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ADA President and Broken Promises

8 Responses

1. Dr. Pruitt, on August 13, 2009 at 10:50 PM said:

   Accept a clue, ADA

   The popular 2000 book “The Cluetrain Manifesto,” written by Levine, Locke, Searls and Weinberger, predicts the struggle of traditional command and control leadership (like the ADA’s) with modern marketplace conversation (such as this). Here is how the popular, timeless book got its title: In a preliminary discussion, Doc Searls told the other authors about an acquaintance at a company that was “free-falling out of the Fortune 500” who said, “The cluetrain stopped there four times a day for ten years and no one ever took delivery.” (From the print edition of “The Cluetrain Manifesto.”)

   “If because of my aggressive and ‘unprofessional’ conduct, ADA leaders cannot stoop to face me in an open conversation here on the PennWell forum, someone should post something on the ADA News Online very soon in order to show concerned members that our ADA leadership is now paying attention and indeed recognizes the need for institutional reconsideration of plans for digital interoperability.” I posted this on the PennWell forum on December 23, 2008. (See “The game is over, ADA. We all lost.”)

   http://community.pennwelldentalgroup.com/forum/topics/the-game-is-over-ada-we-all

   After 3 years of ignoring my complaints about what appears to be institutional malfeasance that permeates his rogue department, are ADA Senior Vice-president Dr. John R. Luther and the head of the Department of Dental Informatics prepared to finally be honest with membership concerning the liabilities of digital dental records? Are they at last accepting delivery of clues that their calculated deception is coming to an end? Until membership demands that our reticent leaders step forward and accept the responsibility for bad decisions, they will repeat them again and again. Leaders have weaknesses just like everyone else.

   On August 5, the ADA News Online reluctantly posted a discouraging article titled “New HIPAA rules stem from federal recovery act provisions,” written by Arlene Furlong.

   http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3681

   Furlong’s first ever honest assessment of IT’s bankruptcy-level hazards will not only drive even more dentists from purchasing electronic dental records, but if we are lucky, it will also attract long overdue attention to Dr. Luther’s failures in his responsibilities to membership and his obligation to stay within the mission of the ADA. Leaders with similar ambitions who helped shield HIPAA and eDRs from membership scrutiny, including current President Dr. John Findley, President-elect Dr. Ron Tankerslsy and President-elect candidate Dr. William Glecos, realized years ago that eDRs face insurmountable security problems. I know the three dentist/politicians were made aware that their judgment day is coming because I personally warned them again and again. Each one still pretends that I don’t exist, and this is starting to really irritate me. Long ago when I recognized the ADA’s HIPAA blunder, and dutifully reported the mistake – respecting the ADA’s designated chain of command – I told a shy Texas Dental Association President that I didn’t want to raise my voice any more than he wanted to raise his. Nevertheless, I promised him I would become as loud as it takes. I never imagined I would have to suffer this much visibility, and for this long, to persuade adults in Chicago to act like adults. Why are healthcare IT enthusiasts so damned hard headed?

   As badly as members have been treated in the last few years by proudly clueless ADA leaders, it looks like if we do nothing at all, ADA members are destined to endure the same good ol’ boy unresponsiveness for several more years. The next President, Dr. Ron Tankersley, has ignored my questions about eDRs for about ten months, and President-elect candidate Dr. William Glecos, who is past Chairman of the Electronic Health Record Group, is up for election at the annual ADA meeting in October. Since Tankersley is already a disappointment, do you think Glecos can handle the accountability that angry members will demand like never before?

   I’m afraid Dr. William Glecos is hardly an improvement. His candidacy statement recently posted on ADA News Online betrays that he proudly sports the pedigree of one more in a string of irrelevant leaders. He appears to be in complete agreement with current President Dr. John S. Findley concerning the urgency of eDRs: Both say that the reason the ADA has to be closely involved with the planning for dental records is not because eDRs are in demand by members and their patients – because they are not – but rather because digital records are going to be mandated anyway. Can’t the Electronic Health Record Group’s PR Committee come up with higher quality talking points than that?

   When one reads Arlene Furlong’s August 5 article, it’s not hard to recognize that we are approaching a tipping point. Dentists with patients’ identities on their computers (96% of dentists) are likely to become very discouraged with HIT when they discover the amount of time it requires for non-productive administrative tasks in order to benefit from time-saving, but dangerous computers. Not to mention the fines providers risk from the HHS and now the FTC if every one of the tedious tasks are not correctly documented and inspection-ready.

   Now that the security of digital records is enhanced by unprecedented, super-enforcement from multiple departments of the US government, what could possibly go wrong with dentists’ enthusiasm for technology?

   Let’s imagine that tomorrow morning, a dentist in Texas discovers a broken window and a computer missing. Let’s say he does exactly what he is expected to do following a breach and promptly confesses to losing more than 500 patients’ personal identifications. After word gets out about his bankruptcy, preceded by local media news about the disaster, but before he pays the fines he is assessed for not having HIPAA paperwork in proper order, it is very likely that dentists across the state will progressively abandon computerization. When I mentioned this result long ago, few believed such a catastrophe was possible. Everyone underestimated the power of bozo.

   Once dentists move back to pegboards, they will be slow to re-adopt computerization. That is certain to set back meaningful research in dentistry even farther, and you and I will never learn about the magic of open-source evidence-based dentistry. Our grandchildren will be stuck with the bills for our ARRA stimulus funds, but will enjoy far fewer rewards than if we simply separate dangerous identities from otherwise uninteresting dental records now. Not later. One doesn’t store bombs with fuses attached because of devastating reasons. We’re losing time, friends.

   What a senseless loss to dentistry – all to keep from embarrassing a hand full of overly-zealous leaders who resist accountability. Sometimes I fear I’m still not being aggressive enough to make a difference. I will deeply regret if later I lament that I foolishly held back a few painful words while hoping for the best. Our nation’s chances of safe, interoperable digital dental records that are trusted by our patients, are slipping away – lost forever because stakeholders inside and outside the ADA seek power and money no matter how many patients it hurts.

   We MUST de-identify digital records in dental offices, damn it. Screw CMS, screw HHS and screw CCHIT-certified eDRs. Dentistry MUST seek its own path to digitalization before innocent dentists’ careers and reputations are irreversibly damaged because selfish, cruel people don’t have the guts to accept accountability for their mistakes.

   I’ve been fighting mind-numbing bureaucracy for a long time. To finally read an article from the ADA that is honest about insurmountable problems with digitalization in dentistry is as good as surrender, ADA. Come out with your hands up.

   D. Kellus Pruitt; DDS

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2. Dr. Pruitt, on August 15, 2009 at 8:42 PM said:

   I sent the anonymous editor of dentalblogs.com this message:

   Hey, Nancy, I posted the following comment on Dentistry iQ forum. To find it, google “dentalblogs.com.” Right now it is your 4th hit. It is clear to me that DentalBlogs’ page rank is so weak that I can push this, and even more harsh criticism up to your 2nd, or even 1st hit. And I can keep this up forever, Nancy. It’s sort of fun.

   Are you ready to negotiate yet? Or, would you like for me to keep whittling on your reputation? If you are ready to talk, post this comment under your article, “Growth and Expansion of Your Dental Practice.”

   http://community.pennwelldentalgroup.com/profiles/blogs/growth-and-expansion-of-your

   After you send me an email that you have done so, we’ll work out the details of our discussion about ethical standards in journalism.

   You better believe that I’m a kind of special bastard like you have never had to deal with. As long as you remain silent, I own you. You recognize that, don’t you?

   D. Kellus Pruitt; DDS

   Dentalblogs.com cannot hide from me

   I don’t like dentalblogs.com because the anonymous editor of the Website cannot be held accountable for what she posts. Recently, a blurb was posted on DentalBlog’s Facebook page that links to a PR piece purchased for by the ADA.

   http://news.prnewswire.com/ViewContent.aspx?ACCT=109&STORY=/www/story/08-11-2009/0005075970&EDATE=

   The ADA is raffling off a $150 gift certificate for suggestions on a design for their new Website. After sending a message to Nancy through Dentistry iQ blog, warning her that I intend to cause her some problems today, I posted this on DentalBlog’s Facebook. If she decides to censor it, that will be a very regretful mistake. If she allows it to remain posted – signaling to me that I can say anything I want about DentalBlogs, any time I wish, even on their own Facebook page – that will be a very regretful mistake.

   I’ll let Nancy know I posted it here as well.

   D. Kellus Pruitt; DDS

   http://www.facebook.com/dentalblogs?ref=ts&__a=1

   The problem with the ADA Website is not its design. Like dentalblogs.com, the problem is their lack of transparency. ADA leaders selectively respond to members’ questions depending on the subject. For example, just try to ask whether signing up for ADA-approved CareCredit makes a dentist a covered entity under the Red Flags Rule. The anonymous editor of dentalblogs.com, whom I call “Nancy,” refused to put Cindy Hearn, VP of CareCredit/GE on the spot over this important question, and Informatics@ada.org refuses to discuss it as well. Nancy likes advertising dollars, and GE has a bunch of them.

   Darrell K. Pruitt; DDS

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3. Darrell, on September 1, 2009 at 9:50 AM said:

   Is the ADA responsive to membership?

   Week 3

   It has been 3 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:

   Three 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?

   ———————————

   You know sometimes when you have a really good hold of a lower molar with a cowhorn, and you’ve already torqued the tooth with about 90% of your controllable strength, and the tooth still doesn’t’ budge? As you start to give it just a little bit more, do you also experience a profound instant suspended in time immediately before the tooth either breaks or the roots emerge intact?

   Can you feel it yet? The stress is building all the time. Something’s going to break. Sometimes breakage is as necessary as it is inevitable.

   I trust that one day, someone is going to share with me the reason that nobody in the ADA has yet responded to my sincere and straightforward questions that I started asking the Department of Dental Informatics, not 3 ½ weeks ago, but 3 ½ years ago.

   Even without a clue as to the stated reason I hope to live long enough to hear, preferably face-to-face, I do know this: The tale will be simply fascinating and probably worthy of a chapter in a book. Another missing part of that chapter is the name of the character selling the reason.

   I am not exaggerating when I warn fellow members that we are quickly running out of time. If as individual healthcare providers we do not step forward and take responsibility for our patients’ security, breaches are destined to needlessly harm our profession as well as the oral health of American citizens. We could lose the future.

   This time next year, what do you want to be conducting business on? Computers or carbon paper? Or will you just retire?

   Attention anonymous email attendant in ADA Headquarters: Since I am a dues-paying ADA member, I have reason to believe that everyone following my effort agrees that I’ve granted you – whoever you are – enough of my patience. What is your name? Who is your boss? Is it Jean Narcissi or Dr. John R. Luther or both? And who should I hold publicly accountable for six years of negligence that is endangering my profession? The entire ADA House of Delegates?

   Perhaps ADA members could be afforded a response from Chicago if a TDA official were to quietly ask my first three questions as if they were representing the interests of an anonymous TDA member. Then the official could post an anonymous report here on the TDA Facebook. You see? We can solve this communication problem.

   Is it worth risking a try, TDA? I have to say that the ADA-recommended method for members to voice complaints blows.

   D. Kellus Pruitt; DDS

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4. Darrell, on September 12, 2009 at 4:35 PM said:

   Dr. Ron Tankersley’s interview draws a rebuttal

   This week, “ADA President-Elect’s Interview: Part 1,” written by Judy Jakush, was posted on ADA News Online (for members only).

   https://www.ada.org/members/resources/pubs/adanews/090907_tankersley.asp

   Rather than such canned, no-risk interviews with Judy Jakush, I think what dentistry needs today is meaningful communication between ADA members and Dr. Ron Tankersley – who will take over as figurehead of the ADA in a couple of weeks. Since traditional ADA protocol still prevents transparency, allow me to offer a few blunt counter-points to Dr. Tankersley’s committee-approved, committee-lame talking-points.

   First of all, in response to a series of Jakush questions, Tankersley makes incredibly careless mistakes in his prepared responses for one who is soon to take over as the ADA President. He could be the next embarrassment for us, following close on the heels of President Dr. John S. Findley, a disappointment for fellow Texas dentists. Tankersley writes:

   “Credibility is the most important element in us [the ADA] maintaining our relevance. Without credibility, our market share and other assets would be meaningless. The focus of the ADA Board of Trustees during the past couple of years has been to keep us a member-driven Association and maintain credibility. The Board knows that if we lose our credibility, we can’t accomplish our mission.”

   Who couldn’t help but notice that he mentioned “credibility,” four times in four sentences. I have to say that this paragraph reads as if he was assisted by an SEO (Search Engine Optimization) clown trying to link “ADA” to “credibility” on searches. I could be wrong. I can think of another, less technical reason for this error that is not rooted in cheap Internet tricks, but in psychology and human nature. Dr. Tankersley coincidentally offers to Jakush that an advantage he brings to the presidency is that he was a pre-med/psychology major in college. Even without such training, I think most people intuitively recognize that mentioning “credibility” once would have been credible. Mentioning it four times suggests over-compensation caused by lack of confidence in the veracity of what he says. That could be labeled an acute symptom of cognitive dissonance. (I was a psychology/German major).

   “As the technology improves and our members become more comfortable with that technology, more of our communications will be electronic. We will, indeed, become more of a ‘virtual’ Association. That will make us more nimble, inclusive, and cost effective.”

   How can I describe this statement without calling the next president of the ADA a liar? If Tankersley is not a liar, are we to believe the oral surgeon is naïve? Either way, God help us and our patients, because regardless of back slapping good ol’ boys’ enthusiasm, things don’t look promising for organized dentistry, friends. What does Tankersley mean by “inclusive”? I personally asked the dentist to include us in his plans for digital health records, and have been ignored for almost a year. If you think he simply hasn’t noticed it, my unanswered invitation has been his first or second hit ever since it was posted. That means when curious ADA members, members of Congress or Tankersley himself google his name, they read about a grossly inadequate leader at the very top of our professional organization. (See “An invitation to Dr. Ron Tankersley, President-elect of the ADA).

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

   The ease with which I can pin critical remarks to his reputation also means that Tankersley has no Internet presence, and almost anyone can exploit his weakness. I’m getting better at undermining bureaucrats all the time, and God help me, I do enjoy it so. Here’s the deal: Unless the ADA spends lots of money on press releases to protect the president’s first page image, and we all know how important image is to ADA leaders (“Image is everything” – ADA/IDM), in a matter of weeks my opinions of Tankersley, good or bad, could occupy most of his first page. I’m self-syndicated now and very successful. I’m offered more venues all the time, and my credibility is different than that of the ADA. It’s real. It is my opinion that we’ve allowed insensitive committees to elect bozos to the presidency for a while now, and it looks like more of them are standing in line hoping for chance for a plaque that celebrates traditional irrelevance.

   Dr. Tankersley writes: “Today, people seem to be comfortable rationalizing almost any behavior and don’t seem to feel personally accountable of anything.” I agree, Dr. Tankersley. It’s not the members who are uncomfortable with technology – it’s the entrenched corps of leaders. As a matter of fact, we demand access to tools with which we can actually hold them more accountable. Leaders like Dr. Ron Tankersley and Dr. John S. Findley before him find it easy to use buzzwords like “transparency” and “credibility” because words are cheap in canned interviews.

   Let’s look at Dr. John Findley’s campaign promise of “Findley for the future.” It has been over a month since I emailed questions about HIPAA to informatics@ada.org per the Department of Dental Informatics invitation. I still have not received as much as a hint of a response. If virtual representation means “not real,” we’re there already. Dr. Tankersley, you can forget about any hope of leading a “nimble” ADA. You are the head of a slow-moving, insensitive, and clumsy dinosaur that is oblivious to dangers of extinction. Let me show you nimble. (See “Is the ADA responsive to membership? Week 3”)

   http://community.pennwelldentalgroup.com/forum/topics/is-the-ada-responsive-to-1

   “The Board of Trustees is functioning well. Since we trust one another, we can have spirited debate without it becoming personal. I don’t think any Board members are bashful about speaking their minds, even when they know that others don’t agree with them.”

   I suppose this is like saying, “If you could only see us when we’re behind closed doors. Take my word for it. We sometimes get rowdy!” Please, oh please let me speak to just one Board member who is not bashful. If there actually aren’t any, would your statement be called a fantasy, an exaggeration or a lie, Dr. Tankersley? Does it bother you for a common ADA member to address you man-to-man like this? If you were in the room with me right now, would you like to take a swing at me, or are you OK with what I say? I really cannot tell as long as you are silent. From one psychology major to another, I think you need to be more assertive.

   “That is characteristic of effective decision-making groups. We all understand that we all want the same thing for the Association. We would like to develop that same degree of trust in the House of Delegates.”

   Can you please share with us the reason you said this? It sounds like there is some lack of unity in the ADA. Am I wrong?

   Lastly, I take extreme issue with your lament about “… a general decline in the emphasis on ethics and accountability by both dentists and their patients ….” Why did you fail to mention the lack of ethics of insurers? I think there is a tendency for leaders like Dr. Tankersley, as well as national politicians, to blame those they rule rather than parasites like Delta Dental, BCBSTX, United Concordia, and the ADA Department of Dental Informatics.

   I can’t wait to read part 2 of your interview, Dr. Ron Tankersley. I bet it’s full of good fodder as well. Come on out if you feel the urge, Ron. Let’s mix it up. ADA members want to see what you are made of.

   D. Kellus Pruitt; DDS

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5. Dr. Pruitt, on September 23, 2009 at 10:23 AM said:

   D. Kellus Pruitt’s rebuttal to Dr. Ron Tankersley’s interview – Part II

   “Much of our work will be seamless and below the radar screen for our members.” – President-elect Dr. Ron Tankersley, in Judy Jakush’s September 2009 interview. A year earlier, President Dr. John S. Findley promised membership transparency, but he couldn’t deliver once he was told what the word means. I think Tankersley’s actually got the tools it takes to succeed with his sneaky way of doing business.

   Yesterday, I read Dr. Ron Tankersley’s second part of his interview on ADA News Online.

   https://www.ada.org/members/resources/pubs/adanews/090921_tankersley.asp (ADA members only and for good reason)

   The title of Judy Jakush’s interview is: “’We share the same beliefs and goals’ – Dr. Tankersley talks about the dental family, strength in numbers.“ Dr. Tankersley told Judy Jakush: “My most important responsibilities are to (1) represent the Association’s members,…” But as you will see, he doesn’t really mean it like some could be tempted to believe.

   Tankersley adds: “I want to reduce the misunderstandings and distrust that exists within the dental family… we need to work together. …This will require better interprofessional communications.” He sounds convincing, doesn’t he? He’s good.

   Then Tankersley casually pushes his pile of crap smooth over the line when he promises: “I will encourage continued proactive initiatives on the ADA’s part to accomplish that end.”

   If as a common member, I were given the unprecedented opportunity to discuss dentistry with ADA President-elect Dr. Ron Tankersley, I would respectfully point out that when I google his name, his second hit is a member’s invitation to discuss eDRs from November 8, 2008. I’m still waiting for a response. Is that proactive? Is that even civil?

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

   In your defense, Dr. Tankersley, the insult isn’t your fault. Away from the official ADA image you are obligated to protect, you’re probably a nice guy who is loved by patients, friends and family, just like I am. I’m sure that if it was up to you, you’d happily show me the level of respect you show people you meet who are not ADA members. But since image is everything for someone in your showcase position, your rudeness to individual members is out of your control. You are painfully adhering to the role you were elected to play according to your leadership capabilities and good looks. If things go well for you this year – and I can pretty much promise you they will not – you’ll leave an image of the perfect figurehead because your work is “seamless and below the radar screen for members.” I think that is decidedly more ominous than “transparency” President Dr. John S. Findley promised in his Jakush interview. However, I commend you because somehow it seems more honest, and when you say you are the kind of person that can pull off such stunts, I believe you. It’s probably bad form to brag about it though.

   Ultimately you will receive a nice plaque for your wall celebrating yet another irrelevant ADA Presidency. In a few days, we’ll all learn who will be the ADA’s next figurehead. I think Dr. William Glecos’ ethics are flexible enough. Like you, Findley and what’s-his-name who preceded Findley, Glecos also resists defending his name. He gallantly sacrifices self-respect to protect the ADA’s image.

   “Continued proactive initiatives to reduce the misunderstandings and distrust”? I bet Judy Jakush didn’t think to ask the obvious follow-up question: “What the hell are you talking about, Dr. Tankersley?” This spring, I posted 17 important questions for the ADA on their website over a period of 10 weeks and got a 24% response rate – and those were only the easy questions. Nobody dared touch the challenging ones. (See “Transparency and the ADA – a dissecting experiment” – February 22 to May 4, 2009)

   http://community.pennwelldentalgroup.com/forum/topics/transparency-and-the-ada-a

   If Dr. Tankersley is sincere in his desire to reduce misunderstandings and distrust that exists, his proactive initiatives that must still be below the radar screen are not working, ADA members.

   The policy of stealthy unresponsiveness like Tankersley describes is a newly obsolete defensive strategy. ADA officials, elected and paid, can no longer hide behind nameless, gullible boards to insulate themselves from personal accountability to common members like me. I intend to show readers how the forever trusting volunteers who devote their hearts to our profession get hoodwinked every time by the self-perpetuating ADA bureaucracy. This is a crippling, terminal weakness inherent in the ADA’s traditional business model. If I can easily exploit the ADA’s information vacuum between checking hygiene patients, members should be aware that others more dedicated than I can exploit the organization as well for any number of devious purposes. It’s a damn good thing I’m benevolent.

   Tankersley proclaims: “The Board of Trustees and the House of Delegates need balanced information to make informed decisions.” Dr. Tankersley, do you mean something like the balanced information they were given about HIPAA by Newt Gingrich around six years ago? He sure has a slick sales pitch, doesn’t he?

   Or are you talking about Dr. Robert Ahlstrom’s controversial testimony to HHS about how wonderful HIPAA is for dentistry? Do you realize that two years following Ahlstrom’s embarrassing statements, I am the only person who has quoted his list of benefits of electronic dental records? (If readers want to see my rebuttal of Ahlstrom’s testimony, just google his name. It’s Ahlstrom’s first hit). What does it mean when the ADA’s chosen expert in healthcare IT is ignored by everyone in the industry except one skeptical dentist?

   Let me show you a typical example ADA-approved, balanced information: “Health information technology will reduce the cost of dental care.” This pile of deception can be found today on the ADA Website on the ADA Advocacy page. If members are interested in what the ADA is telling lawmakers below the radar screen, you might want to visit the site.

   http://www.ada.org/prof/advocacy/agenda.asp

   I pointed out this lie to you almost a year ago, Dr. Tankersley. If it is not a lie, please tell us how money can be saved in dental care using eDRs? Do the projected savings that the ADA insists upon have anything to do with government/insurance plans for cost control using dentists’ NPI numbers? (Gasp!) I too found it hard to believe ADA leadership would betray practicing dentists like that when ADA employee Patrick Cannady revealed the real reason for the NPI in an email. That was on February 16, 2006, and ever since then, I have been seeking clarification from ADA leadership about their partnership with stakeholders for the “quality control” Cannady was so excited about.

   Don’t you know ADA members will be pissed when they discover the real purpose of the NPI number? Thousands volunteered for the ten digit identifier only because Jean Narcissi, head of the ADA Department of Dental Informatics, pushed them to do so. Her boss, for those who are interested in trails of accountability for natural reasons, is ADA Senior Vice President Dr. John R. Luther.

   How about the chunk of ADA-balanced information the delegates were provided about ADA/IDM by the ADA Business Enterprise Inc.? That sure turned out to be a stinker of a mistake, didn’t it?

   Here’s an idea, Dr. Tankersley. Please tell common members like me what the delegates were promised from GE below the radar screen if they agreed to sell CareCredit to membership. To you, “balanced information” is a flexible buzzword – just like “membership representation.”

   Now on the other hand, if you were to make it a point to make sure ADA members are properly informed that by offering ADA-approved CareCredit to one’s patients, a dentist signs up for the Red Flags Rule – I would call that balanced information. The House of Delegates has surely been informed of this complication. Haven’t they?

   “The ADA is the only professional organization that is a Designated Standards Maintenance Organization under HIPAA.” Do you know why I find that scary? Other than your tendency to do under the radar crap? Dr. Robert Ahlstrom and his testimony. Ahlstrom went out of his way to provide HHS with the misinformation laws will be crafted around. Thanks a lot, Robert.

   “The Association is committed to developing standards that are realistic and pragmatic for dental practice.” You mean like HIPAA? Like NPPES? Like CDT codes?

   “…there is no doubt in my mind that without the ADA’s input, the new era of electronic interchange could be a disaster for dentists…. The government is going to develop these standards regardless of what we do. Without ADA input, I would hate to see the results.”

   Aren’t we a nation built upon a free market and not tyranny like you describe, and even welcome? It sounds to me like Tankersley is the problem. Not the solution.

   Expect me to be in your face all year, Ronnie. I hope it’s not presumptuous for me to assume we are on a first name basis by now. I figured since we share a similar level of respect for each other, formalities kind of suck.

   D. Kellus Pruitt; DDS

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6. Darrell Pruitt DDS, on October 18, 2009 at 12:00 PM said:

   NADP has 64 year old legs

   NADP, you can kiss your fat cartel bye-bye because your bony 64 year old M-F Act is played out.

   This summer, in the long hot days before the final passage of the HITECH Act into law, dental benefits brokers’ lobbyists hired by the National Association of Dental Plans (NADP) slopped sweat and drool on each other as they scrambled to get the attention of bored lawmakers who could not care less about their group panic attack. Then as now, there was one overriding issue which is critical to not only the cartel’s continued business-as-usual-and-customary niche market, but also the very existence of the NADP as a national organization. If the insurance-friendly McCarran-Ferguson Act of 1945 is repealed, NADP-sponsored junkets to exotic islands that were swell fun for executives and salespeople will end. And Repeal is exactly what Obama threatened this morning. And that would force the insurance industry to play by the same rules as all other businesses in the land of the free, including dentists.

   Some dental benefits companies will quickly go bankrupt for natural, Adam Smith reasons of competition. The economy already has their market gasping for air even while dentists are learning that full payment in cash at the time of service is a nice, friendly way to do business.

   What makes lobbying particularly tricky for PR specialists like Delta Dental’s Janis Oshensky is that at the same time Delta’s leaders are trying to quietly get the attention of politicians, they refuse to discuss their policies with the dentists in the nation who must ultimately be involved in delivering Delta’s outrageous promises. Is that not modern bizarro? That’s got to look weird to lawmakers.

   What’s the difference between Delta Dental Plans Association CEO Kim E. Volk and a tyrant? Tyrants who listen to idiots and overestimate their power eventually underestimate their opponents’ – just before they don’t survive in the free market. And Americans are typically cruel to its toppled tyrants (for a little while). I know my day is coming as well because I’m just having too much damn fun for there not to be payback at some point in this adventure.

   Obama seems sincere about eliminating the law which gives unfair business advantages to the insurance industry at patients’ expense. If the McCarran-Ferguson Act is repealed – unleashing the FTC – NADP cartel members will scatter like roaches and will be less likely to recognize each other than Baptists in a bar.

   Over the last four years, I think I’ve learned enough about ADA leadership to know that all but a hand full of high-level humorless officials find the sudden bad fortune for the NADP as hilarious as schadenfreude gets. I also bet leaders with common sense in Chicago wish they too could exercise their freedom of speech. However, most ADA officials are prudent, and the fear of the FTC is so ingrained that when they find themselves alone in the Headquarters elevator with an NADP member, they can only snicker quietly – not with the NADP, but at the NADP.

   For the last two decades or so, part of the NADP’s quarterly entertainment was to have their janitor turn in the ADA to the FTC. It’s a clever game of ornery harassment that keeps the ADA leaders irrelevant and hidden from membership. It works swell as long as there is a M-F Act because every time Washington is called, Henry causes the ADA to spend funds that could have otherwise been used to serve the interests of dental patients.

   Let’s hope that the days our ADA leaders let themselves be jerked around by the NADP cleaning crew are over. I’ve got your six, good buddy. Let me slap a friendly armpit on ya.

   D. Kellus Pruitt; DDS

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7. Dr. Pruitt, on October 26, 2009 at 6:07 PM said:

   ME-P Readers,

   If you’ve followed me, you’ve noticed I’ve slowed way down on posting comments. It’s not that I’ve lost my passion for exposing unaccountable bozos in the healthcare system, oh heavens no. It’s just that new interests take up the free time I once used to writing vitriol.

   ###

   Besides, what more can I say? I’m sure many in my social network have asked themselves that same question, only to be surprised, again and again. For example, I’ve warned the ADA and the TDA more than a hundred times in the last few years that stolen computers will bankrupt dental practices, and NOBODY above my society level even acknowledges that I’ve said anything at all. Talking to the ADA is like talking to a wall, yet the Presidents freely use buzzwords like responsiveness, inclusiveness and transparency in their election campaigns.

   This weekend, I was indirectly threatened by an attorney because I publicly warned a sensitive HIPAA consultant that he or she will be held accountable for shopping her lies about HIPAA. It is easy to see how the attorney misunderstood the statement to mean that I was calling his or her client a liar. But I wasn’t. The misunderstanding arose from my use of the phrase “her lies.” Of course they aren’t her lies. She just innocently presents “someone else’s lies” as the truth. Once I changed the wording to reflect that, all was just swell once again, and I had successfully evaded the grasp of another attorney. And so far, I still haven’t had to hire my own lawyer to fight a nuisance suit. I’ll let everyone know if at some point I find that I must defend my right to offer my opinion. I promise it will become public ugly.

   This isn’t the first time I’ve brushed up against ambitious attorneys. But so far, nothing sticks. And if it did, how much help do you think I could count on from employees in the ADA Legal Department – a traditional institution that is supported by my dues? Even though President Dr. Ron Tankersley claims the ADA represents my interests in Washington DC, I think we all suspect that if it came down to expert testimony from the ADA, Dr. Robert Ahlstrom, the ADA’s expert on HIPAA, would be more likely to testify on the consultant’s behalf than mine. After all, he’s the one who created the lies she naively believes.

   If one googles “Dr. Robert Ahlstrom,” I describe Ahlstrom’s lies in his first two hits. So will I hear from Ahlstrom’s attorney? I’m not too worried. If he could have defended himself against my allegations, he would have done so years ago.

   Want to see what the ADA House of Delegates accomplished last month in Hawaii at the National Convention? The ADA’s unquestioned obedience to both insurance concerns and HIT is clearly stated in Res. 60H-2009. Just today, an article appeared in the ADA News Online titled, “House of Delegates expands ADA health care reform policy” by Craig Palmer:. He writes, “Res. 60H-2009, adopted as amended, says that in addition to policy approved by the 2008 House of Delegates, ‘the ADA shall also advocate that any health care reform proposal:

   [Emphasis is mine]

   •maintains the private health care system;

   •should increase opportunities for individuals to obtain HEALTH INSURANCE COVERAGE in all U.S. jurisdictions;

   •assures that INSURANCE COVERAGE is affordable, portable and available without regard to preexisting health conditions;

   •develops prevention strategies that encourage individuals to accept responsibility for maintaining their health and which may reduce costs to the health care system;

   •be funded in a sustainable, budget neutral manner that does not include a tax on health care delivery;

   •exempts small business employers from any mandate to provide HEALTH COVERAGE;

   •include incentives for individuals and employers to provide HEALTH INSURANCE COVERAGE;

   •contain medical liability (tort) and insurance reforms;

   •ENCOURAGE THE USE OF ELECTRONIC HEALTH RECORDS with rigorous privacy standards; and

   •The American Dental Association supports Health Savings Accounts, Flexible Spending Accounts or any other tax incentive programs that allow alternative methods of funding health care costs.”

   The expanded health care reform policy also stipulates that:

   •”the ADA shall direct its lobbying efforts to assure that legislators fully understand the consequences of any health care reform legislation;

   [On the Advocacy page of the ADA Website, it says that electronic health records will save money in dentistry. That’s a lie. Any ADA attorneys want to come after me for that stinker?]

   •the ADA direct its lobbying efforts to inform our federal legislators of the ADA’s existing health care reform policy and advocate for efforts to implement it.

   [Such as the Robert Ahlstrom’s testimony to HHS in July ’07 Here is my unanswered rebuttal, point by point]

   https://healthcarefinancials.wordpress.com/2009/01/08/hipaa-and-dentistry/

   •the ADA’s Health Care Reform policy be promoted to the dental profession and the public through the ADA News, ADA Web site and other appropriate avenues of communication.”

   That would be the command and control fantasy described in “The Cluetrain Manifesto” a decade ago. “Corporations do not speak in the same voice as these new networked conversations. To their intended online audiences, companies sound hollow, flat, literally inhuman.”

   Most of Cluetrain’s predictions are reliably becoming history for slow-moving dinosaurs like Delta Dental, BCBSTX, United HealthCare, the ADABEI, the ADA Department of Dental Informatics, TDA’s Membership Department, CareCredit/GE, NADP, CCHIT, and others I am hounding which I cannot recall at the moment.

   Volunteering my time for my profession as a lookout – unwelcomed by some, loved by others and virtually unknown by almost all – I am approaching a point when instead of pointing it out the risk one more time to leaders in the ADA, I may just draw a picture of some landscape instead.

   From my vantage point, I have followed the progress of a huge, ugly-entertaining manuretrain wreck that is now too late to avoid. I’ve done everything I could do to soften the disaster. Now I’m almost content to observe it from a safe distance and draw pictures of it as it happens, using words I’ll fight for with a viciousness that might surprise bozos.

   D. Kellus Pruitt; DDS

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8. D. Kellus Pruitt DDS, on October 26, 2009 at 8:52 PM said:

   Let me draw a picture for you. This was posted today about the same time the ADA News posted Craig Palmer’s article stating that the ADA is solidly behind digital health records: “Medicaid Payer Gives Breach Notification,” by Joseph Goedert, HDM Breaking News, October 26, 2009

   “Medicaid Payer Gives Breach Notification”
   HDM Breaking News, October 26, 2009
   http://www.healthdatamanagement.com/news/breach-39246-1.html?ET=healthdatamanagement:e1059:134820a:&st=email

   “CalOptima, a Medicaid managed care plan serving 360,000 recipients in Orange County, Calif., has lost claims data on 68,000 members. The missing data includes substantial identifying information on affected members. The insurer has posted the following notice, first reported by HIStalk, on the home page of its Web site: “CalOptima has identified the potential loss of past medical claims information for approximately 68,000 of its members that was stored on electronic media devices.”

   Do you know what it means if any one California provider, physician or dentist, has more than 500 of those 68,000 members as patients? According to HITECH, news about the breach, along with the doctor’s name, must be publicized by local media. Do you think that might hurt business?

   The Ponemon Institute estimates that 65% of the costs incurred by breach notification are due to loss of business – regardless who is at fault. So even if it’s a stakeholder who does something stupid, innocent providers of healthcare can go bankrupt. Yet the ADA leadership claims eDRs will save money, and they are telling lawmakers that ADA members also think they are just swell.

   That’s one of the ugliest picture I’ve ever drawn.

   D. Kellus Pruitt; DDS

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