 AM said:

ADA transparency experiment – week ten continues

(Point proven – ADA is unresponsive to at least one ADA member’s questions)

Results

Summary: In the past ten weeks, I have emailed 17 questions to various ADA addresses. Four were welcomed with responses, and 13 were a waste of time. I have experienced a response success rate of less than 25%.

The question I sent to the ADA E-mail Discussion Forum a week ago was “Are any employees and officers of the ADA planning on opening Twitter sites? If so, could those names be provided to ADA members? D. Kellus Pruitt DDS.” As expected, the question did not elicit a response.

This concludes this series of transparency tests of the ADA.

Discussion

Of the five possible answers that the ADA could have provided, the answer is (e) None of the above.

Shortly after I asked if the ADA were going to open a Twitter site, I was notified that the ADA indeed has a Twitter account. It is under the name “ADA News.” The way that I was notified was priceless. I unexpectedly discovered that the ADA News was following Proots – my Twitter name. But wait, there is more.

I was flattered that for a short while, the ADA News was following only one Twitter site in the world – Proots.

Fame is fleeting simply because priorities change fast in a rapidly changing world. The ADA just as suddenly ditched following Proots, and started following the CDC’s swine-flu Twitter site. I humbly suggest that in my opinion, that was a sound decision by ADA leadership (They still follow me, but they think nobody knows … That’s OK too).

Oh yeah. The last time anything was posted on the ADA News site was March 6, 2009. There is not much information moving in or out of the ADA’s Twitter site.

Conclusion (Short version)

Why bother, ADA? The ADA’s President-elect Dr. Ron Tankersley may act like my organization cares about members’ ideas – good, bad or irrelevant, and he may even promise transparency, just like ADA President Dr. John Findley did. The truth is, leadership has been downloading on membership for as long as I can remember, and 2010 looks like we’re in for more slick stuff.

(Longer version to follow)

Final note: An invitation to Dr. Tankersley to discuss the potential empowerment of Evidence-Based Dental research by interoperable dental records has been unanswered for six months. It was posted on the PennWell forum on November 8, titled “An invitation to Dr. Ron Tankersley, President-elect of the ADA.”

Do you think Dr. Ron Tankersley has not noticed it? If one googlesearches “Dr. Ron Tankersley,” it is his third hit. Yep. He’s noticed. Evidently, lots of people have noticed.

D. Kellus Pruitt DDS

LikeLike
Sharon, on May 5, 2009 at 10:15 AM said:

Now, that is creepy!

When I’m concerned about the swine flu; I’ll call my internist. When I need my tooth filled, I’ll call my dentist. Perhaps the ADA should worry more about dentistry, and its’ members, than the swine flu.

Talk about “mission creep”.

Sharon

LikeLike
Darrell, on May 5, 2009 at 11:57 AM said:

Thanks, Sharon

I think in the best of all possible worlds, the ADA should indeed be more concerned about a pandemic than what one member might post on Twitter.

I actually think it would be prudent for the ADA to advise dentists to screen for flu symptoms before treating patients who may be contagious. It doesn’t take long to take someone’s temperature.

Why the ADA’s Twitter is silent when schools are closing for several days across the nation to halt the spread of the flu is beyond me. It’s quiet. Yea. Too quiet.

That would be called a creepy mission.

Darrell

LikeLike
Gen, on May 5, 2009 at 7:25 PM said:

Primary Care Shortage and DNPs

Darrell has a god idea; so why not extend it a bit more. To help solve the primary care shortage, why don’t the dentists assist?

For example, if they took patient vitals signs, they might be able to detect the flu, infections, colds or other fever inducing illness; or detect hypertension and related conditions. A modern Dip-stick or Accu check-like machine for diabetes monitoring also comes quickly to mind. How about the flu spot test for an extra $15?

In this way, patients are served, dentist perform an almost cost-free community service, MD/DO referral relationships are enhanced, and the DDS gets to feel like a real physician; rather than the “drill em – fill em – bill- em” technicians they often seem to be!

Link: https://healthcarefinancials.wordpress.com/2008/05/29/stemming-the-primary-care-exodus

Genevieve

LikeLike
Darrell, on May 8, 2009 at 3:00 PM said:

Thanks, Genevieve. You bring up good points. In fact, some ideas you mention are so good that they are already performed regularly by most dentists at no additional charge.

In my practice, we routinely screen for hypertension, and I thank a local dental leader, Dr. Griff Murphey, who is the former editor of my local dental society newsletter. Long ago, he took on the unthankful job of persuading reluctant members like me to incorporate the life-saving routine. In Texas, it is considered standard-of-care – as it should be.

On occasion, my staff uses a digital thermometer to confirm perceived fever from skin warmth, or when the patient shows symptoms of malaise. I think most people understand that because of the nature of our work, incidental contact with the skin of patients’ faces can hardly be avoided. I think most who work in the field can readily detect elevated temperatures.

Diabetes screening is another adjunctive service which could arguably improve dental patients’ health. Modern, non-invasive monitoring might be easily incorporated some day. However, diabetes screening isn’t the reason consumers pick dentists, and the idea of handling urine in my dental office does not appeal to me at all. Let’s see, what is the phrase? Oh yeah, “You could not pay me enough.”

I think I will consider my career fulfilling even if never called on to interpret the color changes of a “Dip-stick” withdrawn from a cup of warm urine. There are more appropriate places for patients to have that procedure done.

Prevention at any cost is not prevention. Like unfunded mandates that actually make sense, such as checking patients’ blood pressure, increases in cost always decrease access to care.

As far as feeling like a mere “technician” instead of a “real physician,” that has never been my concern, nor does it seem to bother any colleagues I know, even the few dentists who tried and failed to get into med school.

Here’s something I find interesting. In Maine, there is such a shortage of dentists that physicians are being trained to pull teeth like real dentists.

Darrell K. Pruitt; DDS

LikeLike
Dr. Pruitt, on May 8, 2009 at 8:55 PM said:

I had a nice, shortened camping trip to the beautiful, rustic banks of the Cibolo Creek, east of San Antonio. I left on Tuesday, and I intended to fish until Saturday or Sunday, but the South Texas heat and humidity drove me back north yesterday (Thursday). Today, the heat index on the slow-moving Cibolo is 102, and I happily sit in an air conditioned office in Fort Worth.

My friend and I together kept five bass, six catfish and a huge Rio Grande perch. We grilled two of the bass soaked in butter and lemon over open coals on Wednesday night, and served them with sweet corn and cherry tomatoes. The meal alone was worth the trip.

If Schertz keeps growing in a southerly direction, my own Walden’s pond will vanish as will a source of enjoyment for me and those who share it. That puts me in a nasty, disobedient and uncivil mood. Who did you expect? Henry Freakin’Thoreau?

Dr. Kathleen O’Loughlin – new ADA Executive Director

A couple of days ago, Dr. Marty Jablow posted what looks like a tribute to Dr. Kathleen O’Loughlin, the new executive director of the ADA on his dental technology blog.

http://dentechblog.blogspot.com/2009/05/dr-kathleen-oloughlin-is-named-as-adas.html

Dr. O’Loughlin replaces former exec, Dr. James Bramson, who was suddenly fired a year ago, yet ADA members were never given the reason. I find such disrespect increasingly strange for a non-profit, service organization whose devotion should be to dues-paying members. One naturally must ask, “What are you hiding, ADA?” I’ve asked. Nobody utters a peep.

For similar reasons, I have deep reservations about what Dr. O’Loughlin’s employment will mean for the future of the ADA. It is my opinion that current leaders of my obscure professional organization continue to recklessly cater to insurance and political interests at the expense of my dental patients’ concerns. I have found that they resist being held accountable to membership. Hello, sunshine.

Marty and I have met. I thought his blog would be a good place to pick up where we left off long ago. Then again, he can always decline to f/u a post or comment to it.

Darrell

Marty,
Thanks for the in-depth bio of Dr. Kathleen O’Loughlin, the new executive director of the American Dental Association. She certainly has lots of experience in big-business boardrooms. But I have to ask, does it concern you that Dr. O’Loughlin is not only a former officer of Delta Dental, but also of UnitedHealth – Two of the sleaziest insurance companies in the nation?

You may recall that recently, UnitedHealth’s wholly-owned subsidiary, Ingenix, was found guilty of cheating health insurance clients as well as their physicians. I only hope that the abysmal ethics didn’t rub off on our next exec. I cannot help but think that she must have known about UnitedHealth’s atmosphere of crime. If not, how effective can she be as executive director of the ADA?

As for Delta Dental, did you know that on DrBicuspid earlier this year, a Delta PR representative named Ari Adler said that Delta guarantees its preferred providers’ fillings? How do you feel about that?

There’s more: Delta treats its PR employees poorly. They abandoned Janis Oshensky who they hired to promote the NPI number. She put her heart into her job, and now that everyone knows that the NPI number is a lie, her reputation is sunk. Delta simply does not care. I hope Dr. Kathleen O’Loughlin treats ADA employees better. By now, I know several of them. Almost all seem to be very fine people.

Finally, let me offer that dentists I know who have battled Delta’s legendary tyranny will not be endeared to learn that “… through her leadership, [Delta Dental of Massachusetts] doubled its reserves, grew membership by 400% and executed a dramatic five-year growth plan.”

Nope. That will not sell well at all in my neighborhood. Thanks … Marty.

Darrell

LikeLike
Darrell, on May 9, 2009 at 12:11 AM said:

Did Findley just say what I think he said?

“Our goal is for the Association to be transparent and accountable to our members.” – Dr. John Findley, President of the American Dental Association upon welcoming Dr. Kathleen O’Loughlin as the new executive director (ADA News Online, May 5, 2009).

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3565

When Dr. Findley comfortably talks about transparency and accountability, you know the dental profession is in trouble.

In June of 2007, I emailed candidate Dr. Findley a simple question, “What should a Texas dentist do if a computer that contains personal identifiers is stolen in a burglary?” I was not only given the bum’s rush, but I was sufficiently scolded by his campaign manager for bothering the busy and important doctor. This means that as far back as two years ago, ADA leaders firmly, but silently, huddled together to defend their egregiously foolish support of HIPAA and paperless practices. In spite of the controversial testimony that ADA representative Dr. Robert Ahlstrom provided HHS two months later about the 11 wonderful advantages of HIPAA in dentistry, do you know who electronic dental records benefit most? It’s neither dentists nor their patients as Ahlstrom claims. HIPAA favors the ADA Department of Dental Informatics and sleazy insurance companies like UnitedHealth and Delta Dental – both Dr Kathleen O’Loughlin’s former employers. Now, those who work in the informatics department in Chicago will have a sympathetic Dr. O’Loughlin as their boss. Funny how things work out like that in Chicago – my kind of town.

To finally pry a response from Findley, as if I actually had that right, I had to publicly remind him of my question six months later. On January 8, 2008, he relented under what must have been extreme pressure from somewhere. However, instead of returning his response in a pdf which would have travelled at the speed of light, he delayed accountability another day or so by hiring a fat, but pleasant, postman. The letter, which the President-elect cc’d to Dr. S. Jerry Long, trustee, Fifteenth District; Ms. Mary Kay Linn, executive director of the Texas Dental Association; Ms. Tamra Kempf, chief legal counsel; Ms. Mary Logan, the chief operative officer who was fired three months later with Bramson; and Dr. James Bramson, then executive director of the ADA whose 14 month vacancy along with Logan’s will be finally filled by Dr. Kathleen O’Loughlin in a few weeks.

Here is what I find cute: The ADA President’s campaign slogan was “Findley for the future.” Now he heartily welcomes Dr. Kathleen O’Loughlin … Get it? Now that is funny.

D. Kellus Pruitt DDS

LikeLike
Jake, on May 10, 2009 at 11:56 AM said:

All these posts from Darrel, and on AMA censorship elsewhere, makes my wife sad. She always thought the AMA and ADA were forthright medical societies. NOT so, I’ve always told her; just power grabbers.

Oh Well: “Ding-dong, the wicked witch is dead” – self immolation.

Jake

LikeLike
Dr. Pruitt, on May 10, 2009 at 7:05 PM said:

I know the disappointment your wife feels, Jake. It also saddens me to know that spineless leaders of the ADA and the AMA, both traditionally benevolent and mighty bastions of professionalism, have foolishly allowed control to be overrun by big-business pirates who commandeered doctors’ authority. I for one, simply refuse to sit back and watch them carelessly run the ship aground for their selfish benefit. Thanks for the opportunity to harass some deserving good ol’ boys. I hardly need an invitation.

Entrepreneurs and politicians have worked hard to unfairly share in making cost-effective life and death decisions for patients they never meet – overriding doctors’ expert recommendations for the sake of Wall Street profits and the common good. Physicians and dentists have been strategically demoted by sleazy people. Unelected rulers in our democratic society now call doctors “providers” while granting insurance MBAs the more generous-sounding title of “payers.” There is power in semantics, and these stinking pirates are erudite.

For the next phase in the degradation of healthcare, the pirates will continue to use their custom designed leveraging tools like pay-for-performance, the FTC and HIPAA to steal even more control from doctors and patients. For example, just days ago, an anonymous BCBSTX employee whom I named Sidney told me on Twitter that I don’t have to get an NPI number (as mandated by HIPAA) unless I want to get paid. Almost a year ago to the date, Dr. Robert Ahlstrom, the ADA’s HIT expert said almost exactly the same thing as Sid, the not-gracefully balding BCBSTX PR hack with bad breath. Dr. Ahlstrom told an audience of more than 100 gathered at the ADA Headquarters in Chicago that, “HIPAA is voluntary unless you want to get paid.” Just what would that be called? Oh yea. Tyranny.

Here is something cute about comedian Dr. Robert Ahlstrom’s confident unveiling of his personal and convenient cause-I-said-so science: He was addressing attendees of the 3rd Annual Evidence-Based Dentistry Conference.” Get it?

Here’s another lingering punch line that is sure to have dentists laughing for decades: A couple of years ago, Ahlstrom was appointed chair of the ADA’s ”Dental Practice Model 2020 Committee.” He and his friends are secretly planning the future of our profession. Is that not rich?

I can already tell that in a few years, labels will again be re-worked according to the ever-changing levels of authority. Insurance giants and government will be called owners of healthcare, and if any primary physicians can be found in the nation, they will be called slaves. So what will patients be called? Does it matter? Since patients are even less valuable to owners than slaves, and since actual health care cuts directly into profits, patients are already the last in line (yet it is their bodies and their money!). The ADA and the AMA no longer offer powerless American patients protection from pirates, and the Hippocratic Oath only interferes with MBAs’ plans for more power.

Cut-throat pirates are everywhere. For example, look how little BCBSNM cares about patient privacy. Recently, a former employee named Martin Ethridgehill posted a comment on ModernHealthcare.com wisely cautioning the nation to slow down in the adoption of eHRs. BCBSNM quickly sent PR specialist Becky Kenny to persuade ModernHealthcare.com to drop Ethridgehill’s comment because it “does not reflect the views of BCBSNM.” New Mexico’s own BCBS also has a talent for dark humor as you can see.

Everyone is a stakeholder. Some just hold more stake than others.

In expounding on the power of semantics, I would like to point out that in around 2002, non-doctors in the Bush administration found a need for a new catch-all name in healthcare to reflect equal rights for everyone in the digital democratization of even US citizens’ most personal health secrets. That is when they rolled out the buzzword “stakeholder” – as if everyone in the nation has a rightful claim to some sort of 17% GDP natural resource called doctors’ practices. To this day, the bone-headed, slow-thinking parasites in Washington DC still fail to mention the “principals” of healthcare – those would be the doctors and their patients – to distinguish them from other who just hang and offer bad advice.

Greed has turned America’s most respected healthcare institutions into unresponsive fortifications of bureaucratic power that serve the interests of stakeholders over principals. Piracy of health is a grievous, creeping loss for our nation, and our government is an accomplice to the crime.

It does not have to be this way.

D. Kellus Pruitt

LikeLike
Darrell, on June 3, 2009 at 8:28 PM said:

Semantics and the TDA – Approaching accuracy

Every spring, following the state dental convention in San Antonio, incoming Presidents of the Texas Dental Association choose a title for their monthly column that appears in the TDA Today

http://www.tda.org/displaycommon.cfm?an=1&subarticlenbr=56

When you read the titles the last three TDA presidents chose for their columns, can you see a pattern developing?

Dr. David May’s, “Let’s Talk” – 2007
Dr. Hilton Israelson’s, “Ask the President” – 2008
Dr. Matthew Roberts’, “In the Loop” – 2009

I’ll share with you what I see: May’s,” Let’s Talk,” is a warm, inviting column title. One easily reads the spirit of the friendly greeting to what promises to be two-way, free conversation where no question is a stupid question and all those nice things. Well, he never responded to my question about the NPI number that the TDA was promoting back then. In my experience, “Let’s Talk” was an extreme exaggeration of the level of conversation.

Then, a year later, Dr. Israelson rolled out “Ask the President.” Do you see the change? No promise of two-way conversation in that invitation. And as I discovered, one is not even assured of getting a response. Nevertheless, I immediately sent him my questions about the NPI number (copied below) to an email address he provided. After all, in his inaugural “Ask the President” column, Dr. Israelson wrote, “It is my hope that this monthly column in our TDA Today will serve as a forum for members to ask questions and dialogue about key issues facing the TDA.”

In addition, Dr. Israelson’s closing remarks sounded promising, even if the title of his column sounded like a step closer to command-and-control than “Let’s Talk.” “Please send your questions and comments to me via email. I look forward to hearing from you!”

My questions were never addressed in Israelson’s column. In fact, to this day, there has been no response at all.

Even though Israelson’s responsiveness was no better than May’s, the lowered expectations make Israelson’s title still a little more accurate.

This week, new TDA Pres. Dr. Matthew Roberts rolled out his, “In the Loop” column in the May TDA Today. Maybe it’s my cynicism, but the title makes me think of smarmy good ol’ boy delivery of privileged information directly from the top in a smoky bar. However, since Dr. Roberts doesn’t even go through the effort to ask for members’ questions – much less provide an email address – I think the TDA has successfully eliminated for this member all possibility of disappointment.

I already have a suggestion for the title of next year’s President’s column: “Hey, you! Yea you”

Darrell

From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Wednesday, June 25, 2008 10:07 AM
To: TDA
Subject: Welcome

Dear Dr. Israelson:

Congratulations on becoming the President of the TDA. It is a fine compliment when so many colleagues put their trust in you.

Here is a topic for your new “Ask the President” forum:

CHIP – Charity to a Fault

I think it is noble of dentists to help the state with their obligations by volunteering for CHIP. I have always respected dentists who work for near-charity fees plus the bureaucracy – just like I respect those who work in charity dental clinics for no pay and without bureaucracy. They are equally generous.

Personally, I would consider helping with CHIP, but the NPI number really scares me. I have watched how the NPI number has delayed physicians’ pay for months because of crosswalk foul-ups. Recently, the IRS has added their requirements to the NPPES as well. If a provider’s name does not match up with the IRS records it will also delay payment. I have even heard that some of those who need NPI numbers may have to reapply all over again because of the IRS’s late intrusion into the mess.

But that is not the worse part. By volunteering for an NPI number, a dentist permits insurance companies to rank their quality by data-mining CHIP dental claims that they have been collecting for years. CMS intends to allow payers to post grades of CHIP dentists according to how long the restorations in kids’ mouths last, and compare the results to kids’ whose parents have dental insurance. As a general rule, children who are treated by the state do not keep their teeth as clean as others. Why should I risk so much for charity?

It just does not seem fair to be treated with such disrespect by our own state when we are trying to help them out of their mess that we did not cause.

D. Kellus Pruitt; DDS
Fort Worth, Texas

LikeLike
Dr. Pruitt, on June 5, 2009 at 3:54 AM said:

Dr. Kathleen O’Loughlin’s background counts … Doesn’t it?

The day after taking charge as Executive Director and Chief Operating Officer of the ADA on June 1, Dr. Kathleen T. O’Loughlin must have discovered that her new job is challenging in a really personal way. On June 2, the ADA News posted the article, “Delta plan to submit new fee methodology,” written by Arlene Furlong. I’m proud of Furlong.

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3607

Her piece describes how Delta Dental of Massachusetts was caught red-handed – cheating clients by lowering reimbursements for their UCL (usual, capricious and lame) profit-driven reasons. Furlong writes, “’Unreasonable’ is how the [Mass] division of insurance’s order describes part of the fee methodology Delta Dental Plan of Massachusetts is using to reimburse dentists who participate in its Premier network. Some 95 percent of Massachusetts’ dentists participate in the plan.”

Do you think the “95%” thing is what gives Delta leaders the old-school idea that they can do pretty much anything they want since 95% easily qualifies for the All-American capitalist plateau of “too big to fail”?

Old school General Motors can’t seem to make cars that customers want to pay for. Sure enough, long ago GM reached the cushy plateau and was oh so justifiably reluctant to change a thing. And the market share GM executives enjoyed less than a year ago was nowhere near the 95% safety margin of Delta Dental of Massachusetts. But things change with new administrations that are plunged into crises. GM’s margin was not enough. Now the US government is the majority owner of GM. Nevertheless, 95% is enough to draw attention, so hold your pointed head high, Delta. GM hasn’t failed yet, completely.

Value counts, always

It is well known among almost all ADA members that the business ethics of Delta Dental leaders is pitiful starting at the very top, and permeating all the way down to their PR geniuses like Ari B. Adler and Janis Oshensky. I don’t know about others, but for me it is obvious that complicated, actuary-driven malfeasance has been Standard Operating Procedure at Delta for decades. Unfair protection from fee-market competition has caused Delta Dental to progressively become over-valued. An inevitable market correction is due, in my opinion. In addition, I welcome the bad news for Delta stockholders. I think Wall Street’s speculative sacrifices such as this are increasingly important in lowering our grandchildren’s bills for health care beyond just teeth and gums. But what do I know? I’m a dentist.

That is why it is so refreshing to witness Furlong tear Delta apart without letting them up for air. She’s pretty darn clever when the ADA unleashes her. This makes me giddy in so many ways. At last, ADA leaders are not huddling silently in the corner hoping nobody will notice them, and Dr. Kathleen O’Loughlin, former president and chief executive officer of the same, sleazy Delta Dental of Massachusetts I previously described from 2002-07, is leading the way to eliminate policies she probably put together. Sweet.

Is that not the most imaginative, and exciting piece of non-fiction you have read in the last week or two concerning the dental profession? Get this: there were over 200 applicants for O’Loughlin’s executive director/COO position – replacing Dr. James Bramson and Mary Logan who were mysteriously fired over a year ago. Intriguing and obscure dental history this is. Who says dentistry is boring?

I’m sure more than one dentist under contract with Delta Dental is asking themselves if there could possibly be a conflict of interest in this ADA arrangement. Naah. At least ADA President Dr. John S. Findley doesn’t think so. He offers only glowing compliments for Dr. Kathleen O’Loughlin. Findley evidently considers her ethics at least adequate for what the job requires. He says, “Dr. O’Loughlin’s background represents the right mix of experiences we sought in an executive director.” (Furlong)

Dr. Findley’s campaign motto was “Findley for the Future” and he says Dr. Kathleen O’Loughlin is “just the right mix.”

One more thing about the influences in the development of O’Loughlin’s long career as a national leader in dentistry: Before she honed her ethics at Delta, she was Chief Dental Officer of UnitedHealthcare. And what a nidus of good-will that sensitive organization is! Have you ever heard of the Ingenix, a UnitedHealth wholly-owned subsidiary that was busted by NY Attorney General Andrew Cuomo for fraud? Similar to BCBSTX’s price-fixing scheme that was recently squashed under the heel of Texas Atty. Gen. Greg Abbott’s boot, Cuomo caught word of Ingenix distilling claims data for cost effective insurance solutions and dealt justice.

Our ADA Trustees sure know how to pick our leaders, don’t they? Another lesser known but equally ethical subsidiary of UnitedHealth, Dr. O’Loughlin’s former employer, is the American Association of Dental Consultants based in Scottsdale, Arizona where they convened their annual meeting last month. The graduates of AADC-recognized courses are the ones who make money for their bosses by delaying payments of insurance clients’ claims. Just today, I discovered that last week, an anonymous dental consultant for Humana Dental decided Humana really needs a pre-operative x-ray from me to justify paying a portion of the price of their client’s filling, that left my office firmly attached the satisfied patient long ago. No kidding.

When the wickedly funny Humana dental consultant finally receives my patient’s radiograph I mailed today, and chuckles with me and not at me when he discovers that sure enough, Dr. Pruitt was not lying in order to unfairly rake in tens of dollars – the consultant who watches over my ethics like he is paid on commission, will then stamp the claim approved to be paid, but a little less than the advertised 80%* – and after a month delay plus the cost of postage.

(*80% of my fee according to the usual, customary and reasonable fee schedule for a four-surface filling in my area code as determined by proprietary algorithms – a service purchased from companies like Ingenix with employees’ health care dollars.)

I just must take this opportunity to ask my ever so patient readers who hang with me this far down the page: Have you ever seen any consultants with Humana’s talent for dry, dark humor? I know I’ve been cheated in more creative ways, but never have I been insulted with such uninhibited flair.

ADA executive director Dr. Kathleen O’Loughlin is “just the right mix.” So remember to always brush your teeth before going to bed and use a toothpick in place of floss while entering onramps or otherwise driving at highway speeds.

D. Kellus Pruitt; DDS

LikeLike
Dr. Pruitt, on June 22, 2009 at 5:30 PM said:

ADA / idm – A bad union after all?

It should certainly not be a surprise to anyone that I really, really enjoy writing. I’ve discussed my addiction with a few friends who are likewise afflicted – professionals as well as amateurs like me. Several agree that the compelling appeal of sharing with others our latest most-important-yet discoveries – one right after another – is only part of the hook. The true kick comes from building words into creations that most accurately reflect what we feel – intricate, precise post-renaissance wordsmithing. The computer makes it so much easier than it was our founding fathers during their post-renaissance information boom. Not to mention improved lighting. And air-conditioning.

As an amateur, I feel additionally fortunate for the freedom I can afford compared to commercial artists and other more seriously oppressed people in the world who are held in line by risks far more precious than one’s employment. I’m thinking of Iran, of course. What would happen to Iranian citizens if the world stopped tweeting?

Humbled and grateful, I cannot lose perspective about my no-risk obligations as one who is equipped and able to help those who cannot represent themselves – my dental patients. If I don’t speak up for them, who will?

The problem with ADA/idm is deeper than start-up capitalization woes.

After a little over a year together, there is credible evidence that within the ADA/idm, the partnership has turned sour in the worse way – publicly. Why did it have to come to damaging the reputation of the ADA? I warned them, but nobody listened to me. One day they will learn.

The original idea behind the partnership was for IDM to sell logos, Search Engine Optimization (SEO) tricks and direct mail advertisements to ADA members with the help of the ADA News. The pitch that sold the ADA House of Delegates on the partnership was certain profits for everyone. Now what could possibly go wrong in that complicated business plan?

Yesterday, I was shocked when a Twitter acquaintance informed me that Trajan King was ousted as CEO of ADA/idm over a month ago. I had no idea. The last contact I had with Trajan was when he preemptively blocked me from following him on Twitter before I even had a chance to tweet him a welcome. That was around the first of May. Such an abrupt, in-your-face avoidance of a dentist by a leader in the dental marketing industry might seem odd if one didn’t know that Trajan King and I have a history.

I should point out that I haven’t yet read a confirmation of the corporate shake-up from the ADA, but nevertheless, when another piece of information came to me from another source, it lent credibility to the news of Trajan’s ouster. One should understand that the ADA is secretive about the arrangement with ADA/idm. And I have to hand it to ADA leadership: Yours is a very tight and disciplined organization. Nobody has yet betrayed the reason behind Dr. James Bramson’s firing from his executive director position. It will be 14 months this week. That’s impressive. I thought you’d only last 8 months. Your crew is cohesive and tough.

Here are the two messages, from two distinct parties, that are posted on the ada/idm.com Website. The first is undated.

“ADA/IDM’s customer base is currently at its capacity limit. So we may meet the fulfillment demands of existing customers, ADA/IDM has determined that no new customer accounts will be accepted at this time. We’d be happy to take your contact information and follow up with you when we are in a position to accept new customers.”

Did you notice anything unusual the comment? How long has it been since you have heard of an advertising business turning away work because they were “over-capacity”? Don’t feel bad. I missed it also until this morning.

Someone who is somehow oblivious to the state of the economy, as well as the competition in the advertising world, might read the ADA/IDM statement and come to the conclusion that as recently as five days ago, business was surprisingly booming. But four days ago, someone with authority posted the second message on the ADA/idm Website:

“Update from the ADA (6/17/2009) – The ADA has recently determined that the timely delivery of services to many ADA/idm customers has been impaired. This Update is to let you know that the situation is being thoroughly examined, and the ADA is now in close contact with ADA/idm staff. As always, the interests of our members is of paramount importance to the ADA.”

Do you know how I can tell if a note is from the ADA or IDM? Intelligent Dental Marketing calls the partnership ADA/IDM, whereas the ADA calls it ADA/idm. This shouts to me loud and clear that there have been problems between the ADA and IDM for a long time – at least as far back as when they couldn’t agree to what to call their Rube Goldberg business entity.

Hey, ADA employee. Yea, you. The one who never bothered to respond. I also posted my concerns about IDM over 6 months ago, in a comment titled “Time is up, Intelligent Dental Marketing.” Did you read it? To locate the article, googlesearch “ADA/idm” or “ADA/IDM.” Either way, it is the third hit. You can’t miss it. As a matter of fact, nobody can miss it.

“As always, the interests of our members is of paramount importance to the ADA.” – an as yet anonymous ADA employee, June 17, 2009. One day, I will learn the name of who wrote those words. I find the statement incredible.

“The world is my country. To be good my religion.” – Thomas Paine, another post-renaissance wordsmith. He was unpopular for a hundred years until his writings were re-discovered by Thomas Edison.

I’m even more patient than he was.

D. Kellus Pruitt; DDS

LikeLike
Dr. Pruitt, on June 23, 2009 at 6:45 PM said:

The downside of winning

Twitter is an incredibly fast and nimble platform for surfing the edge of the event horizon. Inevitable real-time gossip, moving too fast for spin, is just what this nation needs to become lean, mean and decentralized. We are competing for nothing less than our survival in the world economy. And like everything else of importance, it starts with a pissed off dentist.

For example: How would a soon-to-be former employee of Intelligent Dental Marketing, who was intent on sharing important information with a certain dentist hundreds of miles away, have ever found me without Twitter? And if the alert department head hadn’t come across my writings, how would you, in turn, have known before almost all other ADA members that the ADA/IDM partnership was sinking fast?

Now then, how long do you think it will be before we read about this on ADA News Online? Before committing yourself to a date, remember that we are waiting on a slow-moving dinosaur with a committee as a central nervous system to tell us bad news that cuts right to the core of ADA leadership. I suspect that right now a very lonely person in Chicago is frantically, but stoically, looking for PR help with the ADA/IDM failure. It will be interesting to see what kind of spin the story will acquire before it is published – I say no sooner than this Friday, June 25. (No wagering please) The past stories about ADA/IDM have been lacking bylines. I wonder which reporter will be given the task to roll this one out. Will we ever know?

I won’t mention the ADA/IDM employee’s identity here, because it’s not important for this comment. However, if one is interested in hiring an ambitious former department head with seven years of experience in web design and development – and a sharp understanding of transparency on the Internet – one can find him through our conversation on Twitter under “Proots.”

As you can see from some of his recent tweets, the union is indeed breaking apart. They pick up the story of the imminent collapse of ADA/IDM starting two months ago. They also tell of a man with a family who, like so many others these days, is anxiously looking for a new place to work. Even though I look forward to resolution for this problem in my ADA, the short-term effects on innocent employees of IDM don’t make me happy.

– feeling bad, for having to give 2 employees a “not needed notice”. Do they pay me enough to can my department?

11:59 PM Apr 23rd from web

– 10 hrs from now, I will now my employment status. Anyone need a well versed Web Designer or know anyone who is hiring? http://bit.ly/Gmgu2

12:17 AM Jun 17th from Tweetie

– It’s official. ADA IDM is winding down. 30 days, 90 days, who knows. In the meantime, I am looking for work. http://bit.ly/PNJNv

2:53 AM Jun 18th from Tweetie

– Know anyone needing a website for their business? Basic websites for only $50,000. j/k only $500. Limited to first 10 twits to respond.

1:35 AM Jun 20th from web

He’s sharp and he’s talented. He’ll land on his feet. Besides, there was never a future for anyone at ADA/IDM. It was a dead-end job, right from the giddy start.

D. Kellus Pruitt; DDS

LikeLike
Darrell, on August 24, 2009 at 6:35 PM said:

Is the ADA responsive to membership?

Week 2

It has been been 2 weeks since I posted the first three of several questions I have for the ADA Department of Dental Informatics. (See “HIPAA consultants – Who can one trust?”)

http://community.pennwelldentalgroup.com/forum/topics/hipaa-consultants-who-can-one

Dear ADA

Two weeks ago, I sent you three questions which are still awaiting a response.

1. If a dentist neither maintains nor sends digital patient records, is he or she a HIPAA-covered entity? The Fort Worth District Dental Society was recently provided information that appears to contradict that provided by the ADA.

2. Is encryption a viable security alternative?

3. If a computer is stolen in a burglary, compromised by a dishonest employee who sells IDs on the side, or otherwise hacked, will it not inevitably lead to bankruptcy even if the dentist reports the tragedy according to the letter of the law?

This email is being simulposted on TDA’s Facebook page, which currently has 200 members. So please respond promptly.

Have you noticed that the ADA has not yet posted last week’s news about HITECH-enhanced HIPAA rules yet?

Because the ADA is cornered, I predict on Tuesday or Wednesday, Arlene Furlong (?) will post her shocking article revealing the ADA’s “sudden” discovery that computers in dentists’ offices are unacceptably dangerous for dentists and their patients. Several of you know that I have been warning them about the coming day of reconciliation for four years. I’ve also repeated several times that the longer confessions are delayed, the worse it will hurt: “Those who hang onto absurdity the longest will be hurt the most.”

On Friday, Tony Rinkenberger, a reporter for the Minneapolis Health Care Business Examiner, posted an article about the enforcement of HIPAA titled “HHS Issues Rule Requiring Individuals Be Notified of Breaches of Their Health Information.”

http://www.examiner.com/x-14940-Minneapolis-Health-Care-Business-Examiner~y2009m8d21-HHS-Issues-Rule-Requiring-Individuals-Be-Notified-of-Breaches-of-Their-Health-Information

Naturally, Rinkenberger did not mention dentistry, so I posted the following response:

Tony, when you wrote “HHS Issues Rule Requiring Individuals Be Notified of Breaches of Their Health Information,” you may not have considered that the enforcement of the breach notification rule will eliminate computers from dental practices in favor of low-tech pegboards and ledger cards. Don’t feel bad. It’s a secret that neither the HHS nor the American Dental Association dares admit.

Fact: If a dentist notifies patients that their identities have been fumbled by a stolen computer, dishonest employee or hacker, the dentist will be facing risk of bankruptcy. A few years ago, the Ponemon Institute estimated that 20% of clients won’t return to a business following notification of a breach. Furthermore, they estimated the cost of notification to be $80 per client, based on past breaches.

If the kinder, pre-HITECH HIPAA had been enforced, many dentists would have abandoned computerization years ago. Here’s another secret: That is precisely why it wasn’t.

D. Kellus Pruitt; DDS

LikeLike
Darrell, on August 25, 2009 at 5:33 PM said:

Hello, Philip McClendon – VP of American Benefit Credit

When I left readers yesterday, we were waiting to see if DentalBlogs editor Nancy was going to attempt to censor me again by refusing to post this question for American Benefit Credit Inc: “If a dentist participates in your financing program, will that cause him or her to become an FTC-covered entity according to the Red Flags Rule?”

After several hours, DentalBlogs posted my question, along with happy notes from two anonymous ABCI cheerleaders, Heather W. and Cosmetic Dentistry. That’s progress, sports fans. The last time I challenged Nancy, it took much longer to get to this point in our negotiations. Eventually, I proved to her that she is no longer in control of her blog, and we can see how she learned to step aside much more quickly, yet still not immediately. Since Nancy is a smart editor, I’m certain her responsiveness will improve.

Nobody has yet volunteered to address my question, so I went back to the blog today and called out by name, ABCI’s Vice President Philip McClendon. Perhaps I should have given Philip more time, just to be fair. Right. If Philip shows up, I’ll tell him I’m sorry if my impatience messed up his day.

As you can see, I also re-opened an old challenge for CareCredit/GE’s VP Cindy Hearn and ADABEI’s Chair Dr. Robert Faiella. Do you see what happens to those who hide information they ethically should share with consumers? They lose the capacity to defend themselves. That naturally makes them docile and easily herded like cattle into a holding pen to await their opportunity in the squeeze chute where branding and other things happen.

http://www.dentalblogs.com/archives/administrator/press-release-new-patient-financing-company/

Dear American Benefits Vice President Philip McClendon, Heather W., and Cosmetic Dentistry:

As you surely must know, the compliance deadline of the FTC’s Red Flags Rule is November 1. If I sign up for the American Benefits financial plan on behalf of my patients won’t it make me an FTC-covered entity? Has anyone researched this?

When ADA-approved CareCredit posted their similar press release on dentalblogs.com in July, announcing their 24 month no interst loans, I tried for weeks to obtain an answer to the Red Flags question from Cindy Hearn, Vice President of CareCredit/GE. I also asked the ADA Business Enterprise Inc (ADABEI), headed by Dr. Robert Faiella. As incredible as it sounds, I am still awaiting a response to my simple question: Will CareCredit or American Benefits cause a dentist to become an FTC-covered entity?

I hope American Benefit Credit is more transparent than CareCredit and the ADA. There could be repercussions.

D. Kellus Pruitt; DDS

LikeLike

The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants

Subscribe MEDICAL EXECUTIVE-POST?

Member Statistics

ME-P Information & Content Channels

Ann Miller RN MHA [Managing Editor]

CERTIFIED MEDICAL PLANNER® program

Most Recent ME-Ps

PodiatryPrep.org

ME-P Free Advertising Consultation

Medical & Surgical e-Consent Forms

iMBA Inc., OFFICES

ME-P Publishing

SEEKING INDUSTRY INFO PARTNERS?

Reader Comments, Quips, Opinions, News & Updates

Start-Up Advice for Businesses, DRs and Entrepreneurs

Up-Trending ME-Ps

Capitalism and Free Enterprise Advocacy

OIG Fraud Warnings

ADA Mission Creep

31 Responses

Leave a comment

Calendar

Advertising Info:

Book Offerings:

Dictionary Offerings:

Dr. David Marcinko [Publication List]

Education Online:

Health Dictionary Series Wiki Project

Lower Extremity Medicine & Surgery

Pending NIHCM Grant Applications:

Practice Lists:

Professor Marcinko

Related Blogs:

Speaker's Bureau:

Thought-Leaders:

White Papers:

The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants

Subscribe MEDICAL EXECUTIVE-POST?

Member Statistics

ME-P Information & Content Channels

Ann Miller RN MHA [Managing Editor]

CERTIFIED MEDICAL PLANNER® program

Most Recent ME-Ps

PodiatryPrep.org

ME-P Free Advertising Consultation

Medical & Surgical e-Consent Forms

iMBA Inc., OFFICES

ME-P Publishing

SEEKING INDUSTRY INFO PARTNERS?

Reader Comments, Quips, Opinions, News & Updates

Start-Up Advice for Businesses, DRs and Entrepreneurs

Up-Trending ME-Ps

Capitalism and Free Enterprise Advocacy

OIG Fraud Warnings

ADA Mission Creep

Rate this:

Share this:

31 Responses

Leave a comment

Calendar

Advertising Info:

Book Offerings:

Dictionary Offerings:

Dr. David Marcinko [Publication List]

Education Online:

Health Dictionary Series Wiki Project

Lower Extremity Medicine & Surgery

Pending NIHCM Grant Applications:

Practice Lists:

Professor Marcinko

Related Blogs:

Speaker's Bureau:

Thought-Leaders:

White Papers: