Are Bad Reviews Fair?

A few days ago, I was talking on the phone with my brother-in-law and he mentioned that he googled me to get my office address so that he could mail me something. He remarked that, “you have a bunch of great reviews online”. I cringed. I make it a point to ignore those reviews because I saw one several years ago where someone was complaining that; “he cemented a crown without even using anesthesia and it hurt!” I looked back in the chart and saw that the tooth that had the crown cemented was endodontically treated. It still bothered me enough that someone had posted this that apparently, I still remember it.

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Can You Afford a Dental Board Investigation?

Date: September 18, 2012,   5:30 p.m. – 8:30 p.m.

Location: Austin Country Club

Continuing Education: *2 Hours State CE Credit

Cost:
$40 Member Dentists/$50 Members with late registration (after 9/14)
$50 Guests of Member Dentist; $70 Non Member Dentists

RSVP: 512-335-1405  or  www.capitalareadental.org/qa by noon Friday, September 14th.

If you don’t make a reservation, we cannot guarantee a meal. If you need a vegetarian meal, tell Nancy when making your reservation. Reservations not cancelled by Friday, September 14th will be billed.

Overview:

This presentation will address the Dental Board investigative process and the events which may trigger an investigation and possible disciplinary action. In 2011, there were almost 1,200 Dental Board complaints filed in Texas. There were over twice as many disciplinary actions taken by the Board in 2010 and 2011 than in the three previous years combined. Furthermore, there were more dental licenses revoked or suspended by the Dental Board in 2010 than in the three previous years combined. This presentation will address the intangible costs related to a Board investigation and the steps which may proactively be taken to reduce a dentist’s risk profile for such a proceeding.

Objectives:

  • Be able to identify issues in your own practice which will reduce the risk of a Dental Board investigation.
  • Identify the essential elements which must be in every dental record to allow you to comply with Dental Board Rules.
  • Learn the steps which must be taken to increase your chances of a favorable outcome in a Dental Board investigation.
  • Understand the documentation issues which can reduce your exposure from investigations by other State and Federal agencies.

Edward P. “Joe” Waller, Attorney

Joe Waller is a member of the State Bar of Texas and is admitted to practice in the United States District Courts for the Southern and Western Districts of Texas. He is also admitted to practice before the United States Court of Appeals for the Fifth Circuit and the Supreme Court of Colorado. Joe assists clients with a wide range of matters involving medical or dental malpractice, disputes involving practices, and matters before the medical and dental review boards in Texas.

Joe earned a J.D. from St. Mary’s University School of Law in 1990. Prior to law school, he earned a D.D.S. from St. Louis University School of Dentistry in 1969 and was a practicing dentist for over 16 years. Prior to his dental practice, Joe served his country as a Captain in the United States Air Force. He earned his undergraduate degree from the University of Texas at Austin in 1966.

Joe is a member of the Texas Dental Association and the American Dental Association. He is also a member of the San Antonio Bar Association, the Texas Association of Defense Counsel, the Defense Research Institute, and the American College of Legal Medicine.

To register for this event, please click here.

If you have any questions about this event, please contact us by clicking here.

 

 

Where Has the Time Gone?

Many years ago I began down the path of organized dentistry and like so many of you, have reaped the benefits of camaraderie, sharing in knowledge, working as a united front to protect the profession, and to work towards helping those that desperately need dental care but have no means to seek help.

It takes many dedicated and unselfish people to make truly great things happen and I have seen this play out in many situations where someone had a great idea and had the drive to actually make the idea a reality. I believe that your Capital Area Dental Foundation is a perfect example of this. Besides being editor of the Capital Star, I am fortunate to also be a founding member of the foundation and currently serve as Chairman.

It is no small task serving as Chair of the foundation, especially following our first fearless leader, Dr. C. Leonard Dolce. Since the inception of the foundation the amount of care through four programs exceeds $700,000. I know many of you are providers and without you we could not provide this wonderful service for our community. In just over four years, the foundation has grown and we are working hard to improve our systems and improve efficiency. Additionally, we are researching treatment models in order to provide the most care for each dollar spent. Our most impressive Board of Trustees is diverse in experience and professions.

We are in a position of growing pains. There are real expenses involved in the functioning of CADF and while we are searching for grants to help offset these expenses, there continues to be a need for sponsors and donors. Many of you have been very generous in past years and we hope we can count on you again.
As I mentioned last fall, my plate is full and I believe that the time has come for a new editor for the Capital Area Dental Society. Eleven years is enough but I admit that it has been a pleasure. I mentioned that my path in organized dentistry began many years ago and I now sometimes find myself running out of gas more easily than I used too.

I would like to be able to focus more on the Foundation so that we can get it in the strongest position possible before my tenure is up. If you are the least bit intrigued by the idea of being editor, please call Dr. Tom Wicheta.

I believe that the work of the dental society and foundation together to make the community in which we live a much better place is a huge benefit to all. We as a profession should be very proud of what we have been able to achieve. I look forward to great things as a result of the efforts of many.

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Something to be Thankful For

Summer is finally winding down, and most of us are looking forward to cooler weather, hunting seasons, or football, to name a few.  I hope that everyone had a great summer, and if you went on a vacation, that you had a wonderful and safe time.

As for myself, I did have a chance to get out of the office and go to Colorado and do some hiking, mountain biking and trout fishing.  It gave me a chance to unwind, and to once again put things in perspective. Read more

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TDA Leadership Conference Summary

The TDA Leadership Conference was held on Saturday, June 16, at the Hyatt Regency Hotel in Austin. It was wonderful to hear about all that the TDA is doing for the dentists of Texas, and to me, it was a very rewarding day. To those of you who have never had the opportunity to attend one of these meetings, think of this as a board meeting of the TDA, with the component society Presidents and President Elects attending. Representing CADS in various capacities were Misti James, Wayne Radwanski, Jerry Katz, Jeran Hooten, Mark Peppard, and myself. Read more

Not an Easy Fix

Since the beginning of time, man has naturally attempted to get the best deal possible for goods and services. Dentistry is no different. We all have heard of dentists receiving a chicken for dental services and many examples of bartering. Even today, there are people that come into our offices and want to bargain for their care. I always say that, “it doesn’t hurt to ask” but the reality is that all offices have numerous expenses. While dentistry is an interesting combination of art, science, and judgment, a dental practice is a business.

The time and money one invests to become a dentist is enormous and it does cost real dollars- and a lot of them- to operate a dental office. Without a fair profit, it is impossible to maintain a dental practice for very long. Almost all dentists that I know are caring and compassionate individuals that provide a great deal of free or reduced-fee services on a regular basis out of the goodness of their hearts and an attempt to do the right thing for someone in need that has no means to compensate the office for a necessary service.  Dentists have willingly provided free dental services either in their offices or at dental mission venues. I haven’t seen many automobile dealers or manufacturers give away cars to people that cannot afford them. I haven’t seen many houses given away either. My point is that I feel dentists do more than their fair share to provide for those in their communities but cannot give everything away for free for very long.
I keep reading that, “the dental care system in this country is broken”. I also notice that every article that I read seems to talk about all of the people that do not have dental insurance. In fact, 27% of Americans 65 years old or less had no dental insurance in 2008.  I have always been a little mystified by folks with the means who think that they cannot get dental services if they do not have insurance. People make far more costly purchases without third party help. Again, the $30,000 automobile is a good example. Certainly, part of the equation involves choice. Certainly, oftentimes people are not able to purchase dental insurance or directly pay for dental services.

I contend that the dental system is not broken. It is just that there are many that cannot afford to have the care that they need. Your Capital Area Dental Foundation is very aware of the access-to-care problems in our community. We have teamed up with various entities to continually study the problem of limited access to dental care in our area and to try to provide solutions. St. David’s Foundation, Texas Dental Association Smiles Foundation, Central Health, and the Health Alliance for Austin Musicians (HAAM) and St. Vincent de Paul have been major players.
Now, more than ever, there are many people in our community working to make the lives of central Texans better by providing dental solutions and treatment to those in need. Many of these people are not dentists but caring people with unique talents who have become passionately engaged in dental care for the needy. They provide varied viewpoints and expertise. Of the twenty Trustees for the Capital Area Dental Foundation, seven are professionals in areas other than dentistry.

The Kaiser Family Foundation has done much research in the area of unmet dental needs. The latest results from Kaiser tell us that one in four children in the United States have untreated tooth decay and that one in four Medicare beneficiaries are missing all of their teeth.

The situation is dire but what should we do? Many believe that dental therapists are the answer. Others feel that dental care is a right and the government should provide this service. So we have a dilemma of having well trained and highly skilled dentists providing treatment or lesser-trained and educated making life-changing decisions and providing care. The alternative that we all contend with on a daily basis is the pressure to provide highest quality care for a fraction of a fair fee. If this trend continues, what would be the incentive for one to spend years to become a dentist while spending many thousands of dollars in the process to become a licensed dentist? The result is too much disease and a shortage of dentists.

The following points are central to my experience in the access to care problem:

  1. To educate everyone possible about the importance of effective oral hygiene. Especially those in high-risk groups. Prevention is the real key.
  2. To eliminate pain and infection for those not able to help themselves. This means that those that have the means to pay for their services should, so that the pool of those that cannot is smaller. We should strive to help those that truly are in need.
  3. To improve the appearance for those that have a dentition that affects their self-esteem and the ability to become employable.
  4. To maintain the high standards of treatment. Patchwork or inferior care would only worsen the problems.
  5. To do all we can as professionals to improve treatment models and the dignified delivery of care.
  6. To maximize donated dollars by keeping administrative costs to a minimum.

I contend that the dental care system in this country is not broken. What is broken is the lack of many Americans to take responsibility for their health- especially prevention of disease. Parents allow their children to eat and drink anything they wish and are surprised when there is decay. There are those, as in any profession or trade that are milking the system for all it’s worth. This is particularly notable in government-funded solutions such as Medicaid as highlighted on the PBS Frontline Dollars & Dentistry program which aired in June 2012. This is a big concern, but doesn’t reflect the practices of the great majority of dentists in the United States. Efforts to “fix” the dental care system all seem to involve lowering of standards and the creation of more administrative costs. As the late Dr. Jim Pride once told me, “everyone wants to fly first-class for coach fares.” There will always be more dental disease than can be treated. Education of the people to prevent disease continues to be the most valuable tool in any health professionals’ toolbox.

[1]    http://www.cdc.gov/nchs/data/databriefs/db40.pdf

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An Invitation to Get Involved

As your new president of the Capital Area Dental Society, I want to welcome all of you to the start of another great year. I want to thank all of the members who had the confidence in me to elect me to this position.

Our Society has accomplished so much in the past years, and we should all we proud of the work that has been done. I know that I have several hard acts to follow, but I am inspired by the fact that my job will be made easier, thanks to the support of my fellow Board members and our past presidents. Read more

A Sincere Thank You

Dear Colleagues,

It has been almost 4 years since I joined the CADS Executive Committee and began the path that has led me to be the President of this great dental society. My first feelings when I began this journey were those of apprehension and then excitement. The apprehension comes naturally from being in an unfamiliar situation. Sure, I had been in leadership roles before but nothing with the magnitude of being the President of the oldest and first dental society in the state of Texas. I’ve known since high school that I wanted to be dentist. I knew years before moving to Austin that the Capitol City is where I wanted live, practice and have a family. However, I never would have imagined how well Austin and dentistry would have accepted me.

I have had the honor to follow in the footsteps of many others that have dedicated time and efforts to make CADS what it is today. It was knowing that I had the support and encouragement of previous leaders and other members that helped ease the apprehension and led to the excitement of what is next.

In these four years, much has been accomplished that has added to this excitement. A group of leaders from CADS, including Past-President Leonard Dolce, took the initiative to start what is now a successful and growing foundation to benefit the oral health of our community. Past-President Dr. Wayne Radwanski led the way in starting a fund to allow us to be fiscally prepared in the event that CADS needs a physical structure to operate. Past-President Dr. Stan LaCroix and Dr. Ensy Atarod started a dental health educational program targeting local elementary children. Past-President Dr. Eric Hollander supported these programs as well as asked many important questions of our TDA leadership that has led to positive change at the state level. As you can see, there is not only tremendous support but also big shoes to fill.

With so many great things being accomplished I asked myself—”How can I help, what can I do?” This thought consumed me for several weeks until I had an idea while on break at the Kois Center in Seattle, WA. “I should see if Dr. Kois would come speak to our membership.”

Thankfully, Dr. Kois was interested. Most importantly the CADS Board of Directors was also keen to this idea. It was not an easy decision to bring a speaker of this magnitude to Austin. There would be substantial costs to the society if the meeting was not successful. CADS had never been in this position before. I asked your Board to take a calculated risk. I was warned of my fiduciary responsibilities to the membership, but I felt that this was a risk worth taking. Thankfully, your Board agreed and as many of you know the meeting was a smashing triumph in both education and attendance. The financial success of this meeting has given CADS greater flexibility and has likely prevented any dues increase for several years.

However, this Board and Executive Committee are not done yet. With all of these changes that have been detailed, we needed a new strategic plan. By now you should have seen the new CADS strategic plan. We have new goals in place to help carry us forward on a defined path. Due to the hard work of many individuals, I believe that your dental society is in a better position today than it has ever been.

On a personal level, I thank all of you for giving me the opportunity to contribute. I entered this society young and eager to help. Without your reaching back to me, I could have never realized the potential that this profession can provide. I have cherished this role and responsibility. I have learned more than I could have ever expected and step aside knowing that future leadership is strong. Your next CADS President, Dr. Tom Wichita has shown a steady hand and leadership style that will continue our society’s success. Although my role as President is coming to an end, I am not leaving and I will continue to help this society whenever and wherever there is a need.

Sincerest thank you,

Jeffery Brunson

What’s New?

I try to keep my eyes open for dental and medical stories that are interesting that most of us may not have heard about. With the explosion of technology, many researchers and scientist are looking for new ways to employ the technology. I hope you find these tidbits interesting and informative.

Tooth Tattoos

Graphene is a one-atom thick layer of carbon with specific peptides attached to identify specific bacteria. According to a report online from Co.Exist, posted on March 29, 2012, Mike McAlpine of Princeton University, work is being done to make the graphene sensors as tooth tattoos which will supposedly detect bacteria. It does not elaborate about how the device would be “tattooed” onto the tooth, how long it would last or any specifics as to how the detection of ever-present bacteria would aid in diagnosis. I looked up the story because a patient asked me if I had seen the story. It is amazing what our patients teach us sometimes.

http://www.fastcoexist.com/1679583/tooth-tattoos-will-tell-when-youre-ill”

Ph Sensor for your Mouth

According to a Wellspere online story, another type of passive medical sensor is being developed that would have a power supply, a Ph sensor, and a wireless communication device that would be affixed to a tooth. Unlike the previous sensor, this one is a bit easier to understand the rationale as to how it would be effective. Say you were eating too many sweets and starches and haven’t been brushing and flossing as you should, the device would detect the low Ph of the oral environment and alert you that you are at risk for caries via your smart phone. Sounds like a good plan.

http://www.wellsphere.com/dentalhealtharticle/moredentaloddities/746983?query=Dental+Caries

Plaque Detection Camera

You have seen the commercials on TV where a camera is used to show the plaque on a person’s teeth. I was wondering if this bright multicolored device was for real or if it was a simulated display. It turns out that it is probably a simulation. I did discover in my search, that a Japanese company named Miharu makes a nice intraoral camera that sells for about $119 that plugs into your TV at home. Wow! Wonder why my in-office camera cost so much?

http://inventorspot.com/articles/dental_plaque_detection_camera_puts_your_teeth_tv_29754

Pain & Suffering

CBS Sunday Morning had a feature on March 11, 2012 about the state of pain management worldwide. It was reported that more than 80% of the world’s population has little or no access to pain medications. Almost 5 billion people suffer because they have access to about 5% of the world’s morphine supply while the United States consumes about 95% of the overall supply. The story was very moving when people were shown dying from chronic disease without any relief. I was surprised to find that the United States is much different than the rest of the world in the availability and use of analgesics.

A Dental App for your Smartphone or iPad

The iTunes app store has literally hundreds of applications specific to dentistry. Some are geared toward patient education and encourage healthy habits. Ryan Newsome has an application entitled ToothbrushTimer that not only times your brushing but also gives reminders to reach specific areas. It even tells you when it is time to change your brush. There are more of these and worth considering recommending to patients, especially since they are free. The Dental Prescriber by Dr. William Ha is designed to help dentists on the go to quickly look up scripts. PerioVoice by Taboom is a voice recognition app that allows for hands-free perio charting. Check out your apps!

Capital Area Dental Foundation 2012 Gala

Your Capital Area Dental Foundation 2012 Gala, Mardi Gras & Casino Night was well attended and great fun. Hope you had a chance to experience the great energy and excitement. A special thanks to all of the sponsors for their support of the Foundation and the Society. Austin Oral & Maxillofacial Surgery committed that evening $20,000 to the Capital Area Dental Foundation Endowment. With this generous gift, the Austin Community Foundation will contribute the maximum of $5,000 per year for the next three years. Thanks to each and every person that has allowed the Foundation to grow to serve our area with dental care for those that otherwise would not have much needed treatment!

Thank you to all of our member dentists who provide compassionate care in the many programs of the Foundation. Without you, we would not exist.

Continuing in the vein of compassionate care, the state-wide efforts of the Texas Dental Association Smiles Foundation, through the Donated Dental Services program and the Texas Missions of Mercy (TMOM) events has provided almost $17.5 million in care since 2001 serving 25,234 patients. The next TMOM is in San Antonio at St. Mary’s University on April 13-14th. You can sign up to volunteer at tdasf.org.

Kudos to our CADS President, Dr. Jeff Brunson not only for his great leadership but for the very well stated President’s Message about the importance of involvement in organized dentistry.

See you at The Texas Meeting in San Antonio, the 142nd Annual Session of the Texas Dental Association, May 3-6, 2012.