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Introducing Darrell Pruitt’s Platform

5 Responses

1. Darrell, on January 27, 2010 at 1:58 PM said:

   Texas Dental Association – too slow for survival

   Yesterday, my mailman delivered my January 2010 edition of TDA Today – a monthly newsletter published by the Texas Dental Association. Here’s the page 1 headline: “TDA Kicks Off 2010 with Highest Membership Numbers in History.” (No byline).

   According to the unnamed author, we have 8133 TDA members. That is up 108 from 8025 in 2008, but it’s only a 1.4% increase. I agree with the author that in this economy, we should be thankful we haven’t witnessed a decline in membership. But it’s still early.

   I sincerely dislike trumping good TDA news with bad when it involves my patients’ representation in my state, but I think more than 108 dentists were newly licensed in Texas last year. So what does that mean? At best, TDA, It means that we are barely keeping up. Sorry, friends, but sometimes optimistic bureaucrats play creative with numbers and half-truths. It’s called “spin,” and it is best done anonymously.

   Nevertheless, TDA members indeed have lots to be proud of. It’s noted that the TDA Smiles Foundation held 10 charitable care events in 2009. That is 7 more events than in 2008. “The value of charitable care provided increased by 28 percent for a total of $1,219,210.”

   As frustrated as I become with traditional lack of accountability in the ADA, the charitable nature of Texas dentists who are members is one reason I refuse to give up on the TDA. We sincerely care. TDA members are the dentists I want in my neighborhood. Let’s not blow the future of meaningful patient representation in Texas on good ol’ boy image concerns. Let’s be honest with one another. Leadership can no longer hide from members.

   The author continues: “Impressively, in a non-election year, DENPAC contributions were up $18,000 over 2008,” His or her elation with thousands of dollars dentists spend on inefficient lobbyists – just to represent our dental patients’ interests – reveals an inconsistency as big as Texas, completely contained within one four page newsletter.

   On page 3, Dr. Mark Peppard, a member of the DENPAC Board of Directors, writes that a TDA delegation attended the ADA’s State PAC Best Practices Conference in November. So did the team bring anything back to Texas of value? He reports that keynote speaker Monte Lutz of Edelman Public Relations presented “Social Media and Its Impact on Grassroots Lobbying.”

   Dr. Peppard writes: “[Mr. Lutz] brought home a message of extreme reality and timely significance that I feel is important for all our members to understand – the importance of ‘Digital Advocacy.’ Mr. Lutz fascinated attendees with his extensive analysis of the success of digital advocacy in both the Obama and McCain campaigns, but the delineation of he sheer facts of our media world is what shook the room beyond what we felt we knew.”

   Lutz reportedly said that 90% of Congressional staffers are online, and their average age: 31. In addition, 300 million people in 60 languages are on Facebook and 50 million are on Twitter. In other words, the enthusiastic TDA delegation returned to Texas with great ideas for modern tools of communication… just days before the TDA shut down its Facebook page.

   You know where I’m going with this, right, TDA? There is a six-week delay between the time the TDA Today is finished and when it reaches TDA members.

   Let’s return to the headline article on page 1 with no byline: “The TDA Facebook group page, which started in June 2009, is now up to 235 members.” The author adds that the TDA Twitter page has 44 followers. Remember, that was six weeks ago. Today, the TDA Twitter has 45 followers. For those keeping score, that is a 2.2% increase. Compare the addition of one Twitter follower with the membership increase of 1.4% over the whole year. (See how easily I imparted opposite spin).

   The new Twitter follower is the best news here, because as I mentioned, the TDA Facebook which had 235 members is no more. (a 100% decrease). It was taken offline on December 7 because the communications director could not handle a troublemaker who started posting nonsense on the site. She had to close up shop because the only dentist in Texas who could have sent the anarchist quietly on down the road was kicked off the TDA site weeks earlier for petty cosmetic reasons.

   Have you had enough yet? No you haven’t.

   Let’s return to p. 3 and I’ll share another huge absurdity packed tightly into the TDA Today. Dr. Matthew Roberts, TDA President says, “Stay engaged, and when asked, contact your member of Congress [six weeks later].”

   I have been known to call the ADA a fat, slow-moving dinosaur facing extinction. If we are to effectively represent the interests of our patients, we must become nimble. Command-and-control is lame.

   We can no longer wait on cold blooded reptiles. If we have to, we’ll leave them behind.

   D. Kellus Pruitt; DDS

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2. Darrell K. Pruitt DDS, on September 28, 2010 at 2:47 PM said:

   This is what keeps me going, friends. For me, this is what makes it all worth getting up in the morning to go to work.

   http://fort-worth.doctoroogle.com/reviews/viewdentist.cfm/pageID/8/dentistID/83147/fort_worth_dentist/dr_darrell_pruitt

   “Tonight was my first visit with Dr. Pruitt. I am a chicken when it comes to dentists. I had neglected taking out my wisdom teeth for some time now. I had been in a lot of pain the last week so I finally decided to take the leap and make an appointment. I am very glad I did. Dr. Pruitt was very calming and gentle with me. I cried after the extraction just to let go of the anxiety I had when I came in. It was virtually pain free. I am at home now, my mouth is still numb, and hopefully I will recover quickly. I highly recommend him. I will be bring my kids and hubby back very soon.”

   Darrell K. Pruitt DDS

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3. D. Kellus Pruitt DDS, on February 27, 2012 at 6:57 PM said:

   In defense of trolls

   Jill “J.R.” Labbe is editorial director of the Star-Telegram. On Thursday, she posted an editorial justifying censorship of “trolls”… like me. In a comment following her article, I described how NextGen censored my concerns about the cost and safety of their electronic dental records.

   http://www.star-telegram.com/2012/02/25/3762612/slaying-trolls-in-the-name-of.html

   Dear J.R. Labbe,

   In the middle of your editorial titled, “Slaying trolls in the name of online civility,” you write, “Let’s face it, the trolls ruin it for everyone.” Do they really, J.R.? As a troll who is often blamed for ruining it for everyone in the electronic dental records business, please allow me to defend making executives uncomfortable enough to censor this dentist’s concerns from their company Facebooks.

   Since few choose to think about dentistry until they can no longer avoid it, and even fewer understand the simplicity of the business of dentistry, you are likely unaware of the growing controversy over the need for politically-correct EHRs in dentistry. Starting almost a decade ago, the reckless promotion of unproven EDRs by naïve leaders is a regrettable part of dental history very few dentists openly discuss – not unlike hidden shame in a dysfunctional family.

   In the dental industry, all that separates you from us trolls are repeated demands for answers to reasonable questions about the cost and safety of electronic dental records. I challenge you to investigate the troll bait for yourself: Imagine you are a dentist considering spending $40,000 dollars on an EDR system to replace paper dental records that have served your business needs adequately for decades. You must agree that there are two very important questions that have to be asked before investing money and effort: “Are EDRs less expensive than paper dental records?” and “Are they safer than paper?”

   The word on the street is, dysfunctional EDR stakeholders are shamefully aware that the software they promote is not only way more expensive than paper dental records, but with an “epidemic level” of data breaches of patients’ financial and medical identities, EDRs are of course far more dangerous to both dentists and patients than paper charts – which are stored in bulky, heavy and loud metal filing cabinets.

   With the frequency of digital data breaches doubling every year, once the nation learns of the hidden risks – perhaps as wary victims of identity theft – many will seek dentists with paper records. Then what will happen to the benefits of interoperable patient records, including the promise of new cures through real-time data-mining?

   Let’s jump ahead a few days. After getting no response to your concerns about the cost and safety of EDRs, which you won’t, by posting only one or two unwelcome follow-up questions you too will join us trolls – the despised, stubborn bottom-feeders of the internet who ultimately dispose of garbage others won’t touch – sometimes in ugly, vicious ways. As Thomas Paine said, “He who dares not offend, cannot be honest.”

   The fact is, huge, insensitive, dental software companies routinely delete my comments from internet sites to shield potential customers from learning the true cost and danger of lousy products. As a matter of fact, in the last few days, an anonymous NextGen employee censored my not-anonymous comment and follow-up questions about their EDR system, and then blocked me from the NextGen Facebook to keep transparency from hurting sales. For NextGen customers, there is no recourse for such rudeness because anonymous employees (and their supervisors) cannot be held accountable. Wal-Mart employees, on the other hand, wear name badges.

   “The consequence of breaking the social contract clearly expressed at the top of every comment page is removal by the online editors. And that’s not censorship. We aren’t the government.” Wrong. Trust me on this, J. R. Whether a person’s comments are censored by government or by a newspaper employee, angry customers cannot tell the difference.

   Even though slaying trolls is the right, and even the duty of Fort Worth Star Telegram editors, always remember that censorship is aggression, even if the trolls deserve it.

   Sincerely,

   D. Kellus Pruitt DDS

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4. D. Kellus Pruitt DDS, on February 28, 2012 at 10:19 PM said:

   Trolling for HIPAA consultants

   It’s much more rare than it once was, but occasionally I still attract responses from indignant HIPAA consultants who haven’t noticed the climate change. Andy Weitzberg, President of HIPAA Continuity Planners, responded to my comments with an air of authority following an article in the Examiner.com. titled, “Healthcare providers must be prepared for a HIPAA audit.”

   http://www.examiner.com/technology-in-long-island/healthcare-providers-must-be-prepared-for-a-hipaa-audit-1#comments

   ———————

   Thanks for your response, Andy Weitzberg, President of HIPAA Continuity Planners

   As I said yesterday, EDRs are both more expensive and more dangerous than paper dental records, and there is nothing holding down the cost of HIPAA. So when you tell me that I nevertheless cannot opt out of HIPAA, does that mean that I am helpless to protect my dental patients from unnecessary risk of harm? What’s more, you seem proud and even patriotic about what appears to be a lack of concern for my vulnerable dental patients’ welfare. It’s been my experience that stakeholders’ evasive defense of “it’s the law” is an obvious deflection of accountability intended to shut down discussions about a really bad government mandate that stakeholders depend on but cannot defend.

   Maybe you skipped over where I described how breaches of patients’ identities are doubling every year. Maybe you didn’t take me seriously when I told how an identity victim’s digital medical history can be dangerously and imperceptively altered to suit the thief. That life-threatening danger never happens with paper records, Andy.

   I’m sorry, but you still haven’t convinced this dentist of the value of HIPAA to my patients. It certainly complicated obtaining radiographs from previous dentists. How good is that? The mandate is simply absurd in dentistry. And if you haven’t noticed, it’s not saving lives or money elsewhere either.

   Does anyone else on this forum find it suspicious that the GAO has never published an estimate of how much HIPAA raises the cost of healthcare? If the cost of anything is kept secret from those who pay the bill, is the lack of transparency more likely to raise or lower the price?

   Regardless of how many people the complications from HIPAA/HITECH keep employed, when the waste is so bad that stakeholders won’t tell providers how much compliance adds to the cost of healthcare, it is only ethical to warn patients as well as taxpayers about the lack of accountability in the industry. Who can argue with that? No. Seriously. Who?

   Regardless of federal law, and regardless of the good intentions of hard working stakeholders, isn’t it time to admit that HIPAA has always been a failure? Data breaches of patients’ PHI cost $6.4 billion in 2010. Over 96% of healthcare organizations have experienced reportable data breaches in the last 2 years. I could continue with even more evidence of failure and you know it.

   To be frank, I think it’s your enthusiasm for wasteful mandates in healthcare that scares me, Andy.

   D. Kellus Pruitt DDS

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5. D. Kellus Pruitt DDS, on February 29, 2012 at 4:58 PM said:

   CIO of NCQA responds

   A couple of days ago, I entered my opponents’ camp and posted a challenge on “Health IT and Electronic Health Records” – a Linkedin group composed of like-minded individuals with common interest in the success of HIPAA, no matter what. I asked, “Is there anyone who can provide evidence that HIPAA/HITECH isn’t the greatest blunder in healthcare since bloodletting?”

   This morning, Rick Moore, Chief Information Officer (CIO) at the National Committee for Quality Assurance (NCQA) responded to a comment I made yesterday in response to HIPAA consultant, Joy Gray.

   http://www.linkedin.com/groups/Is-there-anyone-who-can-3993178.S.97716577?view=&gid=3993178&type=member&item=97716577

   “Re: increasing failures. It is not uncommon that when things are tracked, their occurrences increase. So, I would not equate increased occurrences of data breaches as a failure of HIPAA. I might go so far as to say that because of HIPAA, we are now starting to understand just how badly we are protecting the information of our patients. And as electronic information becomes even more readily available, we should expect these incidents to increase. To your point, HIPAA should be more prescriptive if it is expected to stop all breaches. To this end, let’s just stop playing around at the edges and demand that all PII/PHI be encrypted at rest and in transit and that whenever it’s transmitted or accessed, the individual is notified. That prescription would certainly raise the bar of protection and the price tag of it. And to your other point about saving lives … I don’t recall that being an objective of HIPAA, but one could extrapolate that medical professionals having real-time access to your secure data may very well save your life.”

   The NCQA is a private, 501(c)(3) not-for-profit organization “dedicated to improving health care quality.”

   http://www.ncqa.org/tabid/675/Default.aspx

   This is one of many organizations hoping to step in and hold providers accountable to national, bipartisan interests for the common good. As a dentist, I’ve learned that not-for-profits are a far greater threat to my patients’ welfare than benign HIPAA consultants. I replied:

   Thanks for your thoughtful response, Rick. Regardless if we disagree about the failure of HIPAA, which we do, the only way solutions will be found to interoperability is through open discussions like this, which for once include practicing providers who are expected to purchase and use in a “meaningful way” today’s lousy, unsafe EHR products.

   “It is not uncommon that when things are tracked, their occurrences increase.”

   Perhaps you missed it, so I’ll repeat: The frequency of data breaches doubled between 2010 and 2011, and is expected to double again in 2012, and over 96% of healthcare organizations have experienced reportable data breaches in the last 2 years. In fact, millions of patients’ digital identities have been fumbled from healthcare organizations in the last year! Surely you don’t believe that data breaches of such epidemic proportions have been occurring with doctors’ paper records for hundreds of years, do you? Quite frankly, this makes me wonder how well the NCQA can accurately measure quality in dentistry.

   Paper records simply cannot be hacked through the internet. Even if a thief manages to slip by office personnel and steals patients’ charts one at a time, the poor slob will still have to be manually enter the data onto a computer to sell it. Yet, thousands of digital PHI can be downloaded in minutes by a dishonest employee of a paperless practice, who by the way, can evade even the most secure and expensive encryption. Nobody is going to attempt to quietly move heavy, bulky and noisy metal filing cabinets out of a provider’s office to steal thousands of paper identities in one haul. Paper records are the gold standard of security. That’s your measure of quality.

   Encryption, which we agree will only make electronic dental records even more expensive, is not the answer either. For example, if you or your family’s encrypted identities were breached, would you rather not be bothered with the news? See what I mean?

   “And to your other point about saving lives … I don’t recall that being an objective of HIPAA, but one could extrapolate that medical professionals having real-time access to your secure data may very well save your life.”

   You caught me on that one. I misspoke when I stated that HIPAA, an absurd mandate, hasn’t saved lives outside of dentistry either. I should have said, HIPAA’s security mandate has failed miserably in its goal to protect patients from medical identity theft – which can lead to quick death.

   As for medical professionals having real-time access to my secure data, there is no security. If I’m in an emergency room unconscious, and my medical history has been imperceptively contaminated by a medical identity thief, I’m dead.

   D. Kellus Pruitt DDS

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