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Can Americans Trust the ADA?

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Trusting the American Dental Association?

[By D. Kellus Pruitt DDS]

In January 2011 – the same month a new Minnesota law demanded dentists purchase e-prescription software whether they want it or not – the ADA Standards Committee on Dental Informatics published White Paper No. 1070: “Implementation of the Electronic Prescription Standard for Dentistry.”

Minnesota lawmakers who logically turned to the respected ADA for what they expected to be reliable and unbiased professional advice, were assured by the Committee that e-prescribing  will not only “insure the elimination of illegible prescriptions” but it will also “reduce preventable errors such as drug to drug interactions, drug-allergy reactions, dosing errors, therapeutic duplication, and other error types.”

http://www.ada.org/sections/scienceAndResearch/pdfs/ADA_White_Paper_No._1070.pdf

Really, ADA? On what evidence did the ADA Department of Dental Informatics base their self-serving claims?

This week, MedicalNewsToday.com reporter Christian Nordqvist posted “11.7% Medication Error Rate In E-Prescribing,” which directly contradicts the ADA’s advice to trusting Minnesota lawmakers and ADA members. Nordqvist writes: “The chances of mistakes occurring in prescriptions sent electronically are no lower than in those written out by hand, a researcher from Massachusetts General Hospital in Boston wrote in the Journal of American Medical Information Association. This will be a disappointment for health reform experts and policymakers [and ADA officials] who assured that E-prescribing would have fewer medication errors, as well as saving the government billions of dollars.”

http://www.medicalnewstoday.com/articles/230296.php

If one considers the JAMIA a credible Journal, research clearly suggests that e-prescribing is a bust for physicians who write many more prescriptions than dentists. Yet ADA officials continue to encourage dentists to adopt paperless practices without mentioning that e-prescriptions not only produce just as many errors as paper, but that they are hundreds of times more expensive because of the cost of computers, software and HIPAA requirements.

In addition, if a dentist’s computer is stolen or hacked – even if he or she properly reports a breach of e-prescription records – the tragedy can easily bankrupt a practice between the HIPAA fines, state attorneys general lawsuits, patient notifications and local media coverage of the breach (as required by HIPAA/HITECH). The Ponemon Institute estimates the cost to be over $200 per dental patient. And the price is only increasing. I just read that HHS is to conduct 150 HIPAA audits in 2012. Ka-ching!!!

https://www.fbo.gov/index?s=opportunity&mode=form&id=9e045aa4f7e6f8499c5b6f74d5b211e9&tab=core&_cview=0

That announcement from HHS should also conveniently boost sales of “The ADA Practical Guide to HIPAA Compliance” (on sale now at ADA.org for $220 while supplies last).

Sounding the Alarm

I personally started warning ADA leaders about this over 5 years ago. Yet as far as I can tell, they continue to blissfully ignore the IT disaster in dentistry. They don’t have to listen to nobody. And it shows.

As illogical as it sounds for an organization whose only purpose is to serve the interests of dues-paying members, the ADA hasn’t a single “vetted” EDR expert who will allow him or herself to be accessed on the internet. One such rumored expert is long-time ADA Trustee Dr. Robert Faiella. Since the Osterville, Massachusetts periodontist is so secretive with the ADA members he serves, like Soviet leaders of the 1970s, it’s hard to tell for sure if he is still in power or even alive.

Suspiciously, in these days of rapidly-expanding openness through social networks, the ADA cannot even contribute experts’ answers to Sharecare.com as promised – much less open a Facebook with over 12,000 waiting fans. So instead of ADA members’ questions about e-prescribing being answered by ADA experts on a convenient venue like a Facebook, ADA members must turn to irrelevant, Committee-approved publications… just like the Soviet Union of the 1970s.

I have personally found it is easier to obtain responses from my US Senator John Cornyn than from shy ADA officials. But then, I’ve discovered that Senator Cornyn is a remarkably caring individual. Not an evasive not-for-profit apparatchik with nice teeth.

Assessment

How long before dentistry’s handful of entrenched ADA leaders apologize for the harm they’ve caused and stop deceiving Americans about electronic dental records? It’s the least Dr. Robert Faiella could do before resigning his ADA position.

As long as obsolete ADA officials wink at a bankrupt policy of deception, can the reclusive not-for-profit organization ever regain America’s trust?

Conclusion

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13 Responses

  1. Millions Lack Access to Dental Care

    Fewer than half of Americans see a dentist each year and millions live in areas where access to dental care is severely limited, a new analysis from the health policy group Institute of Medicine (IOM) finds. A severe shortage of dentists, especially those serving rural and minority groups, is contributing to the “persistent and systemic” barriers to oral health care, the report noted.

    According to the report:

    ** 33 million Americans live in areas that are underserved by dental health professionals.

    ** 4.6 million children went without dental checkups in 2008 because their families could not afford them.

    ** In 2006, almost two-thirds of retirees (62%) did not have adequate dental coverage.

    http://www.webmd.com/oral-health/news/20110713/millions-in-us-lack-access-to-dentists

    Mary

    Like

  2. Business deals that are fair for everyone could solve that problem in the land of the free. Solutions that sound too good to work, don’t.

    Darrell

    Like

  3. Considering that the ADA is American dentists’ “one” voice in Washington DC, does anyone else find it alarming that after 2 months, the very President of the American Dental Association has only 9 Facebook fans and almost as many unanswered comments?

    https://www.facebook.com/pages/Raymond-F-Gist/165275266868843

    The undeniable fact that not one ADA official has enough confidence in their President to support him on the internet is solid evidence that there is no leadership in the ADA. The ADA House of Delegates abandoned Michigan dentist Dr. Raymond Gist long ago. If I were Dr. Gist, I’d be pissed.

    Darrell

    Like

  4. The Bad Dental Economy

    Dentistry, once thought recession-proof, has become a casualty of the tough economy. Americans increasingly see dental care as a luxury, even though neglecting their teeth can lead to serious health hazards, including heart disease.

    Dentists say many patients no longer can tap equity in their homes to pay for implants and other elective treatments. Bank financing for dental work, long a popular way to pay for care, has dried up as lenders stiffened loan standards.

    http://www.latimes.com/health/la-fi-dental-recession-20111201,0,5394632.story

    Pity the dentists? I think not!

    Mary

    Like

  5. Dentists are mostly sole-proprietor small businesspeople who must individually shoulder the burdens of a bad economy that hurts them as well. What’s particularly stressful for some is the belief that they must keep up the appearances of immense success in order to attract patients. And indeed, a dentist cannot afford to look too hungry for business.

    Undoubtedly, some are feeling trapped and alone. Being a small businessperson can be very stressful these days, no matter what business one is in.

    D. Kellus Pruitt DDS

    Like

  6. Proots’ Hypothesis:

    Each time a question is ignored, interest in the answer builds exponentially until the pressure reaches a breaking point for bureaucrats hiding in the corner with their fingers in their ears.

    Background:

    In the last 7 months, ADA-approved experts on Sharecare have never responded to my repeated question: “Are EDRs more dangerous or less dangerous to patients than paper dental records?” I hate to have to bother anyone, but my hypothesis simply cannot be tested without the help of at least one volunteer from the community. Would you please consider fronting the question for me?

    http://www.sharecare.com/group/american-dental-association

    Test:

    Let’s pump up the interest in patient safety until ADA leaders can no longer ignore concerns about identity theft from dental offices. I think such a conversation is much more likely to help our community than harm it. Don’t you?

    Results:

    If one or more of your questions are ignored like mine are, that would arguably confirm the worse: ADA leaders conspire to hide the danger of EDRs from dentists as well as patients for reasons that simply must be shared publicly. It’s common sense that such summary disrespect from ADA leaders would be more ominous than even the wrong, self-serving answers that I expect to happily shoot down.

    If ADA leaders indeed respond to you, but not me, I may be hitting on you again from time to time for more help. Other huge, insensitive dinosaurs in our community have been hiding from climate change far too long as well. Transparency in the ADA will be an incredible shock, but fun as hell to watch.

    Here’s something that favors answers: Until the end of the year, the ADA is sponsoring a contest between Sharecare dental experts to stimulate more membership participation in Sharecare from membership.

    http://www.ada.org/sharecare.aspx

    “Already an ADA Sharecare Contributor? Answer the most Questions and Win an HP Notebook Personal Computer. Beginning October 1 – December 31, 2011, the ADA Sharecare Contributor who answers the most oral health questions on Sharecare.com wins an HP 635 Notebook PC*. Visit Sharecare.com and start answering questions today!”

    If you want to help out, this is also a good time to ask ADA experts how much money patients can expect to save on dental care because of EDRs. Don’t worry. It’s a perfectly reasonable question to ask.

    Results:

    Since even no response reveals important information about the ADA’s allegiances, I’ll consider the test a success if only one friend asks Sharecare if EDRs are safer than paper dental records.

    On the other hand, perhaps the chance to win an HP Notebook Personal Computer will be enough incentive for numerous experts to risk telling the unpopular truth: Data breach liabilities are becoming so bad and Congress is becoming so angry that the cost of HIPAA compliancy alone may drive dentists back to ledger cards and pegboards. According to Ponemon, an estimated 96% of healthcare organizations have suffered breaches of patients’ Protected Health Information in the last 2 years, and EHRs now go for $50 each on the black market.

    Please, please ask yourself why it’s not the ADA warning you about this instead of me… But then, I really don’t mind.

    D. Kellus Pruitt DDS

    Like

  7. ADA Secrets

    I’m disappointed for dental patients, yet impressed with my colleagues’ respect of ADA secrets.

    I don’t mean to get pushy, but so far nobody has shared with me what the ADA said about electronic dental records that they don’t want dental patients to read. Since I’m not a member, I cannot log onto the website to fact-check the article. I need help.

    https://www.ada.org/ada/login/loginv2.aspx?ReturnUrl=%2Fmembers%2F6212.aspx

    I find it impressive that not one ADA member has yet broken ranks even anonymously to share the details of the ADA’s secret article describing the “pros and cons” of EHRs among other things. Do you think members’ fear of the ADA promise to prosecute those who distribute their copyrighted material (without express written permission) is keeping the secrets safe? Or is the impressive cohesiveness simply a reflection of dentists’ unquestioned loyalty to even the bent mission of the ADA? Or is unresponsiveness to my request perhaps nothing more than uncomplicated indifference among ADA members?

    Look around. There’s no one else out here. It should be obvious that if I’m not allowed to see what ADA leaders are hiding, it’s very unlikely that anyone will ever scrutinize what naïve dentists are being told by stakeholders who already have a long history of reckless, self-serving bias favoring dangerous and expensive EHRs over common sense.

    Few in the ADA seem to recognize that it’s the absence of personal accountability in the not-for-profit that continues to erode its credibility in the community. Not me.

    D. Kellus Pruitt DDS

    Like

  8. I think I’ve pissed off an adequate number of dentists and shy stakeholders today!

    I had time to burn today, so between checking hygiene patients I was a wise ass on the internet.

    I started by posting an ominous warning from Kroll Cybersecurity on Dental Economics Facebook in response to a Dentistry iQ press release written by Chris Salierno DDS promoting cloud computing that did not once mention security… well, other than to promise that Dentrix software, which allows dentists to access their schedule and patient data from mobile devices, is “fully compliant with HIPAA,” and that even though the Department of Defense cannot prevent hacker attacks, “this cloud will only be accessible by the appropriate people.”

    Where should I start disassembling Dr. Salierno’s basic misconceptions about the business of dentistry?

    First of all, as everyone other than the author knows, mobile devices have proven to be the weakest link in security so far, and the number of breaches of patients’ PHI they cause is increasing rapidly. Secondly, Ryan Beardall, Dentrix’s Support Operations Technical Mentor, has told me twice on Dentrix Facebook that security is the dentists’ problem, not Dentrix’s. Thirdly and most importantly, in 30 years of practice I cannot think of a single emergency when I needed to know my schedule or my patients’ history while away from the office. Considering the increasing and unnecessary risk of harm to dental patients caused by medical identity theft from mobile devices compared to their miniscule benefit, they are counter to the tenets of the Hippocratic Oath.

    “Companies are smartly embracing the cloud for the associated cost savings and ease of use. Unfortunately, current surveys and reports indicate that companies are underestimating the importance of security due diligence when it comes to vetting these providers. As cloud use rises in 2012, new breach incidents will highlight the challenges these services pose to forensic analysis and incident response and the matter of cloud security will finally get its due attention.” (See: “Kroll Announces Top Ten Cyber Security Trends for 2012” Kroll Cybersecurity, December 14, 2011

    http://www.krollfraudsolutions.com/about-us/press-releases/kroll-announces-top-ten-cyber-security-trends-for-2012.aspx

    Shortly afterward, in response to an Medical Executive-Post editor’s invitation for favorite medical jokes, I posted: “Without looking up from his work, a proctologist mutters, ‘Damn I’m glad I’m not a dentist.’” (I was going to share the joke about the doctor’s check-up and the old, partially-deaf man’s shorts. But there was decorum to consider).

    Later, I returned to Dental Economics Facebook to again highlight the increasing risk of EDRs: This just in. Dentists cannot depend on Dental Economics, Dr. Gordon Christensen’s CR Foundation or the ADA to warn them that patients in small practices (like dental offices) run a higher risk of identity theft than anywhere else. I’ve got your back, Doc. (See: “Small Medical Practices More Susceptible to Health Data Breaches,” January 17, 2012).

    http://www.ihealthbeat.org/articles/2012/1/17/small-medical-practices-more-susceptible-to-health-data-breaches.aspx

    Finally, I posted the following wise-ass remark on several Facebook Walls in addition to Dental Economics’: If ineffective safety requirements and irrelevant documentation busywork force high-tech, HIPAA-covered dental practices to hire employees with specialized coding, security and other IT skills – and if EDRs do nothing to improve the quality of dental care – how will paperless practices ever compete in the marketplace with carbon paper practices which can hire Baby Boomers forced out of retirement? After all, filing away dental charts pays better and is much more stimulating than being a Wal-Mart greeter, and it doesn’t take specialized training.

    (See: “IT Employee Skill Sets, Encryption Should Be Major Priorities for CEs”)

    http://aishealth.com/archive/hipaa0112-04

    I think I’ve pissed off an adequate number of dentists and shy stakeholders today. Don’t you?

    D. Kellus Pruitt DDS

    Like

  9. The California Dental Association Censors Dentists

    Bad news, John. Your criticism of Delta Dental has been censored by an anonymous California Dental Association employee.

    Even though Delta cut payments to California dentists this summer, the CDA censored the link to the KMOV Channel 4 article you posted on their Facebook, titled “Delta Dental’s extraordinary executive pay and perks.”

    http://www.kmov.com/community/blogs/news-4-investigates-daily-briefing/Delta-Dentals-extraordinary-executive-pay-and-perks-138584994.html

    Rather than permit California dentists to read an investigative report about Delta executive’s questionable business practices, here’s the latest news approved by the CDA as worthy of members’ attention: “Deals and a chance to win an iPad – booth #430 at CDA, California Dental Association Spring Meeting.” – from Dental Tribune America, May 13, 2011. Who knows how many dentists have been censored by the CDA and other renegade ADA affiliates?

    https://www.facebook.com/pages/California-Dental-Association/112303385447601?sk=wall

    Other than deleting dentists’ criticism of Delta and other favored stakeholders, I don’t think the CDA moderator has to mess with the Facebook much at all. Even CDA members have no recourse when she exercises her anonymous power. Having a job where she cannot be held accountable for insulting even those whose dues pay her salary sounds like wickedly unethical fun to me.

    John, it’s simply impossible for well-meaning dentists like you and me to quietly discourage such rudeness from CDA employees when their cowardly bosses choose to hide from those they serve. So we must speak as loudly as it takes to get the good ol’ boys’ damn attention. It’s not only swell sport, but it’s the Hippocratic thing to do.

    With such amplification in mind, I was going to re-post the link to the KMOV article on the CDA Facebook to give her something to do this afternoon. Then I discovered that some time ago, she had already banned me from posting anything at all. Just like any badly-treated American consumer, I wanted to go over the employee’s head by demanding her name and the name of her supervisor. However, reclusive and unaccountable CDA officials are thinking ahead. They’ve strategically eliminated all their contact information from the internet – sort of like sitting in a corner with their fingers in their ears singing loudly, “La-la-la-la.”

    Wal-Mart employees aren’t as rude as CDA employees because for one thing, they wear name badges.

    D. Kellus Pruitt DDS

    Like

  10. Contact the ADA
    [Please help me encourage the ADA to be part of our community]

    Since the ADA joined Facebook over 3 years ago, it has attracted almost 20,000 fans. Even though ADA leaders still fear the dental community too much to invite Facebook discussions about dentistry, they recently started allowing fans to leave private messages.

    Please join me in asking leaders in the dental community to be more transparent with dentists and patients by simply opening the ADA Facebook for discussions about today’s issues. Your help is urgently needed and you know it’s the right thing to do.

    https://www.facebook.com/pages/American-Dental-Association/32252997166

    Look at it this way: If you and I don’t join together to demand the respect of our nation’s unresponsive leaders in healthcare, uninformed patients everywhere will suffer. And, whether you are a healthcare provider or not, everyone is a patient at some time or another.

    So please send your personal invitation to ADA leaders to join the community we share. After all, whose interests were they were chosen to serve?


    D. Kellus Pruitt DDS

    Like

  11. Political control of dentistry

    Political control of dentist/patient relationships – Freedom slips away on our watch, Doc

    A TIMELINE:

    200 years ago: “When the people fear their government, there is tyranny; when the government fears the people, there is liberty.” – Thomas Jefferson.

    http://www.monticello.org/site/jefferson/when-governments-fear-people-there-libertyquotation

    23 years ago: “‘We the people’ tell the government what to do, it doesn’t tell us. ‘We the people’ are the driver, the government is the car. And we decide where it should go, and by what route, and how fast. Almost all the world’s constitutions are documents in which governments tell the people what their privileges are. Our Constitution is a document in which ‘We the people’ tell the government what it is allowed to do. ‘We the people’ are free.” – Ronald Reagan

    (“Ronald Reagan’s Farewell Address to the Nation.” 1989).

    http://newlearningonline.com/new-learning/chapter-4-learning-civics/ronald-reagan-on-small-government/

    6 years ago: “If dentists don’t control quality, my MBAs will.’”- HHS Secretary Michael Leavitt

    (Address to the American Dental Association House of Delegates, “Health standard setting: ‘If the DDSs don’t do it, the MBAs will,’” ADA News, October 20, 2006).

    http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2177

    4 years ago: “The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’” – ADA President-elect Dr. John Findley (Interview with ADA reporter Judy Jakush, September 2008).

    http://www.ada.org/members/resources/pubs/adanews/081006_findley.asp

    Last week: “It’s the law.” – HIPAA stakeholder, justifying meaningless signatures on Notice of Privacy Practices (NoPP) forms doctors must maintain for years, that patients might not have even read. “Compliance is cheaper than HIPAA fines.”

    By extrapolating freedom’s apparent downward curve over time, what can you predict for Americans in the dental profession? Here’s a hint: HHS Secretary Michael Leavitt’s promise of tyranny is exactly what Jefferson and Reagan warned about, and it is as real as ADA President Dr. John Findley’s capitulation speech two years later. As for “It’s the law,” federal mandates naturally attract fearless stakeholders to the marketplace, and many don’t like dentists to begin with.

    In a related HHS quality (read “cost”) control effort, were you one of the dentists whom insurance companies unfairly forced to either volunteer for a National Provider Identifier (NPI) or not get paid? Or were you persuaded by ADA leaders who vaguely promised that the NPI would take the place of all those other pesky identification numbers (which it doesn’t)? If you are one of the 90% or so dentists who after carefully investigating the NPI, agreed to become numbered, sorted and graded, what was the deciding factor? Let me guess: Neither the NPI’s advertised convenience or the Hippocratic Oath played a greater role in your decision than respect for ADA leadership. Am I right?

    So years later, who is benefitting more from your permanent number? Your patients, insurers or the ADA Business Enterprise Inc., which earns millions (?) in dental coding royalties? Since the NPI does nothing to improve the quality of dentalcare, doesn’t that make its promotion outside the mission of the ADA?

    Is it possible that non-dues ADABEI revenue prevents dental leaders from recognizing that insurers are members’ business adversaries?

    D. Kellus Pruitt DDS

    Like

  12. ADA – a government tool?

    Like the CMS, the American Dental Association should never again be unquestioningly trusted by Americans

    Lured by the promise of bureaucratic power and non-dues revenue – including taxpayers’ dollars – the loyalty of entrenched, unaccountable ADA officials continues to shift from dues-paying dentists to the U.S. government.

    “Time to apply for May 1-2 [Dental Quality Alliance] Conference in Chicago – The goals of the conference include helping attendees develop a better understanding of how quality measurement and improvement are helping shape oral health care delivery and financing and developing dental quality ambassadors who can help lead change within the profession. The DQA was formed in 2008 through a request from the Centers for Medicare and Medicaid Services.”

    ADA News
    [March 16, 2015]

    http://www.ada.org/en/publications/ada-news/2015-archive/march/time-to-apply-for-may-1-2-dqa-conference-in-chicago

    Starting a decade ago, the ADA has become a tool of the U.S. government – increasingly deceptive to dentists, and unresponsive to Americans’ needs: Got your ADA-endorsed NPI number, Doc?

    D. Kellus Pruitt DDS

    Like

  13. Computers: The ADA’s latest cash cow

    Can non-dues revenue become a conflict of interest for a not-for-profit corporation? You bet!

    Selling Lenovo computers to dues-paying members has just joined The Dental Record and CareCredit to become the latest source of non-dues revenue for the secretive ADA Business Resources ™; and the latest competition for dental leaders’ attention to dentists’ and patients’ concerns about the cost and safety of the ADA-endorsed products they purchase (for a discount).

    http://shop.lenovo.com/SEUILibrary/controller/e/americandentalassociation/StdAffinityPortal/en_US/StdAffinity:Home?affinity=americandentalassociation&home=americandentalassociation

    ADA Business Resources Announces a New Endorsement!

    Lenovo Computers and Technology Products

    Enjoy great new technology options for home and your practice at deep discounts. ADA members will receive:

    • Instant savings up to 30% off Think, Lenovo and Yoga brand PCs.
    • Free ground shipping on all web orders
    • 24-hour technical support
    • Monthly limited time special offers

    Visit lenovo.com/ada or call 800.426.7235 ext. 4886.

    ————————————–

    What is job 1, ADA? Have you forgotten?

    “When we see something change that doesn’t make sense, we have to identify it and let the ADA know about it. Don’t roll over and take it if something doesn’t seem right. Your interpretation might not be accurate every time, but nobody who administrates or interprets the laws will be aware there are any issues to resolve if they’re never brought up.”

    Immediate Past President of the American Dental Association
    Dr. Bob Brandjord
    (ADA News, December 20, 2006)

    Drain the swamp.

    D. Kellus Pruitt DDS

    Like

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