Dentists Check Themselves Out Online

Relax. Accountability cuts both ways. Use it.

It is only fair that dentists are not the only ones in the dental industry who must watch out for their reputations on their Internet these days. Virtually all stakeholders in the field, including healthcare IT vendors, dental marketing CEOs and managed care reps, are being held accountable by the same transparency that has most dentists needlessly worried. On the other hand, there are a few dentists who indeed should be worried.

Let me show you how this works. Janis Oshensky, vice president of professional relations for Delta Dental Plans Association, recently was quoted in a DrBicuspid.com article titled “Study: Insurers’ market power lowers dentists’ income,” written by Rabia Mughal. Oshensky questions the results of a recent study that was published in the JADA titled “The effects of insurance carrier market power on dentists and patients.”
http://jada.ada.org/cgi/content/abstract/140/1/90

The conclusion to the study states that when a large insurer, like Delta Dental, controls a majority of the market in a community, it drives dentists away – ultimately decreasing access. Makes sense. Right? Businesses flee tyranny for natural reasons.

Here is what veteran PR specialist Janis Oshensky said on DrBicuspid less than a week ago:

“The study speculates that dentists will leave markets dominated by a few large carriers, which would lead to higher fees for uninsured patients and reduced access to care. In fact, the miniscule effect of concentration on the fees paid to dentists — as they are reported in the study — is unlikely to trigger a mass exodus of dentists from concentrated areas.”
http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301668&wf=34

Incredible.

Ms. Oshensky further states – on dentists’ behalf – that we actually realize that discounts do not necessarily mean less pay, and that network participation increases dental visits (for the same pay). She seems to have the traditional Delta tendency to insult dentists.

This time, sweet, sporting justice was delivered. Delta’s PR specialist Janis Oshensky got hurt in the very worst way for a person’s whose career is in public relations. When Oshensky ego-searches Google, a link to an article unabashedly titled, “Blindsiding Delta Dental” is her fifth hit, and it will be on her first page for a long, long time.
http://healthcarefinancials.wordpress.com/2009/04/03/blindsiding-delta-dental/

It is my opinion that Janis Oshensky’s PR career is simply over. She no longer has credibility. But here is what buns me: Delta Dental leaders never came to her defense. They used up a devoted employee.

Stand by. I’m not nearly through, and it can only get more exciting. Delta Dental is currently having a really tough time finding PR specialists to promote their dentistry brokerage business on the Internet because I am picking them off one-by-one. Delta CEO Kim Volk is running out of pawns.

I’m hoping they’ll send out someone with an attitude.

My pleasure.

D. Kellus Pruitt DDS

Dr. Pruitt,

Your previous comment contained hyperlinks, so it had to be manually approved. Our blog settings automatically ask us to manually approve any comment with a link in it, as that’s a favorite tactic of spammers.

We approved your comment this morning; we check the comments daily. Rest assured that no offense was intended.

Julie and Jim, if you don’t think our conversation is as fresh as dental history gets, just take a look at the timing.

A few hours ago, Arlene Furlong posted an article on the ADA News Online concerning Internet reputations of dentists – the subject of your article here on The Wealthy Dentist. The title of Furlong’s article is, “Harsh words: Dentists fights online review.”
http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3529

Furlong writes that there is an organization called Dental Justice that offers “mutual privacy agreements” to protect members’ reputations from predatory patients on referral Web sites like Yelp. She says that these days they are called “gag orders,” and since they involve patients’ First Amendment Rights, they can be cumbersome to explain if new patients actually read the agreements before signing.

Camouflage

Finally, there appears a reason for those pesky HIPAA forms. According to Furlong, Dental Justice has not only developed a sleek way to conveniently obtain patients’ signature for the gag orders, but has also found a use for HIPAA in dentistry – quick signatures.

“Dental Justice adds language to the patient’s HIPAA form that says neither the doctor or [sic] the patient will post reviews on the Internet and then sends a database of all dental members to patient review sites to let them know that their member doctors have contracts with patients. He says the Internet services can’t knowingly come between a contract. He says the process can prevent placements and has already been shown to promote removal of listings.”

You guessed it. Dental Justice will re-write dentists’ HIPAA privacy forms and hide those tricky gag agreements for a fee. Is that not bureaucratic clever? Nobody ever reads those things before signing them. But if anyone can cause that to change, it’s a sleazy company like Dental Justice. Leave ethics to them and there will be bottlenecks in all waiting rooms as untrusting patients read entire HIPAA privacy documents before signing them – just to make sure the dentist didn’t slip something in.

Face it.

These days it is futile to fight transparency, and old school tricks are not the answer this time. Desperate traditionalists who panic instead of bravely facing the future will end up paying far too much money to look increasingly foolish. Furlong even writes that Dr. Wong, who has actually had recent tangible success in her case against Yelp, says that she’s not sure she would file suit if she had to do it all over again.

I can only imagine how discouraging a battle this has been for her. But it is far from over, and I think Dr. Wong knows that this will not end well for her. For example, what happens if she coincidentally gets a random bad review that would have otherwise been completely ignored by everyone? It gets worse. What happens if she wins her case against a whiny, greedy parent, and gets thousands of intentional bad reviews from people who just happen to hate dentists? I am afraid that the further Dr. Wong takes this, the worse it will be for her. That is my opinion.

In the last three paragraphs of the otherwise balanced story, author Arlene Furlong transforms from an unbiased news reporter into an employee in the PR department of the ADA. Watch closely for the change.
———————————–
“Dr. Michael Halasz, a member of the ADA Council on Dental Practice, says eventually these sites will reveal themselves for what they are and in the meantime, people should take the reviews with a grain of salt.

“Dr. Halasz thinks having a Web site may be a good way to influence presence on the Internet. “I’ve been told before by patients that they selected me because of how I presented myself on my Web site.”

“ADA Intelligent Dental Marketing offers resources for dentists interested in updating or developing a professional practice Web site. Dentists can visit http://www.adaidm.com/general/websites.htm for information. The ADA is an investor-owner of ADAidm, which offers professional marketing approaches for dentists.”
————————————

Did you see the change?

A couple of weeks ago, an article with no byline on the ADA News Online featured the ADA/idm. It advised members to invest up to 9% of profits into direct mail from the Utah advertisement business.
http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3505

That makes it easy to understand the ADA’s official, committee-approved policy about patient referral sites like Yelp.com and Angie’s list. The officials don’t like them – arguably because of institutional investment reasons that have nothing to do with patient care. Here is a question I would like answered by an official of either Intelligent Dental Marketing or the ADA: How much are ADA members on the hook for if the Utah company goes belly-up in this tough economy. It is time for transparency all over, friends.

Oh yea. I think the instant Arlene Furlong inserted the link to ADA/idm she crossed the line that separates a reporter of the news and a PR specialist.

D. Kellus Pruitt DDS

But wait, Julie. I’m not near through yet. Please let me know when you have had enough. I personally find organized dentistry exciting these days… like a slow train wreck.

I understand that checking out hyperlinks makes your job tedious, so I’ll refrain from using them unless someone specifically asks me to support some incredible, yet in the end, intuitive remark.

I think it is clear to everyone that sooner or later, the ADA will simply be forced to give in to transparency about many issues that they currently refuse to discuss with membership – including the reason that executive director Dr. James Bramson and chief operating officer Ms. Mary Logan were suddenly fired about a year ago. (Gasp!) Was I the only person in the nation to consider the capricious action highly unusual? The leadership of the ADA certainly didn’t plan ahead like they did around six years ago when Bramson took over the job in a well-choreographed transition with more than six months lead time. As I remember, Bramson and Logan were brought on together, and POOF! They suddenly left together.

A year later, the ADA is still searching for a new exec. Allow me to share with you my idea of what it is about the ADA executive director position that continues to scare away potential leaders. Please note that the following is mere suspicion – a worthless piece of non-annotated Internet gossip – so far. Suspicion happens when important information is not shared with those most affected. And the ADA is not the friggin’ National Security Agency.

Immediately following the announcement of the firings, then President Dr. Mark Feldman put a lid on any information about their dismissal before taking over as interim exec. For the loyalists who think I’m over-stepping traditional professional boundaries in speaking so frankly, let me ask this: Since it is my dues that funded the severance packages, don’t I have a right to know the reason for the sudden failure of the top two ADA employees who were so carefully brought on board? I think I have that right. Tell me I’m wrong. And by all means, tell my why.

I found it interesting that almost immediately following the decapitation of the ADA, a renewed push for the NPI number was posted on the ADA News Online. For this and other reasons, I now suspect that Bramson and Logan were fired because of their failure to move membership forward with electronic dental records and HIPAA-related goals that they were specifically hired to achieve. So how badly did Bramson and Logan fail? I recently discovered that only two-thirds of the dentists in Texas, where I practice, have NPI numbers. I suspect that the national figure is similar. I think when the Bramson/Logan contracts were signed, the ADA House of Delegates were pushing for 90% or better HIPAA compliance with regard to the NPI number. In giddy 2002 one could smell the ambition.

Sorry. I drifted off the topic of shaky business models in modern dental marketing.

I mentioned that I wanted to ask the leaders of the ADA and IDM if members’ investments are at risk in the joint venture between my non-profit ADA and the for-profit IDM. Yesterday, on April 9, I posted the following question on both the “E-mail Dental Practice” link for ADA members and in an email to Trajan King, CEO of Intelligent Dental Marketing.

“Dear Dental Practice Department and IDM CEO Trajan King: According to a recent article by Arlene Furlong in the ADA News Online, the ADA is an investor/owner of ADA/idm. Can you tell me if the ADA members’ dues are at risk if IDM goes under? D. Kellus Pruitt DDS”

Even though I long ago learned not to expect any replies from Mr. King, I have had limited success in obtaining responses to my questions from various email links to the ADA. The Department of Dental Practice provided one of three responses I have received out of ten questions in the last six weeks. (See “Transparency and the ADA – a dissecting experiment.” on the PennWell forum).

If my new question addressed to the ADA Department of Dental Practice cannot be answered for some reason, I expect to be told that reason. That chunk of entertainment alone could be worth the trip.

D. Kellus Pruitt DDS

Thanks, Jim. You can feel certain that I am one of many dentists who appreciate the information that you and your staff bring to our profession. Your articles are special because they are not slanted towards advertisers. In addition, your prolific and unprecedented survey studies are terra firma in a rapidly evolving marketplace.

I suspect that an increasing number of ADA members are concerned about the solvency of Intelligent Dental Marketing, as well as other important, yet unaddressed issues affecting the future of our practices. It is undeniable that members deserve to know things like the exposure of their investment. Inevitably, answers will simply have to be revealed by ADA leadership without hesitation, ever again. Unfortunately, since the self-serving institutional stoicism of the ADA is surprisingly entrenched and formidable, I still don’t know how long the good ol’ boys can hold out. They’re shy, but tough.

If we are a fortunate society that rejects tyranny, as history arguably shows us to be, the Internet will ultimately give us the tools to override the wasteful and occasionally deceitful command-and-control business model that is prevalent in US business. Marketplace conversations like those promoted by your blog lead to transparency, which leads to accountability. That can be scary.

Fear of membership – An ADA tradition

The pressure from unsatisfied questions is cumulative. Suspicion causes interest to swell to immense proportions. And as I have shown on the PennWell forum thread, “Transparency and the ADA – a dissecting experiment,” off-limit topics progressively and profoundly paralyze traditional organizations – eventually turning authoritarian “cause I said so” reticence into transparent absurdity that resembles childish behavior. Allow me to show you what I mean: As I pointed out, I have publicly asked the ADA soft questions as well as hard questions over the last few weeks. I believe most department heads in the ADA fear me by now, because over a week ago, even the ADA Library Services began to ignore my softest of questions, such as: “How many dentists are in the US?” How childish is that?

It is impossible for a non-profit, captive service entity like the ADA to be selectively transparent without running the risk of resembling a collection of proud fools.

Some day, truth about less than honorable machinations of the ADA will be shared with us reluctantly yet copiously. Only then can the healing begin. These days, the good ol’ boy defense of unresponsiveness is just an obsolete, cowardly delaying tactic that raises the stakes. Stick around. It’s bound to get exciting around ADA Headquarters just before cleansing downsizing happens. Heads will roll. That’s my opinion.

D. Kellus Pruitt DDS

Dentists, as well as consumers, can access over 40 review sites — all from a single, convenient interface.

Try it out for yourself…
http://www.thedentistreviews.com/

John Barremore
Houston, TX