In the Welcome Letter from Dr. R. Quinn Dufurrena as posted on the Dental Group Practice Association (DGPA) and the DGPA’s press release, I think it’s clear what the plan is for the group; more “creative” dentistry —i.e. teledentistry (whatever the hell that is)—and changing state dental practice acts to be more revenue generating friendly, despite any loss in patient quality of care. After reading excerpts of several articles and interviews with Dufurrena published over the years, it appears he’s wishy washy on many issues, other than teledentistry. Other than that, he will be whatever they need him to me. Of course, I could be wrong.
From Dufurrena’s Welcome Letter at the DGPA:
- Nearly 20 years ago, I first learned of the dental support organization (DSO) model.
- DSOs financial benefits, administrative capabilities and group structure truly resonated with me.
- I’ve practiced dentistry in many different arenas, from the military and government to private practices and the non-profit sector.
- …dental professionals are still unable to circumvent the financial and time limits that have restricted them for years.
- …problem that requires collaboration and unity throughout the dental community.
- It has become a mission of mine to help answer the many challenges dentists are facing in this economic and regulatory environment, and my first step is creating awareness on the advantages of the DSO model.
- …my course of action for DGPA revolves around three key contentions: ethics, metrics and innovation.
- …build on the DGPA’s current code of ethics.
- …offer innovative ideas to dentists around the country
- I believe with the help of our member organizations, we can achieve a level of awareness for DSOs that will diminish the misinformation that has plagued our model and shed new light on the success DSOs
From the March 3, 2014 DGPA Press Release:
- “Much as the Affordable Care Act strives to increase patient access to quality care through innovative approaches to the health care system, the DSO model strives to do much the same.” – Doug Brown, co-president of the DGPA
- “…confident that Dr. Dufurrena will lead our association during an exciting period of evolution in the field of dentistry, one where more dentists are shifting from solo practitioners to group practices and the DSO model” – Doug Brown, co-president of the DGPA
- Use of the DSO model has shown success.
- "Dr. Dufurrena's background – ranging from work as a solo practitioner working on policy for the ADA to serving as executive director of a state dental association – provides him unparalleled insight into the role DSOs and their supported dentists can and must play in helping to bridge our nation's growing dental divide" – Steve Thorne co-president of the DGPA.
- Beyond his chair-side duties, Dr. Dufurrena served an associate professor at the University of Colorado School of Dental Medicine and worked at the ADA as a Hillenbrand Fellow.
- Dufurrena will officially begin his role as executive director on March 3 and will be based in Denver, Colorado.
- "I've been committed to promoting and providing affordable, high quality oral health care throughout my entire career. These are the same values shared by all members of DGPA and their supported dentists.- Dr. R. Quinn Dufurrena
- "I am honored to have been selected and look forward to working with all stakeholders at the state and federal levels to help them better understand the role and value a DSO plays in supporting quality dental care to millions of Americans every year." Dr. R. Quinn Dufurrena
- He is replacing Dr. Ed Meckler who served as executive director since DGPA's inception.
Doug Brown is president of Affordable Care, Inc. Steve Thorne is president of Pacific Dental Services. Neither are dentists.
Dr. Richard Quinn Dufurrena hasn’t been interested in the actual practice of dentistry in years; if ever. But he has been interested in the business of dentistry. So he is going to fit right in the DGPA and the DSO business modeling they promote.
From the June 2008 article about Dr. Dufurrena’s Hillibrand Fellowship and him taking the position as Executive Director of the Idaho State Dental Association:
- The 12-month program comes with a stipend and focuses on non-clinical organizational experience and education and allows fellows to select a special project and area of study. It provides fellows with an intensive orientation to all ADA agencies and departments, orientation to other organizations serving oral health, a basic orientation to federal and state government agencies playing key roles in oral health, academic courses and project experience
- "When I started I had no idea of the massive amounts of resources that are here at the ADA."
- “…enamored with the idea of learning more about leadership in private sector organizations.”
- “intimidating going to work at what he refers to as "the power center" of organized dentistry”
- …compared it to a golfer working alongside Tiger Woods or Jack Nicklaus—people who have reached the top of their game, only instead of athletes, he works with some of "the best minds in dentistry."
- he spends part of the morning studying or researching some aspect of dentistry such as access or dental education.
- he tries to attend as many council and committee meetings as he can.
- spent time traveling and representing the ADA everywhere from Washington to California. He attended a teledentistry conference in Seattle and a dental consultants' conference in Scottsdale, AZ.
- During his first nine months, he audited business classes from the Northwestern University Kellogg School of Management, concentrating on leadership in organizations and negotiations.
- "I don't want things to settle down,"
- recently completed his law degree online and knows it will come in handy when studying or organizing teledentistry programs that cross state lines since just about "everything done in dentistry has legal implications."
- former peer review officer for the North Eastern Nevada Dental Society
- got the idea to concentrate on teledentistry—the delivery of dental services and information through telecommunications technologies—for his fellowship project while living in Nevada. "It's perfect for rural settings," he said.
- the fellowship has helped him become more confident when making presentations to large audiences and conveying ideas and concepts unfamiliar to practicing dentists.
- Seeking an executive director position was a goal he set out to pursue, and he's excited to begin working in Idaho.
- "It takes a year to appreciate the resources the ADA offers and the rest of my career to utilize them for the good of our wonderful profession,"
From the ADA “My View” section. “More dentists needed?” by R. Quinn Dufurrena, DDS.: (Published April 5, 2010 while Executive Director of the Idaho State Dental Association)
- …according to these numbers our population to dentist ratio looks pretty good.
- Idaho's HPSAs shows that the vast majority of the state is a dental health professional shortage area.The big question is whether this dental phenomenon is due to a lack of dentists in the rural areas—in other words, a geographic maldistribution…
- I would suggest that there is a geographic distribution but it is not mal. I would suggest that Idaho has the right amount of dentists, no more no less.
- In fact, an interesting statistic from the Idaho dental Medicaid administrator states that 99.2 percent of its Medicaid recipients have access to at least one dentist within 30 miles. Therefore, if we take this into consideration, along with the fact that a typical Idahoan’s mean travel time to work is 20 minutes, you realize that most people in Idaho are relatively close to a dentist.
- I would argue that there may be a geographic distinction between urbanites and their dentists and ruralites and their dentists, but it’s not a maldistribution.
- …according to a recent study "there is simply no evidence that geographic distance, however measured, is a controlling factor in the utilization of dental services among rural populations."Therefore, I suggest that we don’t even have a maldistribution of dentists in Idaho.
- In fact, a study concerning rural dental workforce size and distribution suggested we look at four other main areas—oral disease rates, demand for services, social economic shifts and the cost of care. Nowhere is geographic distance a factor.
- many younger dentists are increasingly joining group practices.
- Will policies that admit dental students from rural areas, support rural training programs, support loan repayment programs or increase the utilization of dental services by technology help the potential rural access problem?
- The Dentists Professional Liability Trust of Colorado was established by dentists, for dentists as a company that not only provides malpractice coverage for Colorado Dental Association members but also has personal service to address member concerns efficiently and accurately.
- Coverage by the Trust is reserved exclusively for CDA members.
- The Trust provides unmatched customer service where dentists can make a simple phone call to get their questions or concerns addressed by a liability experienced dentist. In addition, the Trust Board is comprised of dentists who not only share your values and concerns, but make them a priority.
- As a CDA member, there is no reason to seek coverage anywhere else but the Trust.
From the Fall 2011 Nevada Dental Association Journal - Reshaping Healthcare
- Many have an illusion that there is an endless pool of money that will allow us to do everything medically desirable with no restraints.
- many Americans have come to view health care as a “right.” The problem with this is that they want someone else to pay for their “right.”
- Language from our courts is developed in an adversarial process and, in this case, is counter-productive to our society’s well-being.
- Where is all this money going? You need only walk through a hospital and view into the rooms to realize where most of our health care resources are expended. They are expended on the elderly with chronic late life diseases.
- We, as a society, must address the hard issues of allocating resources for healthcare.
- I propose that medicine be structured, in one aspect, more closely to dentistry; with a greater amount of allocated resources going toward prevention and education.
- One of our toughest decisions will be dealing with the issues of what aspect of beneficial medicine can we ethically avoid funding.
- We need to learn from others and re-allocate our resources and instead of supplying Frank with two new knees he gets a cane like François. The money spent on Frank’s knees could be reallocated to education in preventive medicine like obesity, smoking and all those other nasty habits we have. (he was comparing healthcare in the US to France)
November 21, 2011 -ADA – Resolution calls for study of teledentistry in dental practice
- Resolution 61H-2011, Practical Development of Teledentistry, also states that a representative from the Division of Dental Practice attend the 2012 American Telemedicine Association Meeting.
- Dr. Quinn Dufurrena, … has taken a keen interest in the topic of teledentistry.
- In considering the use of teledentistry, CDP will need to consider such questions as licensure jurisdiction, regulatory structures, liability, informed consent, standards for doctor/patient relationships, patient abandonment concerns, long distance supervision of allied dental personnel, privacy and payment.
- “Dr. Mark Peppard of Austin, Texas, introduced Rep. Michael Burgess, M.D. (R-Texas), to the WLC audience as “a strong advocate for health care legislation,” and Dr. Jeane Schoemaker introduced Rep. Diana DeGette (D-Colo.) as “a tireless advocate for the health care of America’s families.” Reps. Burgess and DeGette spoke of their legislative advocacy on the House Energy and Commerce Committee and in congressional leadership. “
My personal favorite, entitled “Finding Relevance in What Keeps Our Members Up at Night”, published January 30, 2013.
- In the fall of 2011, the CDA was determined to figure out what our members truly wanted and how to successfully address that demand.
- We wanted to know what aspects of their everyday stole their precious REM cycles.
- There were many answers to this question, but the underlying meaning was unanimous. Our members were struggling with the business side of dentistry.
- Employment law isn't a course taught in dental school - in fact dental students really aren't exposed to any kind of "Small Business 101" type course.
- It was clear that we needed to provide our members with a business resource.
- After several months of collecting data, we found that it actually wasn't the clinical tools that our members were using, but the business resources.
- Our InfoProABC program was more robust than it needed to be. Our members wanted simple, easy and useful, so we went back to our original concept and reworked the program into an educational business e-mail series called the Association Business Brief.
- This business resource addresses commonly asked questions in the areas of practice management, risk management, employment law, regulatory compliance and 3rd party payors.
- The CDA finally cracked the code: it isn't the number of member benefits that an association provides, but rather the perceived value of the benefits by members that counts.
- Figuring out what kept our members up at night gave the CDA the knowledge to invent this invaluable resource that can "help members be more successful."
If one really wants to be entertained by Dr. Dufurrena, they can book him at “The Speaker Agency. His Bio:
Serves as the chief executive officer for the Association. Recommends and participates in the formulation of new policies and programs in cooperation and following the directives of the Board of Trustees. Plans and directs the Association staff to ensure that the Association’s financial, marketing, political and membership objectives are met.
Dr. Dufurrena has authored many articles and presented to numerous audiences on access to oral health care. Participate in the exciting presentation & quest, with Dr. “D”, as we explore:
- The 10 lessons in overcoming the access to care problem, concerning children, the disabled, and rural populations.
- Learn your personal policy, regarding mid level providers, by asking yourself 5 hard questions.
- Understand the urgency of taking immediate action.
- Understand the need to utilize high technology solutions.
- Honestly evaluate your potential for financial success while treating more of the historically underserved.
- Critique your practice and identify opportunities for growth.
- Understand the need to reorganize the dental delivery system.
- Evaluate the need for social marketing to improve oral health literacy
- Understand why we need collaboration between the medical and dental communities.
- Understand why we need to build a sustainable safety net infrastructure.
Dufurrena’s latest speaking engagements:
October 18, 2013 Annual Rural Health Conference – Hired as a speaker and presented The Future of Dentistry in Rural America.
October 30,2013 – Teledentistry – Licensure Issues across Boarders
He’s been on this “teledentistry” kick since 2007 when he left private practice and headed to Chicago for his Hillibrand Fellowship. That’s about the time corporate dentistry really started to spread and the dough from defrauding Medicaid through dentistry was taking off. I’m sure entering the movers and shakers part of dentistry looked extremely appealing at that time. It also happens to be about the same time this blog started.
Maybe Dufurrena has been being “groomed” since 2007. Maybe they have been training him to help introduce teledentistry to Medicaid reimbursement. After all he’s a member of the “Honorary DSO”Pierre Fauchard Academy. There he is, front and center.
Richard Quinn Dufurrena, DDS, JD
a.k.a. R. Quinn Dufurrena, DDS, JD
a.k.a. Quinn Dufurrena, DDS, JD
University of Nevada, Reno— 1980
Dental Degree from University of the Pacific—1983
US Navy Dental Corp— Nov 1986 - Feb 1990 (4 years)
Private Practice in Elko, NV— Feb 1990 - Sep 2007 (17 years)
— Phone number and address associated with practice (775-738-1120) now associated with David White, DDS, Elko, NV
ADA Hillibrand Fellowship in Chicago— Sept 2007- Aug 2008
— Regulatory Options in Teledentistry
—Health Policy Leadership and Management
Audited classes at Northwestern Kellogg School of Management—2008
—Leadership in Organizations
Online Degree Concord Law School— 2008
Executive Director of Idaho State Dental Association—Aug 2008 - Jan 2011
Idaho Dental Political Action Committee Treasurer—
Report 01-01-2009 – 12-31-2009 (lot of money paid to Charles “Skip”Smyser CEO of Lobby Idaho, LLC
Executive Director of the Colorado Dental Association—Jan 2011 – Feb 2014
Nevada – No license on file
Idaho –D-4274 Cancelled Issued 12-10-2009 Expired 9-30-2012
Colorado – DEN10528 Active Issued 7-13-2011 Expires 2-29-2016