Become a Whistle Blower in the Healthcare Industrial Complex

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Dr. Pruitt, on May 11, 2010 at 1:02 AM said:

The Case the Texas Dental Association Lost

Yesterday, I revealed to TDA members that Executive Director Mary Kay Linn was responsible for causing the TDA to be brought before the National Labor Relations Board.

http://community.pennwelldentalgroup.com/forum/topics/undermining-the-old-school-way

Below are the facts in the case according to testimony found in the court document.

Click to access jd-atl-12-08.pdf

TDA members, regardless what you think of me, you should read this. In the name of Hippocrates, is this the best we can do in representation of our patients’ interests in the state? Our leaders make us look like fools for hiring them.

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“Although employees of the Association had various complaints, prior to 2006 those complaints had not resulted in any protected concerted activity. On February 28, Katherine Simms, Director of Ethics, a supervisor as defined in the Act, was discharged by Executive Director Linn. Simms’ discharge followed her breaking off a relationship with a coworker who was also a supervisor. Simms took issue with the discharge decision, hired an attorney, and spoke with Dr. Jay Baxley, who at that time was chairman of the Ethics and Judicial Committee of the Association and had regularly dealt with Director of Ethics Simms. Dr. Baxley raised his concerns that Simms had been unfairly treated with the members of the Ethics and Judicial Committee. The committee agreed. Dr. Baxley sought to raise the matter with the Board of Directors but was informed that “it was outside your committee’s scope of duty.” Dr Baxley concluded that the Board of Directors and Executive Director “were going to sweep this under the rug the best they could.” In an effort “to bring up the issue,” Dr Baxley, on March 21, sent an e-mail to various members of the Association as well as to staff employees of the Association to which he attached an arrest record pertaining to the coworker with whom Simms had broken off the relationship. The e-mail, as confirmed by the arrest record that was attached, stated that the coworker had been “caught on TDA [Texas Dental Association] premises using/possession [sic] of marijuana and other drug paraphernalia.” The e-mail also stated that the coworker had recently “allegedly inappropriately touched another TDA employee.” The e-mail concludes by asking whether the Association “want[ed] people like this represent us.”

On March 21, Dr. Herbert Wade, Chairman the Internal Affairs Committee of the Association, wrote Dr. Baxley directing that he cease any involvement in “these pending legal issues.” Dr. Baxley ignored the directive.

Among the responses to his e-mail, Dr. Baxley received anonymous communications from staff members noting that this “was typical,” that when issues came up that Executive Director Linn did not like, she would “squelch” them either by making the life of the complaining employees “difficult or by terminating them.” The e-mails that Dr. Baxley received made him aware of various complaints of staff members including complaints relating to the facility, alleged financial improprieties, and unfair treatment.

Following the receipt of Dr. Baxley’s March 21 e-mail, staff employees began speaking with each other regarding various issues. There were two meetings at a local restaurant. The first was after work in late March. It was attended by about seven employees as well as two unidentified “directors,” i.e. supervisors. Various concerns were discussed in addition to the termination of Director of Ethics Simms. The concerns included the December 2005 termination of employee Victor Sanchez, a Hispanic maintenance employee. Employee Clark spoke about what he considered to be financial improprieties and problems relating to the building at which the employees worked including the pooling of water in the parking lot, suspected mold on a wall, and a nonfunctioning light in the south stairwell, problems that had been raised but which in March 2006 still existed. Clark recalled that one employee complained that she had been requested to take certain hours off of her time card, and another complained of alleged sexual harassment. Employee Patricia St. Germain stated her opinion that the employees needed to “stand as one.” Although she anticipated that this would involve meeting with Executive Director Linn, other employees were “frightened to go to her or didn’t trust going to her.” The idea of a petition was discussed. The employees were uncertain whether they could petition the Board of Directors, and it was decided that a petition would be submitted to the House of Delegates.

Following that meeting, Clark went home and drafted a petition on his personal computer. Thereafter, the employees again met at the local restaurant. On this occasion, about five or six employees and one director, Barbara Lockerman, were present. Lockerman arrived after the meeting began and left before it ended. The employees were concerned about retaliation, and, in view of that concern, the employees used aliases when signifying their support of the petition. St. Germain and employee Teresa Kim gave up their anonymity at the hearing herein and identified their particular alias, thus confirming that the petition was supported by more than one employee. Clark testified that all 11 aliases that appear on the petition are employees of the Association, and I credit that testimony.

Prior to going to the meeting, Lockerman called Dr. David May, with whom she worked on a regular basis because he was, at that time, President of TDA Financial Services. Dr. May is currently President of the Association. Lockerman informed May that she had no idea what was being discussed and questioned “whether a meeting could take place,” noting that she wanted some guidance. She recalls that Dr. May told her, “Barbara, they’ll be fired.” Although Dr. May did not recall saying “all employees,” he did recall that he cautioned Lockerman about becoming involved, stating that, if she did so, “there’s a chance you could lose your job.” I credit Lockerman’s testimony that Dr. May spontaneously stated, “Barbara, they’ll be fired,” upon learning of the employee activity. Although Lockerman attended a portion of the meeting, she heeded the advice of Dr. May and did not sign the petition. About a week after the meeting, Director of Finance Laura Haufler, who is the direct supervisor of both Clark and St. Germain, spoke with Lockerman and asked her to talk Clark “out of these activities, because … he would be fired.” Lockerman explained that she could not do so, that “Nathan is his own person.”

Following the second meeting at the restaurant, Clark drafted a resolution that called for an independent investigation of the management of the staff of the Association. He sent the draft of the resolution anonymously to Dr. Baxley, and stated that he would be sending a petition in support of the resolution which Clark understood Dr. Baxley would present at the Annual Session. Shortly after receiving that letter, Dr. Baxley received the petition bearing the 11 aliases.

The petition, titled A Petition from Concerned Staff of the Texas Dental Association, in pertinent part, states:

“In order to better serve the membership of an organization for which we have gained great respect and affection … [we] are humbly requesting your assistance. In recent years, we have watched and been saddened as poor management, a dwindling morale, and a declining work ethic … has pervaded your central office in Austin. Many of us have tried on numerous attempts to correct these problems by bringing them to the attention of current management through use of the ‘proper channels.’ Unfortunately, our concerns have gone unanswered and we are now compelled to ask for your help. … We seek not to point a finger at any individual member of the staff, but to voice our concern to an impartial outside source, free from any retaliation or repercussion. You will be surprised when you begin to hear specific examples of poor management, negligence, and unfair treatment that have occurred. … We sign anonymously for fear of retaliation and not because we do not truly believe in this cause. … Please help us make your Texas Dental Association what it needs to be—a better, fairer, and more ethical place to work,–so that it can work better for you.”

Dr. Baxley was a delegate at the Annual Session. Near the end of the first day, when the floor was opened for new business, he asked to read the employee petition. The speaker requested to see the petition, and Dr. Baxley complied. Dr. Baxley was told that he could not read the petition. He was allowed to read his resolution calling for an independent investigation, but, as soon as he finished reading it, he was informed that it was “totally outside the scope of this meeting.” He called the question, and the resolution was defeated.

Clark sent the petition, anonymously, to the Board of Directors. Within a few days, Dr. Baxley learned from staff members that what was described as a “witch hunt” had begun in an effort “to find out exactly who these people were, how they were in communication with me.”

The witch hunt to which Dr. Baxley referred began on Wednesday, May 17, when Executive Director Linn held a staff meeting in which she directed anyone who had participated in any way in “these anonymous communications” to contact her as a condition of their employment. Linn had learned that the petition, which Dr. Baxley had not been allowed to read, had been sent anonymously to the Board of Directors. As the employees were leaving the meeting, employee St. Germain noted that several employees “were making zipper motions across their mouth.” On the same date, Linn sent an e-mail to the staff stating:

“Just to reiterate what I said at today’s staff meeting regarding the anonymous communications–”

By now I am sure that each of you knows what took place on the House Floor on Thursday with Dr. Baxley and the reaction of the House of Delegates regarding the anonymous communication. We have now had another anonymous communication that was sent to the Board of Directors.

In order to allow one more opportunity to discuss any concerns within appropriate channels, I expect that anyone who has participated in anyway [sic] in these anonymous communications to call or e-mail me by the end of this week to schedule an appointment with me on an individual basis. I will be traveling over the next few days so call me … or e-mail … me ….

This is a requirement of your employment & this is a matter we intend to resolve.”
[Emphasis in the original.]

On May 18, employee St. Germain, identifying herself as “[a] concerned TDA staff member,” wrote the then current president of the Association, Dr. Harrison, and the president elect, Dr. May, expressing dismay that the Executive Director had directed that all who had “participated in the petition” make an appointment with her as a “condition of our employment.” The letter points out that the termination of Simms “was only one among many issues.” In that regard, St. Germain noted that the “best receptionist” that the Association ever had resigned after “being given way too many duties.” The receptionist had protested and employees “felt that a case was being built against her that was not based in truth.” Although the request in the petition for an independent investigation had not been granted, St. Germain’s letter states that the staff looked forward to “a day when we need not be in fear for our jobs” and requests appointment of a personnel committee that “can respond to directors and staff impartially.”

Executive Director Linn, after consulting with the Board of Directors, hired Andrew Rosen, a forensic scientist who specializes in computer storage devices and file systems. On May 19, legal counsel to the Board of Directors forwarded the petition to Rosen. Linn identified five “suspects” whose computer hard drives were examined. The five were employees Clark and St. Germain and three directors, including Lockerman. The examination revealed a “fragment of the text” of the petition on Clark’s computer. Clark, at the hearing herein, acknowledged that, although he drafted the petition on his personal computer at home, he may have opened it at the office.

On June 27, Director of TDA Financial Services Lockerman heard rumors that Director of Public Affairs Jenny Young was saying that she, Lockerman, was the “ringleader” regarding what had happened at the Annual Session in San Antonio. Lockerman confronted her and denied any involvement. Young denied to Lockerman that she had made any statements relating to Lockerman’s alleged involvement. On June 28, Young sent a memorandum to Executive Director Linn reporting the conversation and stating that Lockerman had said that she had tried to advise the employees to “take a different route.” Young did not testify.

In July, Director of Annual Session and Meeting Services Sandy Blum reported to Linn that Lockerman, referring to Young’s description of her as the “ringleader,” had denied any involvement but acknowledged trying “to discourage some of the other staff not to continue this activity.” Although directed to reduce her statement to writing, Blum did not do so until August 15. Blum did not testify.

Linn mentioned Lockerman’s conversations with Young and Blum to Lockerman at the time of her termination. Lockerman protested that she did not think it was fair, that they were not present, thus she was in no position to defend herself regarding what they had reported that she had said. Linn cut Lockerman off stating, “This is no time for discussion.” As already noted, Director of Finance Haufler had asked Lockerman to talk Clark “out of these activities, because… he would be fired,” but Lockerman pointed out that Clark “was his own person.” There is no probative evidence that Lockerman had any involvement in the activities of the employees following her attendance at the second meeting at the restaurant. Linn admitted on cross examination that she believed that Haufler “knows more than I think she knows.” Nevertheless, Linn took no action against Haufler, who did not testify, for withholding information. Although Haufler is a director, i.e. supervisor, Linn’s inaction with regard to Haufler confirms the perception of employees stated in the petition relating to unfairness.

Linn received the report of forensic scientist Rosen in early August. Only Clark was implicated as a result of the search of the computer hard drives. On August 17, Linn discharged Clark and Lockerman. On the same day she informed St. Germain that Clark had been discharged and spoke with her regarding a conversation that St. Germain and Clark had with auditor Patti Schmidt in late April or May following a settlement that the Association made with Simms on April 19.

On August 17, Executive Director Linn called Clark to her office. Director Haufler, his supervisor, was present. Linn read from a prepared document and informed Clark that he was being discharged for “participating in this anonymous e-mail scheme and ignoring my request” of May 17 to meet with her on an individual basis. She stated that Clark has also inappropriately used “the Association’s computer and e-mail system” in violation of the Electronic Communications Policy and had acted “outside the scope of his responsibilities” by making “inappropriate enquiries into Katherine Simms’ settlement in a discussion with the auditor.”

The discussion with auditor Schmidt occurred in a telephone conversation following the settlement that the Association made with Simms. Clark and St. Germain had questioned Schmidt as to whether it was proper to code the legal settlement with Simms as salary, which they had been told to do. Linn admitted that it was not improper for them to call the auditor regarding how to code something. She acknowledged that, since Clark paid the bills, he would have known the amount of the settlement but would “guess” that they were seeking “more information regarding the settlement.” She cited no basis for her “guess.” Schmidt did not testify. Although Linn claimed that their conversation regarding the coding was “very inappropriate,” she spoke with neither of them at the time. She did not inform St. Germain that the conversation was inappropriate until after she had cited it when discharging Clark.

The Association has two policies relating to employee use of equipment of the Association. The Information Technology provision at page 18 of the Association’s Personnel Policy Manual permits employees to use software and business equipment for reasonable personal purposes so long as they reimburse the Association for such use including specifically long distance calls and copies of documents. It cautions that such use is “at their own risk,” including specifically “loss of privacy.” In addition, the Association promulgated an Electronic Communications Policy that states that electronic communications are provided “as communications tools for conducting Association business. No other use of Association electronic communications is authorized. In addition, the electronic communications tools provided by the TDA may not be used to solicit or proselytize for commercial ventures, religious or political causes, outside organizations, or other non-job-related solicitations.”

Executive Director Linn, in her testimony, did not harmonize the inherent contradictions between the Information Technology and Electronic Communications Policy. Documentary evidence, including multiple personal e-mails from and to various employees and supervisors at the Austin office, the forwarding of jokes, and solicitation for the sale of Girl Scout cookies, establishes that the official use only requirement of the Electronic Communications Policy was not adhered to. Executive Director Linn acknowledged that prior to the discharge of Clark no employee had been disciplined for violation of that policy. Following my receipt of several documents demonstrating the absence of adherence to the new policy, Counsel for the Respondent stated that there was no question that “we [the Association] allow personal e-mails from the employees,” the practice permitted by the Information Technology provision of the Personnel Policy Manual. Counsel further stated that the Association did not allow “employees

to take the membership list and e-mail addresses of the members of the Association and use it for their personal business,” but Executive Director Linn admitted that the Association publishes a membership directory that can be purchased by members of the general public. Regarding email addresses, Linn testified that if an employee had sent out an e-mail to the delegates selling Girl Scout cookies that “[t]hey would not have been fired,” that she would have “sat down and talked to them and put something in their personnel file.”

On September 14, when responding to the claim of Clark for unemployment benefits, Linn stated that he was discharged for insubordination, violation of the Electronic Communications Policy, and acting outside the scope of his responsibilities.

When testifying pursuant to Section 611(c) of the Federal Rules of Evidence, Linn confirmed to Counsel for the General Counsel that the foregoing three reasons were the basis for Clark’s discharge. When called by the Respondent, Linn agreed with Counsel for the

Respondent that part of the reason for Clark’s discharge was bringing “confidential personnel issues to the attention of people outside the board of directors.” The confidential personnel issues were not delineated. The petition reveals no confidential personnel issues. No individual, specifically Simms, is named. Insofar as the petition was not read, its concerns were not brought to the attention of people outside the Board of Directors. Clark sent the petition to the Board of Directors, not the delegates.

In the prepared statement that Linn read to Clark when discharging him, she informed him that “one of the documents” had been found on the hard drive of his computer. Clark was not questioned nor given an opportunity to explain how this might have occurred. Although Linn denied that she would have “fired someone” who came forward pursuant to her directive and asserted that she would have “listened to them and counseled them on how to appropriately go through the complaint process,” the foregoing denial and assertion were not given specifically with regard to Clark. Insofar as there be any contention that the foregoing testimony related to Clark, I do not credit it.

On August 17, Director Lockerman was also discharged. Linn, citing her conversations with Young and Blum, stated that it was evident that Lockerman “had information of events leading up to the Annual Session petition and the anonymous e-mails and failed to discuss your knowledge with me. This is insubordination on two levels—as a manager and an employee.” Linn also cited Lockerman for “undermining my authority,” a reference to an event in 2005 regarding a paid time off policy. Lockerman had been counseled regarding that matter shortly after it had occurred. Linn also referred to “hosting employee grievances in your office.” This alleged dereliction that purportedly contributed to her discharge was the fact that Lockerman “always was willing to listen to people and their concerns.” Linn admitted that she discharged Lockerman “mainly for not coming to me … as I requested” on May 17 regarding her knowledge relating to the petition submitted by the employees.”

Be proud of freedom of speech. It’s the only thing between us and tyranny.

D. Kellus Pruitt; DDS

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Proots, on May 11, 2010 at 12:37 PM said:

So who lost more, Proots or PennWell?

There is no doubt that I lost a significant part of my audience when I was suspended from DentistryiQ’s Pruitt’s Platform last night. If anyone thinks I’m hurt over rejection by a commercial Website for an undisclosed (contrived) reason, let me assure you that the smell of fear has me giddy-excited. Such foolishness is a sign that high officials, possibly in the ADA or the TDA, are making regrettable, soon-to-be embarrassing mistakes in trying to silence me. I want all ADA members to have the opportunity to learn their names before all this is over. I’m sorry, did that scare anyone?

I no longer need PennWell. Just look at all the venues opening every day for crying out loud. Websites must have content-producers or the words on their page don’t change. And I’m a gusher – even if unmanageable. I’ll find my next temporary home soon enough if that’s what I want.

Even though it’s been suggested for years, I’d never start a blog because it’s not a numbers game with me and I’m not interested in advertisement income. Look what it did to DrBicuspid.com. The ADA bought them off with an ad deal. Just look what going commercial did to The Monkees.

This, friends is exciting personal adventure. I am causing the ADA and other game to progressively work themselves into a corner.

I hope it doesn’t insult anyone for me to say that as far as I’m concerned, an audience is just trees in a forest. My focus is on slow-thinking vermin that still try to hide in the shadows. I’m not anonymous, and I’ve got nothing to lose. And that’s why I occasionally scare a little bit of urine out of dentistry’s good ol’ boys.

If indeed we do discover that the ADA is once again behind the push to silence me with who knows what for evidence, do you think they can do it a third time at the next venue I choose? I would think ADA members would want their dues money better spent than this.

The ADA is running out of places to hide, and is in no position to try to hurt me. But go ahead. Give it your best shot, Dr. Ron Tankersley. Or was the pressure on PennWell coming from TDA Executive Director Mary Kay Linn?

D. Kellus Pruitt; DDS

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Darrell, on May 13, 2010 at 4:30 PM said:

DE’s Lyle Hoyt and marketplace justice

Do I play unfairly? I assume my sense of sportsmanship has been deemed acceptable because nobody’s complaining. In fact, one could be surprised by the number of private attaboys I receive.

So who do you think the mystery ADA official is? I think it’s a woman, and I think she has ties with both UnitedHealth and Delta Dental.

——————————————————————————–

From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Thursday, May 13, 2010 11:06 AM
To: ‘lyleh@pennwell.com’
Subject: Betrayal of source

Dear Mr. Lyle Hoyt, Sr. Vice President, Dental Economics

I’m certain that being in the business, you are aware that courageous publishers have risked imprisonment rather than betray sources of information. The name of the person I am requesting you to divulge is not that kind of source.

I have reason to believe that there is an unknown official in the ADA or affiliate organization who intends to cause me personal harm by repeatedly interfering with my freedom of speech by persuading independent publishers like PennWell to suspend me from their Websites for reasons I have not been told. As anyone can see, that just isn’t right in the land of the free.

Lyle Hoyt, please don’t get scared and clam up like numerous spineless bureaucrats have in the past. We’re not in a civil court, and I have no intention to wait years for justice. If you cooperate with me, this will be cheap, quick and I’ll leave you and your company alone forever. You have my word.

I suspect that the unknown official who persuaded Dr. Joe Blaes to recently suspend me from “Pruitt’s Platform” – after 18 months – is the same person who over a year ago persuaded Brian Casey, the editorial director of IMV Publishing, to suspend me from that Website as well. About a year ago, I provided my opinion of the reason why an ADA – DrBicuspid ad campaign began the day after I was suspended from DrBicuspid. It’s still on Pruitt’s Platform and is titled “DrBicuspid, the ADA and split allegiances” It’s still a relatively popular piece. Nevertheless, I cannot offer a convenient link to it because I am no longer allowed access. Nice going, Dr. Blaes. See how his reticence already inconvenienced you over this problem we must solve.

Mr. Lyle Hoyt, please send me the name and email address of the person who I suspect intends to continue to cause me harm. I’m the one who pays dues to the ADA. Not you. Don’t be foolish.

D. Kellus Pruitt; DDS

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Dr. Pruitt, on May 20, 2010 at 1:49 AM said:

TDA’s slip into transparency

After TDA Executive Director Mary Kay Linn read my email requesting information concerning alleged complaints that have been filed against me, she meant to forward it to someone named “Bill.” But as fate would have it, she accidentally clicked on “reply” instead – sending me her message intended for someone else. She wrote, “Bill – How should I respond to this? MK.”

Shortly after describing her mistake for sports fans, I was told that “Bill” is probably the TDA’s legal counsel on retainer, Bill Bingham. The absence of either a question or an explanation about the complaints in Mary’s note to Bill clearly indicates that whoever Bill is, he knows a lot more about me than I know about him. I’ll even go out on a limb and say that Bill not only knows where I practice, but he also knows verbatim some of my objectionable quotes from as far back as 2007 that I have long ago forgotten. I would offer that the crimes described in the reported 127 pages of complaints can’t be that serious if they can wait 3 years. As a matter of fact, I’m expecting to receive from Mary Kay Linn a compilation of some of my best writing that I lost in a computer crash a while back, as well as possibly more email meant for other people.

For those who are filled with team spirit and are “fed up” with me like one or more TDA officials reportedly are, before you stand up and embarrass yourselves by acting righteously indignant, consider this: In February of 2006, I was a polite, well-behaved little dentist. When I learned about HIPAA and tried to warn the TDA about the absurdity of the unfunded mandate, I got the bum’s rush by my official TDA representative on the same evening he was awarded his perfect attendance plaque at our local dental society meeting. He told me that he considered my complaint not only unprofessional, but he said that if I wanted to pursue my “activism,” I was on my own… Excuse me a second… So here I am, David. I went over your head. By the way, it wasn’t difficult.

The way I see it, when I confronted both the TDA and the ADA about natural results from bad decisions concerning HIPAA as well as other mistakes, they also responded by attacking D. Kellus Pruitt DDS rather than admit that bad ADA policy has already caused avoidable harm to dental patients. Attacking the source of truth is an old intimidation trick used by political types, and was best exemplified decades ago by the late President Richard Nixon. But as you can see, in 2010, the strategy finally turned obsolete in the ADA.

Even if the evidence against my character didn’t seem bad enough to persuade Dental Economics Sr. VP Lyle Hoyt to suspend me from PennWell publications, I suspect that he was just looking for an excuse to get rid of me. After all, I was often blunt with advertisers who evaded discussing the dangers of their dental products with me – the customer. Anyone can see that customer avoidance is never a sign of healthy marketplace competition. It is so Soviet.

I have no fear of being held accountable for anything I said years ago because I more than anyone else am aware of what I am capable of saying. When sports fans finally read the charges against me, they too will understand that for more than 3 years, the ADA has spent an unreasonable amount of resources on one ADA member – even pursuing him beyond the boundaries of the ADA to deprive him of his First Amendment rights without reasonable cause or opportunity to defend myself. I think even Bill would agree that those are pretty serious accusations. He’s probably been spending retainer money trying to figure a way to extricate the TDA safely from this mess.

I told the ADA long ago that I never wanted my involvement to become so public. Now I’m afraid more and more members will soon connect me to the discovery that while they weren’t paying attention, the ethics of the ADA sunk to an unsustainable level. They won’t like me much. This kind of responsibility should not be left to one member to tend to between checking hygiene patients. But if it has to be, you couldn’t have found a more benevolent bastard. I’ll send you a bill later.

D. Kellus Pruitt; DDS

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Dr. Pruitt, on May 30, 2010 at 9:08 PM said:

Fresh out of targets

If one googles “D. Kellus Pruitt DDS,” my first hit announces that I call myself foremost, an “investigative dental reporter” (not even a “journalist”). Those who are actually journalism professionals would cringe at such a label – especially if it was the first hit on one’s pen-name. And it’s hardly my ambition to be instantly not trusted by virtually everyone who wants to learn more about me. But as you can see, petty, cosmetic concerns don’t bother me much. That’s my strength. That’s Tao.

“If they are angry, perturb them; be deferential to foster their arrogance.” – Sun Tzu, “The Art of War.”

I like the slimy label because I know formerly well-protected bureaucrats just HATE lowly, muck-raking amateurish reporters who lack the common, traditional default level of respect for professionals with nice teeth. Besides, good ol’ boys only trust their equally anonymous kin anyway… and only up to the point of personal accountability. For example, “Image is everything” was the slogan of the ADA/Intelligent Dental Marketing joint partnership. It went under about a year ago – six months after I predicted its failure. My article “Time is up, Intelligent Dental Marketing” is probably still on the first page of results when one searches “ADA/IDM.” It could be there forever as a testament to the bad things that can happen when mission creeps. But I digress. I only intended to point out that even now, long after its failure, representatives from the non-profit ADA still call the partnership “ADA/idm” while the veterans of the defunct Intelligent Dental Marketing call it “ADA/IDM.” When the partners can’t settle on a name for the stinker, there’s a good chance that a bastard will be abandoned.

For over four years, I have at times ambushed and bludgeoned slow-moving leaders in government and dentistry with at least one blunt article a day. I rarely posted polite, informative articles like my recent book review of “Cyber War” by Richard A. Clarke that was accepted by the Medical Executive-Post.

Book Review of “Cyber War”

Although putting my spin on startling, overlooked news is fun, doing book reports is bloodless and boring. Just reporting news – as opposed to making and then reporting news – doesn’t awaken me in the middle of the night with ideas that manifest the next day as creative art. I consider my carefully planned, multi-faceted strategic harassment of stoic good ol’ boys as much an intricate, interwoven artistic endeavor as all of the two dimensional portraits I have ever drawn – and much more exciting. Occasionally, I’ve lain awake far longer than I’ve wanted.

“Know your enemy as well as you know yourself.” Sun Tzu, “The Art of War.”

A large portion of my art has been directed at the ADA leaders and included information gathered from three trips to ADA Headquarters in Chicago in 2007 and 2008. Two trips were for National Dental Benefits conferences and one trip was for an Evidence-Based Dentistry conference. Although I am perfectly comfortable fighting my battles at my leisure on the Internet, that doesn’t mean I’m a humanities major who can’t handle himself in public. I may not have developed great num chuck skills, but I think pretty clearly on my feet and express myself well. What’s more, I’ve stared down large, hostile audiences more than once. I’ve also survived being booed, heckled and even blocked from taking the microphone at the First Evidence-Based Dentistry Conference attended by over 100 stakeholders and EBD Cheerleaders. I wasn’t invited back for the second, and I didn’t bother to apply for the third. (Googlesearch “Evidence-Based Dentistry – My search for truth”).

If I have averaged writing almost two articles a day as I suspect, I would have posted about 3000 articles since February 2006. In the last week, things changed. When the leaders of the TDA finally invited me to submit questions previously ignored, the manic cadence of challenges and taunts became unnecessary and even counter-productive in my struggle for my goal of transparency. Those who were paying attention should have also recognized the TDA’s quiet, unconditional surrender to the community. The imminent collapse of obsolete barriers to personal accountability won’t end in Austin. Oh no.

Since the ADA’s support as well as insulation from membership comes from state associations like the TDA, and since several national policies are at least as indefensible as the TDA’s – that means the entire ADA is not far behind. It may not look like a large leak of transparency yet, but when the TDA hands down the answers to my 30 or so questions, ranks will start breaking quietly. And if the TDA continues to ignore me? Ranks will start breaking loudly.

All it takes now is time, Tao and gravity.

So now what?

D. Kellus Pruitt; DDS

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Dr. Pruitt, on June 5, 2010 at 4:49 PM said:

Anonymous truth is mostly wasted

Every now and then, I bump against a talented, anonymous author who I think should join the community instead of hiding. Whoever wrote the Dental Health Magazine article titled “Restorative Dentistry and Composite Dental Fillings Facts,” about the advantages of composite fillings not only did not criticize amalgam fillings which have over a hundred years of success, but she also couldn’t be shaken from her position concerning the safety of composite fillings and immediately expressed her opinion beautifully. And, I gave her my best shot. I’m impressed, but disappointed.

Here is what I posted following her article:

http://worldental.org/teeth/restorative-dentistry-and-composite-dental-fillings-facts/1490/

D. Kellus Pruitt DDS on Jun 5th, 2010 at 1:46 pm

– Dear unknown dental restorations expert, whatever your name might be: What about the BPA that is contained in composite fillings? BPA is an estrogenic compound that is reported to be toxic to children. What’s your opinion, anonymous one?

Dental Health Magazine on Jun 5th, 2010 at 2:22 pm

– The FDA has concluded, “Based on our ongoing review, we believe there is a large body of evidence that indicates that FDA-regulated products containing BPA currently on the market are safe and that exposure levels to BPA from food contact materials, including for infants and children, are below those that may cause health effects.”

The ADA believes any concern about potential BPA exposure from dental sealants or composites is unwarranted at this time. When compared with other sources of BPA, these dental materials pose significantly lower exposure concerns.

Source: http://www.ada.org/3310.aspx , http://www.ada.org/2989.aspx?currentTab=1

A review of key studies on dental resins containing BPA-based materials reveals that the highest reported acute oral exposure to BPA is more than 50,000 times lower than levels shown to cause acute oral toxicity in animal studies. Although repeated exposure to BPA from dental resins is not expected to occur, the highest reported acute oral exposure is also below the maximum acceptable or “reference” dose for BPA, which is set for repeated exposure over a lifetime. Consequently, exposure to BPA from dental resins for both adults and children is minimal and poses no known risk to human health.

Source: http://www.bisphenol-a.org/human/dental.html

My final reply was “Well done.” I guess that was getting too familiar for the anonymous author to tolerate because she declined to post it. I was sincere. Our dental patients need to hear more from this anonymous person, whoever she is. What a loss.

D. Kellus Pruitt DDS

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Dr. Pruitt, on June 7, 2010 at 5:13 PM said:

Calling out Lyle Hoyt

I’ve given Lyle Hoyt, the Dental Economics Vice President plenty of time to reveal to me the name of the ADA official who persuaded him to have me blocked from PennWell’s Pruitt’s Platform.

I’ve heard far too many well-intentioned suggestions that if I would only be nice, someone might listen to me. Grow up. That’s a bunch of crap. Well entrenched bureaucrats like those in Dental Economics as well as the ADA, will not listen until the pain of personal accountability becomes too public to withstand … And, I deliver transparency to make it happen.

D. Kellus Pruitt; DDS

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Dr. Pruitt, on June 8, 2010 at 1:29 PM said:

How would someone from my home town, Panhandle, Texas resolve this problem?

I have reason to believe that in the last couple of months, an ADA official made a quiet deal with Dental Economics Vice President Lyle Hoyt to have me banned from my own blog, “Pruitt’s Platform.”

I had contributed content to Dental Economics for 18 months for free. Yet as far as I know, Dental Economics and Lyle Hoyt is still making money off of the pop-up ad one has to navigate through to read them. I say that is just not right.

D. Kellus Pruitt; DDS

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Dr. Pruitt, on June 12, 2010 at 8:58 AM said:

Giving Dentrix PR consultants hell

If my agitation of an anonymous employee of the Michigan Dental Association made you feel uncomfortable this morning because it highlights flaws in the ethics of our non-profit ADA, I’m hoping your hurt feelings will be soothed by the humor in watching me spoil Dentrix’s latest expensive PR effort. I wonder how much Dentrix paid a PR firm for a bad idea. It’s sort of like trying to get away with a high dollar comb-over on the tennis court while looking cool.

Dentrix is one of the largest electronic dental record vendors in the nation, and probably hires top-notch PR consultants. I just love matching wits with those bozos. I can smell their work a mile away. Yesterday, I thought I recognized their high dollar foolproof advertisement strategy within 11 minutes of its presentation on “Links on DENTRIX” Facebook. That’s a record for me. I was just in the right place at the right time.

http://www.facebook.com/posted.php?id=36429513073&share_id=120654791310165&comments=1s120654791310165

I don’t want to spoil the story that is unfolding in real time, but this will not end well for Dentrix or the silly PR firm Dentrix hired.

June 10, 2:44 pm

DENTRIX – Hey, Dentrix fans. We have launched our new official Facebook page! Our new Facebook page allows us to better communicate with you as well as offer valuable resources like free webinars, tips-and-tricks, fun promotions and technical support. Join the conversation by becoming a fan of our NEW Facebook page. Visit http://www.facebook.com/pages/Dentrix/125795907444011?ref=share today! While you’re there be sure to enter our daily prize giveaway! We’re giving away free Dentrix goodies everyday for the next 2 weeks!

My response was the first

Darrell Pruitt

– It’s good to see you on Facebook, Dentrix. I’m considering going paperless, and I have some questions about them before committing myself to the endeavor. I have to say, I don’t look forward to transitioning from paper to electronic.

First of all, if my office computer were stolen, hacked or otherwise breached, how much would it cost me if say 2000 patients’ PHI were in the computer?

2:55 pm

Tom

– “just an who cares what he thinks deal”—– but if you backup correctly you will have more than one copy of every patient record. ..only one paper but can have muliple copies on electronics.. and so much faster in the clinic… go paperless you will be glad i think.

3:24 pm

As soon as Tom cryptically hinted that he really doesn’t care what I think – immediately before he revealed that he actually did not know what I was talking about – I recognized the smell. I bet Dentrix hired the PR firm Ketchum Inc. I’ll go a step further. I say that the US Department of HHS helped fund the PR campaign using Stimulus money. Secretary Kathleen Sebelius likes Ketchum.

Tom

– we have been paperless with dentrix since 1997.

3:26 pm

From a national security standpoint, I find that scary.

Silvia

– just went paperless last year and its great!

3:30 pm

Darrell Pruitt

– Thanks, Tom and Silvia. But it still doesn’t answer my question. If 2000 records are breached, how much will it cost me?

5:01pm

At this point, I found it incredible that Dentrix can attract such devoted fans who seem to be anxiously waiting to say wonderful things about the company… clearly incredible. Do you yet see how with just a little forensic-like examination, stupid PR ideas reveal latent humor that is otherwise wasted on clueless consumers?

Naturally, I visited the new Dentrix Facebook and discovered that in the previous 2 hours, starting 5 minutes following the announcement of its opening on the Links Facebook, the first of three glowing testimonials welcomed Dentrix’s new Facebook before I could join it myself. Again, I found this incredible…. Too incredible.

So right before I left to golf, I posted my still unanswered question:

Darrell Pruitt

– If I were to go paperless and my system were breached by a stolen computer, hacker or dishonest employee, how much could I expect it to cost me to recover from the loss if 2000 patients’ PHI were involved? It’s difficult to get a straight answer from those who sell eDRs.

5:20 pm

By 8:16 pm yesterday, as incredible as it sounds, on the new Dentrix Facebook, there were 5 more glowing testimonials for Dentrix piled on top of my unanswered question about liability. However, until a few minutes ago, nobody addressed it. At 12:42 pm, Shane said, “.I agree.. Fear should run our lives and hold us back. After all no one knows what’s really out there! That’s why I don’t fly anymore. ‘It’ could happen you know!”

I asked Shane if he thinks my question was foolish. I don’t think Shane will respond, but I’ll let you know.

Back to the Links to Dentrix Facebook where I left Tom and Silvia.

Darrell Pruitt

– Silvia, when you went paperless, did you check into the cost of a data breach?

Yesterday at 9:36pm

Kathi

– most companies have personal patient/ client information in their computers. I think you are worring about something you dont need to worry about. ( you might want to have an alarm in your office) When you set up your system for patient information you do have passwords to access your computers. with Dentrix you can have different passwords for … See Moreeach employee too. you do need a daily back up for your system too. You also could have a single computer not linked with your dentrix sytem for any internet transactions or email.

10 hours ago

Darrell Pruitt

– I know eHRs are really safe because they are hardly ever stolen. However, if a hacker or a dishonest employee were to compromise the security, how expensive would it be to recover?

4 hours ago

Bill

– If you are concerened about the security of your data , then you should deploy information technology best practices. Some examples are to have your internet router monitored by an computer company for intrustions, have your off-site backups encrypted, develop a computer use policy for your staff, use strong passwords for your server, desktops and dentrix. monitor your desktops and servers for securty breaches.

4 hours ago

Darrell Pruitt

– Thanks for your help, Bill. But still, my question has not been answered. According to well respected experts in cyber security, there is no protection from hackers. So we must assume that breaches are not a question of if, but a question of when. It would be foolish to invest tens of thousands of dollars into an effort without knowing the liabilities. Don’t you agree?

My question is simple: How much would it cost a dentist if 2000 patient records were breached? This is a question that I must have answered before I consider modernizing my practice.

Have you ever seen the CarFax commercial, Bill?

2 hours ago

—————————-

The day I can’t outwit the very best PR geniuses is the day that I’ll take up tennis.

D. Kellus Pruitt DDS

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D. Kellus Pruitt DDS, on June 15, 2010 at 8:54 PM said:

“We don’t make the laws – (We just profit from them)”

Nothing grates on my nerves more than stakeholders in healthcare whose businesses would never survive in the free market if it weren’t for ineffective, unfunded mandates like HIPAA.

A HIPAA compliance consulting firm named emPower is one such parasite which uses fear instead of appeal to market their product – as one can see from their press release I copied below.

Nevertheless, if one is a HIPAA covered entity, there is no better source for good compliance information than from a HIPAA stakeholder. HITECH-enhanced HIPAA compliancy will be no more effective at stopping breaches from dentists’ computers than BP’s preparations helped prevent an oil spill.

And like reflexive, costly and ineffective government regulation in the oil business, HIPAA needlessly raises costs for all Americans for the enrichment of a few mandate opportunists. The harsher the penalties, the better the sales for emPower. Bring on the regulation and watch dentists abandon their computers and take their bicycles to work.

HIPAA and oil will never get any cheaper

“Empowered OCR: Ensuring Better HIPAA Compliance From Covered Entity and Business Associate”

http://pr-usa.net/index.php?option=com_content&task=view&id=415624&Itemid=35

The OCR aims to obtain HIPAA compliance from Covered Entity and Business Associate by implementing new rules. This is a part of its strategy to infuse customer confidence to provide their health information to the electronic patient health information system.

The HHS office for Civil Rights also known as OCR, in its attempt to tighten HIPAA privacy regulations has detailed out six new ways to deal with reports related to the breaches in patient health information.

The OCR aims to obtain HIPAA compliance from Covered Entity and Business Associate by implementing new rules. This is a part of its strategy to infuse customer confidence to provide their health information to the electronic patient health information system. This will allow the health administration to easily create and manage effeciently an online national health care system, which will provide better health-care services of, clinical and non-clinical type, to the patients.

OCR now has to its disposal, computer system which makes it easy for complainant to lodge online complains against breach in privacy of their health information. OCR is empowered to deal the breach in following ways.

– Post information online and in Public media of any breaches involving at least 500 individuals

– Directly report to Congress about the number and type of reported breaches, and the action taken.

– Disclose data with purpose to provide technical assistance, training and guidance needed to ensure HIPAA compliance.

– Share information with other federal agencies and contractors so that they can effectively respond and investigate the breaches.

– Disclose information to third parties in order to assist them in their investigation of the reported breaches and conduct compliance reviews.

– Publicly report the results of investigations and compliance reviews and thus provide complete transparency to process.

The OCR is bound to disclose the minimum health data, which is necessary to investigate the breach and should protect the privacy of the individual or groups in the course of investigation. The office has authority, to impose heavy civil fines up to $1.5 million per violation. This should be an eye opener for the health service providers, especially Business Associates, who have not yet achieved HIPAA compliance.

OCR protects patient health information by reporting breaches and punishing violators.

About emPower

emPower is a leading provider of comprehensive Healthcare Compliance Solutions through Learning management system (LMS). Our mission is to provide innovative security solutions to enable compliance with applicable laws and regulations and maximize business performance. We provide range of courses to manage compliance required by regulatory bodies such as OSHA, HIPAA, Joint commission and Red Flag Rule etc. Apart from this emPower also offers custom demos and tutorials for your website, business process management and software implementation.

Our Learning Management system (LMS) allows students to retrieve all the courses 24/7/365 by accessing our portal. emPower e-learning training program is an interactive mode of learning that guides students to progress at their own pace.

For additional information, please visit: http://www.empowerbpo.com/HIPAA_Compliance_Training.html

D. Kellus Pruitt; DDS

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Dr. Pruitt, on July 3, 2010 at 7:27 PM said:

Breaking news: KPMG audits ADA Foundation

If you are an American Dental Association member with a financial stake in the ADA Foundation, yesterday you may have received the following notice from Dr. Arthur Dugoni, former president of the ADA. However, if you didn’t also know about an anonymous letter I received and shared 3 months ago that mentioned the ADA Foundation, Dugoni’s carefully manicured and heavily perfumed notice about problems with our donations probably didn’t catch your attention. Yet I have reason to believe yesterday’s unprecedented email communication with members is as close as the national organization has ever come to offering a confession of malfeasance. (I ask you, Executive Director Mary Kay Linn. Is the Texas Dental Association next?)

I’ve studied the watered-down business principles of my professional organization on a state and national level for years, and have learned that when the ADA has really bad news that it must appear to deliver to those who pay money into the organization, they prefer to do so on Fridays – very quietly. I think you can see for yourself that Dr. Dugoni’s stinker needs every bit of a long 4th of July weekend to air out.

————-

Dear Doctor Pruitt,

As a supporter of the ADA Foundation (Foundation), you already recognize the value of our Foundation in supporting important philanthropic endeavors such as dental research and education, charitable assistance to dentists affected by disasters, and access to oral health care, such as Give Kids A Smile® Expansion. We appreciate your generosity – and we owe you the best possible stewardship of your donations.

Over the last several months, an independent review of the Foundation was conducted by KPMG, a well respected firm of financial and tax advisers. Among its findings, KPMG’s report identifies areas for improvements in terms of governance, operations and financial reporting of the Foundation.

To help facilitate this important work, the Board has retained the services of two outstanding individuals—Mr. Jeffrey Beutler, who will serve as Interim Chief Executive Officer and Mr. Emmett P. Murphy, CPA, who assumes the role of Interim Chief Financial Officer. Mr. Beutler has broad experience in for-profit and not-for-profit organizations, including serving as the Executive Director of the American Association of Nurse Anesthetists. Mr. Murphy specializes in financial and administrative consulting for clients such as the American Student Dental Association, the American Academy of Orthopaedic Surgeons and DePaul University.

Mr. Barkley Payne, who served as Executive Director, is no longer with the Foundation. We sincerely appreciate Mr. Payne’s service and contributions to the Foundation over the years and wish him well in his new endeavors.

The Board is committed to implementing all of KPMG’s recommendations to improve and strengthen the Foundation. I am confident that the improvements will result in a more effective organization.

We remain dedicated to our mission of uniting people and organizations to make a difference through better oral health. Thank you for your patience and understanding as we institute these important changes for the Foundation.

Sincerely,

Arthur A. Dugoni, D.D.S., M.S.D.

————-

So what does this mean? It would appear to me to be a benign statement about a routine audit if it weren’t for the anonymous letter I received on April 1st:

“Ron claims he silenced you! You are no longer asking embarrassing questions because he backed you down! [and just when you were causing some apprehension!] We do not like embarrassing questions!

Focus on two items: audits – more bad news! ADABEI and Foundation!

What is the president hiding? Are both ED and president whitewashing the incidents? ED’s secret letter to the Board of January 1 is interesting. Do you have it? Ask! ED and Board have problems.

John Luther now gone from ADA. Quietly! We hardly noticed!!!! What’s going on? United Healthcare? Other 3rd party? This is touchy.

Want more? “Ask if interested. I will see.”

————————

(“Ron” would be Dr. Ron Tankersley, current president of the ADA)

Even though I’m still not 100% convinced that the anonymous letter isn’t an April Fool’s prank, here’s what I’m beginning to believe: Just like Mary Kay Linn’s boneheaded, authoritarian and capricious mistakes in Austin – which pulled the TDA into court before the National Labor Relations Board – someone in the ADA, perhaps Dr. Arthur Dugoni himself for all we know, is suspected of cheating ADA members through boneheaded, authoritarian and capricious misappropriation of ADA Foundation funds. That is my studied opinion.

Now let’s step back and look at the broader picture. If Dr. Dugoni confirmed one item mentioned in the anonymous letter, I wonder if other items have instantly become worthy of investigation.

Anyone know if Dr. John Luther, Sr. VP of the ADA, still works in ADA Headquarters? He was the second ADA official to call me unprofessional. We parted when he told me to write a letter to the editor if I wasn’t satisfied with his answer to my question about HIPAA. So where’s the huckleberry now?

D. Kellus Pruitt DDS

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Darrell, on July 5, 2010 at 1:33 PM said:

Unexpected transparency and my exciting adventure

During Dr. Raymond Gist’s campaign for ADA presidency less than a year ago, the ADA News Online posted the President-elect’s candidacy statement. Dr. Gist told the ADA News that one of his goals is: “To protect and preserve ownership of the intellectual property of the ADA while demonstrating transparency and fostering an understanding of how our system works.”

I think this means that he intends to protect the ADA’s investments in a transparent manner. In fairness to the man, not only did he not specifically mention the ADA Foundation in his promise of transparency, but at the time of his campaign, the altruism-based Foundation was still above suspicion of malfeasance as far as I know.

“Transparency”

As I recall, the noun was also used by Dr. Mark Feldman in a candidacy speech in 2006. His commitment to the promise would be tested in April 2008 – half way through his term as ADA President. Because of no fault of his own, it became Dr. Feldman’s unwelcome responsibility to announce to membership that both the ADA Executive Director Dr. James Bramson and the Chief Operating Officer Mary Logan had been suddenly fired from the two highest-paid ADA positions. Then he added that ADA officials will not answer any questions concerning the abject corporate failure that was anything but a smooth, well-considered transition for our professional organization. ADA members, whose dues funded the severance pay for the two executives, are still in the dark about shocking display of high-level incompetence. It would be 14 months before Bramson and Logan were replaced by Dr. Kathleen O’Loughlin, a former executive of UnitedHealth and Delta Dental. What can possibly go wrong with that?

“Transparency” – The next president, Dr. John S. Findley, reflexively misused the noun in the traditional way at least once in his campaign with typical lack of understanding. On the other hand, I cannot remember hearing the current president, Dr. Ron Tankersley shop “transparency.” I suppose he understands that as a buzzword, it’s especially tricky just because of the very nature of transparency.

So has Dr. Gist actually looked up the word, or is he the next irrelevant bureaucrat in line to embarrass the office as well as ADA membership?

For those who have been following, I’m certain by now I’ve made it increasingly clear that the signs of trouble in the American Dental Association which I first pointed out over four years ago were right on the money and are only getting worse. As an ADA member for 28 years, I feel more disappointed than victorious. Nevertheless, I’ll take this opportunity to humbly offer, “I TOLD YOU SO, DAMN IT!!”. (OK. Maybe I feel just a little righteous).

My suspicions of serious leadership problems in the Texas Dental Association as well as the American Dental Association started in February 2006 when my pre-designated TDA representative didn’t even bother to hide his disdain for my concerns about HIPAA and electronic health records which the TDA was promoting much more enthusiastically than they are now. Recently, a TDA rep who was trying to distance her department from HIPAA, clarified for me that there is a difference between “actively promoting” and merely “supporting” the Rule. I suppose TDA members are supposed to be able to tell the difference and react accordingly. Wake up.

Four years ago, my designated representative told me that nobody in Austin was concerned about the Rule, and that I was “on my own” with my “activism.” Then he complimented my passion before dismissing me as unprofessional. That ADA official was the first person to call me unprofessional – ever.

Serving society as the TDA’s primary gatekeeper to more important people, my colleague’s authoritarian evasion – with a straight face mind you – intrigued me at least as much as absurd government regulations he refused to acknowledge, dentist-to-dentist. So I took his advice and struck out on my own. As it turns out, my discerning TDA gatekeeper mentored me into the most exciting adventure in my life. My dad would have gotten a huge kick out of this. When I went home last weekend for the first time in years, many said I look a lot like him. Thanks again, David.

As non-profit organizations, the ADA and TDA are failing membership ever more publicly now. For example, shortly on the heels of announcing to membership that dues will increase (in spite of the expected income from sales of the most up to date copyrighted edition of the ADABEI’s HIPAA compliancy guide – that was put on special this week for ADA members only!), the ADA revealed that there have been problems with the ADA Foundation for at least a few months. Coincidentally, on the state level there are the nasty, expensive TDA problems with the National Labor Review Board. Why did these two related, non-profit organizations simultaneously lose their way like this? Is rot endemic?

It is my opinion that dental patients in America aren’t the least bit interested in the ADA’s intellectual rights to the HIPAA compliancy manuals the non-profit organization sells for profit – nor should they be. For one thing, HIPAA is a cruel farce in dentistry that prices extractions beyond the reach of people in pain.

If dental patients in the US are fortunate, the most intense part of the ADA’s leadership crisis will be over before the annual meeting of the ADA House of Delegates in October. Perhaps following numerous resignations of officials who have over-stayed their relevance, effective, simple, common sense representation will be restored to ADA members who actually treat patients’ health problems. These days, old school ADA gatekeepers aren’t even good at getting in the way.

I imagine that the Headquarters’ morale in both Austin and Chicago is worse than it’s been in the history of the organizations. Something is bound to blow in a spectacular and entertaining manner soon, and you can bet I’ll be reporting it, sports fans.

D. Kellus Pruitt DDS

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Mary, on July 5, 2010 at 1:36 PM said:

Darrell,

The ADA is acting like an AMA “wanna-be” and heading for the same abyss.

Mary

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D. Kellus Pruitt DDS, on July 5, 2010 at 6:48 PM said:

Thanks, Mary

It is my opinion that we are witnessing is common, institutional mission creep that has been happening for years. Left to their own intentions, departments seek increases in budgets, not decreases.

The ADA, and you say, the AMA, are examples of uncontrolled bureaucratic growth. As anyone can see, even the largest and most benevolent organizations are not immune to avarice. In fact, organizations which are shielded from consumers by tradition are the most vulnerable to in house malfeasance, in my opinion.

Darrell

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Darrell, on July 7, 2010 at 12:34 PM said:

NLRB’s $900,000 verdict and TDA’s official response

As you can read below, an unrepentant TDA President Dr. Ronald Rhea downplays the cost as insignificant and offers no plans to prevent future infractions of employees’ rights by the TDA. This environment makes our Executive Director, Mary Kay Linn, our biggest liability.

Remember the trouble with the National Labor Review Board (NLRB) that Ms. Linn dragged the TDA into for wrongfully firing TDA employees? How much do you think her impulsive leadership style will cost us next time she blows her cool? Why oh why has she not already been forced to resign? If the TDA were accountable to consumers like for-profit corporations which must compete for existence, Linn would have been fired years ago. Let’s face it, Linn has squandered not only her credibility among both membership and employees, but we can never again afford to trust her to protect the welfare of the TDA. That’s my studied opinion from first hand experience with the evasive tyrant. Yes, I have earned the right to be blunt when describing the Executive Director’s ethics and those of any other officer in the TDA. For my name is currently before the TDA Council on Ethics and Judicial Affairs for complaints that are three years old – that I have never seen, much less corrected. The Council can discuss my unprofessionalism all they want among themselves, but until I’m included in the conversation, what exactly do they expect to accomplish? It reminds me of the “double-secret probation” on Animal House. Childish.

Just how bad can my behavior have been if nobody in the whole TDA has the guts to discuss it with me? Mark my word: When I get to the bottom of this ruse – and I will get to the bottom of it, Mary Kay Linn – the charges against me will be recognized by all as trumped up, politically inspired, vengeful but petty complaints meant to shut me up. As you see, sports fans, TDA officials just can’t do anything right these days.

It was from TDA President Dr. Ronald Rhea’s letter I received, typed and posted below, that I found out that the TDA Executive Director Mary Kay Linn – and our timid TDA Board of Directors who dare not stand up to her – cost TDA members $900,000 in a poor economy. President Rhea points out that the TDA has lots of money, so a million dollars is actually an insignificant amount. In addition, Rhea not only shows no remorse for breaking the law, but his attitude gives me the impression that he and Mary Kay Linn have the capability to cost us a whole lot more money fast. After all, Dr. Rhea is still occupied fighting a battle he already lost terribly.

———————–

Texas Dental Association

To: Members of the Texas Dental Association

Re: Settlement of Nation Labor Relations Board Claims against the Texas Dental Association

Dear TDA Members:

I write you as your President to inform you of the settlement by the Texas Dental Association of certain claims by the National Labor Relations Board (NLRB). These are matters which have been the subject of much information, mis-information [sic] and speculation. These cases and the facts surrounding the cases have been developing since 2005 and have been dealt with by five separate Boards of Directors of the TDA. The TDA has not been able to inform its members of the actual facts surrounding these cases due to pending legal action. Now that the claims have been settled, TDA wishes to make you aware of the facts.

In 2005, a TDA employee informed the TDA Executive Director that she and a second TDA employee had been involved in a relationship, however the relationship had terminated. The employee was emotionally upset. The Executive Director attempted to assist her and responded to her request for modifications in the workplace by making changes that could be carried out without overly disrupting the business of the Association. The second employee involved continued to perform duties and provide excellent service to TDA.

The Executive Director’s accommodation of the employee continued, but her actions became disruptive to other TDA employees not involved with the individuals, and other employees were at times unable to perform their duties After numerous attempts to resolve the employee issues, the employee was discharged.

Thereafter, a TDA member dentist expressed concern over the discharge of the employee. The member’s actions caused concern in the TDA House of Delegates. Anonymous email communications were received by TDA Board members, delegates and employees. The anonymous communications were represented to come from TDA employees. The TDA member continued to be involved. These events caused substantial disruption to TDA business activities. The TDA Board of Directors was concerned enough to unanimously vote to remove the TDA member from the member’s position on a TDA council.

TDA determined that portions of the anonymous email communications were present on a TDA computer used by a TDA employee. The resulting investigation of the communications and the disruption caused to TDA, including the attempts to bypass the Executive Director and theTDA Board with alleged personnel complaints, resulted in the termination of the TDA employee and a TDA supervisor who had knowledge of the events. During this period, a very substantial majority of the TDA staff supported the Executive Director and the TDA in general.

In 2006, a complaint was made to the NLRB. The NLRB initially investigated the complaint on the basis of a then pending NLRB case in a separate matter which held that it was an unfair labor practice to discipline an employee who used the company computer and email system to organize employees. As the investigation proceeded, the pending NLRB case was reversed by the national board of the NLRB and it was determined that it did not constitute an unfair labor practice because they had been discharged for attempting to organize and express concerns regarding working conditions.

The case was heard before an NLRB hearing officer. The TDA member dentist was the lead witness against TDA. A current and former TDA President were called to testify for TDA. The Executive Director testified and the two discharged employees testified as well as other employees. At the conclusion of the case, the NLRB hearing officer chose to disregard all testimony of the two TDA Presidents and Executive Director and instead believed the two discharged employees and the TDA member. The resulting hearing officer’s decision found in favor of two of the employees and ordered back pay and reinstatement of the two employees. A third employee also filed a complaint, but TDA prevailed in that complaint.

The NLRB system required that the NLRB Board in Washington approve or disapprove the hearing officer’s findings. After a substantial period of delay and inaction, the NLRB Board, acting with only two out of five members, upheld the decision of the hearing officer. TDA then appealed to the 5the Circuit Court of App

Several TDA Boards of Directors attempted to resolve the matter over a period of years. A condition to resolving the cases was always a demand by the two terminated employees to be reemployed by TDA. Several different Boards of Directors of TDA, as well as the Executive Director and staff members of TDA, were of the firm opinion that there would be enormous disruption to TDA to have the two employees reemployed by TDA. The Board had the entire proceeding reviewed by separate legal counsel and consulted various outside individuals on how to proceed. It became clear to the Board that the cases had been handled properly, but that the events caused by the member and the employees left TDA with little alternative other than to reemploy the two individuals and pay back pay and benefits for the past approximate five years of settle the cases. The Board of TDA determined that reemployment of the two individuals was not something that could be permitted by TDA. The outside legal counsel hired by the Board to review the handling of the case confirmed this opinion. Therefore, after negotiations involving a number of parties with the NLRB and the 5th Circuit Court of Appeals, the Board of Directors of TDA determined that the cases should be settled on the basis of a payment of back pay and a settlement amount in lieu of there being any chance of having to reemploy the two individuals. In addition, accruing back pay and interest would cease immediately. Thee Board determined that the cases should be settled by the payment of the total amount of $900,000 and the settlements were agreed to. On June 19 the Board of the TDA was to meet to reaffirm the settlement decision.

On Wednesday, June 17, 2010, the settlement agreement signed by the two employees was received from the NLRB. On Thursday, June 18th, before the Board could confirm and the TDA officers could sign and return the agreement, the United States Supreme Court held that the NLRB practice in many cases, including the TDA case, of having decisions made by only two Board members, violated the law and the Supreme Court appeared to reverse or vacate a series of NLRB decisions, including theTDA opinion.

With almost certainty, the NLRB decisions would be reaffirmed by a valid NLRB board, but this could take months and their decision would be the same. Therefore, on June 19, the Board of the Texas Dental Association concluded that the best interest the members, the Association and the Association’s employees was to settle and move forward.

TDA as an organization is in good shape financially and has the strong support of its loyal employees. Conservative financial management has held funds in reserve for such contingencies, and no assessment or dues increase will be required of TDA member dentists. The settlement and conclusion of these matters will allow TDA to continue to focus on the interest of its members and the dental health of the citizens of Texas.

If any member has questions not answered by this letter, you are invited to contact me, members of the Board of Directors, or your Executive Director.

Ronald L. Rhea, DDS

President

————————-

I didn’t read much humility in our leader’s words. Did you? I’ll have more to say about this letter.

D. Kellus Pruitt DDS

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Proots, on July 7, 2010 at 8:35 PM said:

I tattle

@theTDA, I don’t want to disrupt your important work like others have done, but the NLRB judge just might have read the letter this morning.

After I posted it on 3 Facebook accounts, the Medical Executive-Post picked up “NLRB’s $900,000 verdict and TDA’s official response.”

Link: https://medicalexecutivepost.com/2010/05/11/become-a-whistle-blower-in-the-healthcare-industrial-complex/#comment-8380

Surely the NLRB judge wouldn’t angrily respond to TDA President Ronald Rhea’s letter to members, would he?

Here’s something else I discovered, @theTDA. An article I posted on ME-P over a year ago has become the 4th most popular. Why?

“Economic Facts your Dentist Doesn’t Want You to Know” includes a comment I posted on October 9, after being kicked off the TDA Facebook.

“Lee Ann Johnson kicks D. Kellus Pruitt DDS off TDA Facebook” If you google her name, the same comment on PennWell is her 3rd hit.

Link: http://community.pennwelldentalgroup.com/forum/topics/lee-ann-johnson-kicks-d-kellus

Past mistakes don’t disappear off the Internet. Mary Kay Linn’s leadership legacy will last a long, long time for many innocent people.

She has to be stopped now

Proots

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Darrell, on July 8, 2010 at 10:22 PM said:

I rightfully demand respect, ADA – and you know it

Attention, @ADANews Tell Dr. Kathleen O’Loughlin that once I help force Mary Kay Linn to submit a resignation, I’m coming after her.

Once the ADA ED returns to UnitedHealth, Delta Dental or other blessed discount dentistry broker, will ADA VP Dr. John Luther resign next?

Or is Dr. John Luther, the architect of the ADA Department of Dental Informatics, already gone? I’ve heard rumors.

The last thing the knucklehead said to me was “Write a letter to the editor if my answer isn’t good enough for you.” He’s such a kidder!

3 years after Dr. Luther bluntly encouraged me to share my concerns about HIPAA with other ADA members, I sent that letter to the editor.

Still waiting for JADA Editor to post my 7/28/09 letter. So far, he has not even acknowledged he received it. Should I send it again?

PennWell and the Medical Executive-Post had no problems posting my letter to the editor of the JADA. The ME-P has over 200,000 readers.

Link: https://medicalexecutivepost.com/2009/07/28/journal-of-the-american-dental-association-letter-to-the-editor/

The fact of the matter is, neither ADA nor TDA leaders take criticism well – right, @theTDA? So what does this mean? Nothing improves, and…

… TDA loses in court to the NLRB, the ADA Foundation comes under suspicion of malfeasance and the ADABEI creates ADA/IDM.

I find this very entertaining: I’m officially accused by ADA officials O’Loughlin, Linn and Luther of “unprofessional behavior.” Sweet.

Proots

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Darrell Pruitt DDS, on July 13, 2010 at 1:05 AM said:

TDA’s $900,000 lesson lost?

NLRB press release dampens spirit of TDA President’s letter to membership.

Today, the National Labor Relations Board issued a press release describing the findings of the case against the Texas Dental Association’s leadership involving two employees whose firings were determined to be unfair. Immediately below the NLRB’s press release, I again posted TDA President Dr. Ronald Rhea’s official response to the verdict that was mailed to membership last week. If you have concerns about the future of dentistry in Texas, please compare the two letters, and then tell your designated TDA representative your feelings. If enough of us send messages through the proper channels, the TDA promises it will listen.

Ask yourself, whom does Dr. Rhea’s rebuttal serve if not the bureaucracy he protects? Is his poorly hidden defiance ultimately in the best interests of dentists and dental patients – who without the TDA have no representation at all before Texas lawmakers? You be the judge.

——————

Press Release

National Labor Relations Board

Office of the General Counsel

July 12, 2010

Contact:

Office of Public Affairs

202-273-1991

publicinfo@nlrb.gov

http://www.nlrb.gov

NLRB negotiates $900,000 settlement for two fired Texas workers

The Texas Dental Association has distributed $900,000 in back pay awards to two former employees who were fired in relation to a petition complaining of poor management and unfair treatment.

The Association also agreed to post a notice informing employees that they cannot be fired for acting together for mutual benefit and protection.

The case grew out of a meeting of employees in 2006 that resulted in a petition to delegates of the association, which represents more than 7,000 dentists in Texas. The petition, signed by 11 employees using aliases, asked for an outside investigation of management and working conditions at the association’s Austin headquarters.

The delegates declined to authorize an investigation, and the association director initiated an investigation that included a forensic study of office computers. One employee who had helped write the petition was fired after a fragment of it was found on his computer. The second employee, a supervisor who refused to divulge the names of employees involved in the petition, was also fired.

An Administrative Law Judge found the first employee was unlawfully fired for engaging in protected activity, and that the supervisor was fired for refusing to engage in unlawful activity by divulging the employees’ identities. The Judge’s ruling was upheld by the National Labor Relations Board in Washington. The employer then appealed the NLRB decision to the Fifth Circuit Court of Appeals, and the NLRB filed for enforcement of its decision.

While the case was pending, the settlement was reached through the Board’s Alternative Dispute Resolution Program with Fifth Circuit mediation. The two former employees waived their rights to reinstatement and the association agreed to provide a neutral reference.

“This settlement was made possible by the hard work of many NLRB employees, including trial attorney Robert Perez, compliance officer Charlene Donovan, Deputy Assistant General Counsel Margaret Gaines and Attorney Jeffrey Burritt,” said Martha Kinard, director of the NLRB Regional Office in Fort Worth. “We hope it sends a message to employees that they have a right to act together to improve their working conditions, with or without a union.”

The National Labor Relations Board is an independent federal agency vested with the power to safeguard employees’ rights to organize and to determine whether to have unions as their bargaining representative. The agency also acts to prevent and remedy unfair labor practices committed by private sector employers and unions.

—————————–

Texas Dental Association

To: Members of the Texas Dental Association

Re: Settlement of Nation Labor Relations Board Claims against the Texas Dental Association

Dear TDA Members:

I write you as your President to inform you of the settlement by the Texas Dental Association of certain claims by the National Labor Relations Board (NLRB). These are matters which have been the subject of much information, mis-information [sic] and speculation. These cases and the facts surrounding the cases have been developing since 2005 and have been dealt with by five separate Boards of Directors of the TDA. The TDA has not been able to inform its members of the actual facts surrounding these cases due to pending legal action. Now that the claims have been settled, TDA wishes to make you aware of the facts.

In 2005, a TDA employee informed the TDA Executive Director that she and a second TDA employee had been involved in a relationship, however the relationship had terminated. The employee was emotionally upset. The Executive Director attempted to assist her and responded to her request for modifications in the workplace by making changes that could be carried out without overly disrupting the business of the Association. The second employee involved continued to perform duties and provide excellent service to TDA.

The Executive Director’s accommodation of the employee continued, but her actions became disruptive to other TDA employees not involved with the individuals, and other employees were at times unable to perform their duties After numerous attempts to resolve the employee issues, the employee was discharged.

Thereafter, a TDA member dentist expressed concern over the discharge of the employee. The member’s actions caused concern in the TDA House of Delegates. Anonymous email communications were received by TDA Board members, delegates and employees. The anonymous communications were represented to come from TDA employees. The TDA member continued to be involved. These events caused substantial disruption to TDA business activities. The TDA Board of Directors was concerned enough to unanimously vote to remove the TDA member from the member’s position on a TDA council.

TDA determined that portions of the anonymous email communications were present on a TDA computer used by a TDA employee. The resulting investigation of the communications and the disruption caused to TDA, including the attempts to bypass the Executive Director and theTDA Board with alleged personnel complaints, resulted in the termination of the TDA employee and a TDA supervisor who had knowledge of the events. During this period, a very substantial majority of the TDA staff supported the Executive Director and the TDA in general.

In 2006, a complaint was made to the NLRB. The NLRB initially investigated the complaint on the basis of a then pending NLRB case in a separate matter which held that it was an unfair labor practice to discipline an employee who used the company computer and email system to organize employees. As the investigation proceeded, the pending NLRB case was reversed by the national board of the NLRB and it was determined that it did not constitute an unfair labor practice because they had been discharged for attempting to organize and express concerns regarding working conditions.

The case was heard before an NLRB hearing officer. The TDA member dentist was the lead witness against TDA. A current and former TDA President were called to testify for TDA. The Executive Director testified and the two discharged employees testified as well as other employees. At the conclusion of the case, the NLRB hearing officer chose to disregard all testimony of the two TDA Presidents and Executive Director and instead believed the two discharged employees and the TDA member. The resulting hearing officer’s decision found in favor of two of the employees and ordered back pay and reinstatement of the two employees. A third employee also filed a complaint, but TDA prevailed in that complaint.

The NLRB system required that the NLRB Board in Washington approve or disapprove the hearing officer’s findings. After a substantial period of delay and inaction, the NLRB Board, acting with only two out of five members, upheld the decision of the hearing officer. TDA then appealed to the 5the Circuit Court of App

Several TDA Boards of Directors attempted to resolve the matter over a period of years. A condition to resolving the cases was always a demand by the two terminated employees to be reemployed by TDA. Several different Boards of Directors of TDA, as well as the Executive Director and staff members of TDA, were of the firm opinion that there would be enormous disruption to TDA to have the two employees reemployed by TDA. The Board had the entire proceeding reviewed by separate legal counsel and consulted various outside individuals on how to proceed. It became clear to the Board that the cases had been handled properly, but that the events caused by the member and the employees left TDA with little alternative other than to reemploy the two individuals and pay back pay and benefits for the past approximate five years of settle the cases. The Board of TDA determined that reemployment of the two individuals was not something that could be permitted by TDA. The outside legal counsel hired by the Board to review the handling of the case confirmed this opinion. Therefore, after negotiations involving a number of parties with the NLRB and the 5th Circuit Court of Appeals, the Board of Directors of TDA determined that the cases should be settled on the basis of a payment of back pay and a settlement amount in lieu of there being any chance of having to reemploy the two individuals. In addition, accruing back pay and interest would cease immediately. Thee Board determined that the cases should be settled by the payment of the total amount of $900,000 and the settlements were agreed to. On June 19 the Board of the TDA was to meet to reaffirm the settlement decision.

On Wednesday, June 17, 2010, the settlement agreement signed by the two employees was received from the NLRB. On Thursday, June 18th, before the Board could confirm and the TDA officers could sign and return the agreement, the United States Supreme Court held that the NLRB practice in many cases, including the TDA case, of having decisions made by only two Board members, violated the law and the Supreme Court appeared to reverse or vacate a series of NLRB decisions, including theTDA opinion.

With almost certainty, the NLRB decisions would be reaffirmed by a valid NLRB board, but this could take months and their decision would be the same. Therefore, on June 19, the Board of the Texas Dental Association concluded that the best interest the members, the Association and the Association’s employees was to settle and move forward.

TDA as an organization is in good shape financially and has the strong support of its loyal employees. Conservative financial management has held funds in reserve for such contingencies, and no assessment or dues increase will be required of TDA member dentists. The settlement and conclusion of these matters will allow TDA to continue to focus on the interest of its members and the dental health of the citizens of Texas.

If any member has questions not answered by this letter, you are invited to contact me, members of the Board of Directors, or your Executive Director.

Ronald L. Rhea, DDS

President

——————–

Personally, I think the million dollar lesson on workers’ rights was wasted on TDA leadership – elected and hired – leaving my professional organization increasingly vulnerable to even more hearings before the NLRB and other governmental regulatory bodies.

You may not have gotten the word, but we no longer do business this way in Texas, Dr. Ronald Rhea.

D. Kellus Pruitt DDS

cc: NLRB

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Dr. Pruitt, on July 29, 2010 at 5:43 PM said:

KDA

I applaud the Kansas Dental Association’s courage

Today, the KDA posted an announcement on their Facebook celebrating the inevitability of transparency through social networks.

http://kda-dailybriefing.blogspot.com/2010/07/july-29-2010.html

“We hope to grow our reach to the public to enhance our ability to foster and awareness of the obligations of the dental profession to society… It’s a decision we’ve made because we believe that in many ways, our organization is stronger by engaging not just the dentists of Kansas, but engaging the patients in which those members serve.”

The Kansas Dental Association leads the nation in meaningful use of social networks in dentistry. I’m proud of you, Kansas. My wife is from Liberal.

So where is the Texas Dental Association? How interactive is the TDA Facebook? Seriously. I would like to know.

I’m no longer allowed to visit the site because I ask serious questions that leaders don’t want to answer. That means I really have no clue how the TDA Director of Membership is doing with it. I know that none of my Facebook friends post items on the TDA Facebook, or the comments would show up on my Facebook community’s “Home” page as well. Can anyone tell me (confidentially if necessary) how many fans the TDA Facebook has? And am I missing anything? Finally, does the TDA yet exhibit a sense of obligation like the Kansas Dental Association promises?

And what about the American Dental Association’s Facebook? There are 5955 “People” who are waiting for it to open. Hundreds have been waiting for over a year. The ADA leaders refuse to discuss their intentions for the Facebook, yet more soon-to-be-disappointed consumers from around the world are optimistically joining every day. While the KDA “fosters an awareness of the obligations of the dental profession to society,” the ADA hides from its customers and insults the world because there is no accountability to membership.

The ADA let Americans down years ago when they closed their first edition of ADA.org because naive leaders discovered that many of their traditional ways of doing business cannot tolerate transparency.

But do leaders in Kansas actually have that much more courage than Texans? What’s wrong with you, Austin? You are shaming us.

D. Kellus Pruitt DDS

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Dr. Pruitt, on August 4, 2010 at 9:54 AM said:

Negotiating with Dr. Roy N. Burk Chair, TDA Council on Ethics and Judicial Affairs

I received another letter from the TDA concerning the mysterious allegations against me – some of which are three years old. This letter from Dr. Burk was sent as a PDF as well as a certified letter – and I appreciate the TDA’s consideration. I was able to cut and paste his letter this time.

My reply follows Dr. Burk’s letter. If he rejects my offer he’s an idiot. Is it unprofessional to say that?
——————–
TDA – Texas Dental Association

August 3, 2010

Dr. Darrell Pruitt
6737 Brentwood Stair Rd., Ste. 220
Fort Worth, TX. 76112

Via email & US Mail, Certified, Return Receipt Requested

RE: Judicial Case No. 12-2010-3

Dear Dr. Pruitt:

The Texas Dental Association (TDA) Council on Ethics and Judicial Affairs (the Council) has received a copy of the case file from the Judicial Committee of the Fort Worth District Dental Society in connection with the above-referenced case. It has been alleged that you may have engaged in unprofessional conduct regarding your communications to and about the TDA and/or the TDA staff.

The Council is proceeding with its review and consideration of the above-referenced matter. Prior to making a decision the Council wishes to extend to you the opportunity for an in person informal conference to address these matters. In accordance with the Judicial Manual, neither the Council nor you shall be represented by legal counsel at the informal conference. The purpose of this meeting would be to have a discussion and hear your response to the matters at issue. In an effort to resolve this, the meeting will take place as follows:

DATE: Saturday, September 18, 2010
TIME: 10:30 AM
PLACE: Omni Fort Worth Hotel, Black Angus Boardroom, 15th Floor
1300 Houston Street
Fort Worth, Texas 76102
Phone: 817-535-6664

Please note that cooperation with the Council and judicial process is a requirement of TDA membership. Every dentist must certify during the application process that he or she will abide by the Principles of Ethics and Code of Professional Conduct and the Constitution and Bylaws of the ADA, TDA, and component society and that failure to abide by such may result in disciplinary action.

Non-compliance with the Council and/or the judicial process constitutes unethical conduct. Specifically, the Texas Dental Association Code of Professional Conduct, §I Ch. 2(H)(7) provides, in part:

“It is the duty of the member to comply with the reasonable request of a duly constituted committee, council, or other body of his component society of this Association necessary or convenient to enable such a body to perform its functions and abide by the decisions of such body….Any violation of this duty constitutes unethical conduct.”

Please confirm that you will be able to attend by contacting the Texas Dental Association.

Thank you for your cooperation with the Texas Dental Association and with the Council.

Sincerely,

Roy N. Burk, D.D.S.
Chair, TDA Council on Ethics and Judicial Affairs
________________________________________
From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Tuesday, August 03, 2010 10:15 PM
To: ‘rjburk42925@valornet.com’
Subject: Unknown complaints

Dear Dr. Roy N. Burk, Chair, TDA Council on Ethics and Judicial Affairs:

You’re to be commended for volunteering for the thankless job you’ve taken on, Dr. Burk. You’ve got courage and dedication, even if you are truly oblivious to being played.

Seriously, Dr. Burk, grab some common sense. Do you really expect me to walk into the Black Angus Boardroom of the Omni Fort Worth Hotel on September 18th to defend myself against allegations I have no way to prepare for simply because I have only heard rumors about them? And if I don’t cooperate?

“Non-compliance with the Council and/or the judicial process constitutes unethical conduct.”

When you mention “ethics,” “attorneys” and “disciplinary action,” you get my focused attention. You and I need to talk man-to-man before someone gets hurt. Are you still allowed to do that Roy, or are you trapped, helpless and scared?

Please note that in the four years of being ignored, evaded and lied to by ADA officials much higher in the organization than you are, I have never once threatened as a consumer to enlist an attorney to oversee my disagreements with my professional organization. So congratulations, Roy. You’ve already unnecessarily escalated the fight without ever having met me. So why are you so quick to harm me, Roy? I’m going to take a chance on getting you really pissed by suggesting you should have another conference with Mr. Bingham about your plans because in my opinion – backed up by copious documentation witnessed by thousands over the last four years – you are on thin ice, friend. Both you and the TDA could get spanked hard if I decide I’ve already been harmed.

You should also consider that following the recent National Labor Review Board $900,000 judgment against the TDA because Executive Director Mary Kay Linn was found guilty of treating employees unfairly, membership may not have the appetite for another futile courtroom fight that could last years before the TDA loses again even bigger. Listen to reason, Roy. I know what I am capable of saying to TDA employees and whoever else my dues fund who might have what I consider over-sensitive feelings. Trust me when I tell you that anyone can see that if you had anything but trumped up petty complaints nurtured by leaders for political reasons, someone would have mentioned something to me by now. Think about that really hard. Did I mention that I have yet to read the complaints? Save yourself and the TDA some embarrassment, Roy. You don’t have a single good reason that TDA officials would keep the complaints a secret from me for THREE YEARS!

In light of this and other inexcusable TDA mistakes that can potentially come back to bite you and others for the rest of your careers, I suggest you tone it down a little, Roy. You need to stop listening to what others are saying ABOUT me that they cannot say TO me. You are being used.

It is in your interest to stop thinking of me as an adversary. Let’s not hurt each other. You and I can work this out cheaply, quickly and easily if in your heart, resolution is what you really want rather than to be part of someone else’s personal war that has nothing at all to do with treating dental patients. Imagine me as a dentist who practices down the street from you, and you have only heard some really strange rumors (and please share those rumors with me), Benefit of doubt is civil. The kangaroo court you invited me to attend is not.

Let’s not kid ourselves. I would be foolish to walk into that room in the Omni Fort Worth Hotel. Apart from the impossibility of preparation, I’ve also had the opportunity witness how shamefully TDA officials treated a fellow TDA officer who tried to do the ethical thing and inform the Board that the TDA Executive Director was unlawfully mistreating employees. In the end, the NLRB agreed. You know who I’m talking about because he was kicked off your council as punishment for standing up for the ideals you say you represent. Ironic, isn’t it?

His punishment didn’t end there, Roy.

“Just met with Mary Kay Linn. I for one feel ridiculously comfortable with her as the TDA ED. You are dead wrong about her.” – TDA Delegate from San Antonio, July 9, 2010

Years after the selfless, courageous dentist was cast aside by insensitive TDA leadership, a dentist from San Antonio let me know that he is a TDA Delegate before he expressed what I have to assume is the official opinion of the brave dentist I respect, as well as his opinion of me. Here is what he tweeted me on July 10th “Why don’t you and [the other dentist] start your own org? TCDA. Texas Curmudgeon Dentists Association.”

I hope that I’ve clearly pointed out my advantage, Dr. Burk, without even scratching the surface. I’m a keen observer, but nevertheless, I’m also a benevolent and reasonable man. If you didn’t notice, I took care not to hurt the innocent and naïve. In the spirit of giving, I’ll offer you an unprecedented solution for an unprecedented mess that the TDA is about to drag you and your committee into. If we can trust each other, here’s a deal that will allow us both to walk away from this distraction with honor, and it won’t bother anyone who matters.

If you promise that you will drop all complaints, I won’t demand to even read them – much less point out the silliness to everyone. Then, maybe one of these days we can start out on much better terms. You’d be a fool to pass up this offer, Roy. Trust me. The TDA doesn’t need this and neither do I.

D. Kellus Pruitt DDS

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D. Kellus Pruitt DDS, on August 6, 2010 at 2:10 PM said:

I think Dr. Roy N. Burk is going to drop Judicial Case No. 12-2010-3 because he has the best interests of the TDA at heart and he’s just a smart man.
________________________________________

From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Thursday, August 05, 2010 8:33 PM
To: rjburk42925@valornet.com
Subject: I await your response 8.5.10

Dear Dr. Roy N. Burk, Chair, TDA Council on Ethics and Judicial Affairs:

Two days ago you sent me a certified letter commanding me to appear before the TDA Council on Ethics and Judicial Affairs on September 18th to defend my reputation against allegations of “unprofessional conduct” that have still not been made available to me – even though I’ve been told that some complaints are over three years old. You also mentioned “attorneys” far too quickly and carelessly.
If you don’t yet realize it, this very history of inaction on the part of your Council concerning the alleged complaints will never make sense to me or anyone else who is witnessing our exchanges. Face it, Roy. The TDA’s delay is an inexcusable error that severely limits your options if you choose to pursue trying to harm me for whatever misguided reason. The TDA lost against me three years ago when one of your own committee members from the Fort Worth District Dental Society wisely dismissed the vindictive complaints as petty. I haven’t yet met the man. However, I possess acute foresight and it looks to me like you, I and a handful of proud TDA leaders might just succeed in hearing the dentist from Fort Worth say the same thing in a deposition some day.

What?

When you threatened me with “disciplinary action” as well as being officially labeled “unethical,” did you not anticipate that I would fight viciously for my reputation in my community? Roy, you can’t even imagine my fury. It’s fierce, it’s forever and it’s nationwide. Once again, on behalf of the TDA, you were the one to escalate the mistake to the level of attorneys. (By the way, are you planning on using TDA’s in-house attorneys?)

If TDA leaders honor common sense and fair play over politics, I’m confident you and I can quickly resolve their dangerous mistake without attorneys. What’s more, following the TDA attorneys’ $900,000 failure in front of the NLRB, TDA members who paid the judgment will be relieved to hear that you aren’t as careless as your certified letters to me would lead a jury to believe. Almost everyone can see that dismissing this nonsense immediately is best for the TDA as well as the profession – not to mention you and me.
You and other TDA leaders never had a chance anyway. Besides, to say I’m unethical and get away with it, sooner or later one would have to attack my character. How are TDA attorneys going to attack my character when by just googling “Darrell Pruitt DDS,” jury members will discover that I’m the highest rated dentist on DR.Oogle in Fort Worth? (doctoroogle.com). As a matter of fact, if one does a little more research on the dentist rating Website, one can see that I’m the highest rated dentist in Texas.

I should say that this is the first time I’ve mentioned this honor on the Internet because I suspect the boastful claim could make me a target for hotheads, not new patients. Nevertheless, this seems to be a worthy time to risk hate mail because it might just knock the foul habits of aggression smooth out of the TDA leadership forever. That would greatly please me and numerous other TDA members – as well as employees. Without these prideful distractions, the TDA could better represent Texas dental patients’ interests as well. Everyone wins except attorneys.

(I wish to thank my generous patients for all 132 sweet reviews. Some of them, including authors of the reviews, are following our negotiations with interest.)

If you change your mind about punishing me, my offer still stands. Should you quietly drop Judicial Case No. 12-2010-3, I won’t demand that you share what could be some of my most inspirational writing – judging from at least one TDA employee’s excited reaction. I hope before proceeding you understand that regardless of which article the employee found offensive, it was also posted simultaneously on the Internet for everyone to see. More importantly, you should know that the TDA employee is the only person in the nation who turned me in for unprofessional conduct (as far as I’ve been told by the TDA). So you see, it’s beyond silly to keep what I said a secret any longer. I’d like to know what I wrote that actually elicited a passionate response. I’m just curious.

You’ve seen the evidence, and you know right now that I’m patiently offering you the best deal you will ever get. You should consider that following the NLRB blunder, it will be difficult to convince a jury that Executive Mary Kay Linn is trying to protect her employees this time instead of wrongfully firing a couple.
On the other hand, if you aren’t ready to negotiate like a reasonable adult in the land of the free, let me help prepare those same TDA attorneys for the downside of resolving mistakes your way. I’ll start by suggesting you tell Mr. Bingham to bone up on the e-Discovery law. Talk about foresight! I emailed the TDA a warning about the law on the day it passed in December 2006. By that time, I had already endured almost a year of TDA evasion and it occurred to me that the lawsuit you now desire might indeed be unavoidable. The law means TDA representatives cannot deny that the organization was repeatedly informed of my suspicions of malfeasance up to four years ago. Right, Mr. Bingham?

Before we get too far into this nasty, public brawl, you and your team should give serious consideration that you are pursuing a regrettable mistake motivated by pride and politics – not professionalism, and certainly not ethics. I know the names of a few NLRB officials who might argue that the TDA is actually running low on ethics these days – if you know what I mean.

As is common with the methods of the TDA and totalitarian regimes, what you are attempting is tyranny. Your Council’s level of ethics isn’t allowed anywhere else in the free world, and as such, the blatant disrespect of TDA members (your customers in a free market) is completely out of place in a non-profit professional organization supported by the dues of the members and elected officials you thoughtlessly harm.

I requested a copy of the allegations from Mary Kay Linn numerous times, but she refused to respond. Within hours of receiving your command two days ago, I emailed you a similar request for a copy of the allegations as well, yet I haven’t received a response from you either. I obviously cannot help the fact that you feel it is important to use certified letters with me, but do you intend to force me to use them as well, just to know if you are getting my emails? Certified letters are archaic and inefficient – not to mention less than civil. Besides, since the e-Discovery passed over four years ago, certified letters are obsolete as far as I’m concerned.

After you threatened to officially declare me an “unethical” dentist, as well as threatened to impose unnamed “disciplinary actions” against me, can you justify your silence? I’m personally accountable for my actions (when given a chance) and I especially expect those who would judge and punish me to be personally accountable as well.

By now, you should agree that you and I need to talk with each other like reasonable adults, Dr. Burk. Does the TDA really want to label me unethical over an issue that has nothing to do with patient care? You must be aware that I am very disappointed with my Texas Dental Association over this, and I intend to resolve the mistake as soon as possible before you and others harm the organization any worse.
Certified letters! We’ll laugh about that one day. I’m saving every one.
Let’s get reasonable and stop playing games you aren’t very good at. You are making others look foolish, and this vindictive nonsense has already forced me to make myself much more visible than I ever wanted to become. Thanks a lot, TDA.

As Chair of the Council on “ethics,” you cannot allow others to push you into abusing your position. I’ve invested 28 years into the TDA and I’d rather not see you bring it any more dishonor than it’s already suffered this year.

D. Kellus Pruitt DDS

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Dr. Pruitt, on August 6, 2010 at 2:22 PM said:

Dr. Roy Burk, Chair of the TDA Council on Ethics and Judicial Affairs responds at last.

From: Roy
Sent: Thursday, August 05, 2010 9:01 PM
To: pruittdarrell
Subject: Re: I await your response

Dr. Pruitt

I do not check my e-mails very often. I would prefer to talk to you on the phone which I shall do next week. Till then,

Regards and respectfully,

Roy

———-

Within minutes, I responded:

Sorry, Roy. This has to be done on the Internet. Sorry to inconvenience you, but that is the way it is.

———–

“I do not check my e-mails very often.” Dr. Roy Burk is asleep at the wheel!

Let me briefly review my history with the Chair of the TDA Council on Ethics and Judicial Affairs, and then you decide for yourself if we might need someone with a little more sensitivity in Roy’s position of power.

This week, Roy threatened me with “disciplinary action” including being officially labeled as “unethical,” yet days later, the man who would judge me, still knows NOTHING about me… until yesterday when he happened to check his email.

Let me remind everyone that the man who mentioned that I may need an attorney to help defend myself against charges that continue to be kept secret from me – is the Chair of the TDA Council on Ethics and Judicial Affairs.

I would send this to Roy, but after getting to know him a little better, I don’t give a crap if he ever reads it.

For the rest of my life, Dr. Roy Burk can call me unprofessional all he wants. His words have no meaning. That will never change.

D. Kellus Pruitt DDS

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Dr. Pruitt, on October 13, 2010 at 11:28 AM said:

Unfair NPR Article

Dan Ariely, an entertaining and knowledgeable blogger challenged the profit incentives of the dental profession on NPR a week ago. He holds the position of the James B. Duke Professor of Behavioral Economics at Duke University. He isn’t a reactionary lightweight.

In response, an almost unprecedented conversation with him has erupted in the blogosphere concerning dentists “over-diagnosing” cavities and upgrading treatments based on profits.

I offered my opinion today.

——————————————————————————–

From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Tuesday, October 12, 2010 1:28 PM
To: ‘dandan@duke.edu’
Cc: others
Subject: Unfair NPR article

Dear Dan Ariely:

Welcome to my community. Usually it’s a lot quieter around here. Your October 5 interview by Robert Siegel for NPR seems to have caused some excitement.

(“The ‘Irrational’ Way Humans Interact With Dentists.”)

http://www.npr.org/templates/story/story.php?storyId=130356647#commentBlock

I think you’ve gotten yourself deep enough into my profession to recognize that dentistry is a uniquely emotionally-driven microcosm in healthcare – not to mention American business. Dentists’ daily work is intricate and to exacting tolerances in occasionally uncooperative mouths of anxious and vulnerable patients. Our work simply cannot be rushed without sacrificing quality, and loyalty to a dentist year after year isn’t the worst thing that can happen to our nation’s consumers. Delta Dental is.

As a practicing dentist with an amateur interest in the business of dentistry that parallels your professional interest in behavioral economics, I find the way you strolled right on into areas never before ventured by outsiders simply riveting. It’s as if nobody warned you it’s unprofessional to publicly discuss taboo topics in dentistry such as over-diagnosis and capricious, financially-biased solutions … or maybe like me, you said what the hell and took your chances.

As a group, I know dentists pretty well. I thought it was encouraging that you received a response from ADA President Dr. Ron Tankersley considering he was busy with the ADA annual meeting last week Dentists – especially ADA officials – almost never speak up on Internet venues like this to defend our business practices. Nevertheless, I assure you that the vast majority of my colleagues are honest, caring people who go to work each day with the sincere desire to serve those who depend on our watchful eyes and careful work to help them keep their bodies healthy and their mouths pain-free.

The economics of trust.

I’m surprised nobody has mentioned Ayn Rand’s over-quoted justification for paying doctors well. Since few dental patients understand the intricacies of diagnosis and treatment of their dental problems, and are left to trust dentists’ recommendations, it’s indeed in the public’s interest that dentists are fairly compensated however you want to do it. Fee-for-service for dentists and freedom of choice for consumers happens to be the simplest, fairest and least expensive way to prevent the unnecessary treatment you mention.

Ethics aren’t free. As discount dentistry brokers like Delta Dental continue to seize more power in the marketplace causing unfair downward pressure on dental fees, the clueless patients get hurt the most while Delta executives cannot be held accountable for their lousy product and deceptive advertisements. Delta Dental is a healthcare parasite without friends that has thrived only because of the protection of the McCarran-Ferguson Act which permits members of the National Association of Dental Plans an exemption from the Sherman Anti-Trust Act and the FTC… but then that’s a different kind of behavior problem.

If you wanted to poke a more sensitive spot for defensive and stoic professionals in a slow economy I’m not sure what that would be unless you were to say Delta Dental treats dentists just swell. It could be said that you must have hit a nerve

I think if more dentists felt comfortable about openly discussing the weaknesses of the profession with outsiders, one would discover that most of us shamefully recognize the lapses in ethics that you describe in your interview – as do dental patients who are more and more likely to express their disappointment online. Nevertheless, you only give part of the story. For example, I don’t think anyone can accurately diagnose tooth decay by radiographs alone – not even specially trained dental consultants.

Your response to Siegel could be interpreted to mean that the longer one stays with a dentist, the more expensive their dental care becomes – not because of natural wear of teeth but because of questionable diagnoses and treatment upgrades that help the dentist more than the patient. I noticed on your Website, you ask for ideas for studies. Here’s one: Compare the amount of dentistry done on patients who frequently change dentists with those who see the same dentist year after year. Then compare the expense. Do you think long-term patients have more cavities?

Delta’s got your answer.

On August 15, 2008, I was attending the ADA’s annual benefits conference in ADA Headquarters in Chicago when I heard one of the speakers from Delta Dental, Dr. Maxwell H. Anderson, tell the audience that after mining 7 years of Delta claims data, they discovered among other things that “changing dentists causes fillings.” I wasn’t the only dentist who found his statement shocking in its honesty.

When one considers that Delta’s contracts with its preferred providers last only 12 months at a time, that makes the Delta official’s statement an especially candid revelation. During the next discussion period, he was asked to share Delta’s data. At that point, Dr. Anderson apologetically said that if it was up to him, he’d gladly provide us access to it. But since posting the proprietary data would give competitors in the dental benefits industry an advantage (as well as help consumers make informed decisions), he regrettably declined. We didn’t have as much luck as you did. Now that you have a name, maybe you could dig into that a little deeper. Delta ignores my questions because they aren’t accountable to dentists.

Here’s another study I’d suggest. Go to DR.Oogle (doctoroogle.com) for any major city in the nation Then compare the popularity ratings for all dentists with the ratings for preferred providers posted on lists for Delta, Aetna, UnitedHealthcare and others. You will invariably notice that the providers that Delta and other discount dentistry brokers prefer are generally less popular than fee-for-service dentists.

Does popularity matter in dentistry? Of course it does. Freedom of choice validates the preventive benefits of a “dental home’ that the patient chooses year after year regardless of preferred provider lists. People can think up lots of reasons for not going to the dentist. Satisfying dental consumers is prevention and it can’t be done 12 months at a time.

D. Kellus Pruitt DDS

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Dr. David E. Marcinko MBA, on October 13, 2010 at 1:49 PM said:

Professor Dan Ariely from Duke University responds

—–Original Message—–

From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
Sent: Wednesday, October 13, 2010 7:37 AM
To: ‘Dan Ariely’
Cc: others
Subject: RE: Unfair NPR article

Thanks, Dan. Please let us know if you have any questions. I think you have an audience.

Darrell (D. Kellus is my pen name. It keeps my dental practice separated from my online activity. I’m also sharing this on Facebook.)

—–Original Message—–

From: Dan Ariely [mailto:dandan@duke.edu]
Sent: Wednesday, October 13, 2010 5:21 AM
To: pruittdarrell
Subject: Re: Unfair NPR article

Dear Kellus,

Thanks a lot for the information and insight about the profession.

I am realizing more and more the problems between dentists and the insurance companies, and also between individual dentists and their professional society.

I am going to try and get more data and see if I can learn more about this.

Irrationally yours

Dan

Misbelief

PUBLISHER’S NOTE:

We welcome Professor Dan Ariely to the debate and ME-P forum.

Dr. David E. Marcinko MBA
[Publisher-in-Chief]
http://www.MedicalBusinessAdvisors.com

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Mary, on October 13, 2010 at 8:23 PM said:

Hello Darrell,

Enjoyed your reference to Ayn Rand, above.
Here is an ME-P post on her from back in 2008.

Ayn Rand on Domestic Health Care

Search and ye shall find.

Mary

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Darrell K. Pruitt DDS, on October 15, 2010 at 7:09 PM said:

Mobile Dentistry

Mobile dentistry is the Medicaid dentistry of the future whether you like it or not. And, it’s coming to a school near you.

In Arizona, a child without cavities who shares a name with child who has cavities got fillings from a mobile dental clinic that dropped by an elementary school.

http://www.azcentral.com/video/bcplayer/636851787001&pop=1

Oops!
Darrell K. Pruitt DDS

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Darrell K. Pruitt DDS, on October 17, 2010 at 6:50 PM said:

Who is Telling Our Story?

I heard a rumor that the ADA has a story to tell, but can’t find any Delegates to tell it.

A week ago, ADA President Dr. Ron Tankersley addressed the ADA House of Delegates at the annual meeting of the American Dental Association. He provided five “heartfelt beliefs” on how the delegates could advance the ADA’s reputation, credibility and relevance. The last one is to “insist that the Association do a better job of telling its own story because the ADA and the dental profession have an incredible story to tell.” (See ADA reporter James Berry’s “A ‘unique’ perspective.” I would suggest that if one intends to read Berry’s article, one should either do it now or copy it for later. The editor of the ADA News Online has been known to delete stories that later prove to be embarrassing and this one won’t age well).

http://www.ada.org/news/4869.aspx)

Until the Association does a better job of telling its own story, NPR, Channel 12 News and others stand ready to assign us sufficiently incredible ones of their own – such as two stinkers this month about both private and public dentists performing unneeded dentistry on clueless patients – including children.

I think years from now, October 2010 might well become the recognized tipping point in history for Americans’ faltering trust in all dentists. On October 5, in a Robert Siegel interview on NPR’s “All Things Considered,” Dan Ariely argues that patients’ loyalty to private practice dentists they continue to see by choice is not because they are necessarily happy customers. Ariely, who holds the respected position of the James B. Duke Professor of Behavioral Economics at Duke University, says patients stay with their dentists because of “cognitive dissonance” – a clinically-recognized phenomenon of emotional bonding similar to the social loyalty one develops for a fraternity after surviving hazing… or perhaps the blind loyalty dentists develop for the profession after having survived dental school.

Furthermore, Ariely suggests that the longer one is with a dentist, the more one gets ripped off. I thought that was courageous of the Duke Professor.

http://www.npr.org/templates/story/story.php?storyId=130356647#commentBlock

That’s why I must say that it thrilled me to see that even though ADA President Dr. Ron Tankersley is not quite ready for social media, he at least sent a private email to Ariely in protest – from which Ariely promptly posted on his blog the paragraph in which Dr. Tankersley suggested that perhaps the professor hadn’t seen a dentist in a while. Way to go, Ron! That was an admirable try, and I vicariously feel your satisfaction of subtle retaliation. However, the cheap stuff simply doesn’t work as well on the Internet as it does with hecklers in an auditorium full of supporters. You probably should have left that one in your pocket because Ariely is no slouch. He turned it against you.

Nevertheless, I think Dr. Tankersley validates his own advice to “tell our story” to the best of his current ability with his limited, private response to the NPR piece. A more effective way to challenge Ariely’s naive misconceptions would have been on a vibrant ADA Facebook. Unfortunately, instead of the unprecedented, powerful grassroots reaction that Dr. Tankersley’s “come-and-get-it” statements would have ignited among ADA members, there’s still simply nobody out here to tell our story – if you don’t count me.

Only days after Robert Siegel’s biased NPR piece, Channel 12 News in Arizona uncovered a much more embarrassing story about a child who received unnecessary fillings from a Medicaid provider because she shares the name with a child who actually has cavities.

http://www.azcentral.com/video/bcplayer/636851787001&pop=1

Just how much time does it take for a dentist to confirm there is indeed decay in a tooth before cutting into it with a dental bur? About a second. I think everyone recognizes that an underpaid dentist’s inexcusable error endangers the credibility of all American dentists much more than Siegel’s NPR piece about a naïve professor’s educated imagination.

Dr. Ralph Green, the careless dentist’s employer, was interviewed in the Channel 12 News story. He holds a $6 million contract with the state to provide Medicaid services and is the owner of the mobile dentistry business which profits from doing fillings – whether school children need them or not. Dr. Green claims that this is the first time an incident like this has happened in seven years. Perhaps it’s the first time his unwritten business policy has been exposed in seven years.

Before I go any further, let me say that I sincerely believe that there are only a few dentists in Arizona or any other state who succumb to greed like the practice depicted by Channel 12. Dentists who put up with the mind-numbing, frustrating Medicaid bureaucracy for less-than-adequate pay have always owned my highest respect. They should be honored nationally as hard-working humanitarians who perform near-charity dentistry to prevent children from having toothaches in the middle of the night. If you accept Medicaid, you are a hero.

That said, I’ve suspected for a long time that overtreatment of Medicaid patients happens far more often than it should simply because the pay is typically too low to cover expenses – including the cost of ethics. For example, in restoring teeth, it sometimes takes much more time to prepare for the procedure than to actually complete the restorations – especially when working on children. Whereas the pitiful Medicare payment might not cover a dentist’s expense to do one filling on a wriggly target, a second filling close by will quickly provide a return on investment, and a third will double the profits.

Sorry, I know unspoken incentives like this are not what my colleagues want me to reveal, and such blunt honesty is not what anxious parents enjoy reading. But America simply must face the fact that ethics aren’t free. Here’s another fact that nobody will enjoy reading: If Medicaid or other managed care payments for dental care don’t cover the cost of ethics, it is simply impossible to police against predictable fraud without raising the cost of dental care for everyone to an unacceptable level.

When Medicare payments are insufficient, hungry dentists will reliably prove that the cost savings of “cheap” is only bi-partisan political illusion, and more regulation will only aggravate dental office managers. As a dentist, I can assure any ADA leaders who might be reading this that dentalcare stakeholders’ calculated plans to prevent fraud – even by micromanaging the profession using interoperable electronic dental records for quality control – is hugely entertaining. However, accountability through algorithms is rapidly proving to be nothing more than a fantasy that Newt Gingrich sold to naïve ADA leaders six years ago. Because of common sense and the fact that eDRs have not shown a return on investment for dentists, Newt’s tyrannical ideas are going nowhere in dentistry, and there is no plan B for quality control in the profession.

That leaves quality control to consumers’ choice of dentists whom they prefer to visit. So let’s make a meaningful investment in the health of tomorrow’s adults and create competition among dentists for Medicaid dollars the old fashioned way: Offer a few more of them.

ADA Delegates, Dr. Tankersley is right. We simply must find a way to tell our story because left to their imaginations, university professors tell the wrong story and children from poor families are powerless to tell their story at all.

Darrell K. Pruitt DDS

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John, on October 24, 2010 at 6:33 PM said:

CA Can’t Stop Dental, Podiatric [Foot Care] or Chiropractic Medicaid Services Without US Approval – Judge Rules

A Sacramento federal judge has ordered the state to keep providing adult dental, podiatric, and chiropractic services to poor people in underserved rural areas until it gets permission from federal heath authorities to discontinue the benefits.

US District Judge Frank C. Damrell Jr. just ruled that, while the services are not mandatory under the federal Medicaid program (Medi-Cal in California), the Legislature’s decision to end them last year as a cost-saving measure was unlawful without federal approval.

Damrell issued an injunction barring further implementation of the change in the Medi-Cal plan until the state gets federal approval.

Anthony Cava, spokesman for the state Department of Health Care Services, said Thursday the department, which oversees the Medi-Cal program for people below the poverty line, will abide by the judge’s order. He said that the department will resume reimbursements to qualified healthcare centers and rural health clinics for the services.

Source: Denny Walsh, The Sacramento Bee [10/22/10]

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Darrell Pruitt, on January 17, 2011 at 2:35 AM said:

Do you know the difference between a troublemaker and a whistleblower? Redemption.

The Internet greatly improves whistleblowers’ chances of survival compared to the dark ages when media was expensive and tightly controlled by even the most democratic governments (other than Holland). For insulated command-and-control leaders who are unaccustomed to transparency, sudden accountability can be a bitch. And for those in power who opened offshore bank accounts to evade taxes that lesser Americans obediently scrape together and pay, it makes me giddy to report that tomorrow, Wikileaks will blow your crime wide open. So where are you going to move your fortune first thing tomorrow morning if the Bank’s servers are overwhelmed? I bet it’s too late to use frequent flyer miles to fly to the Caymans. What am I thinking? By now every puddle-jumper within range of the western Caribbean islands are probably booked by sweaty tourists with empty suitcases sitting between ambitious reporters and IRS agents. “Going down to Grand Cayman for relaxation?” one or the other might ask.

Today, Ed Vulliamy, writing for The Observer, posted “Swiss whistleblower Rudolf Elmer plans to hand over offshore banking secrets of the rich and famous to WikiLeaks.”

http://www.guardian.co.uk/media/2011/jan/16/swiss-whistleblower-rudolf-elmer-banks?cat=media&type=article

“The offshore bank account details of 2,000 ‘high net worth individuals’ and corporations – detailing massive potential tax evasion – will be handed over to the WikiLeaks organisation in London tomorrow by the most important and boldest whistleblower in Swiss banking history, Rudolf Elmer, two days before he goes on trial in his native Switzerland.”

Redemption

For more in-depth coverage on tomorrow’s announcement, here is an interesting interview with Assange that expounds on Vullamy’s story about alleged widespread tax-evasion and other Wikileaks defensive actions against those inside and outside the government who would attempt to cause further harm to the organization.

http://nos.nl/video/211885-compleet-interview-met-julian-assange.html

Amid the fiery contempt and dirty tricks whistleblowers have traditionally endured from frightened good ol’ boys – self-limited by primitive leadership tools – I find it sporting that contemporary, non-anonymous activists for transparency like Rudolf Elmer and Wikileaks founder Julian Assange will likely witness the inevitable success in their personal goals if they can manage to live long enough. Jeff Jarvis, who 7 years ago spanked Dell Computer using a popular Website called “Dell Hell,” has done quite well for a whistleblower. But then, Jarvis only took on a single proud, insensitive computer giant while Assange and his team are calling out dozens of proud, insensitive international leaders.

Dell Computer surrendered to the relentless Jarvis, a former television critic for TV Guide and People magazine, after a few months of public and sometimes profane lynching by Jarvis and thousands of other dissatisfied and vocal Dell computer purchasers turned sour by notoriously bad customer service from the Texas-based company. Ultimately the pain Jarvis brought to shy Dell leaders improved the company’s product and arguably saved Dell from oblivion in today’s competitive computer market. It that way, Jarvis helped Texas, and in turn, me and my family.

Maybe the tax cheats’ illicit funds that Wikileaks digs up can help solve our nation’s Social Security crisis if untainted Members of Congress can persuade guilty colleagues to trade their fortunes for jail time or perhaps exile. Bi-partisan income tax cheats aggravate me – especially at this time of year.

A little over a month ago, Sarah Palin, who could become the Republican candidate for president in 2012, said WikiLeaks founder Julian Assange should be hunted down like the Taliban and Al-Qaeda. This week, I heard serious fat commentators on Fox News say with what appeared to be confident authority that Julian Assange should be “taken out” by covert means if necessary. It’s as if a single whistleblower is a threat to democracy in America. So how fragile is democracy here?

I don’t care what one thinks of Assange and his dedication to WikiLeaks’ mission of bringing transparency (accountability) to international relations, Assange, his associates and his family are being treated unfairly. The only charge against the man is a questionable sexual misconduct case in Sweden… from where he can be conveniently extradited to the US. Yet Fox News authorities and a potential President of the United States are calling for his assassination. I wonder if they know anyone who has tax-evasive money in offshore bank accounts. I say there’s a 50-50 chance that inevitable investigators will find even more of Al Sharpton’s money.

I’m often reminded that if it weren’t for modern, pervasive Internet communications, troublemakers like Assange would have long ago been secretly prosecuted and hanged – possibly by rendition – without a chance to defend themselves. How many whistleblowers have disappeared throughout history that we will never know about — courageous people whose warnings could have quite possibly improved life for everyone had they not been carelessly discarded for selfish reasons? Consider the inestimable number of undocumented career sacrifices offered in vain by well-meaning people. Censorship policies beyond reasonable and fair protection of individuals are shameful.

As an amateur whistleblower and recently suspended member of the Texas Dental Association for related reasons, I feel a bond with Mr. Assange on a much smaller scale involving much less money and much less threat to trusting informants and American soldiers risking their lives for freedom. It’s my stated opinion that organized dentistry is a historically obscure microcosm of the cold war era government model still used as a last defense by trapped politicians and endorsed by Fox News experts.

I am Julian Assange.

Yours truly,
Darrell Pruitt

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Ann Miller RN MHA, on January 25, 2011 at 10:58 AM said:

CMEs Focused on Physician Behavior

Each year, physicians are caught crossing the lines of appropriate practice behavior and are reported to regulatory boards. Their actions may not warrant revoking a medical license, but they signal poor judgment and a lack of understanding about rules governing medical practice. Hoping to curtail such behavior and prevent it from leading to more serious offenses, state licensing boards, hospitals, and medical groups are turning to continuing medical education programs for help.

CME classes similar to those that doctors take to maintain a medical license are being used as a disciplinary tool when physicians get into trouble. In such instances, mandated CME course topics may include physician-patient communication, anger management, maintaining appropriate boundaries between professional practice and personal life, and proper prescribing and recordkeeping. Courses are designed to help physicians avert future transgressions.

Source: Carolyne Krupa, amednews [1/24/11]

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Martin, on April 4, 2011 at 11:17 AM said:

How safe is your hospital?

A medical error at the University of Chicago led to the death of James Tyree, a well-known financier and philanthropist being treated for cancer

http://articles.chicagotribune.com/2011-03-31/news/ct-oped-0331-hospital-20110331_1_preventable-medical-mistakes-medical-examiner-hospital

Martin

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Mike, on April 14, 2011 at 10:29 AM said:

Surgeon Barred from Operating Room

Just say “no” to PODs [Physician-Owned Distributorships]

http://online.wsj.com/article/SB10001424052748704336504576259142044058726.html

Mike

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Ellen, on May 1, 2012 at 10:14 AM said:

VA Nurses Scrutinized After Patient Deaths in Two States

A review of records at 29 Department of Veterans Affairs hospitals found that only half the nurses had documented proper skills to care for patients.

http://www.propublica.org/article/va-nurses-scrutinized-after-patient-deaths-in-two-states

Ellen

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Ginny, on November 6, 2013 at 7:05 PM said:

Surgeon Pleads Guilty to Fraud, Faking Surgeries

An orthopedic surgeon who botched and faked thousands of surgeries over a five-year period has pleaded guilty to one count of healthcare fraud.

http://abcnews.go.com/Health/surgeon-guilty-fraud-faking-surgeries-faces-civil-suits/story?id=20795227&utm_source=Copy+of+11.5.13&utm_campaign=11713&utm_medium=email

Dr. Spyros Panos, who practiced medicine in Poughkeepsie, N.Y., changed his plea from not guilty to guilty when he appeared in federal court in White Plains, N.Y. last week. Under a plea arrangement, he faces up to 10 years in federal prison and must pay a $250,000 fine.

He has also agreed to pay the government $5 million as restitution for false and overstated Medicare and Medicaid charges.

Ginny

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