Tuesday, March 23, 2010

Whistle Blowing

Hey guys,

Man Dr. Ric is funny. Loved Monday's blog.
Real life stuff and a great message. If he keeps this up people are going to demand that the Wednesday and Friday guy be eliminated.

Well a lot is going on so I will get right to it.
The message boards are blowing about Brican but I just don't know what is going to happen.
It appears there are about 1800 dentists/optometrists in my boat and they are all pissed off.
So it makes me feel a little less of a dumbass (misery loves company) but not much.

I watched the Hurt Locker this weekend.
This movie was very good. I thought it was intense. It was very well done. I believed the characters...I give it two molars up.

I finished with Three Cups of Tea. This is a true story about a guy who spends his life building schools in Pakistan and Afghanistan. What bad can you say about this guy?
But I will tell you that he puts his whole life into this, almost to a fault. He ignores everything, including his family and his safety, to get things done. I am not looking a gift horse in the mouth because I know that in order to be great at something you have to give up a lot. This guy has gave a lot (he worked as a nurse and slept on the floor of a friends apartment for a year just to save money to build his first school).
It became an interesting point in the book when he began to focus not on building schools but to build girls school. He felt that if you educate the women that life would start to change.
This is an interesting concept.
Mainly because men somehow are not around.
He didn't talk about where the men were but I was assuming they are in the military fighting again the Taliban or in the Taliban or just plain traveling to find work (maybe they were out building schools for other countries....low blow).
But none the less the men were gone and if you educate the women they can begin to educate the children and change the country.

This was an awesome point because in the times I have been to Mexico on mission trips there was a significant lack of men in the "family" centers. There were plenty of woman with lots of kids...but no men.
Things that make you go hmmmm.

Okay topic du jour.

I told you I was pissed about something and lucky for you I did not write this on Friday.
I was so hot last week my head was going to blow off.

I spend my whole life trying to make the worlds teeth better.
Now did I say I spend my whole life trying to make money off of people's teeth?

Let me back up and tell you what happened last week that got me started.
I was having dinner with some friends. One was a previous patient that moved out of town and the other is a friend that lives across town and my office is kind of a pain to get to for him.
He goes to a dentist down the street from him (understandable).
So we get to talking about teeth at the dinner table.
Okay here are the stories....
Big M was a patient at my office. He is 28 years old. He was a patient here for a couple of years and he never had any work done because his teeth were in really good shape. He had a couple of occlusal amalgams but over all very good teeth.
He moved away. He went to another dentist and this new dentist told him he had 8 cavities.
EIGHT, OCHO, HUIT, ACHT (french and german....I googled it).
Now how do you go from a dentist in Orlando and be okay and then move to Georgia and have 8?
Now to this dentists credit, he/she did the first three and told him that they were "calcium deposits" and didn't need to do the other five.

Now the other guy has been going to his dentist for a while. My friend is kind of lukewarm about his dentist. See he has never had a cavity. So to him he goes, gets his teeth cleaned and then gets out of there. No problem. He says that he doesn't even pay, his insurance covers the whole thing.
When we were talking he mentioned in passing, "my dentist just comes in and says 'hi' and reads my x-rays and leaves, it is so easy."
I said, "HOLD UP. Did you say that he reads your x-rays and leaves or does he actually look in your mouth?"
And he says, "No he doesn't look in mouth, he just says 'hi' and leaves.

Once I started bitching about this stuff to my assistant she told me some of the things she heard. She goes on to tell me that her sister who lives 2 hours south of here was at the dentist and the assistant gave her an injection. Yeah, the dentist gave her one and the assistant asked if she was getting numb and she said, "No". So the assistant picked up the needle an proceeded to give her a "booster".
Oh no you didn't.

Okay we all hear of the stories....this dentist did this to me or I went to this guy and he did this to me. I am not talking about these kind of stories. I am not talking about getting story about a patient about how they perceived a situation.
I am talking about black and white. He charged you for an exam and you didn't get one. The assistant gave me an injection.
This kind of stuff makes my blood boil.
It is wrong in so many ways.
It is greed in the purest form. AND I AM SICK OF IT.

I hear this crap all the time and I am going to do something about. I am going to start whistle blowing.
People that are screwing the system are hurting our profession.
They are making it harder for guys/gals like me and you to do the right thing.
They are making health care more expensive (don't even get me started).
They are selfish SOB's and they must be stopped.

Now don't get me wrong I am not going to start calling the Board of Dentistry for every little thing. But wrong is wrong.
You and I both hear stories like this all the time and just shake our head. We cuss under our breath and move on.
NOT ANY MORE. No more Mr. Niceguy.

I think one of the reasons why I never make the call is because I feel for the dentist.
I would never want a call from the Board. I am the kind of guy that gets an envelope with an attorneys letter head on it and start an all out panic attack.
And you all know how I am with confrontation. And I am not doing anything wrong.

One thing though, maybe this guy is a good guy. Maybe he has just strayed a bit.
Does he deserve a full on investigation of his office. Should I get my friend to call the dentist and call them on it and see what they do.
(I was talking to a patient once who had the same thing done to them and he called the office about it. The person at the front that they talked to said, "you had an exam." He said, "No I didn't, the doctor never came in." She said, "Oh our hygienist did it."
Oh, no she didn't just say that.
Does anyone have a whistle I can borrow?)

I can see how this can be a slippery slope.
What do you "whistle blow" for?
Breaking rules?
Over treatment?
Attitude toward patients?
I mean I want to blow the whistle ever time I think a disservice has been done to a patient.
But if there was no intent then the dentist didn't do anything wrong.
(As much as I try to avoid it, I have to admit that someone out there has felt duped by me)

But I am going to do it.
I am at the point in my career that I am starting not to care if dentists like me anymore (except for you guys). I try to do a good job, I try to be very honest, I do my best and care about my patient. If someone has a problem with me then they just don't know me.
Do I have some personality problems that some might not like? Yes
Am I boisterous? Yes. Do I act unprofessional sometime? Yes
Will all of the above rub people the wrong way? Yes.

Now if you only care only about yourself, if you are dishonest, if you are greedy, if you are a fraud, if you over treat, if you don't do your best.
Well then consider yourself warned. I am blowing the whistle on you.

In my best Mel Gibson in Brave Heart speeches.....Are you with me on this one? Come on, LET'S DOOOOO ITTTT!!!

Now that I said the above....what do you think?
Have you blown the whistle on someone?
Did you want to and didn't do it?
I would love to hear about it.


TBOX said...

Dear GatorDMD,
I tried to blow the whistle a couple years ago on a small dental lab that was doing direct patient care in making dentures and denture repairs in his lab. He even had a yellow page ad. In our state we do not have denturists and labs cannot deal directly with the patients.
I called the State Board of Dental Examiners and found out they knew about this but could do nothing unless a patient complained.Since he was not licensed, they had no jurisdiction.
They could only "police" the licensed dentist.

gatordmd said...

See that is such BS.
I feel the steam coming out of my ears.
This kind of shit makes me so mad.
What do they mean they can't do anything about it? IT IS ILLEGAL!!!
If they can't do anything about it, who can?
Can they at least call the cops?

Don't even get me started.


Anonymous said...

Now before you go blow your top about another dentist, I would first always talk to the dentist first. Lots of patients hear what they want to hear and see what they want to see and remember what they want tp remember. Some actually lie and make stuff up too. Yes there are some things that go on that should not.
A perfect example is a pt was told last year he needed perio surgery and then a new bridge twice. A special consult visit was even done to talk about it. Spoke with the specialist and everything was dedcided. Then here we are this year and he acts like nothing was discussed the day of his surgery and wants to know what is going on.
This is even better. Two patients come in wanting me to look at the dental work they had done in mexico. Anterior composites look rough like an unfinshed flat sqaure wall. Posterior composite is falling out, but is ok because some special pink stuff was put in the tooth to make it not hurt. Cantilver bridges and inlay cantilver bridges placed with cement still in place. Packing from a sinus exposure still in place. Some special herb to prevent pain and healing that looks like wet dead brown grass.
Told them the work will need to be redone but it is there for now. Offered to redo the filling but she declined because it was $20 cheaper in mexico. Told them if they like the dentist and work that was done in mexico to go back there and have all there needs taken care of.

When I hear something froma Patient I always call the person who did it and ask what did you do or say before I pass judgement. You should too.

Anonymous said...

I suppose I qualify as a whistle blower since I have rendered legal opinions against two dentists in the past. Both were post op care on wisdom tooth extractions, one case where the DDS saw the patient 3 times in a week and did not refer to an MD/ER despite external swelling and difficulty breathing. That case ended up in the ER and the kid needed a trach--less than 1/4 inch airway left and over 2 cups of purulence removed. (pseudo Vincents) In his deposition, the DDS said that a trach was not needed and the ENT had been "too aggressive".(You should have read the ENT's response!) Both cases settled before court. A third case was Medicaid fraud--extra surfaces restored and filed over actual existing and also full mouth extractions on an 8 yr old, supposedly for ortho reasons--all the way to the 6's. The teeth were intact; no caries and there was NO crowding. There are definitely bad ones out there and I dont want to be associated with them at all.. The Medicaid doc ran across 3 states before they completely nailed him. What is this nonsense about being able to get a "new" license if you lost yours in a previous state!?! I couldnt come to Florida or Hawaii to practice without retaking boards and I have practiced 27 years in my state without any suits! (Thank God and knock on wood....) It is not politically correct to get active in this arena except in peer review, which I have also done. Not sure what I would do if it was close to home...I'll have to cross that bridge when I come to it. And make sure I have all the pertinent info before I give an opinion.

Anonymous said...

Amen John!!! Seriously agree with you one hundred percent! I could go on for hours about the things that i've seen....how about walking past an operatory and seeing an assistant with k-files in her hands (and no dentist in the room) doing an endo on a molar....or how about an assistant telling me about how one dentist she worked with did 9 filling in 9 minutes (she timed it), and 5 of them were out in 3 months (and of course they were charged as MDB's, not simple buccal fills)... or how about guys that charge EVERY extraction as a complicated extration regardless of if it was surgical or not....or better than that: an oral surgeon who purposely snaps of crowns so that he can charge as surgical exos (classy guy)...i've seen more crap than i ever want to see again, and it makes me mad as well john! it's basically screwing us ethical, normal guys because we are either lumped in as "just another crooked dentist", or it will get to the point where the government is going to have a say in dentistry (in canada anyway).

the very first dentist i ever worked with was a great mentor and teacher, and told me something last year that i'll never forget. 25 years ago dentists were considered very respected by the public, right up with physicians, surgeons and other professionals. last year, a major magazine did a survey, and we ranked in the lowest 25% of public respect and faith, right beside used car salesmen....FANTASTIC!!!

I have no problem blowing whistles these days, especially when i see the disgustly amounts of money that some dentists are making these days, simply taking advantage of people and insurance companies.

Lacee Gerleman said...

In the book Ethics in Human Communication by Richard L johannesen, Kathleen Valde, and Karen Whedbee they describe whistle- blowing as going outside normal internal communication and appeal channels in order to expose publicly a serious problem of safety, legality or ethics not being adequately faced by the organization (Johannesen, Valde, Karen. 2008. 168). I believe if these other dentist are cheating people out of a service they are paying for then they need to be exposed. You should not feel guilty for wanting people to be treated with the respect that they deserve. It also sounds like one of the dentist is trying to get your friend to pay for work that is not even necessary which is also unethical. I believe you are doing the right thing by reporting them. I personally have never had to report anybody for doing something unethical but I have seen it happen at a prior job I had and things were not handled correctly so it made for an uncomfortable work environment.


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