Agency Capture: Association of Dental Support Organizations (ADSO) main goal to get corporate dentists appointed to state dental boards

The Association of Dental Support Organizations, (ADSO) governmental affairs committee, chaired by non-dentist Heartland VP and 6 other non-dentist corporate guys decided that their number one priority is getting corporate/chain friendly dentists appointed to state dental boards.  

Read the article and tell me this isn't flat out corruption.  They are asking for volunteers in states where they have lobbyists.  They want to influence regulatory decisions.  And you've got to love the whole "often political preferences will apply to the candidate selection process".  

Government of the corporations, by the corporations and for the top dogs at the corporations.

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October 2015 Association of Dental Support Organizations Quarterly Newsletter:

ADVOCACY UPDATE

The Importance of Getting DSO-supported Dentists on Dental Boards

The ADSO Government Affairs Committee was formed this summer.  The committee, chaired by John Pantazis, Heartland’s Vice President, General Counsel and Secretary with representatives from 6 other ADSO member companies, meets monthly and is charged with providing the ADSO with strategic guidance on state and federal legislative and regulatory issues.  Among the committee’s top priorities is promoting DSO-supported dentists for appointments to state dental boards. 

Board appointments are a top priority for the ADSO government affairs team because many of the state issues the DSO industry faces grow out of dental board actions.  We strongly believe that having one or more DSO-supported dentists or strong public sector members on the board involved in discussions and rule-making will go a long way in mitigating state legislative and regulatory issues we have faced in recent years. 

While we are happy to promote candidates in any state, we recognize that we are much more likely to have success in one of the 13 states where we have a contract lobbyist on the ground to assist in shepherding the candidate(s) through the process. So make a committed effort when openings are coming up to reach out for potential candidates.  We include in our Government Affairs Weekly Round-up, which is distributed every Friday, the list of states with lobbyists where we need our members help to promote candidates (if you are not on the distribution list for the Round-up and would like to be, please contact Wendy Chew).  The lobbyists are able meet with the governors’ appointment staff and follow up throughout the decision-making process.  They can also assist the dentist in getting letters of support from state legislators or other recognized leaders in the state to support their nominations.

With few exceptions, Board appointments are made by the governor of the state.  Dental boards generally consist of dentists, hygienists, public sector (non-dental related) members and sometimes academics.  All states have rules around the appointments and can include: how long the term of service lasts; requirements on how long the candidate has been a resident of the state; how long the dentist/hygienist have practiced in the state; what area of the state the appointee needs to be from; as well as many other possible requirements.  Since the appointments are made by the governor of the state, often political preference will also apply to the candidate’s selection process.  

In the past year, the ADSO has helped get DSO-supported dentists on the dental boards in Colorado, Iowa and Florida and are actively working on appointments in every other state where we have lobbyists. In addition to supported dentists, the ADSO has also promoted public sector members for state dental board appointment.

If you haven’t already done so, please participate in the ADSO database project.  Your dentists’ information is confidential and will not be shared in any way, but having the information in the database allows us to identify potential candidates in states where there are openings on the dental board. Participation in the database also helps us when we have legislative issues in a state.  We are able to reach out through a contact at your company to activate supported dentists on issues of concern to our industry.

Dental Hygienists Struggle In Corporate Dentistry

Deborah Stewart is a dental hygienist, author, mentor, office manager, coach, consultant, and popular speaker for dental hygiene schools. She holds degrees in dental hygiene, organizational behavior and coaching as well as an MBA. She is author of the 2014 book “Perspectives on Dentistry: An Insider’s Guide to the Professional Business of Dental Hygiene (available here).

Deborah passionately promotes collaboration, ethical standards, and high achievement in both hygienists and the dental industry she loves. A proud member of The Daughters of the Republic of Texas, she is also an historian and a civic and community advocate. 

What Do Dental Hygienists Do to be Employed?
by Deborah Stewart

North Texas, the area where I live, was once roamed by Frank and Jesse James, and home to one of the top ten feuds in American history. The Lee-Peacock Feud was a continuation of the Civil War. North Texas was very prosperous with cotton agricultural growth after the Civil War, so a feud developed whether North Texas would continue to have slaves. Fighting a Civil War apparently was not enough for the additional 200 lives that were killed in the feud. 

To say North Texans are a bit hard headed is an understatement.  

One hundred fifty years later, North Texas dental hygienists are fighting another war. Striving to maintain respect for their profession, they fight the battles of what preventive dental hygiene services are to be performed and how they are to work in dental offices. Faced with very few options, what allies do dental hygienists develop in this fight to stay employed? 

What is obvious is disrespect and disregard for the dental hygiene profession by Texas dentists. This behavior by dentists provided a growth opportunity for corporate dentistry business models.  

You don’t have to have multiple offices and a logo to become corporate dentistry, you just have to have a mindset of disrespect. Texas dentists began disrespecting the profession of dental hygiene in the 1980s when the Texas Dental Association (TDA) decided that the Texas Dental Hygiene Association (TDHA) needed to have their own convention.

Since then, the industry has progressed to a corporate way of thinking that now thrives in North Texas. The “dental business” has a checklist for employment of dental hygienists.

Those items include: 

       1)  Businesses will set minimum production dollars per day 

       2)  “CREATE URGENCY” to pressure patients/parents to consent to procedures immediately

        3) Identify 3 patients that need SRP each day 

        4) Use intraoral camera to identify 3 patients per day that need dentistry with $1200-1900 per day. 

        5) All patients seven years and up need an orthodontic appointment    

        6) All patients 14-20 years of age need a wisdom tooth evaluation 

        7) All patients requiring Scaling and Root Planing (SRP) need to be referred to in-house Periodontist 

        8) Call 5 people per day to come into the clinic for treatment

        9) Clean the bathroom 

       10) No employment benefits with longevity  

       11) Hiring through temporary employment agencies; having no intention of providing full-time employment 

       12) Abusive employment policies.

Does anyone think this list of job duties is appropriate?  

DSO Business Model Includes Violating State Labor Laws

 
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net.





David Sohn is the principal attorney at SOHN LEGAL GROUP, P.C., which prosecutes and defends employment and business disputes on behalf of individuals, small businesses, and non-profit organizations.  Prior to starting his own law firm, David worked at several prominent national law firms in San Francisco.  He received his bachelor’s degree in Economics from Stanford University and his law degree from Harvard Law School.  Due to the successful results he has achieved for his clients, David has been recognized as a Northern California Super Lawyer by Super Lawyers Magazine. David can be reached at 415-421-1300 and david@sohnlegal.com.
 
INTRODUCTION
David Sohn is an attorney in San Francisco specializing in employment litigation matters. Last year, he represented a dentist in his wage and hour lawsuit against Western Dental Services, Inc. (“Western Dental”) for misclassifying him as an exempt employee and not paying him overtime wages and providing proper meal and rest breaks, among other things. Mr. Sohn tried this case in San Francisco Superior Court against an army of big law firm lawyers hired by Western Dental – and prevailed. As a result of his trial victory, the overwhelming majority of dentists in California are now misclassified. They should be receiving overtime wages, proper meal and rest breaks, and all of the benefits and protections of California’s employment laws.
The case is entitled Nanda v. Western Dental Services, Inc . (Case No. CGC-13-529601).

Dr. Davis: Mr. Sohn, I sincerely thank you for taking the time and effort to address matters of this case. I understand much of your legal work involves labor workplace rights. The public may not appreciate how even a licensed dentist may have their rights violated in the workplace. Could you give our readers an overview of the merits of this case and how your client was damaged? 

Mr. Sohn: Thank you, Michael, for giving me an opportunity to discuss with you and your readers my trial victory against Western Dental. This is a very important, game-changing case that all dentists and to-be-dentists need to know about so that they understand what their workplace rights are.

When I decided to take on this case back in 2013, I didn’t know anything about the dental industry. I took it on because I saw a very interesting legal question. That question was: are dentists employed by Western Dental compensated in the form of a “salary?” Western Dental compensates its dentists by a fixed daily rate and/or a percentage of their production. They are not guaranteed in advance a minimum weekly or monthly amount of compensation.

This legal question is important because in order for dentists and other licensed professionals to be exempt from all of the benefits and protections of California’s employment laws – such as overtime wages and proper meal and rest breaks – they must be paid in the form of a “salary.” If they are not, they must be provided these benefits and protections.

California law does not provide a definition for the term “salary.” Instead, California courts look to federal regulations for the definition of “salary.” The pertinent federal regulation, 29 C.F.R. § 541.602(a), states that an employee is paid on a “salary basis” if he or she “regularly receives each pay period on a weekly, or less frequent basis, a predetermined amount constituting all or part of the employee's compensation, which amount is not subject to reduction because of variations in the quality or quantity of the work performed.” This same federal regulation also explains that if an employee is ready, willing, and able to work, but he or she does not work due some reason occasioned by the employer, he or she is not being paid on a “salary basis.”

At the conclusion of trial, the judge held that the dentist I represented was not paid in the form of a “salary.” The dentist never received on a weekly, or less frequent basis, a predetermined amount of compensation which was not subject to reduction based upon variation in the quality of quantity of work performed. He was only paid for the days that he worked and on occasion received a percentage of the production he generated. On numerous occasions, even though he wanted to work, if he was not called into work, he was not paid. Given these circumstances, he was entitled to overtime wages and proper meal and rest breaks like other non-exempt staff employed by Western Dental.

As a result of the judgment issued in my case, all dentists – and for that matter any licensed dental healthcare professional (such as orthodontists, periodontists, etc.) – in California paid on any basis other than a salary basis are “non-exempt” employees who are entitled to overtime wages, and proper meal and rest breaks.   

Dr. Davis:  The defendant in this case, Western Dental, is the largest employer of dentists in the state of California. They also operate dental clinics in Nevada and Arizona. They are the largest provider of dental Medicaid services for California. As large of a dental industry operation as is represented by Western Dental, is it reasonable to speculate on the pervasiveness of dentist/employee workplace labor violations (both in Western Dental and the dental service organization (DSO) industry, as a whole)?   

Mr. Sohn: During the course of my case against Western Dental, I discovered that Western Dental’s approach to how it compensates its dentists is not unique. I spoke to a number of dentists and specialists who worked for other practices large and small, including other DSOs and small private practices, and the impression I received was that the overwhelming majority of dentists and specialists in California – and in the country – are paid on a similar non-salary basis. That’s when I realized my case could have significant industry-wide consequences.