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Looking to Convert to a Paperless Dental [Medical] Practice?

Why Does the ADA Promote eDRs?

By Darrell K. Pruitt DDS

Not so Fast!

Before a dentist trustingly accepts the recommendation of the American Dental Association and unwittingly converts his or her practice to paperless, one should read the story I copied below which was posted on VillageSoup.com yesterday.

Unlucky dentist loses everything …


Worst Way to Start Off the Year

I have been on my own for last 7 yrs. We have a small business server (windows 2003) 6 work stations, completely paperless using Dentrix 11 and Vixwin platinum. One morning, when we returned to work, we could not access the server. Went into panic mode! Not able to get anything! Not knowing the schedule. Who is coming what they are coming for, etc. It was decided that my server crashed. It was set up w/2 hard drives to mirror each other and also had an external drive back up (Seagate). We ended up rushing the drives to a data recovery company in (data doctors). They sounded very promising claim 90% success). I agreed to pay additional $4100 to rush case! We were led to believe all is well once they diagnosed case. A few hrs later every thing changed. We got the bad news that both drives are not recoverable since they found a minute scratch on one of the plates. Also we are not able to recover anything from the external drive.

At this point I have lost all patient records including x rays going back 7 yrs. I have no access to schedule, ledgers, notes, insurance, X-rays, anything. This is leading both me and my wife into depression. We are very stressed, at a loss. This is a catastrophic loss. Not sure how to move forward?

I am worried about the liability on top of everything else. How do I tell my patients? How do I know who paid for what balances on work that needs to be done, etc. I keep waking up at night thinking of all the possible problems.

This is the lowest point in my career. I don’t even want to go into the office from stress. If any one can offer any advice I would really appreciate it. I know in the past you guys lifted me up. I love forum name.

Thank you.


On top of the anguish this person already suffers, the HIPAA violation must be reported to the Department of Health and Human Services. Thanks to HITECH, an expensive inspection is likely to follow. The dentist’s letter reminds me of a desperate private note from a dentist a few months ago describing his HIPAA violation. He lost a laptop computer he was using as a daily backup device. Since there were thousands of his patients’ unencrypted PHI on the computer, he was similarly paralyzed by the same cold and lonely panic a professional feels when optimistic career plans suddenly crumble into a dark void that includes abject business failure. People sometimes hurt themselves and others when even choosing to do the right thing leads to ruin. A person with any compassion can tell from reading the dentist’s plea for help that the newer harsher penalties from HHS and state Attorneys General for data breaches will only further destroy the lives of innocent dentists and their families. HITECH is cruel nonsense in dentistry and ADA leaders are stone-cold heartless.

Although encryption is strongly advised in the “ADA Practical Guide to HIPAA Compliance,” If ADA officials dared to keep track of their failure in promoting safe digital dental records, I bet their own data would show that less than 3% of US dental patients’ PHI is encrypted. Yet proud leaders in my profession remain stoically unresponsive to members’ and patients’ concerns about risks of data breaches. They call their aloofness “professionalism.” It infuriates me that shy ADA officials hide from personal accountability for the careless harm they cause dentists and dental patients.

“Image is everything” ADA/IDM slogan

The nation’s ambulatory healthcare providers – including dentists, podiatrists, chiropractic doctors and physicians – cannot continue to blindly trust our professional organizations to protect our practices from the dangers of the electronic health records they promote for their personal benefit. We’ve been sold out.


As far as I can tell, selfish ADA leaders with careers invested in dental informatics just can’t tolerate truth. When I consider the pain they cause at no risk to themselves, I say the parasites should be encouraged to move on down the road and look for their power in a field where they won’t endanger others.


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Are You Scared of Investment Losses?

Well Doctors – You Should Be!

By Somnath Basu PhD, MBA
President: AgeBander
Thousand Oaks, CA

There is a very simple way for medical professionals, and us all, to approach investment decision making. To start with, begin by asking yourself some basic and preliminary questions such as what is the investment for (to buy a house, to fund a kid’s education, or is it to fund retirement and the like) and how long these investments will last (for example, up to 40 – 50 years sometimes when one starts planning for retirement early).

Basic Questions

Once these basic questions are answered then ask this $64 million dollar question of your-self. Over your planning time horizon, how much of this money are you willing to lose? For example if you are trying to accumulate $100,000 for a house, how much could you afford to lose and still not lose your bearings? What if it is a five-year plan and in the 4th year you lose 50% of your accumulated funds with only one more year to go. How would you feel? This is the critical question in any investment decision. Typically you will not hear a financial planner [FP] or financial advisor [FA] talk in such terms; but perhaps they should!


Conservative Investing

When financial planners and financial advisors talk about conservative investing, they couch the same idea in terms of risk and return. In the language of these experts such measures are often quantitative and difficult to understand for the average investor. While return on investments seems like a fairly straightforward concept (8% or 11% for example), risk is mentioned usually in terms of standard deviation, a statistical terminology difficult both to explain and to understand. Hence, most physicians and investors are pretty much in the dark when it comes down to making the decision itself since it is their sole responsibility. Thus, the investor is left with no other choice but to decide on whether the suggested investment return sounds attractive or not. On this track, the higher the return, the more attractive the investment seems.

Furthermore, FAs may suggest that a return such as 8-10% is a conservative rate whereas 12-15% is aggressive. Hence if an 8-10% based investment is being suggested, the investor is likely to go with what she/he thinks is the most conservative decision, being the conservative investors they believe they are. (As an aside, there is a whole theory about physician investors being conservative and risk averse)

Unwinding the Mystery

To unwind this basic mystery, simply ask the FA the likelihood of various amounts of losses in any single year including the last year of the investment. Could half your funds be wiped out in any year including the last year? What is the likelihood of such an event? What is the likelihood that it could be 25% in any given year? Suppose your planner shows how your $100,000 will grow to $150,000 in five years if you were to earnings the average rate of 8% per year for five years. Under such a scenario, what is the likelihood that you could lose half your accumulated funds in the last year and come out with a negative investment return even though you still earned that 8% average rate over the five years? As we know now such possibilities not only exist but are not uncommon either. As an extreme case in point consider the 2008-09 financial debacle [flash-crash]! If your investment was maturing in 2009, the outcome would have been a lot worse.

The Driver of Concern

This concern of loss is what should drive us in our investment decisions. Most planners are unable to explain this concept of loss aversion to their clients because they themselves are not adequately educated to understand the concept themselves. However, as mentioned before, the solution is simple. Now reconsider the example above of earning an average annual rate of 8% over 5 years. While it sounds conservative on the surface, it is actually quite aggressive. Earning 8% a year for five consecutive years (or averaging out over the five years to an 8% rate) is a very tall order. To do so, especially under most circumstances, one would actually be exposed to a large amount of loss in any given year.

Without getting into the details of how the standard deviation measurement of risk converts into the loss propensity and using very rough estimates, another way to view the 8% investment opportunity is to understand that in any year, you may not even earn a dollar (0%) and this could happen in each and every year. The likelihood of such an outcome is astonishingly high – about 25%. Thus, the investment decision is about whether you are willing to bet where the odds of loss is one to four (25%) every year for each of the five years. Of course the reverse is also true that in each of the years you have a 75% chance to  earn a positive return on your investment and the earning rate itself could be anywhere from zero to the highest rate imaginable. Further, there is a 12% chance that you could be actually losing 8% a year for each of the five years! In prolonged economic downturns, which are not so uncommon, such are the outcomes. Now ask yourself this question: If you were told about these odds of losses, would you still consider the 8% investment opportunity to be conservative? Hopefully not, especially when you feel unsettled about the existing economic state of affairs. Further, would you consider a 10% return to be attractive and conservative if you were rejecting a 15% investment and choosing the 10% one?


As mentioned earlier, this idea of loss aversion is probably the most powerful tool in the investor’s bag. Once you understand the implications of loss from any investment decision, then the loss aversion approach to making this decision is a dimensional shift, something that can be easily understood and applied by all investors. Furthermore, if most physicians and investors behaved similarly, collectively we would make the investment market a much safer place. Unfortunately for now, there are no known ways of educating all investors about this critical aspect since the tools that currently exist are all based on statistical concepts of risk and return which make little sense to most lay investors.


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