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I Want Obama Transparency for the ADA

No More Hiding Places

By D. Kellus Pruitt; DDS

Today, Ed O’Keefe of the Washington Post posted “New Obama Orders on Transparency, FOIA Requests.”


O’Keefe writes:

“In a move that pleased good government groups and some journalists, President Obama issued new orders today designed to improve the federal government’s openness and transparency. The first memo instructs all agencies and departments to ‘adopt a presumption in favor’ of Freedom of Information Act requests, while the second memo orders the director of the Office of Management and Budget to issue recommendations on making the federal government more transparent.”

Soon, other ADA members are going to bluntly ask Pres Dr. Ron Tankersley:

“If the President of the United States has the courage to face those whom his actions affect, why oh why doesn’t the President of the American Dental Association support transparency in the non-profit organization that belongs to dues-paying members?” After all, ADA members pay more than $1000 per year for ADA services.”

“If you are an ADA leader, pay close attention. This is the future I warned you about that far too many of you avoided out of convenience. As you can read below in his memos, Obama promises, “The Government should not keep information confidential merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears.”

Who will be held accountable for the ADA/IDM blunder… among other bone-head ideas?

Obama promises that his administration:

“Will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”

I think openness will do the same in healthcare if we can move a handful of entrenched ADA leaders on down the road. They are weighing us down with their selfish special interests.


Did you hear that, Dr. Ron Tankersley, President of the American Dental Association? There are simply no more hiding places for the anonymous ADA hobbyists who elected you. I’m sure the long run of irrelevant ADA Presidents was fun before electricity and social networks, though.

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22 Responses

    Office of the Press Secretary

    For Immediate Release January 21, 2009


    SUBJECT: Freedom of Information Act

    A democracy requires accountability, and accountability requires transparency. As Justice Louis Brandeis wrote, “sunlight is said to be the best of disinfectants.” In our democracy, the Freedom of Information Act (FOIA), which encourages accountability through transparency, is the most prominent expression of a profound national commitment to ensuring an open Government. At the heart of that commitment is the idea that accountability is in the interest of the Government and the citizenry alike.

    The Freedom of Information Act should be administered with a clear presumption: In the face of doubt, openness prevails. The Government should not keep information confidential merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears. Nondisclosure should never be based on an effort to protect the personal interests of Government officials at the expense of those they are supposed to serve. In responding to requests under the FOIA, executive branch agencies (agencies) should act promptly and in a spirit of cooperation, recognizing that such agencies are servants of the public.

    All agencies should adopt a presumption in favor of disclosure, in order to renew their commitment to the principles embodied in FOIA, and to usher in a new era of open Government. The presumption of disclosure should be applied to all decisions involving FOIA.

    The presumption of disclosure also means that agencies should take affirmative steps to make information public. They should not wait for specific requests from the public. All agencies should use modern technology to inform citizens about what is known and done by their Government. Disclosure should be timely.

    I direct the Attorney General to issue new guidelines governing the FOIA to the heads of executive departments and agencies, reaffirming the commitment to accountability and transparency, and to publish such guidelines in the Federal Register. In doing so, the Attorney General should review FOIA reports produced by the agencies under Executive Order 13392 of December 14, 2005. I also direct the Director of the Office of Management and Budget to update guidance to the agencies to increase and improve information dissemination to the public, including through the use of new technologies, and to publish such guidance in the Federal Register.

    This memorandum does not create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

    The Director of the Office of Management and Budget is hereby authorized and directed to publish this memorandum in the Federal Register.

    Transparency and Open Government


    Office of the Press Secretary

    For Immediate Release January 21, 2009


    SUBJECT: Transparency and Open Government

    My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.

    Government should be transparent. Transparency promotes accountability and provides information for citizens about what their Government is doing. Information maintained by the Federal Government is a national asset. My Administration will take appropriate action, consistent with law and policy, to disclose information rapidly in forms that the public can readily find and use. Executive departments and agencies should harness new technologies to put information about their operations and decisions online and readily available to the public. Executive departments and agencies should also solicit public feedback to identify information of greatest use to the public.

    Government should be participatory. Public engagement enhances the Government’s effectiveness and improves the quality of its decisions. Knowledge is widely dispersed in society, and public officials benefit from having access to that dispersed knowledge. Executive departments and agencies should offer Americans increased opportunities to participate in policymaking and to provide their Government with the benefits of their collective expertise and information. Executive departments and agencies should also solicit public input on how we can increase and improve opportunities for public participation in Government.

    Government should be collaborative. Collaboration actively engages Americans in the work of their Government. Executive departments and agencies should use innovative tools, methods, and systems to cooperate among themselves, across all levels of

    Government, and with nonprofit organizations, businesses, and individuals in the private sector. Executive departments and agencies should solicit public feedback to assess and improve their level of collaboration and to identify new opportunities for cooperation.

    I direct the Chief Technology Officer, in coordination with the Director of the Office of Management and Budget (OMB) and the Administrator of General Services, to coordinate the development by appropriate executive departments and agencies, within 120 days, of recommendations for an Open Government Directive, to be issued by the Director of OMB, that instructs executive departments and agencies to take specific actions implementing the principles set forth in this memorandum. The independent agencies should comply with the Open Government Directive.

    This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by a party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

    This memorandum shall be published in the Federal Register.



  2. Correction:

    For those who didn’t notice, I misread the date of the Washington Post article. In my excitement about Obama mentioning “transparency” for the first time in about a year, I read January 21, 2010, when in fact Ed O’Keefe’s article in the Washington Post, including the White House memos meant “for immediate release,” are dated exactly 12 months earlier, January 21, 2009 …. about the same time I first heard about Obama’s transparency plans – which turns out to be the first and only time.

    My bad. Sorry.

    In my defense, I suppose I can argue that if Obama was effective at carrying through with transparency in government a year ago, I hadn’t noticed.

    D. Kellus Pruitt; DDS


  3. Mary is my friend I often visit with on Pruitt’s Platform. Yesterday, in a conversation we are having about the McCarran-Ferguson Act of 1945, and the urgent need for its repeal, Mary said she feels that “Insurance and Big Drug Companies run this country anyway.” That caught my attention.

    Let me show you how much I’ve overcome my shyness. I am forced to get louder and louder in my efforts to bring transparency to the American Dental Association.


    Mary, I enjoy your thoughtful remarks, and please don’t take offense if I use your expression of a common attitude to make a point: If we tell ourselves again and again that someone else controls our lives, guess what.

    That is defeatist.

    “We are resolved that the method of consultation shall be the method adopted to deal with any other questions that may concern our two countries, and we are determined to continue our efforts to remove possible sources of difference, and thus to contribute to assure the peace of Europe.” – Neville Chamberlain, September, 1938.

    “The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’ That’s why we absolutely need the profession to be represented in the discussions about EHR to make sure our ideas are enacted to the greatest extent possible.” – ADA President Dr. John Findley, September, 2008.

    Do you see why defeatism is so prevalent today? Our leaders teach it.

    Here’s another quote from Dr. John S. Findley – possibly the worse ADA President in the history of the professional organization:

    “We need to position dentistry correctly for the future, working to maintain as much control for dentists as government will allow.”

    I’m damn sure not going down without a nasty, nasty fight that I will win. I bring empowerment that Thomas Friedman described in “The World is Flat.”

    D. Kellus Pruitt; DDS

    (Pretty salty for a Monday morning response, wasn’t it? Do I sound confident?)


  4. Truth in advertising, the ADA and DrBicuspid.com

    Brian Casey is the editorial director for IMV Publishing – the parent company of DrBicuspid.com. Today, he ventured out onto DrBicuspid’s Facebook to put in a good word for Sirona (for a price). “DrBicuspid.com announces Sirona’s exclusive sponsorship of its Imaging and CAD/CAM Community.”

    Then Brian Casey posted the following press release for 19 Facebook fans:

    “TUCSON, AZ–(PRWEB), February 17, 2010–DrBicuspid.com, the leading provider of online daily news and information for the dental community, is pleased to announce Sirona’s exclusive sponsorship of its Imaging and CAD/CAM Community. The interactive Imaging CAD/CAM Community will be a focal point for current news and technology and application trends related to this rapidly growing area for the dental community. Visitors can reach the Imaging CAD/CAM Community through a link on the DrBicuspid.com home page or directly at http://imaging.drbicuspid.com.”

    I trumped it with only two quotes:

    “DrBicuspid.com is your source for unbiased daily dental news.” – ADA, Feb 2009 in advertisement for DrBicuspid.

    “DrBicuspid.com announces Sirona’s exclusive sponsorship of its Imaging and CAD/CAM Community.” – IMV Publishing, Feb 2010 in advertisement for Sirona.


    I wonder how much Sirona paid IMV for the spot. If I hadn’t picked up on it, there would have been only 19 viewers. Now there are thousands. That’s accountability, Brian Casey.

    D. Kellus Pruitt; DDS


  5. Twenty-two days until April Fool’s

    After 4 years, thousands of articles and incalculable numbers of atta-boys from sports fans like you, I can finally look forward to holding the ADA accountable to one irritable ADA member. This time, the dinosaur is fast running out of wriggle room. Sit back and watch me corral and domesticate the untamed beast in a squeeze chute. We simply must put a halt to this cold blood line.

    Today, I used Twitter to remind ADA leaders and employees that I expect my non-profit professional organization to keep its word about opening the long-awaited ADA.org Website on or before March 31.

    Did you know that at a time when Websites can be built in hours, the ADA.org. will have been 18 months in development? So does this mean we should expect world-class dazzle from the ADA’s communications team – even as everyone else has run out of new tricks in Website design?

    Lots can change in the modern marketplace environment over a year and a half, and unfortunately, the ADA is like a slow-thinking, slow-moving, but proud dinosaur with an anonymous committee for an unresponsive central nervous system. Insensitive creatures throughout the business world that have never had to adapt to climate change are facing extinction. They are also known as “prey.” Right, sports fans?

    Who cares what others think of my unprofessional taunts? They entertain me. My disappointment developed for natural, good ol’ boy reasons and it makes no difference to me if I’m the only pissed off ADA member in the nation. I demand to know how shy leaders have been quietly spending my dues. After 27 years, I own the ADA.

    Anyone object?


    @ADANews, only 22 days until you either have to open the new ADA.org Website, or explain why not. What are you going to do? I’m waiting.

    @ADANews, did you see that Dr. Larry Emmott deleted my comment on Emmott on Technology. LLC Facebook yesterday?

    I can’t really blame him. He’s rented by Dentrix dental software and I suggested he tell readers to delay purchasing eDRs for a year or so

    So is censorship the way you plan on controlling me, @ADANews? Over time, I’ll show you, Dr. Emmott and others the hidden price of evasion.

    Dr. Darrell K. Pruitt


  6. The cost of cheap

    Yesterday, Dr. Larry Emmott posted “The Cost of Recall.” He accurately illustrates the cost-savings of computerized recall mailings in dental practices over the old fashioned way. He has a good point. However, he only tells part of the story. I responded in a comment following his article. (Since he censored my last comment I posted on his Facebook, I’ve copied it here – just in case.)


    You are correct, Dr. Emmott. The computer is a notoriously cheap tool for spamming. Even dental patients recognize this. But, for the sake of argument, which method is more effective – a computer generated recall card or a personal phone call from a staff member?

    There’s another significant downside to storing patient information on one’s computer – even if it’s only their names, addresses, birthdates and phone numbers. I know it’s a silly HIPAA Rule, but nevertheless, if any two of those four personal identifiers are breached, even without insurance information, social security numbers and other items of Protected Health Information, the patients affected must be notified and the incident must be reported to HHS. If the breach involves 500 or more patients, the regrettable incident must be reported to the local media as well. As I say, it’s a silly, silly rule.

    Occasionally technology can become very expensive.

    D. Kellus Pruitt; DDS


  7. The revolving door at ADA Headquarters

    If I don’t ask the unpleasant questions on behalf of my patients, who will? I posted this on Twitter this morning:

    Good morning, @ADANews. You almost have 3200 waiting fans on your Facebook. And you have 20 days until March 31. What are you going to do?

    You going to invite the fans to our new and improved ADA.org Website, Dr. Kathleen O’Loughlin? You’re quiet for an Executive Director.

    I think the responsibility for the ADA’s blunder in social networking ends with you, doesn’t it? Where’s Dr. James Bramson when we need him?

    The 2 years since he was fired have been different around the ADA Headquarters, I bet. I wonder if employees are quieter in the elevators.

    I bet the feeling of “us against them” is stronger than ever before. Clearly, the non-profit organization keeps secrets from members. Why?

    I look forward to discussing this and more on the new ADA.org when it opens in less than 3 weeks. Ready for transparency, Dr. O’Loughlin?

    I want to moderate a debate about the McCarran-Ferguson Act between you, Dr. O’Loughlin, and Kim E. Volk, CEO of DDPA – your former boss.

    This is an important question that has to be asked: Are the ADA’s revolving-door officials capable of defending policy in spite of conflict?

    I say, prove it, Dr. O’Loughlin … or resign!

    Darrell K. Pruitt; DDS


  8. Transparency and the ADA – A dissecting experiment, year 2

    “When we see something change that doesn’t make sense, we have to identify it and let the ADA know about it. Don’t roll over and take it if something doesn’t seem right. Your interpretation might not be accurate every time, but nobody who administrates or interprets the laws will be aware there are any issues to resolve if they’re never brought up.” – Dr. Bob Brandjord, an oral and maxillofacial surgeon and ADA past president. From ADA News, 12/20/06

    That’s a quote worth repeating, friends.

    On May 4, 2009, I posted the last installment of “Transparency and the ADA – a dissecting experiment” which I started on February 22, 2009


    The purpose for the experiment was to test a hypothesis that the ADA is unresponsive to members’ questions. Over a period of ten weeks, 17 questions were emailed that fit Dr. Brandjord’s description of identifying “changes that don’t make sense.” Every question was legitimate and reasonable.

    By early May, the results showed that 4 were welcomed with responses, and 13 were ignored. This means the questions experienced a response rate of less than 25% a year ago. My question is, has the ADA’s rate of responsiveness improved? My hypothesis is, No.

    Week 1

    On April 5, I posted “Two questions for the ADA Advocacy Dept”


    These were directed to the Federal Affairs, American Dental Association – part of the Advocacy Department of the ADA.


    Question 1 – “If a dentist signs up for CareCredit, he or she cannot possibly escape the Red Flags Rule. CareCredit, which the ADA promotes and profits from, is exactly the financial tool targeted by the Rule. What do you think?”

    Question 2 – “[According to the ADA National Oral Health Agenda], one of the ways the ADA intends to reduce the cost of dental care is to promote health information technology. Considering that we want to preserve what works, could you please forward me a link to the evidence on which such a drastic change is based?”

    Yesterday, April 7, I posted “Where’s the ADA.org forum?”


    It carries two more questions, this time to the Member Service Center.


    Question 3 – “Am I correct to assume that the ADA.org Website will not offer the capability for discussion between members and leadership? Or has the “forum” not yet been added?”

    Question 4 – “If ‘interactive’ is not to be included in the new ADA Website, can you please provide me the email address of someone in the ADA who might be able to answer some timely questions about electronic dental records, as well as HIPAA, the NPI number and CareCredit?”


    If the ADA is at least as responsive as they were last year, one of these four questions will be almost answered soon.

    D. Kellus Pruitt; DDS


  9. Dr. Pruitt,

    Thank you for your April 7 e-mail.

    As you are aware, the ADA has recently introduced a complete redesign of its Web site, ADA.org. As a second step toward improved membership service, the Association is exploring a range of enhancements, including a member discussion forum or other collaborative options under the banner of “social media.” To do this correctly, while ensuring we are adding value to our members, will take some time. We invite you to watch for updates on ADA.org as this process proceeds.

    In the meantime, you have touched on a number of issues that involve different areas within the Association. In order for the ADA to respond as thoroughly and directly as possible, it would be helpful if you could pose specific questions on the many topics you’ve raised—electronic dental records, HIPAA, CareCredit and so on.

    Once we receive your specific questions, we will compile responses from appropriate ADA agencies and get back to you as quickly as possible. We hope this approach meets with your approval, and we look forward to hearing from you again.

    ADA Member Service Center


  10. Darrell

    I fear the ADA Member Service Center is simply “playing you”; ie., keep him busy and get him out of our face, etc.



  11. That is ridiculous.


  12. Tipping point – the worst is behind us

    Success at last. In the next few weeks, insurmountable problems with eHRs in dentistry will be finally revealed by ADA officials.

    Never again will an ADA President announce that “Whether we want eHRs or not, they will be forced upon us.”

    Soon, the ADA Advocacy page will delete the claim that eDRs decrease the cost of dentistry.

    I imagine this morning, there are several dedicated, ethical ADA and TDA employees who feel a burden has been lifted. No more cover up.

    No more lack of support from bosses who also don’t know where to turn for the approved answers. This is communication. This is freedom.

    As we look back on it, it’s easy to recognize that continued business-as-usual at the ADA would have eventually doomed the organization.

    We have reached a tipping point to transparency that I’ve only sought for 4 years. I know ADA members who’ve been waiting decades for this.

    The non-profit ADA, of all American business entities, has never had the right, or the need to hide policy from its dues-paying members.

    It seems like any other Saturday morning, maybe even a little more normal than usual. Yet very quietly, I’m celebrating. Others are too.

    I stepped outside and there’s a fresh, cool breeze and all around are bright green hints of new growth. New beginnings.



  13. Steve,

    I didn’t mean to sound so abrupt. I was moving through things quickly this morning. I did not intend to infer that your statement was ridiculous. History proves that yours is a very fair and reasonable statement. I intended to say that it would be ridiculous for ADA leadership to try to evade me further. I’m sorry.

    The ADA and I have come to our showdown. They blinked. I am their huckleberry.

    The leaders of the ADA are intelligent people with common sense. They are fully aware that they simply cannot get away with old school evasion any longer. And, that is exactly why I call this is the tipping point. Never in the history of the ADA has there been unencumbered access for members like I am prying open. Never before have American dental patients been offered an increase in meaningful representation instead of virtually no representation. By the way, this kind of demand for transparency is going to happen regardless of what I do. I just saw it coming long before most dentists did.

    There are billions of dollars worth of healthy rewards for the nation that can suddenly appear from more direct dentist participation in the shape of dentistry for the future. There is NOT ONE dentist on the IOM board and the chairman is OK with that. He says that too many specialties make healthcare reform too darn complicated … but that’s another story.

    All stereotype humor aside, dentists are not insensitive people who desire to cause harm to those who trust their health to us. Please believe me when I say that no dentist wants his or her patients to experience discomfort and complications. We understandably want the best for those who trust us with their care.

    We’ve broken down a barrier. Since we’re bound to already be in trouble for unprofessionalism anyway, let’s think big. Why not? If not now, when?

    You witnessed it here. The ADA Member Service Center as much as said to me, “Mi casa is su casa (por favor).” If things continue to go well, from now on ADA leadership will always be transparent with members except in perhaps rare and extreme circumstances. This is freedom like we have never before experienced in our profession, friends. This means that if ANY ADA member feels a need to leverage dues against the organization the dentist supports, he or she can now find accessible purchase instead of “Write a letter to the editor.” That’s at least something, isn’t it?



  14. Darrell
    I sure hope you are correct, but I still fear not.


  15. I respect your opinion, Steve. Needless fear of The Man is still common. But look around. This platform we share at the pleasure of ME-P is not your dad’s CB radio. I contend that nothing beats the effectiveness of marketplace conversation for promoting respect for consumers’ interests.

    Let me show you something neat about the multiplier effect of transparency. How many readers do you think are following our conversation?

    Now multiply your guess by five and that’s the readership numbers ADA officials fear.

    I think numerous behavioral studies would support that estimate, but don’t hold me to it.

    D. Kellus Pruitt; DDS


  16. Breaking news: ADA accepts transparency – a little at a time.

    For those who support my struggle, the following official ADA reply to my email unceremoniously signals that today, ADA members who actually care for dental patients have returned to establish a beachhead in ADA Headquarters, and can never again be turned away.

    A year from now, you will see an entirely different ADA built on transparency, Evidence-Based Leadership and service to members, not secrecy and anonymous, unaccountable employees. That is my goal, and I have yet to meet anyone who can stop me.

    Does anyone have anything to say about the ADA’s not entirely evasive reply to my first 3 questions? If not, I’ll email the next question soon to the “MSC Password” (a default name for an unintended public forum portal). One question at a time works well for me, and is very little to ask of my professional organization. So I don’t expect to hear any complaints about my questions no matter how long it takes to get through my list.

    Let’s stop focusing on past shortcomings and celebrate the fact that the ADA won the race to transparency. Involving real dentists is a commendable advancement in effective representation of the nation’s dental patients’ interests. We won’t let the nation down now, will we?.

    Don’t feel too bad, Texas Dental Association you’ll eventually come limping home to capture second place, I promise. I’ll even help you make it happen.

    D. Kellus Pruitt DDS


    From: MSC Password [mailto:mscpassword@ada.org]
    Sent: Thursday, April 29, 2010 8:42 AM
    To: pruittdarrell
    Subject: RE: My questions are still unanswered

    Dr. Pruitt

    In response to your questions:

    While the ADA is hopeful that the FTC’s Red Flags Rule will be further postponed, the Rule is due to be enforced on June 1. If the Rule is not delayed for a fifth time, then any dentist who accepts payment from a patient in installments is arguably subject to the rule. It is important to bear in mind, that if the practice accepts installment payments from any patients, the FTC is likely to consider the entire practice to be covered by the Red Flags Rule. However, if patients avail themselves of a financing service, or use a credit card, the dentist is not considered a creditor under the Red Flags Rule.

    If you have further questions, additional resources are available through ADA.org at the following links:


    Click to access redflag_guide.pdf

    Regarding your second question, in an effort to support communication between members and the Association, the ADA is actively exploring enhancements to ADA.org. These enhancements may include a discussion forum and other collaborative options that fall under the banner of “social media.” However, to do this correctly, while ensuring value to our members, will take some time.

    Lastly, given the breadth of questions the Association receives, we rely on the expertise of myriad staff and Divisions. When we receive inquiries, we typically find it best to collect responses and communicate directly with members via the Member Service Center.

    ADA Member Service Center


  17. Welcome to my neighborhood, Dr. Rhea

    Ronald L. Rhea, DDS is the new President of the Texas Dental Association. I’ve never met him and know almost nothing about the dentist from Houston. The only thing I’ve heard is that he is a bigger fan of Internet conversation than any previous TDA President. That’s encouraging, because our patients need us to openly discuss important issues with one another without fear of endangering our reputations.

    In Dr. Rhea’s first “President’s Message,” I found the following paragraph interesting. He first praises the meticulous way in which the TDA leaders approach weighty decisions. He says, “The process and the collective wisdom of the house do prevail.”

    Click to access 05-10_TDAT.pdf

    Dr. Rhea continues: “Even the closed executive sessions bear out the wisdom of TDA policies developed over years of experience and debate. Unlike the popular press in our country, not to trivialize freedom of the press, the delegates of your House are unwilling to sully reputations or imply impropriety until all the facts are known. Your delegates fully realize that once impugned in the permanent records of the TDA, reputations can never be totally repaired even if later facts exonerate the accused. Trust in your delegates, the Board of Directors and officers, and the TDA staff, proves time and again to be well placed. All of them have, after all, the same goals — the preservation of quality dental care for the citizens of Texas, ability of Texas dentists to practice unimpaired by over-regulation, and maintaining the strength of the TDA as ‘The Voice of Dentistry in Texas.’”

    Quickly. What was that about?

    I’ve read the paragraph several times, and I get the impression that Dr. Rhea, who supports freedom of the press, is playing to a group of dissatisfied but influential TDA members who appear to want one or more persons’ reputations to be officially impugned in permanent records of the TDA – and it doesn’t seem to bother the accusers that damaged reputations can never be fully repaired if later facts exonerate the accused person(s). From what I can tell, someone sure is pissed at someone else and wants revenge in the worst professional way.

    Does anyone find it unusual that the new TDA President’s first official address was to allayed members’ fears that the TDA might sully reputations and imply improprieties “before all the facts are known”?

    I argue that Dr. Rhea provides us proof that it is in the interest of Texans that their dentists communicate openly with each other for crying out loud. Outsiders never find inside jokes entertaining and cryptic, targeted messages are never as clever as planned. There are better ways to spend our energies than playing childish games. Besides, I can assure you that our patients have no interest in the TDA’s opinion of dentists in Texas. An anonymous Texan or two need to grow up or move north a few hundred miles. Anyone have any problems with that?

    Can you see why we need transparency in the TDA? You may not have noticed, but for a minute, I thought Dr. Rhea was talking about me.

    D. Kellus Pruitt; DDS


  18. ADA and NYSDA become NY Atty. Gen. Andrew Cuomo’s voter bait

    Because shy Texan bureaucrats recently made themselves an annoyance in my life, I’m uncharacteristically late delivering news you may have overlooked as well If I hadn’t been busy defending my own reputation against hearsay understandably nurtured for political reasons, I would have noticed the two related ADA News items on September 6 when they appeared online. Blame proud good ol’ boys with nice teeth and bad manners.

    Nevertheless, I’m observant. And though I was distracted from my habit of scanning the Internet for obscure but meaningful news about the dental industry, I recall that on Monday or Tuesday, while looking up a reference on the Medical Executive-Post, I happened to notice that my article that was posted on the ME-P on July 28, 2009 had become popular among ME-P readers. It puzzled me, but until today, I had no clue why a hundred or so people suddenly found interest in “Journal of the American Dental Association [Letter to the Editor].” from a year ago.


    Often, just by posting a link, I bring with me enough readers to cause targeted articles to be hit hundreds of times. Even for a Website as popular as the ME-P – with almost 250,000 readers – a hundred or so meaningful hits are usually enough attention to cause a long-forgotten article like the one featuring my letter to the editor to become one of the dozen “Most Popular ME-Ps” listed on the left side of the ME-P page – even if my effort was never even acknowledged by the rude editor of the JADA.

    However, it wasn’t me plugging my ME-P article (until just now). Whenever anyone looks into CareCredit/GE’s current legal problems with incumbent NY Attorney General Andrew Cuomo – who needs someone with big pants to spank before the election – my letter from a year ago pops up on the first page of various search engines. What timing, ADA! I bet several of my newest fans are from New York and are politically active. Thanks, ADA. Without you, my rants would have no value.

    And just think: If the letter I worked hard on had actually been accepted for publication in the Journal, it would have been unread and long forgotten. Yet the proud but shy editor does not even have the common decency to acknowledge receiving letters from members. Is that “professional conduct”?

    My feedback that the editor ignored last year has become even more relevant this year:

    – 1. I voiced my concern about the ethics of the business agreement between ADA Business Enterprise Inc. (ADABEI) and CareCredit/GE

    – 2. I warned that the same ADABEI officials who destroyed member trust in the ADA with the ADA/IDM blunder are likely to cause more problems for the ADA with CareCredit/GE if they are not held personally accountable for their mistakes. That’s common sense.

    A year later on September 6, 2010 – about the time I noticed the spike in interest for my letter to the editor on ME-P this week – the ADA News posted two seemingly unrelated articles online:

    – 1. “Subpoenas for ADA, NYSDA [New York State Dental Association] issued in New York patient financing query,” written by Kelly Soderlund, is about ADA-approved CareCredit/GE’s problems with New York Attorney General Andrew “incumbent” Cuomo. Predictable.


    – 2. “Year of transformation,” by Stacie Crozier which features ADA accomplishments from June 2009 to June 2010, including a statement by ADA President Dr. Ron Tankersley about the long awaited final settlement of the ADA/IDM partnership that predictably went belly-up.


    – 1. Soderlund’s article about CareCredit is an attempt to whitewash the poor ethics of the ADA-approved dentalcare financing tool in which GE and ADABEI share profits made from membership. A year after I personally warned the ADA about CareCredit/GE, Soderlund shows that ADA officials still choose to side with a vendor rather than the consumers – who are ADA members’ trusting patients. It’s the dental patients’ credit that participating dentists have arguably put at risk.

    – 2. In Crozier’s PR piece, the accomplishment of “Managing the wind-down of ADAidm, including customer refunds and vendor settlements” was one of the first noted in a statement by ADA President Dr. Ron Tankersley.

    Did you notice that the non-profit ADA still proudly calls the failed partnership “ADA/idm” while ex-partner, Intelligent Dental Marketing from Utah still calls it “ADA/IDM”? ADABEI and IDM officials couldn’t even agree on a name for crying out loud. Yet as official complaints about me began to secretly pile up years ago, I’m apparently the only dentist in the nation who pointed out obvious warning signs in the doomed marriage. Would membership have been better served if I hadn’t said a thing? How about dental patients?

    Is it any surprise that the ADA is defending CareCredit/GE – a profit center? In Crozier’s pretty, pretty article, even Dr. Tankersley cryptically admits there have been “difficult financial challenges” in the last year.

    Dr. Tankersley also drops “insider-only” hints of recently uncovered but still unexplained ADA financial irregularities which caused KPMG to be brought in for an unplanned audit of the ADA Foundation. He says, “Last, but not least, there was a major effort to reorganize the ADA Foundation this year to increase its efficiency and effectiveness.” I think his evasive statement serves as evidence of tremendous pressure on ADA officials to produce income even if it runs counter to the mission of the TDA as well as the Hippocratic Oath…. I’m sorry. I meant to write “ADA.”

    There’s one more thing Tankersley mentioned that caught my eye. He cryptically broke the news that “several critical senior staff positions” were filled in the last year. I know of one. The ADA has a new Executive Director.

    Please hang with me. This all fits together into a neat little package of sharp objects.

    Dr. Kathleen O’Loughlin is a former official for both United Healthcare and Delta Dental. The rumor is, she was chosen for the executive director position because of her proven potential to make the ADA more profitable by tapping dental practices. By applying business techniques sharpened at Delta and UnitedHealth, ADA officials are hoping that the non-profit organization won’t have to be so dependent on fickled members’ dues.

    The previous executive director, Dr. James Bramson, had been suddenly fired 14 months before O’Loughlin took over. In addressing Bramson’s shocking dismissal which allowed no transition time, then President Dr. Mark Feldman, who would take over Branson’s duties as acting executive director of the ADA, announced that the non-profit will not answer members’ questions about the awkward transition So far, he’s correct. (See “The Bramson – Logan mystery”)


    And here’s to dentistry’s small circle of shy bureaucrats:

    Following the reticent past-president Dr. Mark Feldman’s stint as acting executive director of the ADA, he accepted the position of Executive Director of the New York State Dental Association. (NYSDA) – the other non-profit dental organization subpoenaed by incumbent NY Attorney General Andrew Cuomo because of CareCredit/GE’s sleazy business practices that I tried to warn the ADA about long, long ago.

    I wonder if my cautionary emails to the ADA will be subpoenaed. (Gasp!)

    Darrell K. Pruitt DDS


  19. Accountability in the ADA is inevitable

    During my camping trip last week, I had lots of time to reconsider a lot of things about my continuing struggle with the ADA over more accountability to membership.

    I know some of those following don’t agree with my blunt methods for promoting transparency in the ADA, and I too look forward to the day when I no longer have to intrude on others’ privacy to get their attention. I deeply regret enforcing personal accountability on volunteer TDA officials who sincerely, but mistakenly, believed their attempts to marginalize me would preserve the “dignity and honor” of the profession. They didn’t sign on to take such abuse from a member. However, I make no apologies. I will continue to use what works, and so far, it’s been shown that tact sucks even worse than rudeness.

    Maybe that will change sooner rather than later. However, for those like me who desperately want transparency in the ADA, an atmosphere of mutual fear separates members from leaders. So how do we make members more comfortable asking questions? For one thing, we stop punishing them for it. Even back in dental school all that produced was silent “professionalism.”

    In ADA President Dr. Raymond Gist’s address to the ADA House of Delegates a few weeks ago, he said “The only way to ensure that your dues dollars are spent wisely is ask these questions before, during and after everything we do.” He adds, “I’d like to see dental meetings take on the feel of town hall meetings.” That’s the spirit I’ve been hoping for, but if we want to give dignity and honor a chance, town hall meetings may not be the best venue for engaging impassioned members. For one thing, very few will show up at the designated time and location.

    I’ll suggest that the ADA can more efficiently – and more safely – engage members in dialogue on the Internet rather than through heated, face-to-face local debates where regrettable, careless things are likely to be said – causing permanent damage to relationships. I’m just thinking ahead a few years.

    There are a couple of words I’m beginning to notice more and more in ADA publications that bother me: “vetted officials” and “one voice.” How do we navigate around those two obstacles to civility?

    Let’s say a properly vetted leader recites a canned “one voice” response that doesn’t adequately answer a member’s sincere question. What then? Will the exasperated official be expected to continue reciting committee-approved responses and/or worthless links to CMS like a parrot until the frustrated member’s unprofessional conduct thankfully gives the official an excuse to terminate the conversation?

    As communications become easier, expect membership to increasingly challenge “one-voice” talking points. Repeatedly, vetted officials’ devotion will be misinterpreted as aggressive evasion and they will be publicly mauled because of the obsolete policy they pledged to follow. There goes dignity and honor. The ADA’s inflexibility is exactly why they cannot open the ADA Facebook. Committees are simply incapable of handling important questions in a timely manner and that makes the counsel of my professional association – which represents my patients’ interests in front of lawmakers – worse than worthless.

    When practicing dentists are finally allowed to freely “tell their stories” on an ADA Website, revolutionary changes in the ADA will be inevitable. Following a period of adjustment, I strongly believe transparency will reward our profession with increased respect among dentists, the public and lawmakers. Everyone applauds accountability even if it brings bad news – especially if it’s bad news. On the other hand, nobody respects evasion even from the highest officials – especially from high officials.

    It’s time for us to consider that the old way of doing vetted business in the ADA is no longer viable. The Internet means progressive and unavoidable de-centralization of power for dues-supported, not-for-profit organizations. This will happen regardless of what I do. I simply recognized the implications for organized dentistry before most people, and continue to be one of the very few to comment about it.

    Once ADA leaders surrender to transparency, I figure it will take a couple of years for a meaningful return for our patients, but look at it this way: 2014’s tenacious grassroots representation in dentistry will have never stood a chance growing out from under the ADA’s suffocating tripartite business model from the 1950s. And besides, compared to the ADA lobbyists that will be let go, social networks don’t cost a thing.

    Darrell K. Pruitt DDS


  20. Transparency lessons for the TDA … think they’re paying attention yet?

    Mondays always seem to pass faster when I have a writing project or two going. I’ve a couple of things in mind.

    First of all, Delta Dental posted a self-serving link on Twitter this morning leading to a press release purchased by Delta Dental announcing: “Delta Dental of Virginia was recently named to the inaugural list of the 2011 Best Places to Work in Virginia.” I’ve already sent Delta a Twitterpoem reviving a 2 year old unresolved complaint I have against their advertising ethics. I’ll invert it and share it soon.

    Secondly, here’s a joke I received with help from the Freedom of Information Act:

    A precious little girl walks into a pet shop and asks, in the sweetest little lisp between two missing teeth,

    “Excuthe me, mithter, do you keep widdle wabbits?”

    As the shopkeeper’s heart melts, he gets down on his knees so that he’s on her level and asks, “Do you want a widdle white wabbit, or a thoft and fuwwy bwack wabbit, or maybe one like that cute widdle bwown wabbit ober there?”

    She, in turn, blushes, rocks on her heels, puts her hands on her knees, leans forward and says, in a tiny quiet voice, “I don’t think my python weally gives a thit.”


    Know what is weally funny about this joke? Two things: First of all, the TDA email was subpoenaed in the NLRB hearing because it and others (including an anti-gay, vulgar joke) were shared between TDA officials for grins. But more relevant to Judge Carson’s interests in the case, one of the TDA Executive Director’s stated reasons for firing an employee was because the computer forensics expert she hired discovered personal business on the TDA computer the employee was assigned. The Judge seemed perturbed that this was the only instance in the history of the TDA that any employee has EVER been sanctioned for personal information (like jokes) discovered on company computers. It’s my opinion that the Executive Director’s capricious use of the obscure rule was part of the cost TDA members paid in the $900,000 judgment. But then, I’ve been officially labeled “unethical” and suspended from the professional organization because I “fail to uphold the dignity and honor of the profession.”

    Know what’s ornery? I’m going to potht thiith thit.

    D. Kellus Pruitt DDS


  21. Organized dentistry: A microcosm of state-sponsored repression in an age of enlightenment

    [Let’s keep those apologies coming, ADA. Renaissance is never kind to stubborn tyrants]

    This morning, I read a story by Elizabeth Dickinson in Wikileaked (below) which credits the release of repressed information uncovered by Wikileaks as a catalyst stimulating Tunisians to finally rise up against the nation’s tyrannical ruling family that has been historically supported by the US government – and vice-versa. Throughout the story, I recognized my own 5 year struggle against dentistry’s ruling family of similarly entrenched, command-and-control leaders who long ago stole the American Dental Association from membership for selfish reasons of power, money and other Washington DC favors – with perhaps similarly ominous consequences.

    If there should be any ADA official reading this who feels it is important for the dignity and honor of the profession to respond to my public accusations, he or she should be prepared to continue ADA President Dr. Raymond Gist’s example of offering humble apologies to the nation on behalf of the fallible not-for-profit organization. I’ll also warn that bringing to an Internet discussion an authoritarian attitude or committee-approved talking points would be painfully regrettable. Nevertheless, even traditional evasions are invited – even encouraged.

    What do I bring? I bring transparency. One only has to google my name to confirm that for over a period of 5 years, I have methodically assembled an over-abundance of important and timely still-unanswered questions concerning possible malfeasance in the ADA that starts at the very top of the organization. In some cases, all one has to do is google one or another ADA leader’s name and you’ll find examples of one or more of the unanswered questions on their first page. (One can do the same with leaders in the dental insurance industry I’ve unsuccessfully confronted). I’m different than the hand full of vetted ADA officials who failed to offer me the common decency of a response. I’m not anonymous, I’m out here in the community I serve and I’m confident enough in what I believe to stand behind what I say.

    I hope that Dr. Gist’s recent apologies for the ADA’s history of racial discrimination helped to heal senseless wounds caused by garden variety good ol’ boys decades ago. Although the numerous press releases were sincere, I think the confession was far too cost-free – perhaps even self-aggrandizing – and far too late to be called a success in justice for those who were senselessly harmed. So I ask the ADA, how long must the nation wait for apologies for the prideful blunders the current generation of good ol’ boys are scheduled to make this afternoon?

    Don’t stop apologizing just yet, Dr. Raymond Gist. We’re just now getting to the much more exciting real-time stuff that moves too fast for committee-approved spin.


    D. Kellus Pruitt DDS


  22. Leaders in hiding

    Our leaders are hiding from us, Doc.

    I imagine there are several shy dental leaders both inside and outside the ADA – and in between jobs – who find my efforts to bring transparency to the industry a threat to the insulated comfort they’ve grown accustomed to.

    And, to prove how unprofessional I am for being the only dentist in the nation demanding accountability, the good ol’ boys are prepared to hide from me for as long as it takes.

    D. Kellus Pruitt DDS


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