Dentists Beware: The Government May Want To Tell You How To Manage Your Practice

dentists' hands in chainsThe North Carolina Senate recently upheld Senate Bill 655, which would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

No other state in the union has implemented such restrictions on dental practice management, or sought such inclusive authority over how dentists manage their business.

Talk about the far-reaching arm of the government!

As reported by Dr. Clifton Cameron in the Fay Observer –

“As a practicing dentist in Fayetteville, I know how this legislation will impact dentistry in North Carolina.

When my partner and I established our practice in 2008, we quickly realized dental school taught us much about clinical care, but little about running a business. And the dental industry, much like the rest of the health care industry, is changing and becoming more complex.

So like many small-business owners, we looked to outside companies to help finance the practice, manage billing, handle payroll, file insurance and execute other administrative tasks. The arrangement helped our dental practice operate so efficiently that we can charge lower rates and accept dental insurance from patients.

Instead of helping foster lower fees for patients and wider insurance acceptance, Senate Bill 655 would require dentists to personally handle all the administrative tasks of their practices.

The bill would forbid dentists from taking advantage of the types of business services that millions of small businesses use. Many dentists like me would be forced to spend less time on patient care and more time on managing the complexities of a modern dental practice.

Senate Bill 655 would give the Dental Board complete control of how dentists in North Carolina run their practices so they can keep fees charged to patients artificially high and insurance acceptance artificially low.”

The North Carolina State Board of Dental Examiners position on on Management Agreements with dental practices is as follows:

“The Board has become increasingly concerned about the expanding scope and nature of management company services and agreements, and their impact on the control of dental practices by the licensed dentists.

The bundled services offered by management companies typically involve some combination of (1) administrative management services; and (2) financial management services.

Based on its knowledge of the operations of dental practices, and after reviewing management arrangements with dental practices for almost ten (10) years, the Board has identified features of management arrangements which it has determined to be highly likely to create a situation where the ownership, management, supervision or control of a dental practice is impermissibly conveyed to an unlicensed person or organization because either separately or when bundled, those features interfere with the licensed dentists’ professional decision-making and their exercise of clinical skill, judgment and supervision in the dental practice.”

Have you read about this story? What are your thoughts about the government and a State Board of Dental Examiners dictating how you administrate your dental practice?

We look forward to hearing your thoughts on this subject.

For more on this story see: Op-ed: Legislation would restrict dentistry in the state and the North Carolina State Board of Dental Examiners position at (opens in a pdf file).

A Dentist, Bill Gates and the Hells Angels

A Dentist, Bill Gates and the Hells AngelsA former University of Pittsburgh football player and dentist, Anthony Dinozzi, was arrested for threatening to send the Hells Angels biker gang after an FBI agent and is now awaiting sentencing.

It began in 2011 when Dinozzi began to believe that Microsoft founder, Bill Gates, had been sending him brain-damaging “radioactive waves” through his computer.

At the time Dr. Denozzi was questioned by Pittsburgh International Airport FBI security agent, Gregory Heeb, when Dinozzi tried to board a flight to Seattle in order to “arrest Mr. Gates and his wife, Melinda.”

As reported by the Pittsburgh Post-Gazette, Mr. Dinozzi told Agent Heeb that the flight had been booked by Attorney General Eric Holder and that Mr. Gates was emitting waves through his computer that were harming his health.

The dentist was not arrested for the airport incident.

A month later the FBI Joint Terrorism Task Force interviewed Dinozzi at his parents’ home because he continued to call federal officials demanding that they arrest Bill Gates. After the interview, the dentist ceased making phone calls until January of this year. Agent Heeb called Dinozzi’s mother to let her know that the phone calls to arrest Bill Gates had started again.

This didn’t go over well with the dentist, who then allegedly called Agent Heeb and threatened to beat him up and hire the Hells Angels attack him.

This was the final call that got him in hot water and arrested by the FBI.

His attorney is hoping to see the dentist get a light sentence, if any, and mental health treatment instead of months in prison.

For more on this story see: Former Dentist Faces Prison for FBI Threat

Dental Care: Do Dental X-Rays Cause Brain Tumors?

Dental Care: Do Dental X-Rays Cause Brain Tumors?Last week the American Cancer Society published Yale University research findings that dental patients who received frequent dental X-rays a generation ago, are at greater risk for developing meningioma, a non-cancerous brain tumor.

The Yale study involved more than 1,400 dental patients from around the U.S. who were diagnosed with the non-cancerous tumor. The study also tracked a similar group of dental patients who did not have a meningioma.

What the Yale researchers discovered is that patients with meningioma were twice as likely to have had dental X-ray exams where they bit down on a tab of X-ray film at least once a year when they were children.

An even greater link was discovered between meningioma and the single X-ray outside of the mouth. Dental patients who had the panorex dental exam when they were younger than 10-years-old had almost five times greater the risk for meningioma.

Since the research publication dentists have found themselves on the defensive regarding dental X-rays.

The American Dental Association released a statement on the study asserting the following, “The ADA has reviewed the study and notes that the results rely on the individuals’ memories of having dental X-rays taken years earlier. Studies have shown that the ability to recall information is often imperfect. Therefore, the results of studies that use this design can be unreliable because they are affected by what scientists call ‘recall bias.'”

In the ADA statement, Dr. Alan G. Lurie, a radiation biologist and head of radiology at the University of Connecticut School of Dental Medicine, voiced concerns about the study’s design and outcomes. “I think it’s a very flawed study,” said Dr. Lurie, who is also president of the American Academy of Oral and Maxillofacial Radiology.

He characterized at least one outcome of the study—reflected in a table that related meningioma risk to types of dental X-ray examination—as “biologically impossible.”

Said Dr. Lurie, “They have a table, Table 2, in which they ask the question, `Ever had a bitewing,’ and the odds ratio risk from a bitewing ranges from 1.2 to 2.0, depending on the age group. Then they asked ‘Ever had full mouth’ series, and the odds ratio risk from a full mouth series ranged from 1.0 to 1.2.

“That’s biologically not possible because the full mouth series has two to four bitewings plus another 10 to 16 periapicals. A full mouth series, just to round things off, is 20 intraoral X-rays of which two to four are bitewings. They are showing that one bitewing has 50 to 100 percent greater risk than a full mouth series that has multiple bitewings plus a bunch of other films. That’s biologically not possible.”

Explaining this gross internal discrepancy is difficult, as the epidemiologic and statistical methods are widely accepted, Dr. Lurie said. He attributes the perceived discrepancy in the data to possible recall bias in the patients involved in the study.

“Epidemiologists are very aware of this bias,” Dr. Lurie said. “What happens is you’re asking people to remember what kind of dental X-rays they had 10, 20, 30 or 40 years ago. It’s anecdotal, and the argument is that it’s just as anecdotal for the group without meningiomas as it is for the group with meningiomas. That is not necessarily true.”

In this week’s survey, The Wealthy Dentist asked dentists if the news reports will change how their dental practice uses X-rays. We are curious what dentists think about the study and if any patients are calling dental practices questioning X-rays.

To take part in the survey, click here, or leave us a comment and tell us your thoughts on dental X-rays and this study.

For more on this study see: ADA Releases Statement on Dental X-rays Study

Ruin Your Smile with Tooth Whitening Treaments!

The Frightening Truth about Whitening Your Teeth…

New research suggests store-bought tooth whitening treatments may actually be damaging consumers’ smiles. The Trading Standards Institute (TSI) examined 20 products available over the counter in the UK. Alarmingly, the study found that 18 of the 20 products contained higher levels of hydrogen peroxide than permitted by law. (In one case, the product contained 230 times the legal limit!)

Teeth whitening treatments are more popular now than ever before. Many dental practitioners are becoming concerned that over-eager consumers are doing permanent damage to their teeth through repeated bleaching and over-bleaching. This is why it’s a good idea for patients to talk to their dentists before delving into an ambitious tooth-bleaching program without supervision.

Read more

Dental Anxiety, Asthma, and Other Dentistry News…

Some news highlights I thought I’d share with you…

  • According to a study recently released in Nature, viewing positive images of dentists and dentistry reduces dental anxiety in kids. In the study, children who saw these positive images in the waiting area immediately prior to their appointment had significantly lower levels of anticipatory anxiety and fear.
  • Thank heavens! The Chinese government has announced it is cracking down on the chemical fraud that has led to a number of tainted exports – pet food, cough syrup, and (most recently) toothpaste. Dental products in particular are receiving more scrutiny.
  • As if dental workers don’t face enough health hazards already (particularly from fillings!): new data suggests that cement in fillings may be linked to asthma in dental assistants. Awesome!

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