The “Selling-Out” of a Profession [Dentistry]?

Posted on November 11, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

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Dentistry …?

[By D. Kellus Pruitt DDS]

1-darrellpruittSeveral years ago, a president-elect of the American Dental Association proclaimed, “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 News, October 2008).

Looking back, it is easy to recognize the ADA’s renegade capitulation to HHS as a warning sign of things to come.

The ADA is the same national healthcare institution whose leaders joined Delta Dental in persuading dentists to volunteer for HIPAA’s NPI numbers – never revealing what they are to be used for. It’s the same not-for-profit Chicago corporation which continues to protect non-dues revenue by misleading the nation about the “savings and convenience” of EHRs in dentistry. Among all healthcare organizations, the ADA is alone in their enthusiasm for EHRs and Meaningful Use requirements.

And to top it off, the ADA leadership has progressively become less accessible by the community it serves – NEVER entering into open discussions of urgent dental issues on the internet, even to the extent of ending its commitment to answering dental questions for visitors to Dr. Oz’s Sharecare.com. It’s only dentistry for crying out loud!

As a matter of fact, Dr. Maxine Feinberg, the new ADA President, recently suggested in an interview with the ADA’s Judy Jakush that telephone conversations are “The best kept secret of the ADA which members don’t understand.” What?

Dr. Feinberg: “The best-kept secret is that if you have a problem or complaint, you will likely walk away with a positive experience. And, on the rare occasion that the staff can’t help you, there is a good chance that you will speak to Dr. Kathy O’Loughlin, the executive director. That’s amazing customer service.”

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Insightful or clueless dentist?

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What’s not to understand? I understand that ADA membership numbers have taken a hit over the last few years, but nevertheless, the dues of a little over 150,000 dentists still help pay the salaries of ADA employees. That’s a lot of phone calls that will have to be transferred to the right person (the first time), scheduled to call back later or be completely ignored. Isn’t email, or even the US Mail a better idea? Or is lousy communication (unaccountability) with dentists and patients the goal?

About that NPI number

How do you feel about the ADA leading the effort to assess and report your value to your community without ever stepping into your office or talking with a satisfied patient? When you volunteered for your National Provider Identifier at the insistence of the ADA and Delta Dental, you agreed to CMS terms. What? Nobody mentioned that?:

“Spread the mission of the DQA – The DQA, formed in 2008 through a request from the Centers for Medicare & Medicaid Services, is comprised of multiple stakeholders from across the oral health community who are committed to development of consensus-based quality measures.” By Kelly Soderlund for the ADA News, November 3, 2014.

Does “multiple stakeholders” sound as costly to you as it does to me, Doc? I say we already have too many stakeholders. What about the principals (dentists and their patients) who pay the stakeholders’ bills?

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eHRs

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Does anyone disagree that DQA looks like the ADA’s desperate mission creep for cash? With the chronic drop in membership, the Chicago corporation has turned to vigorous pursuit of non-dues revenue – probably in the form of federal grants and stimulus money from HHS. The ADA (which prefers clumsy communication via telephone), is asking state and local dental leaders to put their own personal credibility at risk by persuading uninformed dentists to unquestioningly accept multiple stakeholders’ assessment of their value to society – just like clueless dentists cooperated in the NPI effort.

Dr. David Schirmer, chair of the DQA’s education committee, tells ADA News: “Eventually, all of dentistry will need to understand quality measures. But before we reach our grass roots membership, we need our leaders in dentistry to understand.” He adds, “I’m challenging those leaders to pave the way for their younger colleagues and help them understand the long-term impact this will have on dentistry.”

ADA Editor Soderlund: “The DQA has taken the lead on developing quality measures within oral health care. These measures touch every practicing dentist in the United States, and with dentistry, how it’s modeled and how it’s financed changes in the future — specifically as a result of the Affordable Care Act — they’ll become even more prevalent. The mission of the DQA is to advance performance measurement as a means to improve oral health, patient care and safety through a consensus-building process.”

“— specifically as a result of the Affordable Care Act —“ Since you never respond, ADA, how do we know you haven’t sold us out once again for taxpayers’ money?

Assessment

If it’s difficult for the ADA to hold onto membership now, just wait until the nation’s dentists figure out that Obamacare cannot give everyone A’s on their internet report cards. This means the majority of dentists are going to be pissed at the ADA for their bad grades, no matter what.

Conclusion

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On Delta Dental and the National Association of Dental Plans

Posted on August 19, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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ADA News Tries Sarcasm

[By D. Kellus Pruitt DDS]

For fear of retaliation, ADA officials are reluctant to admit that Delta Dental and other members of the National Association of Dental Plans (NADP) have traditionally used the FTC as a tool to intimidate our professional organization. This means that for decades, the federal government has prevented the ADA from adequately representing the interests of dentist members. Something interesting happened in the ADA just days ago that is related to this tyranny. I assume frustration in the ADA’s unfair struggle against both Delta Dental and the FTC caused the editor of the ADA News to recently permit sarcasm for the first time in history – perhaps to attract attention to Delta’s policies?

A Humorous Article 

On August 9, ADA reporter Kelly Soderlund was given the green light to post an uncharacteristic, tongue-in-cheek introduction to her article, “Decision supports Massachusetts Dental Society insurance challenge.” http://www.ada.org/news/4558.aspx She sold it: “For nearly 40 years, Massachusetts dentists have had to abide by a regulatory order that allowed Delta Dental Plan of Massachusetts to receive an additional 5 percent discount off reimbursement fees in addition to other plan discounts.” Soderlund continues, “More than a decade ago, the Massachusetts Dental Society tried to get the order lifted but was unsuccessful. But now, after a reinstated five-year battle, the New England dentists can claim victory.”

OK. I lied.

In spite of her unintentionally humorous description of the Massachusetts Dental Society’s ineffectiveness, Soderlund was actually not sarcastic. That’s right. The ADA indeed hails this (very qualified) success as a long-fought glorious victory for dentists in Massachusetts where 95% of them are Delta preferred providers. That can’t be good for the health of Massachusetts dental patients. Managed care dentistry is dentistry by the lowest bidders with no quality control, and patients notice. Some stop going to the dentist, causing Delta Dental to reap even more profit. That is why it is not in Delta’s interest to satisfy their clients, and the employers who purchase Delta’s plans are clueless. This makes Delta Dental unaccountable to anyone.

The Delta Business Model 

Delta’s business model helps make the company one of the most unfair discount dentistry brokers in the nation, in my opinion. If you want proof, go to doctoroogle.com and visit any major city.

http://www.doctoroogle.com/dentist_ratings.cfm/pageID/2 Then compare dental patients’ ratings of Delta’s preferred providers to fee-for-service dentists’. In the numerous studies I’ve performed, Delta’s dentists’ average satisfaction level as determined by their patients is consistently inferior to fee-for-service dentists. (See Managed Care Report Card from November 10, 2008).

http://community.pennwelldentalgroup.com/forum/topics/transparency-and-managed-care?commentId=2013420%3AComment%3A19577

Delta Accountability? 

As you can see, since the FTC inhibits the ADA from honestly telling our story, dental care principals desperately need the ADA to open our Facebook so Delta can be held accountable to dentists and patients. Otherwise, Delta will never assume responsibility for the dental homes its preferred provider lists break apart – more often than not, sending their clients to less satisfying offices. What’s more, even Delta officials admit that “changing dentists causes fillings.” (See “Managed Care or Dental Homes – You can’t have both,” September 30, 2008)

http://community.pennwelldentalgroup.com/forum/topics/2013420:Topic:14014

FTC Fear 

If dentists and patients are not permitted to tell our story ourselves through the nationally recognized American Dental Association, we will always be 40 years behind Delta Dental and 5% short of what they owe us. Even though ADA leaders will forever be handicapped by fear of the FTC, individual Americans have nothing to fear. The failure of the Massachusetts Dental Association shows us that an ineffective ADA is worse than no ADA at all because a victory after 40 years is defeat.

MDA Victory 

One can read from Soderlund’s words that the Massachusetts Dental Association’s “victory” didn’t even slow Delta down. She writes “Delta Dental of Massachusetts has informed the ADA that the new reimbursement methodology will include the development of regional fee schedules. Information on exactly how those regional fee schedules will be developed and how that will affect dentists’ reimbursement has not yet been made available.” Whatever methodology Delta’s actuaries come up with, you can be sure it will be biased against their clients’ interests and will more than make up for the 5% of principals’ money that they conceded after 40 years. We simply must face the fact that the ADA isn’t helping. Soderlund continues: “The company also announced a new voluntary program to compensate dentists for successfully managing the care of higher risk patients. Delta Dental has not yet explained how that compensation would take effect.”

Assessment

Do you trust a Delta Dental consultant – who works on commission – to decide what is best for your patient? Or are you ready to demand that the ADA open our Facebook so we can all tell Delta Dental what we think of their unfair practices on an individual basis guaranteed by the First Amendment? Our patients depend on us to protect them from harm caused by greedy stakeholders. As Soderlund describes it, we’re losing, but not without humor.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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