The Morning Drill: April 23, 2012

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Good Monday Morning!

On to today's dentistry and health headlines:

6 Unique & Inspiring Ways To Use Pinterest In the Field of Healthcare

A few months back we posted an introduction to Pinterest – the now third most popular social network in the U.S. behind Facbook and Twitter. As it remains the talk of the town, the buzz surrounding Pinterest is naturally giving growth to a lot of questions among many medical professionals. They are wondering how they can incorporate Pinterest into their social media strategy, and whether or not it makes sense to do so.

In my previous post, I outlined a few ways doctors can utilize Pinterest. Today, I am providing healthcare professionals some real life examples of this, which may inspire them to become involved with this site. After all, Pinterest is intended to be a “fun way to discover new things and get inspiration from people who share your interests.”

Budget would delay statewide Medicaid managed care for dentistry

The state budget and an implementing bill signed this week by Gov. Rick Scott would delay the phasing in of Medicaid managed care plans for dentistry, but Scott made clear he would support the plans in the future.

The language would require the agency to continue allowing dentists to bill for Medicaid patients under the traditional fee-for-service system in areas outside Miami-Dade County, but would expire in July 2013. The Agency for Health Care Administration announced it was delaying the statewide implementation of the managed care system after the language was approved by the Legislature.

In a signing statement, Scott indicated that although he did not feel that he could veto the language without affecting other important parts of the budget and enacting legislation,  he will still back the expansion of medical and dental managed care plans.

"In the interest of disclosure he's letting everyone know he's still committed" to remodeling Medicaid, Senate Health and Human Services Appropriations Chairman Joe Negron, R-Palm City, said. "He's not going to stop the process."

Florida Dental Association President Cesar Sabates said in a statement that the group is pleased that Scott approved the provision. In a "white paper" released this week, the group warns that a managed care system creates the possibility that "fewer providers can afford to participate in the government program and access for this patient population can be challenging."

Researchers Find Joint Failures Potentially Linked To Oral Bacteria

The culprit behind a failed hip or knee replacements might be found in the mouth. DNA testing of bacteria from the fluid that lubricates hip and knee joints had bacteria with the same DNA as the plaque from patients with gum disease and in need of a joint replacement.

This study is one of many coming from the Case Western Reserve University School of Dental Medicine that have linked oral bacteria to health problems when they escape from the mouth and enter the blood.

Working with University Hospitals Case Medical Center researchers, the dental, orthopedic and arthritis researchers suggest it might be the reason why aseptic loosening or prosthetic wear of the artificial joints fail within 10 years when no infection appears to be present. The pilot study's findings were reported in the April issue of the Journal of Clinical Rheumatology.

Dr. Nabil Bissada, chair of the Department of Periodontics at the dental school, said the objective of the study, "Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints," was to see if bacteria like Fusobacterium nucleatum and Serratia proteamaculans found in patients with gum disease were present in the fluid.

"For a long time, we've suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Bissada says.

Doc rolls out 'Hangover Heaven' on Vegas Strip

He had a Las Vegas wedding to attend, but Bryan Dalia was hung over from some marathon partying the night before.

"I did two bachelor parties, back-to-back," Dalia said, putting his hand to his forehead as he recalled steins of beer and shots of alcohol the previous afternoon at the Hofbrauhaus Las Vegas, then gambling, dining and drinking martinis at the Cosmopolitan of Las Vegas resort. He remembered "getting a little lost and finding myself on the floor of the Paris" hotel-casino, then "a few more martinis as I gambled my life away."

"How are you doing now?" medical technician Debra Lund asked.

Dalia looked at Lund, swaying with the gentle rocking of a bus named Hangover Heaven as it rolled down Las Vegas Boulevard. Lund checked an intravenous fluid bag, hung from the ceiling, dripping a saline and vitamin solution into Dalia's left arm.

"Better," he replied. "My palms aren't sweating anymore. I don't have that, like, cold sweat feeling anymore."

Dalia, from Caldwell, N.J., was one of the first patients on the rollout day of a mobile treatment center for tourists who spent the night before drinking in all the nightlife Las Vegas has to offer. For a fee, they get a quick morning-after way to rehydrate, rejuvenate and resume their revelry.

"I'm starting to feel great," Dalia said. "This is really very cool."

Doctor and board-certified anesthesiologist Jason Burke calls his fledgling business a medical practice on wheels, analogous to a physician with an RV offering X-rays, MRIs or mammograms, a mobile dentist, or a blood bank bus set up in an office building parking lot.

The idea, Burke said, is to bring relief to tourists with stomach-churning wooziness, headaches and body pains — symptoms that could ruin an entire day in Sin City.

"Many people come to Las Vegas with the intent to drink and have a good time," Burke said as he moved between patients seated on plush benches in the retrofitted, full-sized tour bus. The casino scenery passing outside the windows, the flat-screen TVs, the ceiling mirror and the aide in the suggestive nurse outfit? Hey, it's Vegas.

Enjoy your morning!

The Morning Drill: September 15, 2011

A collection of dentistry and health related links/comments for your day.

ADA asks senator not to fund midlevel provider projects

The ADA is urging Sen. Tom Harkin (D-Iowa), who chairs the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education, not to consider a healthcare appropriations measure that includes funding for the "alternative dental healthcare provider demonstration projects" that were created as part of the healthcare reform law.

According to a members-only bulletin released September 9, the ADA is asking ADA members in Sen. Harkin's home state to contact him and express their opposition to funding the demonstration projects, with particular emphasis on the following points:

•     The existing dental workforce model is a proven delivery system.
•     The dentist workforce is growing; five dental schools have opened since 2000 and more than a dozen schools are at varying stages of development.
•     Dental practices have become more efficient. Today, it takes only 88 practices to serve the same number of dental patients as 100 practices during the 1980s.
•     There is no evidence to support the economic feasibility of midlevel providers.
•     A few states are already testing new dental delivery models, and scarce federal dollars should not be used to duplicate these efforts.
•     Federal funding for oral health programs should focus on fully implementing the prevention and public health infrastructure programs, as education and prevention are the most cost-effective ways of minimizing untreated dental disease.
•     A recent article published in the Journal of the American Medical Association concluded that increasing Medicaid reimbursements levels to dentists boosted the number of Medicaid-eligible children treated.

DENTIST’S MOUTHWASH KILLS PATIENT

Sacha Rumaner, 30, suffered anaphylactic shock and was dead within minutes, moments after complaining she felt hot and had an itchy leg and back before sliding to the surgery floor.

Tests later revealed she had suffered a deadly reaction to chlorhexidinel a chemical in the Corsodyl mouthwash being used to treat a possible infection, a week after she had a tooth out at the Morley Street dental clinic in Brighton, East Sussex. She turned blue, had no pulse and stopped breathing.

Dentist Labina Rahman told the Brighton inquest she used Corsodyl on a weekly basis but had never heard of anyone having a fatal reaction.

Brighton and Hove assistant deputy coroner Dr Karen Henderson said anaphylactic shock was the main cause of cardiac arrest in dental patients so the staff should have treated her with adrenaline.

New Drug Allows Shorter Hepatitis Therapy for Some

Response-guided therapy with the protease inhibitor telaprevir (Incivek) can cut the treatment period for hepatitis C (HCV) in half, researchers reported.

In an open-label randomized trial, 24 and 48 weeks of standard therapy – each combined with telaprevir for the first 12 weeks – had equivalent efficacy among patients who responded early and strongly, according to Kenneth Sherman, MD, PhD, of the University of Cincinnati College of Medicine, and colleagues.

But those getting the shorter therapy had significantly fewer adverse events, they reported in the Sept. 15 issue of the New England Journal of Medicine.

Telaprevir was approved earlier this year to be used in combination with standard HCV therapy with pegylated interferon and ribavirin. It is one of two new medications -- the other is boceprevir (Victrelis) -- that target the virus directly, in contrast to the standard therapy, which boosts the immune system.

Both the standard therapy and telaprevir are associated with a range of adverse events that can lead patients to stop therapy, the researchers noted, so that a shorter course would have important advantages.

In a Race to Out-Rave, 5-Star Web Reviews Go for $5

In tens of millions of reviews on Web sites like Amazon.com, Citysearch, TripAdvisor and Yelp, new books are better than Tolstoy, restaurants are undiscovered gems and hotels surpass the Ritz.

Or so the reviewers say. As online retailers increasingly depend on reviews as a sales tool, an industry of fibbers and promoters has sprung up to buy and sell raves for a pittance.

“For $5, I will submit two great reviews for your business,” offered one entrepreneur on the help-for-hire site Fiverr, one of a multitude of similar pitches. On another forum, Digital Point, a poster wrote, “I will pay for positive feedback on TripAdvisor.” A Craigslist post proposed this: “If you have an active Yelp account and would like to make very easy money please respond.”

The boundless demand for positive reviews has made the review system an arms race of sorts. As more five-star reviews are handed out, even more five-star reviews are needed. Few want to risk being left behind.

Sandra Parker, a freelance writer who was hired by a review factory this spring to pump out Amazon reviews for $10 each, said her instructions were simple. “We were not asked to provide a five-star review, but would be asked to turn down an assignment if we could not give one,” said Ms. Parker, whose brief notices for a dozen memoirs are stuffed with superlatives like “a must-read” and “a lifetime’s worth of wisdom.”

Determining the number of fake reviews on the Web is difficult. But it is enough of a problem to attract a team of Cornell researchers, who recently published a paper about creating a computer algorithm for detecting fake reviewers. They were instantly approached by a dozen companies, including Amazon, Hilton, TripAdvisor and several specialist travel sites, all of which have a strong interest in limiting the spread of bogus reviews.

“The whole system falls apart if made-up reviews are given the same weight as honest ones,” said one of the researchers, Myle Ott. Among those seeking out Mr. Ott, a 22-year-old Ph.D. candidate in computer science, after the study was published was Google, which asked for his résumé, he said.

Linchi Kwok, an assistant professor at Syracuse University who is researching social media and the hospitality industry, explained that as Internet shopping has become more “social,” with customer reviews an essential part of the sales pitch, marketers are realizing they must watch over those opinions as much as they manage any other marketing campaign.

Enjoy your morning!

Update: Social Media Drills Bakersfield Pediatric Dentist Dr. Dove

You remember the controversy and it accelerated expanded to include alleged HIPPA violations.

Now, there is a new Facebook Page since the old one was taken down by Facebook.

Here is the flap from the father's Facebook Page.

This past Monday which was August 22nd 2011 I took my 5 year old son to have a tooth that I was told needed to be extracted. After arriving at the office my son was given a sedative by mouth in a small cup to drink. He immediately threw up at least 50% of the mixture. I was told to keep an eye on him as he might have vomited it up and it not work.

After approximately 15 minutes a nurse came to me and my son and she wanted to take him in the back for the procedure. He was not ready and he was still very alert. I told the nurse this and she informed me she was only going to be taking x-rays and would be back shortly with him.

Ten to 15 minutes later a nurse comes from the back frantically calling for me and I can now hear my son screaming my name. I rushed to the back and he was being held down by the shoulders by 3-4 nurses and I snatched him up very quickly. He had blood coming from his mouth and was wet from head to toe.

He had urinated all over himself. This Dr. had removed my sons tooth while he was not sedated and not numb. My wife and I confronted the staff. I was furious and red. I asked why he was was operated on since I just told the nurse he was not ready. I also asked why they did not stop if he was urinating himself. Dr. Doves exact words were " I cant help it if your son pees during operation" I was getting redder.

At this time I decided it would be better for me to leave the office and get my son out of the office. My wife and I were trying to calm him and get him into the car and my rage got the best of me. I had to confront the Dr. I went back into the office and demanded somebody speak to me and explain how against my wishes my son was operated while not sedated and that I was ( expletive off). The office manager came to the front and took me to a back room to speak in private.

I asked her how they could do this, why they would do this and why did they not stop when he was obviously in pain and scared. The office manager responded" Normally we go ahead with the procedure because people take time off work to get there kids here and we want to get it done for them" I was getting redder. The office manager then said" she would put it my sons file to not operate unless he was completely sedated". I had to leave the office before i burst.

So after leaving I called the Bakersfield Police department and informed them I wanted to file a assault or battery against the Dr. for what the did to my son and explained the story as I did above. I was told by a officer over the phone that this was a civil case and there was nothing they could do. BS!! I thought. So I called a few lawyers to see about filing a claim against the Dr.

No help here locally from anyone I called which was a few big names here in Bakersfield. I then called the District Attorneys office and told my story to them.

Finally after speaking to very nice woman there and telling her my story she gave me the information I needed to be able try and make sure this does not happen to another kid and possibly more. I am now in the process of that and will be filing my case within the week.

If any others reading this have had any dealings with this dentist please forward your story to this site or you can PM me through my Facebook. I hope this also will help in bypassing this dentist office for your kids.

All well and good.

But, if the father has a grievance, then there are appropriate investigators at the California Dental Board and private attorney's who WILL sue for damages on a contingency fee basis, if you have a case.

It is also good to see that Dr. Dove has decided to decline any further comment.

Now, what makes this case unique was the use of Facebook (social media) to drive the discourse. I am positive that Facebook will now change its rules and not allow this type of discourse, particularly if it involves possible legal issues of defamation, libel and alleged negligence.

I. also, doubt that there will be too much more we will hear about here, unless Dr. Dove is disciplined by the California Dental Board or Mr. Cook sues the dentist.

Controversy on Bakersfield Dentist Dr. Dove Continues With HIPPA Violation Claims

From the frying pain and into the fire of social media driven controversy, Dr. Dove in Bakerfield, California goes.

 The Bakersfield dentist accused of giving inadequate care to small children faces new allegations and more personal criticism. The firestorm against Dr. Edward Dove started with social networking, and now Eyewitness News has learned he's defending himself with some technology of his own.

Dove is also facing down complaints that he violated patient privacy.

Chris Cook started the Facebook page slamming the care his 5-year-old son got. The father said the child was not adequately sedated when a tooth was pulled earlier this month.

Dove has responded that the child was properly sedated, and stated the boy needed a lot of dental work. That's what the dentist told Eyewitness News that last Thursday. Now on the Facebook page, an entry from Adam Dove says the child had a number of cavities.

The father believes that information is part of his son's medical records, which should not be made public.

"That's open knowledge," Dove responded. And he added he did not post any comments on the Facebook page, but admitted his children have been affected by the criticism, and they have made comments. "My kids, they're just hurt by it."

The father, Chris Cook, is also infuriated that Dove has reported the little boy needed the tooth pulled and a lot of other dental work because he had "poor oral hygiene." The dad thinks that information that should not be public, and he also told Eyewitness News there are reasons for his child's dental condition.

Cook said the child was born premature, and circumstances associated with that can lead to dental problems. Cook gave Eyewitness News permission to make that public, and ask Dove about that.

The dentist said that is not a reason for the little boy's dental conditions. "If you have proper oral hygiene, a cavity here, a cavity there," would be expected, Dove said. "Not massive decay like he had."

And the dentist said reporting the number of cavities was also not a violation of privacy laws.

"No, I'm not saying exactly what I did to him," Dove said.

Now, HIPPA violations?

This entire FLAP needs to be handled by the California Dental Board and Dr. Dove needs to go on vacation for a few weeks.

Let the father protest, stomp his feet and find a lawyer who will take his case. I doubt there will be much of one.

As for allowing patients in the treatment room, I would not change my policy. The idea of installing cameras is really unnecessary.

My office policy when I was in private practice was to always allow parents into the treatment room, if they desired. However, if the child acted out, I would not treat them.

But, Dr. Dove runs a pediatric specialty practice and has to treat far more difficult behavior cases as well as dental pathology than a general practice dentist like myself.


Previous:

Social Media Drills Bakersfield Pediatric Dentist Dr. Dove

Social Media Drills Bakersfield Pediatric Dentist Dr. Dove

Now, dentists will maybe understand why they should hire online social media consultants.

Christopher Cook of Bakersfield started the Facebook pace, "I hate Doctor Dove."

It's probably the best way to get the word out, it went from two people last night, I believe there is 74 people on there right now," Cook said. "I have about six different stories of the same incident or the same type of incident with Dr. Dove."

Cook said, on Monday, he took his 5-year-old son Rogan to Doctor Edward Dove's office on Union Ave. to get a tooth pulled. Cook said Rogan drank a sedative, but threw up more than half of it, still cook said the dentist went ahead and pulled the tooth while his son was still awake.

"They strapped him to a board to hold him in place and pulled his tooth out," Cook said of his son. "He was hyper-ventilating he couldn't talk, he was in shock, he's five."

Doctor Dove disagrees with the father's assessment.

"I'm an ethical pediatric dentist, first of all, he (Cook) said he (Rogan) was not numb, which is impossible because he had a full cupful of anesthetics," Dr. Dove said on the phone. " He didn't even know the tooth came out, he didn't flinch."

But Cook is filing a complaint against Dr. Dove with the California Dental Board. Beyond the complaint, he's giving others a chance to tell their stores via Facebook. But it seems like you can hate anything these days on the Internet, a simple search for "I hate" turns pages like "I hate Justin Bieber," "I hate exams," "I hate cheaters," the list goes on and on.

But, what I do not understand is what issue does the father have with the dentist?

Cook, who works in the oil industry, says he created the Facebook page Monday night as "a vent." He was frustrated with his five-year-old's morning dental visit to extract a tooth. His son, who was given an oral sedative, threw up some of the mixture, he said.

During the procedure, which Cook was not permitted to watch, his son urinated on himself. Cook alleges that his child, who was physically restrained, was not numb, and should not have been operated on.

He should NOT have been treated? And, from what dental school did Cook graduate? There seem to be some facts missing here.

Here is the search on Facebook for the Facebook page in question which appears to be a members only (Ask to Join) Facebook group.  Only 350 members as of today. The link is here.

The problem for Dr. Dove is not from the California Dental Board but from the community. I recommend that he hire a good PR firm and start to undo the damage.

And, remember just because you claim something in social media, like on Facebook, it does not necessarily mean it is true.

Remember, you are not relieved of liability, if you unfairly/untruthfully defame someone. So, be careful on what you say on and offline.