You remember the FLAP.
A number of Utah oral and maxillofacial surgeons have begun a dentistry turf war with a fellow dentist, Heath Hendrickson, over the extraction of wisdom teeth. The surgeons have sponsored a website (Trooth.com) and a billboard on I-15 in Utah County, Utah.
Monday afternoon, I had the opportunity to speak with David Nicholls, D.D.S., one of the oral and maxillofacial surgeons who comprise the Board of Trooth.Com.
Part One of my interview with Dr. Nicholls is posted here.
The interview continues:
Flap: You are saying that you object to Dr. Hendrickson’s advertising. Are you saying it is false and misleading?
I am not speaking to his intent. What I am saying is that his advertisement that he puts out, billboards and other advertisements, do not comply with the Utah State Dental Practice Act that clearly states that if you are a generalist, advertising specialty care you must put on your advertisement a general dentist is performing services – so the public knows. And, as to his intent, I cannot clearly speak.
But, very clearly his advertising is not in compliance with the Utah State Dental Practice Act.
If you look under the section of Unprofessional Conduct, the advertising not specifying the person is a generalist is under Unprofessional Conduct. And, it is the idea of making claims in your advertising that you are somehow better and a more competent clinician than others, while you are only trained as a generalist, if you are advertising in a specialty area, so if you pull up the section of the Dental Practice Act, it is only 14 pages long, and you read it under the section of Unprofessional Conduct, you will see very clearly that it is stated. And, just look at his billboards and his websites and it becomes clear that he is not complying.
Flap: There is the advertising portion of your complaint and there is Dr. Hendrickson’s image in the community, and that the public would be confused with his advertising. Patient care is also an issue. You are saying that he is having complications and he is not managing the complications?
Well, I can speak personally from a patient I saw from the practice who was a young woman, college aged student who had her wisdom teeth out there. A month post-op, she developed a swelling, a mass, in her lower jaw. The patient was concerned about it. She went back to Wisdom Teeth Only, according to the patient. She was told that whatever the specialist is going to do and we will do that.
And, based on that interaction, she lost confidence in the practice. She went to her physician. The physician ordered a CT Scan. It showed a mass associated with a third molar site – the #32 position. And, then the patient showed up at our office for treatment.
What she had was an acute osteomyelitis with destruction of the mandible in that area and the loss of both buccal and cortical plates in the area of the wisdom tooth.
So, what it required was debridement, IV antibiotics and oral antibiotics. And, it eventually resolved.
So, that is an example of something that we see where the patient needs treatment that they will not be allowed to be provided in that practice – or what he can’t provide.
And, so, I am sure you are aware,that if you do oral surgery from time to time you see infection and complications that require hospitalization. and, oral surgeons as you know are dentally, medically trained. And, so all of the oral surgeons are able to manage those complications in the hospital and take the case to completion. Whereas, a generalist doing surgery is not able to do that because he does not have hospital privileges and operating room in order to make care of complications that arise from tooth removal.
That by default falls to the oral surgeons.
And, it somewhat akin to a family practice doctor who is exposed to tonsillectomy in his family practice residency setting up a clinic and saying well, I have done some tonsils and know how to do it, so I am going to do tonsils and that is all I am going to do. And, I am going to advertise that I am going to have people come see me for their tonsils. And, I am going to kind of underbid the ear, nose and throat surgeons so that I can ..since a lot of people need tonsils out.
And, the reason it does not happen is in the medical community is because you have to do surgery in a hospital setting. A hospital demands proper credentialing and training in order for the person to do that type of service. Because dentistry is not regulated in the office setting, the dentist can pretty much do what he wants – as long as he does not get into trouble and the patient’s sue.
There is no other way to regulate what a dentist is doing as far as a physician who says he wants to do ..and the first thing the hospital says, are you trained to do this? And, if you are trained we need to see the documentation of your training, before we let you do this.
It is kind of an interesting dynamic since it is kind of unique to dentistry and there really is nothing equivalent in medicine because the hospitalization part of it, controls it.
Flap: You are aware at least in California (where I am licensed), that as a general practitioner that you can obtain hospital privileges?
We have some general dentists who are on staff here as well. They bring in mentally compromised patients, pediatric patients, bring in patients that need to be sedated and to take care of trauma – tooth trauma on an emergency basis. Dr. Hendrickson is not among that group. He does not have hospital privileges.
In Part Three of my interview with Dr. Nicholls, we will discuss the remedies that these oral surgeons have taken against Dr. Hendrickson and about the impact to their own professional reputations.
Yesterday afternoon, I did have a telephone conversation with Dr. Heath Hendrickson. He told me that he would like to respond to Dr. Nicholl’s interview and the other Board Members of Trooth.Com, after this series of interviews is posted. Also, he has legal counsel and is consulting them about his possible remedies.