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Monday, December 29, 2008

Aggressive or Overtreatment

In an interview a Small Smiles lead dentist, Aldred Williams said:

"We aggressively treat these children to eliminate disease in their mouth. Small Smiles makes no apologies for that. I'm not going apologize for being aggressive," Williams said.

The word 'aggressive' really bothers me. What's worse is to think thats the 'training' the dentists get (could call in brainwashing I suppose).

I guess a person could insert "overtreat" in place of "aggressive" couldn't they an it still have the exact same meaning.

Of course I don't think Dr. Williams is there any longer after saying that publicly to the mainstream media.

I got this particular quote from the Good Morning America story on Small Smiles, but it was said in the interview with Roberta Baskin at WJLA aas well, I believe.

Here are other quotes from the Good Morning America and WJLA TV story:

1. Former Small Smiles dental assistant, Deborah McDaniel, said she was fired for objecting to the way children were being handled.

2."They wanted us to tell parents that they needed services on teeth that were healthy," McDaniel said. "They were healthy and they didn't need it."

3. "It's a competition throughout the country to see who can convert the most patients, not give the patients the most care," said Trina Crosby, another former Small Smiles employee.

4. The pressure to convert patients may come from FORBA. In fact, every morning Dr. Williams and his staff review the production goals set by the managers in Colorado.

7."They're sweating. Sometimes they urinate on themselves. They'll throw up," Crosby said.

5."It does no good for anybody but the dentist, I guess, who's looking for a bonus," said Robert Camps, a nationally recognized authority on pediatric dentistry whose Maryland practice serves mostly patients on Medicaid.

6.When Camps saw video of Miguel's dental visit, he was disturbed deeply. "It's traumatic for me to watch. I can only imagine how traumatic it is for Miguel," he said.

7.FORBA, the company that owns Small Smiles, said its dentists and staff are sent to its Colorado offices for training. (but I hear only the "lead" dentists are sent for training)

There were 158 comments on this story, you can read all of them here.

Here are just three:

1. I think ABC news should do an undercover investigation on the Small Smiles chain. I mean in every clinic. In one month's time, you would uncover mistreatment of children, insurance fraud, ADA violations, etc. As someone mentioned before - when a new doc joins a clinic and are yet to be accredited with an insurance company - other docs sign off on the chart and the insurance is billed under the signing dentists name. BTY - although it was never publicized, the chain is now within the 'portfolio' of a middle eastern bank. In other words, FORBA and Small Smiles is actually owned by a Bahrainian business group. There is so much more I could say - I can only pray that this story does not wither away. I would love to see the Federal Government step in and conduct an indepth chart by chart audit at every Small Smiles site.

2. I will join the ranks of the 'former employees'. I my year and a half at Small Smiles, I saw and heard so much abuse to children, that I actually developed an ulcer. I fought on a daily basis about the manner in which the docs, assistants, and hygienists were allowed to speak to the children. I witnessed the lead doc getting about 6 inches from the face of a crying, terrified, restrained child and yell at the top of his lungs, "That's enough. Stop being a punk." We were often directed to separate siblings. Especially older siblings that would overhear any yelling at their younger sibs. Competitions on converting....any employees remember "The Road to the Superbowl"? We were also trained to forbid parents in the back clinical area. If the parent balked (especially when there was a several thousand dollar treatment plan), the lead doc, in all his arrogance, would have me escort the parent to a consultation room, and proceed to tell the parent that dental work is just as serious and important as heart surgery and that they wouldn't be allowed in the operating room. WTF ever! The insurance fraud is OUT OF THIS WORLD!!! I was instructed to bill for prophys (cleanings) when all that was done was about a 2 minute tooth brushing with some toothpaste. No prophy angle, no scaling, nada. But I was told to bil a full prophy. I questioned that so much, I was actually told that if I asked and further questions and/or 'stirred the pot' any further, my job would be in jeopardy. I do have to add, that the original FORBA was much more caring than the 'business men' that bought FORBA at the end of 2006. The 'new' management was PURELY about the money. The 'old' FORBA cared about its employees and patients. The new FORBA - in an email that was accidentally forwarded to me had these requirements for a dentist - 'if she isn't cross-eyed and has all 10 fingers, let's make her an offer' sadly, I regret not forwarding that email to the dentist in question.


3. I am an employee at a pediatric dental office and very, very familiar with Small Smiles and their practices. Before you judge them you have to look at all angles of the situation. I live in Colorado, and here, there are so many loop holes and in dentistry and things that are not regulated in dentistry that that in itself should be a crime and the state of Colorado should be looking at that and not just be pointing the finger at Small Smalls. Each clinic is so different that you can not judge all of them as a whole. They are a corporation but they are run individually and some by a bunch of morons who don't know dentistry from gardening. Others of the clinics are run by a fabulous staff who really know their patient care, legalities, and methods. The sad part is knowing who is who. I stand up for Small Smiles because I have so many friends in the dental community who work at great clinics and others who work at ones who honestly do not know how to treat their staff or their patients. Like I said above, you can not only point your finger at the clinics. You have to look at the laws and you have to look at the parents who bring their children in. Until I became a CDA - EFDA I did not even know that baby crowns and root canals existed for two year olds, and I did not think that a 14 year old mom with three other kids was going to be handing me this child to do the work on... so you tell me when this 2 year old is screaming and crying after riding on the bus an hour from home with his mom and other 3 brothers and sisters in the cold of you are going to have mom come back to the room with all the other kids???? or tell me that you tell me that you are going to have a meth addicted parent come back and try to calm their child when THE PARENT keeps saying shut up and sit in the chair. Please do not get me wrong either, I am not saying that anyone is a bad person if they are on Medicaid at all, never would i say that.


Monday, December 22, 2008

Virginia Releases December 2008 Smiles For Children Report

Virginia's Smiles For Children December report is out. It appears the enrollment of dentists is up 80%.

In the report it talks about the use or over use of papoose boards;

"The practice of behavior management techniques during necessary dental treatment of children has also been a continual focus of the Smiles For Children program. Inquiries have been received by the media and parents of dental patients regarding behavior management techniques, specifically, protective stabilization through the use of papoose boards. Papoose boards are devices commonly used to immobilize children for dental work. If performed improperly, trauma to a child may result.

According to the American Academy of Pediatric Dentistry, protective stabilization is an approved method of behavior management, and pediatric dentists receive behavior management training during post graduate education. These techniques are allowed under the scope of practice,
as defined by the Virginia Board of Dentistry, for licensed dentists in Virginia."

Here is the sticky part of this, hardly any dentist who work in these dental mills like Kool Smiles, Small Smiles and others are NOT pediatric dentists most are general dentists. I notice Dr. David M. Strange, DDS MS is still listed as one of the Advisory Committee, you may remember him from Kool Smiles.

Friday, December 19, 2008

Kool Smiles Pays U.S. Over $1Million

Dental Clinic Business Settles $1 Million Claim

December 19. 2008

NBC WYFF TV, Channel 4

GREENVILLE, S.C. -- An Atlanta-based dental healthcare provider with clinics in Sumter, Anderson, and Greenville has agreed to pay the United States more than $1 million to settle a claim.

Kool Smiles PC, Inc. was accused of billing Medicaid for the work of an unauthorized dentist in the Sumter area.

The dental health care provider agreed to pay a total of $1,360,528 to resolve allegations that it submitted claims to Medicaid for services provided by the dentist who had previously been excluded from all federal health care benefit programs, including Medicaid.

The dentist in question was disqualified for Medicare funding because she had failed to repay more than $22,000 in federal student loans, according to U. S. Attorney Walter Wilkins.

Under the agreement, Kool Smiles will repay all the money it received from Medicaid for the services provided by the dentist after she was excluded, plus interest and investigative costs.

Under the settlement agreement, Kool Smiles will repay all the money it received from Medicaid for the services provided by the dentist, plus interest and investigative costs.

Wednesday, December 17, 2008

Parents Comment on WAVY TV Report

Click here to read even more of the comments from parents after WAVY TV reporter Derrick Rose reported on Kool Smiles in Virginia

Tuesday, December 16, 2008

Louisville Small Smiles Clinic Owner Not Mentioned in Press Release

Over at FORBA's weblog they have an entry where they had an open house for the Small Smiles Clinic in Louisville, Kentucky.

Melanie Abrams was mentioned as Co-Lead Dentist ('lead dentist': a term used a lot at Small Smiles) but through the whole article the owner of the clinic wasn't mentioned, just Forba and lead dentists.

You would think if a dentist opened a new dental clinic his name would be mentioned.

According to Kentucky Revised Statues (KRS) 313.240 states:

(1)(a)"No person shall practice or offer to practice dentistry or dental surgery under the name of any company, association or corporation except the name of a professional service corporation. Any person practicing or offering to practice dentistry or dental surgery shall practice under his or her own name; the name of the professional service corporation, professional limited liability company or partnership which includes his or her name, or the name of the deceased or incapacitated dentist for whom the person practicing dentistry has contracted to perform continuing operations."

(b) No such person shall conduct a dental office in his or her name nor advertise his or her name in connection with any dental office unless he or she personally performs services as a dentist or dental surgeon in such office or personally supervises such services as are performed in such office during a portion of the time such office is operated by him or her, and shall not use his or her name in connection with that of any other dentist, except as provided for deceased or incapacitated dentists in KRS 313.197

(c) No person shall be an incorporator, director, officer, member, manager or shareholder in more than three (3) professional service corporations, three (3) professional limited liability companies, or three (3) partnerships, or any three (3) of these business entities, rendering dental or dental surgery services. No dentist or dental surgeon or group of dentists or dental surgeons shall practice in more than three (3) locations.

So Jodi Kuhn couldn't possibly be the owner of this clinic, it's said she owns 4 or so in Ohio. Who could be the owner of this Louisville clinic?