Dentist Treatment Options: Patient Quotas

Last year, we discussed how New York state was opposed to patient quotas for dentists in the article, Dentist Treatment Options: NY Opposes Patient Quotas for Dentists.

Dentists and dental associations were outraged when Invisalign announced that dentists would only be able to offer the orthodontic treatment if they began at least 10 cases per year.

Though Invisalign ultimately withdrew this controversial “provider requirement” (read about Invisalign dropping dentist requirements), the backlash kept on coming.

Many were horrified by the idea that a manufacturer could prevent a dental practitioner from offering a treatment modality to their patients.

New York was so disturbed by this precedent that Governor David A. Paterson signed into law, Chapter 504 of the Laws of 2010, a bill that “prohibits corporations and manufacturers from setting quotas on dentists who use the corporation’s product or service.”

The bill essentially states that a manufacturer may not set quotas on dentists who wish to use the manufacturer’s product. Here’s the text of the New York state legislature bill:

“The commissioner shall promulgate regulations to require that a manufacturer or other entity selling, leasing, or otherwise providing any drug, device, or health care service shall not, directly or indirectly, establish as a condition for the use by a dentist of such drug, device, or health care service that the dentist meet any quota for the number of patients on whom the dentist uses the drug, device, or health care service and that a dentist shall not, directly or indirectly, request or receive from any manufacturer or other entity a drug, device, or health care service having a condition that the dentist meet any quota for the number of patients on whom the dentist uses the drug, device, or health care service.”

The bill, A.10943/S.7614, was sponsored by Richard Gottfried, chair of the Assembly Health Committee, and Carl Kruger, chair of the Senate Finance Committee.

The bill was passed and signed into law even though there was strong lobbying against it.

I want to hear your thoughts. Do you feel that other states should take the same action as NY? Are you dealing with any companies who have established a proficiency quota?

Dental Insurance and Obama Care: Who’s Right?

Dental Insurance and Obama CareThe National Journal is reporting that the National Association of Dental Plans is spending more than $1 million on a campaign to change a provision in the health care law that they feel will require some people to buy duplicate dental insurance coverage.

Let me repeat…The dental benefits trade organization is spending $1,000,0000 to hire a lobbying firm to convince the Obama administration to fix the provision by the end of 2011.

Is this a good thing? Click here for a 92-page white paper “Road Map” with Delta Dental as a co-sponsor.

The NADP is concerned that, starting in 2014, the almost 44 million people who receive pediatric dental coverage through small business employers will also have to buy coverage through the new health insurance exchanges. It is asking regulators to clarify that their existing coverage meets the law’s requirements.

“Truthfully, this is the No. 1 issue for our industry,” said NADP executive director Evelyn Ireland. “It is the most crucial thing for us to get done.”

NADP wants to ensure that people will be allowed to keep their existing dental insurance coverage under the new health care, a promise President Obama repeatedly made during the heath insurance reform debate.

For a multitude of reasons I have never been a big fan of Delta Dental. However, after reviewing the 92-page white paper I think there may be some merit to this $1,000,000 argument.

Before, I make up my mind, I would like some pro or con feedback from our readers.

Please post your comments below.

Who Else Wants Dentists Targeted for Tooth Tax?

tooth taxDo you think dental services should be taxed?

Apparently Vermont’s Governor Peter Shumlin believes so.

A $24 million new tax package was recently approved by the Vermont House Ways and Means Committee. They voted 7-1 on a package intended to help make up a $176 million projected shortfall in their state.

Fortunately for dentists and patients residing in Vermont, the package did not include Gov. Peter Shumlin’s plan to expand the provider tax to include dental services.

His “tooth tax” initiative would have imposed a 3% tax on the gross receipts of dental services.

Dentists in Vermont were outraged, and more than 4,500 people signed a petition with the VSDS opposing the 3% tax.

The Vermont State Dental Society vehemently opposed the tax, stating, “We believe it makes much more sense to tax items that hinder oral health like candy, soda and tobacco. Taxing health care to pay for health care is a math problem that just doesn’t add up.” The group called for dentists and patients alike to sign the petition through the VSDS website.

The controversial expansion of the provider tax to include dentists that would have raised another $3 million in revenue for the state.

Even though the increased tax would have increased Medicaid payments, dentists still believe a tax on dental services is the wrong way for the state to raise funds.

Should dental services be taxed? If you were in Vermont, would you have signed the petition?

For more on this story, see the Bennington Banner.

Dental Marketing: Negative Online Review Appears as a Facebook Page

negative dental page on FacebookIn the past The Wealthy Dentist has written about negative online reviews in such articles as Appeals Court Says Yes to Dentist Lawsuit Against Patient for Online Review andWhen a Dentist’s Relationship Goes Bad on the Internet — both stories about harmful dental critiques posted on review sites like Yelp and Angie’s List.

But in August of this year, Chris Cook of Bakersfield, CA, pushed negative online reviews to a new level.

It was reported in dental news site DrBicuspid.com that Mr.  Cook took his 5-year-old son to see Bakersfield pediatric dentist Edward Dove, DDS, for a tooth extraction. Mr. Cook claims Dr. Dove mistreated his son during that visit by extracting a tooth before the child was adequately sedated.

According to DrBiCuspid.com, Cook stated that his son vomited up most of the sedative, screamed, and urinated on himself while allegedly being held down by three dental assistants during the procedure.  Allegations Dr. Dove vehemently denies.

Chris Cook decided to take matters into his own hands and created the “I Hate Dr. Dove of Bakersfield” page on Facebook, attracting more than 200 members in its first 48 hours.

Luckily for Dr. Dove, Facebook does have a policy for pages with the word “hate” and considers them in strict violation of their terms of service.  They swiftly moved to shut down the dental hate page.

Cook was undaunted by the Facebook boot, turned around and created a second Facebook group page, “Bakersfield dentist DOES NOT ROCK!!!!!!!!!” which is still up and active.

Dr. Dove has handled the situation by defending his treatment in the press and pointing to his 23 years in practice without a single disciplinary action. He has chosen not to engage with Chris Cook on his Facebook page, and was quoted in Dr Bicuspid as saying, “I think my reputation will be hurt a little bit, but right now I just want to calm down,” Dr. Dove said, “This guy is going ballistic, he’s trying to smear me, and I’m getting bullied.”

But should Dr. Dove be more concerned?

Just how significant are bad reviews for the future of your dental practice?

A new survey by market analysis firm Cone, Inc., found that four out of five consumers have reversed purchase decisions based on negative reviews found on the Internet. Another survey by Ratepoint found that 40 percent of consumers indicated they are more likely to consider a local business when they respond to a negative online review.

In the case of a Facebook page being dedicated to hating a dental practice, a dentist has little recourse since the unhappy page creator would have to allow the dentist to join the group page in order to issue a response.

Dentists have had little luck in defamation lawsuits when it comes to negative online reviews since the courts tend to look upon unhappy reviews as free speech. In a recent defamation case in California, a dentist has been ordered to pay $80,000 in attorney fees to the parents who posted a negative online review.

So how do you combat something like a negative Facebook page?

By making sure your dental practice has more than one website that appears on the top pages of Google when your business (and personal) name is searched online. Also have your own Facebook page, or pages for each type of treatment you offer. Have a Twitter page and make sure your practice is listed in as many dental directories as you can find. The idea is to control what appears on the first page of Google about your dental practice. Regular press releases help with this too.

For solutions to multiple name search and directory listing go to: www.InternetDentalAlliance.com.

For more on this story see: Facebook Pulls Plug on Angry Dad’s Antidentist Page

What Makes a Dentist go Bad?

when dentists go badIn recent news, dentist Davinder Singh Jamus failed to effectively sedate a patient as he filed down her teeth at the Kensington Dental Spa clinic in West London, causing her to scream out in agony.

His response was to tell her that, “Nobody screams in my surgery,” while botching her veneer job.

On March 21, the UK General Dental Council listened to story upon story from angry former patients of Dr. Jamus.

When one of the former patients complained about the quality of her dental care, he allegedly told her she had been “very ambitious and naughty.” Apparently he tried to intimidate her into silence by advising that if she tried to take it further he “could guarantee she would lose.”

Jamus is also accused of allegedly fitting one patient with dental crowns to two teeth, instead of providing veneers as agreed, and failing to give another patient enough time to consider treatment before asking for consent while not admitting he had perforated her root canal.

Is this a bad misuse of his position as a medical professional, or an example of a poorly trained dentist?

NHS in the UK saw a 4.4% rise in annual complaints about GP services and dentistry to in 2009 -2010. There are twice as many claims on British dentists as there are on British doctors for poorly done treatment, fraud or excessive fees.

Other complaints are for badly done root canals or broken crowns and bridges.

Some believe the rise in complaints in the UK is due to the rise in the costs of procedures during rough economic times. Davinder Singh Jamus seems to be the exception — not the rule — when it comes to quality dental care.

What are your thoughts on bad dentistry?

For more on the Jamus dental story, see: The Daily Mail.

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