Thursday, August 24, 2017

September 2017 Conference: Top Trends in Dentistry Not Heard Anywhere Else

Concerned Dentists of Texas Presents: Business of Dentistry 101

image

When: Friday, September 15, 2017 (9am-5pm) during the Southwest Dental Conference
Where: Dallas Omni Hotel Cedars Room, 555 S Lamar St, Dallas, TX 75202
Registration: Concerned Dentists of Texas (CDOT)
Contact person: Jackie Stanfield, DDS, concderneddentistsoftexas@gmail.com 
                            (972) 355-2273


Topics include:

  • Problems facing dentists, new or retiring, involving dental practices owned and operated by Private Equity companies and Wall Street Hedge Funds.
  • Understanding dental employment contracts: the vulnerabilities and consequences.
  • Discussion about the business model of dentistry such as Dental Service Organizations (DSO’s): the impact on dentists, staff and patients.
  • Legal issues and potential ramification facing dentists today.
  • Medicaid Fraud
  • Government and Legislation issues: overreach and/or underreach.
  • Solutions: what you can do to protect your patients, yourself, your business and financial future.


Rare appearance together by following speakers:

CDOT-Flyer-draft-1
































Lunch will be provided by the following meeting sponsors: 
Dr. Rene Scott
Frank Brown, ADS Watson Brown and Associates
Johnette Green, Wells Fargo, johnette.green@wellsfargo.com
Dr. Shab Krish, MJ and Sleep Therapy Center of North Texas; and
Josh Knowles, Allstate


Concerned Dentists of Texas (CDOT) is committed to the well-being of the dental profession and the patients we serve.

Monday, August 21, 2017

Gentle Smiles, LLC and Dr. Annie Watson, DDS Settles Fraud Allegations with Masshealth

AG Healey Returns $500,000 to Masshealth in Settlement With Springfield Dentist Over Alleged Improper Billing

August  21, 2017

BOSTON – Attorney General Maura Healey announced today that her office has reached a settlement with a pediatric dentist in Springfield, returning $500,000 to the state’s Medicaid program (MassHealth) and resolving claims that the dentist improperly billed the program for services.
The settlement agreement resolves allegations that Dr. Annie Watson, DDS and her dental practice, Gentle Smiles, LLC, improperly billed MassHealth for palliative care (emergency pain treatment) between March 2010 and June 2013, and failed to comply with MassHealth rules associated with the use of that emergency treatment billing code.

The AG’s Office began an investigation into Dr. Watson and Gentle Smiles upon a referral from MassHealth, which identified Dr. Watson as the top biller of the palliative care code among all MassHealth dental providers.

Palliative care is the emergency treatment of dental pain that relieves the pain but is not curative and can include draining of an abscess or prescribing pain medication or antibiotics. In order to bill this code, the patient’s dental record must contain a description of the treatment provided and must document that the treatment was given on an emergency basis.

The AG’s investigation revealed that Dr. Watson routinely billed for palliative care without any supporting documentation, including when patients only received cleanings and x-rays.
Under the terms of the civil settlement, Dr. Watson and her business will pay MassHealth $500,000 as restitution for improper billing. The settlement also requires that Dr. Watson and her employees review and comply with all applicable state and federal statutes, and all regulations governing participation in MassHealth.

MassHealth provides healthcare products and services to eligible low-income individuals, including people with disabilities, children and senior citizens.

This matter was handled by Managing Attorney Lee Hettinger and Investigator Deborah El Majdoubi, both of the AG’s Medicaid Fraud Division. MassHealth assisted in this investigation.

Tuesday, July 25, 2017

Bethaniel Jefferson indicted on a felony charge of causing serious bodily injury to a child by omission

Dentist Craig Jacobs, Nevaeh Hall's mother Courissa and family members look on as attorney Jim Moriarty shows a  graph depicting  the EKG and oxygen levels during the 4-year-old's dental appointment. Photo: Craig Hartley Craig Hartley, Freelance / Copyright: Craig H. Hartley

Photo: Craig Hartley Craig Hartley, Freelance

Excerpts from Houston Chronicle Story:

A former Houston dentist was formally charged Monday (July 24, 2017) with failing to properly treat a sedated 4-year-old patient who was left with permanent brain damage in what should have been a routine procedure.


The child's mother, Courissa Clark, said she was "overjoyed" when she heard the news.


"We're really grateful that justice has been served and the person that did this to our baby is finally being brought to justice," Hall told the Chronicle.


"When little Nevaeh was taken to the dentist that day, (her parents) turned her over to the dentist trusting that the dentist would protect and look after their little girl," said attorney James Moriarty. "But she overdosed her on sedatives."


The girl was sedated at the Diamond Dental office about 8:30 a.m. Jan. 7, 2016, prosecutors said in a statement. Three hours later she suffered a seizure, and her oxygen level and temperature fell dramatically. Prosecutors say it took more than four hours before anyone called for medical assistance.


Jefferson was reprimanded by the Texas Board of Dental Examiners in 2005 and 2012, prosecutors said. The board revoked her license in November after a state administrative judge ruled that she "fell below the minimum standard of care, failed to uphold the duty of fair dealing and committed dishonorable conduct when providing dental care."


The Chronicle's investigation cast a spotlight on Medicaid dental clinics that had flourished through treatment of pediatric patients whose low-income families qualified for government assistance.


Medicaid dental claims in Texas quintupled between 2005 and 2015 to $1 billion a year after the state doubled reimbursement rates in 2007.


Jefferson now faces trial on a first-degree felony charge.


"This indictment should send a message to the medical community that they will be held accountable for abandoning their patients in times of crisis," prosecutor Stan Clark of the Texas attorney general's Medicare fraud unit said in the statement.


"While accidents in the health care industry occur more than everyone would prefer, practitioners must react appropriately and contact higher level medical care providers when they realize their patient is distressed beyond their capabilities," he said.

Read the Entire Article Here

Tuesday, June 20, 2017

3-year-old Daleyza Avila-Hernandez’s Death at Children’s Dental Surgery Center and a Louisana Psychologist.

clip_image001

On Monday, June 12, 2017 3-year-old Daleyza Avila-Hernandez died at Saint Joseph’s Hospital after what was a simple procedure at Children’s Dental Surgery Center, in Stockton, California.

According to Fox40 News, Daleyza was referred to Children’s Dental Surgery Center by a dentist at Western Dental.

“I don’t want this to happen to another mother like it’s happening to me,” said Araceli Avila, Daleyza's mother.

“All I did was I took my daughter to the dentist because they were going to fix her teeth, and about 30 minutes later they brought her back dead,” Avila said.

The mother says she was not allowed to go back with her child during the procedure but while waiting for her daughter she saw an ambulance arrive.

“And I stood up and went outside because I was like 'they are coming for a kid,' but I never thought it was for my child," she said.

Within moment a nurse appeared and told the mother something went wrong and her daugther’s heart stopped, and that “maybe she had underlying heart issues”.

The mother disputes that saying her child “was a very healthy”. Avila and her husband, Jose Hernandez, recalled seeing the toddler "vivacious and full of life" just before the procedure.

According to FOX40 website:

“FOX40 spoke to David Thompson, the administrator of Children's Dental Surgery Center in Stockton, who says they only do general dental procedures -- such as filling cavities and putting on crowns.

Her parents say Daleyza went in to have two teeth pulled and have caps put on two other teeth.

Thompson says the girl had a reaction to the anesthetics, was stabilized and then sent to Saint Joseph's Hospital. They don't know why she died.

"It’s a terrible, terrible tragedy honestly and our thoughts and prayers are really with the family right now," Thompson said. Thompson said staff members at the center were well trained and have years of experience.

"We’re committed to helping kids every single day. That’s our mission, that’s why we’re here. It’s risky. Not everyone wants to do it," he told Fox 40.

The Dental Board of California released the following statement:

"The Dental Board of California is aware of the tragic situation. An investigation is underway so specific details of the case cannot be shared at this time.  Consumer protection is the board’s highest concern and we want to extend our deepest sympathy to the family."

The Stockton Police Department is also investigating. Spokesman Joseph Silva says at this time the case isn't suspicious or considered criminal, but it is still an active investigation.

According to ABC10 Children’s Dental Surgery Center is a non-profit ambulatory surgery center located in the 1500 block of East March Lane in Stockton.

Really? Non-Profit? Hmmm…

Staff according to Children’s Dental Surgery Center website:

image

According to his LinkedIn page Perry Solomon, MD is an Anesthesiology and Cheif Medical Officer at HelloMD, described as:

“HelloMD is the leading digital healthcare platform for the cannabis industry. Patients use our service to connect with a doctor, get a medical cannabis recommendation over live video (Telehealth), and gain seamless entry to thousands of cannabis products, dispensaries and advice on medicinal efficacy.
We are the largest reliable source for cannabis information about medical conditions and products, have our unique platform called Answers where questions are posted from all over the world and are answered by our physicians, product manufacturers and other patients, building a community of like minded people.”


Solomon’s LinkedIn page also says he is:

  • Medical Director at Children’s Dental Surgery and Central California Dental Surgicenter.
  • Medical Director for Cardiac Rehabilitation for Tenent Healthcare
  • Owner of Bridges Mecical Clinic

Sung “Caleb” Cho, DDS operates Ygnacio Dental in Walnut Creek, CA.

Looking at Children’s Dental Surgery Center website, for reasons unknown the title of the page linked to the Patient Information Packet is Sierra Kings Dental Surgery. Huh?

clip_image003


clip_image005


Since search the business entity names at the California Secretary of state site revealed zero results for the company names, a little more research finds Central California Dental Surgery Center is actually US Dental Surgery Center, Inc. incorporated in March 2008 by Philip Goldberg.


image


March 2015 annual report at the California Secretary of State’s website shows US Dental Surgery Center is owned and operated solely by Carol E. Freeman, 429 Chateau Grimaldi, Mandeville, Louisiana 7047. Carol E. Freeman appears to be a licensed Psychologist in Louisiana doing business as CAROL E. FREEMAN, PHD, LLC


clip_image006

clip_image007

The January 1, 2017 annual report for US Dental Surgery, Inc shows no change and Carol E. Freeman still listed as “owner”.

clip_image009


So what in the hell is a psychologist, from Louisiana doing operating dental surgery centers in California?

And exactly what is this “referral partnership” between her and Smiles Depot, Northern Valley Indian Health, Western Dental, Charter House, Shasta Community Health Center, Fremont Dental, Access Dental and ProDental, as shown on Children’s Dental Surgery Center website?

clip_image011


clip_image013

Friday, April 28, 2017

Texas State Board of Dental Examiners Loss of Investigators and Staff, is Michael Melanson’s Gain

 

Debbie-color-sm (6) 12-31-2016By: Debbie Hagan

 

Reports abound this week about the Texas State Board of Dental Examiner’s finding insufficient  of wrong doing by Dr. Michael Melanson as it related to the death of Daisy Lynn Torres:

AUSTIN (KXAN) — The dentist who was treating a 14-month-old girl for cavities when she died after going under anesthesia has been cleared of any wrongdoing by the Texas State Board of Dental Examiners.

Dr. Michael Melanson was working on Daisy Lynn Torres’ teeth at the Austin Children’s Dentist in northwest Austin on March 29, 2016 when she suffered complications and died. The child’s autopsy report ruled that anesthesia caused her death.

There was an anesthesiologist on-site during Daisy Lynn’s appointment, according to a 911 recording and a spokesperson from Austin Children’s Dentistry. However, what as at issue in a lawsuit is a portion of the autopsy including a report from a forensic dental examiner, Dr. Robert Williams. The report questioned why the child was having a dental procedure before she died. The report prompted Austin Children’s Dentistry to suspend Dr. Melanson, who no longer works at the practice, last July.

At the time, the dental office said he would remain suspended until the State Board finished its investigation.

Read entire story here.

I think the keyphrase here is “finshed its investigation”. 

Melanson’s attorney Mike Yanof said, “The dental board has closed its investigation and they found insufficient evidence to support proceeding further in the matter.”

Could that be because there are no investigators left to investigate? The last Lieutenant Investigator, Travis Mott, took a demotion back to Sergent and Kelly Parker has “decided to make investigators file clerk, arranging fild folders for the Dental Review Panel, according to once source.

One reader wrote:

I am seething upon hearing this, as there was testimony in the autopsy report by forensic dentist Dr. Robert Williams that no dental disease was present upon autopsy of Daisy Lynn Torres. The child need not have been administered general anesthesia or subconscious sedation to the level to create death.  While the dentist may not have caused the death, the circumstances that precipitated the death surely involved the dentist's and clinic's actions to cause a surgical procedure to be done. If the TSBDE foing "no evidence," what about the misdiagnosis of dental disease in the name of bilking Medicaid?

The civil lawsuit will, no doubt, march ahead.  However, given the past evidence of this dentist's shaky affiliations and representations of skills, competency, fraudulence, and ill-will, the TSBDE just didn't look. Just as they glazed over my claim...they are toothless.

I agree.

Tuesday, April 11, 2017

Texas State Board of Dental Examiners: Decaying Rapidly Under Direction of Executive Director Kelly Parker

Debbie-color-sm (6) 12-31-2016By: Debbie Hagan


DTM has learned that in recent weeks the following people have submitted letters of resignation or already ended their employment with the Texas State Board of Dental Examiners(TSBDE):

  1. David Durkop, Lieutenant Investigator for Texas Dental Board;
  2. Greg Gilchrist, Lieutenant Investigator for Texas State Board of Dental Examiners;
  3. Donnie Head, Assistant Director of Investigations at Texas State Board of Dental Examiners Jones, Director of Investigations;
  4. Lisa Jones, Director of Investigations, and;
  5. Jeff Roach, Lieutenant Investigator for Texas Dental Board

Additionally, other than the Legal Division, every department head has walked out and quit without notice, including the Licensing Department head.

So what happened to the already troubled TSBDE?

Ms. Kelly Parker is what happened.

The TSBDE hired Ms. Parker as the new Executive Director in September 2015. Then they gave her Cate Blanche to run the board as she saw fit and things changed drastically.

Prior to Kelly Parker’s hiring the standing Orders from Director of Investigation Lisa Jones to the board investigators were to share anything they had with other law enforcement agencies.

Parker quickly changed that and demanded that she give her stamp of approval the sharing of any and all information with other agencies—law enforcement or otherwise.  If agencies called investigators requesting information, they were to be directed to the Legal Division, pronto.

Parker is not focused on public safety, not justice, not oversight nor fair resolution. Parker's focus is on "Days to Case Resolution”, nothing else.

“Days to Case Resolution” is how the Board is rated by the Legislature as well as internally by the Board for the Investigative Division. The speed of the case is much more important than the quality of the case. Criminal cases take more time and manpower than Administrative cases, resulting in few, if any, criminal cases being worked.

Additionally, despite it being a violation of Texas law, the Legal Division decided that the DSOs could own, operate or maintain a dental office as long as the DSO did not direct clinical care. We all know that never happens, right?

Gosh, wish I could just decide to change the speed limit law to suit me on any given day.

Throwing another turd in the proverbial punchbowl, was Parker’s insistence that a new database go “live” on September 1, 2016, the beginning of the fiscal year, ready or not.

It was not!

There are two databases: Versa(VR) and Paper Vision(PVE) that are supposed to “talk” to each other, so to speak, and work with the Health Care Professional Council, which consists of 5 agencies; the board of dentistry being one of them.

There are no Standard Operating Procedures in place and the databases being incompatible with each other which means all data has to be entered twice; once into VR and again into PVE.

PVE was so not ready investigators learned for months all the data entered and reports marked “approved” that was to send the matter on to the next “work step” it went to a virtual “dead letter box”.

Why?

Because the next “work step” had not even been created yet! That’s right, folks, it went nowhere and to no one!

Talk about waste of time, money and resources!

With the recent departure of supervisors, the Board has lost close to 40 years of dental investigative experience and over 100 years of law enforcement experience. This is not a common investigative skill set and can take several years to develop.

Saturday, March 18, 2017

Texas State Board of Dental Examiners Refers Investigation to Local Police Departments. Should People Just Call 911 Bypassing the Board Completely?

Debbie-color-sm (6) 12-31-2016By: Debbie Hagan

Last week, News 4 in San Antonio, Texas ran a story about how the Texas State Board of Dental Examiners farms out it’s duties to the local police station instead of investigating themselves. Thanks to a tipster, who says the dental board isn’t the least bit interested in making any changes, I’m publishing the story here, not to critique the story but to comment on the luncy of the content.

Dental board refers out criminal investigations

by APRIL MOLINA

March 14, 2017

“The Texas State Board of Dental Examiners receives dozens of complaints each year; among them, drug diversion and addiction, practicing dentistry without a license and dentists performing unnecessary work.”

Uh, I would say it’s more like hundreds of complaints; maybe even thousands.

"It is I think appropriate that the dental board evaluate all complaints and if they find wrongdoing, either civil or criminal, then it's incumbent upon our dental agency, our dental board to take action," said Texas State Senator Charles Schwertner.”

The citizens of Texas think the board should as well, but over the last several years, I think they have seen the dental board take less and less action. In fact I would say the TSBDE is the least effective of all dental boards, well maybe other than California.

“The dental board has always investigated the administrative side of complaints and for more than a decade board investigators have also had the ability to conduct criminal investigations, often handing cases over to the local district attorneys for prosecution.”

"In hopes of protecting my community and protecting the citizens of Texas I passed this bill that gave them the capacity to have licensed peace officers," said State Senator Jose Menendez.

Menendez's 2003 law enabled the dental board to hire experienced dental investigators with the authority to investigate criminal cases without delay.”

Apparently the TSBDE were not doing their job in 2003 either! Over 14 very long years later, the Texas State Board of Dental Examiners have had the full force for the law behind them to investigate criminal acts of dentists? WOW! Who knew, right? I bet Lisa Jones, the Director of Investigations, should, could and would put the handcuffs on the criminals.

“In late 2016, a whistleblower tipped off the News 4 Trouble Shooters that a decision was made to re-direct criminal investigations at the end of 2015.”

“Re-direct” to where? To be “re-directed” they have to have once been “directed” to someone or someplace, right?

“3 months after Executive Director, Kelly Parker, took over, the director of investigations sent out this email to staff: "Per Kelly, as of today, we will no longer investigate the criminal aspects of a complaint. We will not be filing cases directly with the D.A. any longer. If you have a case with a criminal element, work the administrative side of it and refer the criminal elements to a local police department with jurisdiction."

Say what!! 3 months in and she took this approach? Who hired this Kelly Parker, anyway? And who is she to decide? Clearly, the ED has way too much power. Who’s directing the Director?

At a hearing of the Committee on Public Health in 2012 Lisa Jones, Director of Enforcement for the TSBDE stated she had been with the board for 10 years and Director of Enforcement for over 7. At the hearing Jones stated there had been 153 case of fraud reported and only 5 dentists in 5 years had their licenses revoked or voluntarily surrendered. When asked about cases turned over the local District Attorney’s Jones stated in the last 2 years they had turned over 200 cases and only 5 had some sort of conviction. Lisa Jones is still the Director of Investigations.

The Executive Director at the time was Glenn Parker, who couldn’t attend, but sent a letter. Committee Chair Lois Kolkhorst read from a letter sent in by Glenn Parker, where he made it clear local District Attorneys were reluctant to prosecute these cases, since murders and such took precedence. So, are you telling me, Executive Director of the Texas State Board of Dental Examiners, Kelly Parker, thinks sending a file over to the local cop’s desk would get better results!

SERIOUSLY!!

Kelly, hon, you have a Director of Investigations, right there in your office. I bet you see her at least one or two times a week. She gets paid to “investigate”. Yet you believe you and your office staff are just too busy with ….uh…work….uh… so important that the local police station should do it! I can’t even get my head around that!

Where are you going to “re-direct” the investigations next, the local dog catcher’s desk?

“Parker would not agree to an interview, but sent us this statement: "Other agencies exist for the purpose of pursuing the criminal violation and it would be wasteful and redundant for the dental board to do so, too."

Well, Good God Almighty! Taxpayers wouldn’t want any ‘waste”! (sarcasm)

Ms. Parker, for years, those same agencies along with the state legislators—and the public— have been asking why your agency has done little to nothing to take care of dental related crimes and violations. Earn that $92,000 a year, darlin’! Now, there’s some “waste” for you to ponder.

Friday, March 17, 2017

Facts Reveal ALEC “Overregulation Threatens Market-Driven Solutions in Dentistry” Study is Pure Crap!

By: Debbie Hagan
The below story was posted on Group Dentistry Now; the propaganda machine for the Dental Support Organization(DSO) industry. I first called the whole story “horse shit” but I was wrong—when I’m wrong I’ll admit it. I now need to make that correction and rephrase; it is utter “bull shit”. And this ALEC (American Legislative Exchange Council), well, it’s the “horse shit”. (see ALEC Exposed) and has been under scrutiny for a very long time; some questioning if is even legal—google it. Of course this makes it a perfect match for the DSO industry, right?  ALEC chairman of the board is Mr. W. Preson Baldwin, from the lobbyist group Centerpoint360, which received $442k from the Association of Dental Support Organizations in 2015. (see page 8 of the ADSO tax return) Centerpoint360, received $268K in 2014. Now read the story with the hidden facts revealed. When you are finished ask yourself this: “If it’s so overregulated, why are three of the four examples listed, citing state legislation or regulation was only “sought” and not passed or simply withdrawn completely. Sounds to me like the title should have read “Underregulation Boosts Market-Driven Solutions in Dentistry”.

image
Posted By: GroupDentistryNow March 16, 2017
The American Legislative Exchange Council (ALEC) recently published a 12 page research paper entitled, ‘Overregulation Threatens Market-Driven Solutions in Dentistry’.  ALEC is America’s largest nonpartisan, voluntary membership organization of state legislators dedicated to the principles of limited government, free markets and federalism. Comprised of nearly one-quarter of the country’s state legislators and stakeholders from across the policy spectrum, ALEC members represent more than 60 million Americans and provide jobs to more than 30 million people in the United States.
In the paper, the author, Mia Palmieri Heck, discusses and analyzes the increasing regulatory and legislative efforts to restrict and even ban dental support organizations in several states.  The ALEC study points to the many benefits of dental support organizations, including increased access to care, lower cost of providing that care, and better patient outcomes when dentists are free from the distraction of non-clinical (support) activities. For a list of clinical (services only a licensed dentist can do) versus non-clinical activities (duties which may be provided by a non-dentist), please see graphic below.
Even with all of the aforementioned benefits, dental licensing boards in several states have tried to limit or restrict dentists’ ability to contract with a dental support organization through regulatory and legislative means.  The main function of a state dental licensing board should be to protect paients from harm, as well as to monitor, regulate, and oversee the licensing process.  The licensing board should not be in the business of creating anti-competitive regulations and legislation to benefit and protect the solo practice owners that may sit on the board.
Example of state overregulation of DSOs:
  • North Carolina – [2015] The Unites States Supreme Court ultimately confirmed the findings of a lower court that the NC Board of Dental Examiners had unreasonably restrained trade in violation of the federal antitrust laws.
  • Texas – [2014, 2015] The Texas State Board of Dental Examiners proposed new rules restricting the ability of dentists to enter into contracts with ‘unlicensed persons’ for non-clinical functions.  The board also tried to expand its authority to take disciplinary action against dentists who chose to contract with a DSO.  The board received numerous public comments and letters protesting these proposed rules, including a letter from the Federal Trade Commission.  These proposed rules were eventually withdrawn by the board.
  • Maryland – [2014, 2016] Maryland’s state board tried to adopt regulations making it nearly impossible for DSOs to operate in the state, even though dental support organizations have operated in Maryland for decades.  The MD administration did not approve these regulations, so the MD state dental association and board of dental examiners sought legislation restricting the business functions a DSO could provide.
  • Wisconsin – [2015]  The Wisconsin state dental association sought legislation that would give the dental board authority to regulate dental support organizations on matters related to non-clinical activities.  The bill did not pass mainly due to state legislators, many of whom are members of ALEC.

Mia Palmieri Heck
Heck is Director of ALEC’s Health and Human Services Task Force.  She leads the nationwide effort to promote free-market, pro-patient health care reforms at the state level. In her immediate past position she served as an executive at a Texas-based child and family services provider, where she led the strategic planning and program development efforts for the agency.
To review the entire study, which is the source for the majority of the content in this piece, click HERE.







See all of the ADSO tax returns here

Monday, March 13, 2017

Comfort Dental Agrees to Washington State Permanent Cease and Desist

 
By: Michael W Davis, DDS, Guest Contributor
Dr. Michael DavisDr. 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. 
 
 



Comfort Dental Group, et al, a Colorado corporate dental entity has signed and accepted a Consent Agreement (permanent cease and desist order) with the Washington State Department of Health, on February 28, 2017. Comfort Dental admits engaging in the unlicensed and unlawful practice of dentistry. Comfort Dental was active in the sales and management of so-called sub-franchised dental practices, outside the bounds of Washington statutes.

Unlicensed parties, and not duly licensed dentists of dental practices, were selecting dental laboratories for patients, dental supplies, office supplies, & janitorial services. The dental corporation's restrictive covenant on doctors was deemed overly restrictive and outside the bounds Washington statues. Further, Comfort Dental's restrictions on the ability of a doctor to transfer their practice ownership was also deemed unlawful. The 5% "royalty" fee Comfort Dental charged licensed doctors on gross collections was determined unlawful, as it allowed Comfort Dental an excessive beneficial ownership in dental practices.

Respondents of Comfort Dental agreed to Pay a fine of $340,000, agreed to the permanent cease and desist order to discontinue their unlicensed and unlawful practice of dentistry in Washington, and reform each of their Washington State dentist contracts to comply with state law.
Reporter's note: This outcome in Washington State, in which the dental profession, public and state government stood up for consumer rights, is in stark contrast to Colorado. In Colorado, the dental profession and state legislators capitulated to the interests of corporate dentistry and Comfort Dental.

Reporter's note: Here's an interesting facet to this story. If Comfort Dental fully complies w/ their consent agreement w/in an allotted time frame, their $340,000 fine will be reduced to $25,000. However, in public record evidence submitted in the earlier legal action of Drs Carl & Craig Bahr, verus Comfort Dental, et al. (case now settled & sealed), in an email from Comfort Dental founder & president Dr Rick Kushner, he stated that w/out control of the dental lab, Comfort Dental wouldn't be viable as it is today (loss of corporate control & money). It seems the Comfort Dental business model (as it exists today) may collapse, w/out control of the lab & mandatory lab utilization by franchisees (dentists). This is seemingly at distinct odds w/ expressed terms of the settlement w/ WA State.
Evidence of the earlier cited civil case clearly demonstrated problematic issues w/ the mandated dental laboratory, which was operated by Dr Kushner's brother. One might assume doctors would be free to select what dental lab operated in their patients' best interests. However, that's almost NEVER the case w/ corporate dentistry.
So, now it will come down to a serious effort at state enforcement. Is the WA State AG's office a paper tiger, or a true protector of the public interest & enforcer of the rule of law? We'll see..
Related: TOXIC TROIKA FOR DENTAL PATIENTS











Thursday, March 09, 2017

Lawyers battle over whether dental procedure was necessary for child who died

imageBy: Jennifer Kendall
Posted:Mar 08 2017 10:28PM CST
Updated:Mar 08 2017 10:28PM CST
Wednesday, lawyers argued in district court about whether a 14-month-old who died after a dental procedure in North Austin actually needed dental work done.
A medical examiner's report said Daisy Lynn Torres died due to complications of anesthesia, but part of the report has led to a defamation lawsuit against a forensic dentist
Read the entire report here


Dr. Michael Melanson was an employee of Austin Children's Dentistry, whose President is Brian J. Peters.
Austin Chilldrens Dentistry-Brian Peters-President-sos-tx
Searching the address Brian J. Peters has listed returns results for Southern Pecan Plantation Manufactured Housing Community, owned by Peters’ parents, Robert and Carol Peters.




Whistleblower claims Dental Authority used Restrictive Advertising Guidelines to try to Curb Overzealous Cosmetic Training Program

Special Report:

Did a Canadian Dental Authority have serious concerns about a training program that promoted Cosmetic Over-treatment of Patients and look the other way due to a business relationship?

Red Deer, Alberta, Canada- Former dental council member dentist-author Michael Zuk DDS is asking the Health Minister to look into concerns with connections between a harmful 'cosmetic dentist' training program in the USA, a Canadian dental lab and the Alberta dental authority. According to the general dentist, Canadian and American dentists were brainwashed into flying their patients to Las Vegas for irreversible and sometimes harmful cosmetic veneer makeovers where the professionals were unlicensed and unlikely to be covered by malpractice insurance. He claims the local authority looked the other way due to a close business relationship with the primary dental lab that profited from the additional porcelain work. The dentist was contacted by a victim who had complications after aesthetic treatment within this training program sharing that her complaint was ignored by the authority and this inspired him to speak out about the problem. The dental authority retaliated after Zuk published his book Confessions of a Former Cosmetic Dentist in 2010 with fears the truth would ‘harm the reputation of the dental profession.’

The dentist claims the dental authority decided to make an example of one dentist who had been a known attendee of the cosmetic training program in spite of the fact that she did the right thing in recommending a less aggressive treatment alternative of orthodontics instead of ‘instant ortho’ with veneers. The known risk of more aggressive crown/veneer preparations to straighten teeth is root canal complications, and when this occurred after the patient refused traditional orthodontics, the dental authority had the opportunity to indirectly address the concern. Dr. Zuk suggests the dental authority should known patients have the right to accept treatment alternatives with higher risks after they have been provided with the choices. No treatment is without risks and even orthodontics can result in damage to teeth so a exhaustive war against one ‘cosmetic dentist’ was unwarranted and an honest discussion within and outside the profession should have been made. 

A second indirect action against the wave of cosmetic dental mania was against the use of the term ‘cosmetic dentist’ and office trade names containing the words ‘cosmetic dentistry’. Another dentist was selected to be disciplined for this concern, which is usually considered a practice preference or area of interest and not professional misconduct. Again the dentist was found guilty and suspended.

The third attack related to cosmetic dentistry was against Dr. Zuk’s book claiming the authority did not protect the public from over-treatment and his promotion of a more conservative cosmetic treatment called ‘shorter term orthodontics’. The dentist was found guilty of professional misconduct and the complaint director who was also suing the dentist for $3M for criticism of her performance recommended a suspension of 5 years and costs of $270,000 even though no patient complaint was involved. While the council and appeal committee reduce the actual term to 12 months and approximately $176,000 CAN this was still an amount that would lead the author to appeal to the court system.

The problem with sponsored training courses was not isolated to the dental profession, and as an example physicians realized their treatment recommendations were affected by educational programs backed by certain pharmaceutical companies. Bias is a common problem with programs and research that supports the information may be tainted by financial interests. Besides cosmetic dentistry, most dental services are affected in some way by the promotions of the products and services within the dental industry including lasers and less exotic gizmos that may or may not make treatment safer, more affordable, faster or better.

So to summarize, the dental authority had a concern with a particular cosmetic training program, then suspended a dentist whose patient had a few non-life-threatening complications that were known to be relatively common with the treatment provided, then suspended a dentist who named his practice a ‘cosmetic’ dental office and then suspended a dentist who wrote about problems with cosmetic dentistry and promoted less aggressive alternatives that are used across the globe. The authority had published an internal document written by Dr. Gordon Christensen titled ‘I Have Had Enough’ which profiles the US prosthodontists concerns about the cosmetic dentistry becoming ‘a monster, promoting irreversible treatment on patients’ but the dental authority refused to admit that the public interest was more important than the integrity of the profession. 

In his latest e-book ‘The Ugly Truth about Cosmetic Dentistry’ currently available at no cost through a link on the website AlbertaDentalAssociationProblems.com, Dr. Zuk shares the connection between the dental authority and the suspect dental training program which, according to a malpractice lawyer in San Francisco and an expert witness, was associated with numerous cases of gross over-treatment of unsuspecting dental patients.

The dentist claims dental authorities had misgivings about this specific cosmetic training program but did not take any steps to warn the public, and this according to Dr. Zuk, has been confirmed in writing by a former high level executive from the dental authority. “Instead of taking this problem public, the dental authority addressed the concerns about aggressive promotion of veneer treatment with an elaborate mess of advertising guidelines that banned dentists from discussing the courses attended, use of the terms like ‘smile makeover’ and forbidding dentists from using before & after photos of dental treatment. The authority was clearly were more worried about harming the relationship with the dental lab owner who they awarded with an honorary membership in the dental association than they were with the harm caused to dental patients. The financial support of this large Canadian lab allowed the training program to reach out to dentists and patients across North America. While many patients were likely pleased with their new smiles, many could have been treated with less expensive and less risky alternatives with comparable results. Many cosmetic dentists are not treating patients with bleaching, bonding and braces rather than veneers. Veneer treatment can be the best or worst treatment choice, but the training program at the time was pushing porcelain as a cure-all and many patients were harmed physically and financially in the process,” says Zuk.

The outspoken dentist who appeared on an investigative television program CBC Marketplace- Money Where Your Mouth Is -where a 15 year-old girl was told by a different dental professional that she needed most of her health teeth ‘capped’ due to some sensitivity that was later treated successfully by Dr. Zuk with Sensodyne toothpastes. Zuk notified the provincial Health Minister and the Competition Bureau of Canada with numerous concerns with about the dental authority’s mismanagement, excessive advertising regulation that limits competition and lack of whistleblower protection. Dr. Zuk is planning a documentary on the subject and is interviewing patients who were flown to Las Vegas for cosmetic dental treatment during the 1990’s and dentists who attended the program and now regret some of the treatment that was promoted.

For more information contact Dr. Michael Zuk directly at 403-347-8008.

Sunday, March 05, 2017

Significance of Criminal Indictment to Dr. Edward R. Hills

Significance of Criminal Indictment to Dr. Edward R. Hills
By: Michael W. Davis, DDS, Guest Contributor
[image%255B2%255D.png]
Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. 
 
 
 

hillsDr. Edward R. Hills was formally indicted on October, 19, 2016, by the US Justice Department for a variety of alleged criminal violations, in US District Court for the Northern District of Ohio (Eastern Division). Co-defendants included three other dentists, Drs. Sari Alqsous, Yazan B. Al-Madani, and Tariq Sayegh. The government contends Dr. Hills and other defendants engaged in a variety of actions inclusive of Medicaid fraud, bribery, extortion, interference in a federal investigation, witness tampering, tax fraud, defrauding of a non-profit hospital, an interstate kickback scheme, and racketeering. The government also invoked claims of Racketeer Influenced and Corrupt Organizations Act (RICO Act) violations. The indictment was laid out similarly to an action against an organized crime figure and their subordinate mob crew. [Click here to read 93-page, 33-count indictment: https://assets.documentcloud.org/documents/3178765/MetroHealth-Indictment.pdf ]
 
metro healthDr. Hills formerly served as chief operations officer (COO) for Cleveland’s MetroHealth Hospitals from 2010-2014. During that tenure, his salary ranged from over $400,000 to just under $3/4 Mil per year. He also served for 6-months as interim chief executive officer (CEO), following a previous scandal and resignation by Mark Moran at MetroHealth. In this capacity, Dr. Hills had direct supervisory control of the dental residency post-graduate program (which the three other defendants directly ran). Dr. Hills also served on the Ohio State Dental Board from 1999-2008. From 2001-2004, Dr. Hills was the president of the state dental board.

Alleged Extortion of Dental Residents
The government contends foreign national doctors were shaken down (extorted) for cash to apply to the dental residency program at MetroHealth. They were further extorted for additional cash to maintain their dental residency positions. Residents were also forced to work for no compensation, at two private clinics owned and operated by two of the defendants (Noble Dental Clinic & Buckeye Family Dental).

Many of the dental resident doctors were Jordanian citizens, and required an H1B (green card) work visa to obtain an Ohio dental license. Without a green card visa sponsored by an employer (Dr. Hills and/or his crew), these doctors were not eligible for licensure, as they were not US citizens. Obviously, these dental resident doctors were in a particularly vulnerable position.

Double Dipping
Two dentists of Dr. Hills’ crew were allegedly accepting full-time incomes from MetroHealth, as preceptors of the dental residency program, and at the same time running two large scale private dental practices. These were the same private dental clinics were resident doctors were allegedly required to deliver patient dental care, without compensation. These same two crew members allegedly benefited unlawfully, by having MetroHealth fully pay their malpractice insurance premiums.

Dr. Hills allegedly authorized substantial bonuses from accounts at MetroHealth for these two alleged dentist conspirators, in their frequently no-show supervisor jobs (under $93,000 in 4 years). In exchange, payoffs were allegedly afforded Dr. Hills. Kickbacks allegedly included a lap-top and an apartment to entertain Dr. Hills’ girlfriend, bedroom furniture, cash (hundreds of thousands of dollars), a Louis Vuitton briefcase, airplane tickets for the lovers, a flat screen TV, and controlled prescription medications (exact medication name redacted from indictment).

Friday, March 03, 2017

Lawsuit Filed Against Dr. Michael Melanson et. al. Over Death of 14 Month Old Daisy Lynn Torres

 

 

image

 

Thursday, March 02, 2017 09:26AM

AUSTIN, TX (KTRK) --

The family of the 14-month-old girl who died after a visit to the dentist has filed a wrongful-death lawsuit against Austin Children's Dentistry.

The toddler died while under anesthesia for multiple baby root canals and crowns on four of her teeth.

Her parents believe it was part of a Medicaid scam and are suing the dentist and the anesthesiologist who worked on her.
The cause of death of Daisy Lynn Torres, who died on March 29, 2016, was determined to be the result of anesthesia administered for the treatment of tooth decay, according to the Medical Examiner's Office.

"We haven't heard much, so we are kind of just taking action here, getting some answers so we can get some justice going on," said Elizandro Torres, Daisy Lynn's father. "We want this to be heard so that it doesn't happen again." …

 

…The lawsuit claims the girl's death was part of a corporate scheme to bill Medicaid for unnecessary dental procedures. Her parents are now suing for $1 million. Their attorney, Sean Breen, told us Tuesday night they hope this lawsuit will protect other children from the dangers of pediatric predators and their money-making schemes.

"A big component of people that use Medicaid happens to be people who are low income and sometimes not as formally educated as others and they make for very good targets because they are trusting," said Breen, with Howry Breen & Herman.

Breen says other families have come forward saying their children were also underwent unnecessary dental work at Austin Children's Dentistry…

Read the entire ABC 13 story here.


More on Dr. Michael Melanson

Dr. Melanson was the fake owner dentist for non-dentist Brian Lynne Walker who owns North End Healthcare, LLC. North End owns and operates 3 ambulatory surgery centers (ASC): Houston Children’s Dental Center, San Antonio Children’s Surgical, and DFW Children’s Surgery Center. All designed exclusively for sedation dental procedures. In fact the website of these clinics list their “privileged” providers and they are only dentists, oral surgeons and endodontists. April 29, 2016, exactly 30 days of the death of Daisy Torres, North End Healthcare began to change its name to Blue Cloud Pediatric Surgery Centers and scrub Dr. Michael Melanson’s name from their website;, replacing Melanson with Dr. Ketan Sukkawala as “owner”.

Being Melanson works for a group that owns surgery centers one must wonder why he didn’t use one of those facilities. Or at the very least understand the need to sedate babies somewhere other than his office!

Saturday, February 04, 2017

Corporate Healthcare: Important Contracts

imageJanuary 1, 2017 Written by Michael W. Davis, DDS

There exist 3 common contracts doctors sign with corporate dentistry. These include employment contracts, purchase sales agreements, and business service agreements (BSAs). Each of these contracts may be peppered with legal landmines. It is imperative that doctors accept that their expertise is patient care, and not swimming with the sharks of corporate healthcare. Nothing in corporate business negotiation can be taken at face value. This is not a relationship based on mutual trust and respect, as in the doctor-patient relationship, or when working with a specialist colleague. Corporate interest is almost exclusively directed at the financial welfare of investors. By contrast, a doctor’s focus should be his or her patients’ best welfare. The conflict of interest is self-evident.

It is advisable for dentists to secure the services of highly capable legal counsel before entering into such agreements. The attorney should have a solid background in corporate healthcare employment and contract law, especially in the dental service organization (DSO) industry. These are not well-intended local attorneys who may also spread their time between divorce law and personal injury cases. The DSO industry retains the best legal counsel that money can buy. You need to be on a somewhat equal footing.

EMPLOYMENT CONTRACTS
Legal counsel advice is invaluable with employment contracts. Attorneys may tell you from the onset their personal knowledge of the reputation of a corporate employer, saving you headaches later. Some employers are quite hostile toward employee doctors, as contracts may be routinely dishonored, and workplace abuses abound. In this case, you need to immediately walk away.

Read the entire article here

Tuesday, January 31, 2017

Put dental patients’ care ahead of corporate profits

image

  • By Jennifer King  Jan 30, 2017
  • Debate in Olympia regarding operation of corporate dental chains might seem to matter only to those directly involved, with little impact on the public in Yakima.

    That’s not the case. The outcome will have a dramatic impact on the quality of care received by dental patients here and across the state.

    Corporate chains, or Dental Service Organizations (DSOs), operate in Washington under names like Aspen Dental, Modern Dental, Bright Now, and Gentle Dental. But they do so in a gray area outside of the oversight of the state regulators.

    They’re now pushing legislation to give themselves virtually unlimited authority to continue operating here, with no regulatory oversight.

    As a practicing dentist, this worries me. Not because corporate chains represent new competition, and not because there’s anything inherently wrong with a dentist contracting for administrative support. As dentists, we should be open to models than deliver better patient care.

    But that’s not the case with DSOs. Based on my 18 years of practice, the best care results when decisions are made solely by the patient and his or her dentist. Interference in the doctor-patient relationship by third party, for-profit corporations can lead to inferior care or overtreatment, or both, and should not be allowed.

    Read the entire article by Dr. Jennifer King here

    Monday, January 30, 2017

    WTH! DentaQuest Texas Offer’s $10 Walmart Gift Cards

    DentaQuest Texas, yes the same one that ran for the hills just two years ago is back and offering $10 WalMart card to patients! Besides being an MCO don’t they also own some clinics? Didn’t MB2 just get nailed for this same practice? What am I missing? They aren’t offering it in NM, or TN or CO, or any other place I can find. Only Texas.

    Dental Quest kickback

    Thursday, January 26, 2017

    In 2011 the MB2 Dental Solution clinics brought in roughly $50,000,000.00 seeing roughly 350,000 patients.

    Maybe they just didn’t have this sign up at the time.  The hotline number could be the direct line to payroll to request a bonus check too, I suppose.

    MB2 internal fraud poster(2)

    Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case

    January 23, 2017

    Contact: HHS OIG Media Communications
    Media@OIG.HHS.GOV

    Washington, DC - Unlicensed New Jersey dentist Roben Brookhim agreed to pay $1.1 million and accept a 50-year exclusion from participating in Federal health care programs as part of a settlement to resolve his administrative liability for presenting false claims to Medicaid, billing for services furnished by an excluded person, and owning and controlling a Medicaid-participating entity while he was excluded, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced today.

    "Fifty years is one of the longest exclusion periods ever imposed by our office," said Gregory E. Demske, Chief Counsel to the HHS Inspector General. "This period of exclusion, coupled with the significant monetary recovery, is an appropriate resolution for an individual who went to such great lengths to defraud a Federal health care program and put patients at risk," said Demske.

    OIG alleged that from November 2005 through October 2012, Brookhim owned, controlled, and managed Associated Dental NP, LLC (ADNP), a New Jersey dental practice with multiple locations, in violation of his exclusion from Federal health care program participation in August 2000.

    Tuesday, January 24, 2017

    3rd Grader’s Teeth Removed at School by Mobile Dental Clinic; Then Had to Walk Home!

    Outrageous? Indeed it is! Sadly I still hear these stories about children, in essence, tortured by unexpectedly having teeth removed by these school dental programs.  This time it’s in Baltimore. Although it’s unclear, in my opinion it’s very likely Reachout Healthcare’s Smile America Partners that is owned by Morgan Stanley investments.  I would love to see the permission slips sent home to parents. If anyone has one, please email to cckaddie@yahoo.com

    Other websites include:

    mobiledentists.com
    smileamericapartners.com

    From Smiles Programs website:

    imageSmile Programs is currently active in 24 states and has ongoing strategic partnerships with Detroit Public Schools, Chicago Public Schools, the School District of Philadelphia, Boston Public Schools, Baltimore City Public Schoolsimage, Indianapolis Public Schools, Cleveland Public Schools, LA Unified Schools, Prince George's County Public Schools, Washington DC Public Charter Schools, Phoenix Area Public Schools, and St. Louis Pubic Schools as well as many others.

     

     

    Mom Outraged, School Dental Program Removes Child’s Teeth Without Her Knowing

    BALTIMORE (WJZ) — A mother is outraged after her third grader came home from school with three of his teeth missing. She says his elementary school performed a dental procedure she never knew about.

    A Baltimore City mom is looking for answers: Why did the school allow serious dental work — without making a single phone call to parents.

    9-year-old Michael is still brought to tears by the pain. He’s now missing three teeth — pulled out by a dental program visiting his school. His mother, Shanda Flemming, tells WJZ she never was notified that the procedure was happening.

    “And then two on this side. One top and one bottom,” says Flemming.

    Baltimore City Schools says Flemming signed a permission slip, but Flemming thought it was for routine cleanings.

    “I’m angry about this. I don’t think that it should have happened like that,” says Flemming.

    She says she was blindsided when Michael came home with a swollen mouth.

    “They just said they was gonna clean my teeth,” says Michael.

    Read Entire Story Here

    Monday, January 23, 2017

    Washington State Senator Ann Rivers Working Hard to Legalize the Already Operating DSO’s in Her State with SB 5158

    It appears Washington State’s Senate Healthcare chairperson Senator Ann Rivers (R) is trying to legalize the illegal activity already taking place in Washington by introducing SB 5158 in the 2017 Session. Sen. Rivers represents, the 18th district, which happens to also be the hotbed of many DSO’s which are still considered to be practicing illegally by the current Washington law. Sponsors of the Bill besides Rivers are Senators Annette Cleveland (D) and Karen Keiser (D).

    Rivers gave her bill a hearing January 19, 2017, introducing it by stating “I don’t think it is government’s job to outline the type of business structures that can exist.” She forgets, however, that the role of government is to also protect its citizens by only allowing dentists to practice dentistry. (I wonder if a racketeering business structure is also a type that government should not outline)

    At the hearing Senator Rivers stated a lot of her motivation (her words, not mine) was about “young dentist starting out have an organization that they can slip into if they’ve got significant debt” and she also wants to “make sure patients have a place they can go on Saturdays”

    HUH?

    Friday, January 20, 2017

    MB2 Dental Solutions Alaska Operations

    After the settlement with MB2 Dental Solutions and Chris Villanueva, DDS et. al. I noticed a couple of states not mentioned: Alaska and Tennessee. Well, you can guess what happened then—I just had to see how much they continued to expand their business model while under investigation. What I found in Alaska was at least 3 dental clinics and 1 real estate company.

    Let’s begin.

    1. Frost Dental-Anchorage
    3024 Mountain View Dr, Suite 107frost dental-anchorage-email(2)
    Anchorage, AK 99501
    Gentry Toone, DDS

    This one was formed in May of 2016. The NPI record for Frost Dental-Anchorage states Mary Pu is VP of Finance and the mailing address is…wait for it…wait for it…2403 Lacy Ln, Carrollton, TX.  I know, right! You thought what I did—that’s the same address as MB2! Did you notice the email address, frostanchorage@mb2dental.com? Remember, Mary Pu is Trung Tang’s wife. Tang being a major player—and classmate—of Villanueva.


    2. True North Family Dental
    3708 Rhone Circle
    Anchorage, AK 99508
    Gentry Toone, DDS

    image

     

     

     

    True North used to be owned Charles Michael Sage, DDS, Sr. under the shingle of Alaska Center for Dentistry Anchorage, until he retired in 2014.  His son, Charles Michael Sage, DDS, Jr. operated Alaska Center for Dentistry in Wasilla until he turned it over to MB2 cohorts. C. Michael Sage, DDS, Jr continues to see patients at both clinics according to the 151226 mb2 -new mngt-Gentry Toone-anchorage locationrespective websites.

    True North Family Dental is owned by South Anchorage Family Dentistry, LLC, mailing address is that of MB2 in Carrollton, Texas.

    South Anchorage Family Dental is supposedly owned by Gentry Toone, mailing address is that of MB2. Justin Puckett is the Organizer, with documents filed by one Mary Pu.

    Whether MB2 owns Alaska Center for Dentistry Anchorage in Wasilla, is unclear. However, the two associate dentists working at the Wasilla location are husband and wife with ties to Texas. In addition, MB2 operated Sage Dental clinics, so who knows. Just between you and me, I say “yes”.

    Did you note the email address for True North Family Dental? truenorth@mb2dental.com

    Wednesday, January 18, 2017

    Dr. Jason Hirsch Talks Changing the Approach in the Treatment and Care of Childhood Caries

    Interview with Dr. Jason Hirsch

    By: Michael W. Davis, DDS

    [image%255B2%255D.png]

    Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. He may be contacted at: MWDavisDDS@comcast.net

     

     

    Dr. Jason Hirsch(2)

    Jason Hirsch DMD MPH maintains a private practice of Pediatric Dentistry in West Palm Beach, Florida. Dr Hirsch has degrees in Chemistry, Public Health, Dentistry and Pediatric Dentistry and has been a Dr. Jason Hirsch logolicensed dentist in his home State of Florida since 2002. Dr Hirsch's philosophy is simple, treat children like they were your own, treat the cause of the problem first and foremost and practice with principles of benevolence, non-maleficence and veracity.
    Contact information: DrJ, 685 Royal Palm Beach Blvd, Suite 201, Royal Palm Beach, Florida, 33411. Phone: 561 795 7959 Email:jhirsch1971@gmail.com

    Introduction

    Dr. Jason Hirsch is at the vanguard of revolutionary changes in dental care for pediatric dental patients. This advancement goes far beyond progress in dental methods and materials. Dr. Hirsch examines dental disease in its totality, and arrests the causation and progression of dental caries (tooth decay). He has rejected the paradigm in restorative dentistry of continual drill-and-fill (or steel crowns), followed by pulpotomies (baby tooth root canals) and extractions. His emphasis is solidly on evidenced-based medicine and dentistry in treatment for the root causes of disease, and not simply the manifestations of disease (seemingly an endless cycle of tooth decay).

     

    Question 1

    Dr. Davis: Dr. Hirsch, I feel quite honored to provide this interview for our readers. Could you explain how our current mode of dental care for pediatric dental patients is irrational? We see endless cycles of restorative dental services for our nation’s children, especially disadvantaged Medicaid children. Costs to taxpayers are outrageous, with unsustainable deficit government spending. Too many parents are only given two options involving their child’s dental treatment; “juice them (sedation), or papoose them (restraints a/k/a- protective stabilization)”. Each venue has its own set of risks. How is your vision for children’s dental care different, in relation to immediate benefits for the youngster, associated cost of treatment, and the long-term wellbeing of the child into adulthood?

    Dr. Hirsch: Pediatric Dentistry (or children’s dentistry) has become too focused on teeth treatments instead of disease Jason Hirsch pull quote 2treatments. I fully understand that dentists are trained to repair teeth. How can we achieve this lofty goal of incorporating dentistry/oral health into systemic health, if we are hypocrites and continue to myopically focus on teeth? I hear these oral-systemic connection buzzwords, but how are we supposed to connect the dots, if we don’t begin doing this in children?

    You cannot take an adult in the middle of his/her life and try to convince them of the oral/systemic connection. It just won’t work. This has to be accomplished in pediatrics with mothers/moms as the gatekeepers to this paradigm change.

    The care system is irrational because we have acute treatments for a chronic disease. If you look at diabetes management you will see some parallels that frankly pediatric dentistry needs to focus on. Diabetics’ needs daily insulin and a child with tooth decay in whatever stage, needs daily fluoride. I don’t see dentistry promoting fluoride as medicine and that is disturbing to me. The pharmaceutical industry has created longer lasting insulin, so we have created a longer lasting fluoride, silver diamine fluoride (SDF).

    Jason Hirsch pull quote 5We have an opportunity to stop dental disease faster than ever before because of this SDF product and because of SDF; we can reduce the need to papoose children or sedate/ anesthetize them. What SDF buys is time, and we all know that the most precious and expensive commodity in life is time to ignore this therapy would be a great setback for children and dentistry in general.

    We cannot talk out of both sides of our mouth. If we want to integrate oral health into systemic health, I’m telling you it starts and ends with this concept of care, and it starts with children. Period.

    Question 2

    Dr. Davis: I’d like to get into some of the “nuts and bolts” of your modalities of arresting the dental caries (tooth decay) process. Are you giving little children shots with needles, to numb teeth from pain of dental therapy? Do you generally require sedation of the child to gain patient cooperation? How long is the child sitting in a dental chair for these therapies?

    Dr. Hirsch: SDF treatment requires skill, not in the delivery of the treatment, but in assessing whether or not the situation requires SDF treatment. We cannot think that we can just slather this medicine everywhere and we can sit back. On the contrary, we must identify the specific children that will benefit most from this therapy, and then we can slather it judiciously.

     

    Frank conversation with Florida dentist Dr. Michael Barr

     

    Frank conversation with Florida dentist Dr. Michael Barr
    by Dr. Michael W. Davis

    Dr. Michael DavisDr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. He may be contacted at: MWDavisDDS@comcast.net

     

    image

    Dr. Michael Barr is a private care general dentist at Palm Beach Smiles in Boynton Beach, Florida. He began his dental career spending three years in the U.S. Navy. Two of those years were onboard an aircraft carrier, the USS Independence, which was the first response in the Persian Gulf (Operation Desert Shield).

    Dr. Barr’s dental passions include Cosmetic and Reconstructive Dentistry. He served on the board of the local affiliate dental association (South Palm Beach County Dental Association) up to President. He has also served on the board and as a lecturer and clinical instructor (currently) at the Atlantic Coast Dental Research Clinic. He writes an eclectic blog about dentistry, marketing, current dental events, and frequent musings about personal safety, security, and armed self-defense at www.TheDentalWarrior.com. You can also find him stirring the pot on DentalTown.com.

     

    Question 1

    Dr. Davis: Dr. Barr, you’ve been very outspoken on how government administered healthcare like dental Medicaid has not served the public favorably. We’ve seen disadvantaged patients abused, taxpayer monies wasted, and ethical caring doctors forced out of this dysfunctional government program. Please give our readers an overview of your perspectives.

    Dr. Barr: I have not had any personal exposure to Medicaid. But, my first “wake-up call” was when a dentist posted (on DentalTown) about his run-in “with the law” as a Medicaid dentist. He ended up doing time in prison for, if I recall correctly, $5,000 worth of administrative errors over the course of five years. He lost everything.

    Another frightening case involved Dr. Morse, in New York. He was suspected of Medicaid fraud. They shut down his practice. The state attorney was intent on “cracking down” on Medicaid fraud (and make examples of the offending doctors). The short version of the story is that not only was this dentist exonerated, but the state attorney’s office was found to have fabricated false evidence against him. In such cases, the defendant can sue the state. And, so he did… and won a $7 million settlement. Of course, it dragged on for 11 years and made it all the way to the Supreme Court. (No kidding!) You can read about his case (and others) in my blog and read Dr. Morse’s own comments at the bottom of my article.

    I wouldn’t accept Medicaid if they offered to pay double my fees. If you are suspected of fraud, you can be shut down BEFORE Due Process. You can have your assets frozen or seized BEFORE Due Process. It can take years to clear your name, and even then, you’ve already lost everything. No thanks. No way. Never. Too risky.

     

    Question 2

    Dr. Davis: Dr. Barr, could you give us your ideas on a few mechanisms, which might help ameliorate our toxic dental Medicaid program? Further, what suggestions might you offer for a financially disadvantaged parent who relies on the dental Medicaid program for their children?