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.
The interview continues:
Are there any remedies to those issues besides doing a website or placing a billboard? Because, you know, it is unusual, for a group of oral surgeons to take out a billboard on a major interstate highway about a general practitioner. You have to admit that this is unprecedented?
So, everyone asks why would you risk your reputation, which is excellent and with excellent training, and any community would be proud to have you as their oral surgery practitioners.
So, why would all of you risk your own professional reputations, risk a lawsuit for libel or for slander and why would you risk alienating your general practitioner referral base to address Dr. Hendrickson’s advertising and his portrayal of being an oral surgeon?
I can answer that straight forward. We all care about our community and our professional community as well. And, we are interested in the patients and families in our area. And, the only reason we are doing this is we believe it is the right thing to do. Stand up, stick up for something that is right because the other remedies that we have pursued, that have tried to remedy this, have not been successful.
And, there comes a time where it says it is not right that this is going on. Patients are not being treated properly, not getting the proper standard of care. They are not being properly informed with respect to their care. And, they are just being taken advantage of. And, so somebody needs to stand up and say something about this.
And, so in our view, we are not doing anything but standing up for and telling the truth. It is not about revenue. It is not about competition. It is not about any of that.
We all do things other than wisdom teeth. But, it is about standing up and telling the truth. And, so people know that if you need surgery, you need at least to consider to go to a surgeon and not have a generalist do it.
But, that is not to say a well-trained generalist of which there are many in our state, many who have served in the military and done GPR’s, had extended training are not adept to do surgery. That is not the case. There are many general practitioners who take out teeth, wisdom teeth and do a fine job.
All we are say is that if a generalist is going to represent himself to the public as a wisdom tooth specialist, then he needs to comply with the State Dental Practice Act, which says he has to say he is a general dentist.
And, he is not a trained surgeon.
He doesn’t have to say he is not a trained surgeon, but has to say on his advertisements, that services are preformed by a general dentist. And if he would put that on his advertisements , on his billboards and on his flyers and all of the stuff he has up, services performed by a general dentist, then that is all we have to say about it.
Then, he is advertising truthfully. And, people would look at his website and his billboards, whatever and they know what they are getting. They are going to a general dentist to have their wisdom teeth removed.
And, if they choose to do that, knowing full well that who it is, then it is their choice.
And, we are not going to change that. But, what we want him to do is accurately represent himself to the public, period.
So, there appear to be some very specific remedies that he could take that would maybe allow the billboard to come down: portray himself as the dentist that he is, to put disclaimers on all of his advertising, and what about the patient care issue as far as post-operative care?
If you have a bunch of orthopedic surgeons and a certain number of them have a higher complication rate than the other surgeons, then there is nothing that will allow the group or an individual to allow, what happens is there is internal monitoring by the State Medical Board and by the hospital that kind of questions that individual if they are having an excessively high rate of complications.
In dentistry there is nobody to do that.
So, if a clinician, an oral surgeon, periodontist or anybody are having a higher rate of complications is to, the only way that comes to the public forefront is if patients register complaints with the State Dental Board. And, then there is some kind of investigation, some remedy to be taken in that way.
We cannot really do anything about that.
If patients are unhappy with the way they are treated, they have to take it up with the State Dental Board. And, we believe the way surgeons provide surgical care is the standard to which the care should be provided.
And, so if a generalist, is going to do surgery, then he should do it as well as an oral surgeon. And, if he does then he is entitled to do all of the oral surgery that he wants to do.
But, he needs to represent himself properly to his patients and that is really our only issue.
If Dr. Hendrickson decides he is going to comply with the statute, that he needs to be truthful in his advertising, and if he puts up his advertising that says performed by a general dentist, then we are done with our campaign.
Then, we just go back doing what we are doing, because he is entitled to do what he wants.
Have you ever filed a complaint with the DOPL, regarding his advertising?
No response (from DOPL)
But, you have file complaints with the Board?
OK, and you have received no response from the Board?
Do you know of other Board Members of your group who have filed complaints with the Board?
The complaints have been filed on behalf of the Utah Association of Oral and Maxillofacial Surgeons. And, so specially, I have not filed any complaints but other members of our specialty have and the President of the society has been overseeing that effort. And, by his account DOPL (Department of Professional Licensing) says look we have too much going on and we are aware of it and nothing has happened. And, this has been going on for years now.
I saw that Dr. Jason Chandler of the UAOMS (Utah Association of Oral and Maxillofacial Surgeons) testified at the last Utah Dental Board meeting. And, he raised some of these issues. And, the Board Executive Director said if there were specific complaints that they should bring them directly to the division in that the Dental Board which acts usually as a jury does not get involved in the specific details of the cases. But, if there are complaints she recommended that the UAOMS that they should file complaints with the division and that they would be investigated. That if they were not being investigated, then the Division director should be contacted and the point be made that they are not being investigated. Do you know if there has been any follow-up?
You know, I don’t know that.
I am not on the State Dental board and I interact with Dr. Chandler and his partner who is on the Board. I interact with them somewhat. But, this is something we decided to do and be done locally.
And, again, we are not out to make anything happen other than compliance with the Utah Dental Practice Act.
There are some people who would argue that, they would say that if you don’t with the enforcement mechanism of the DOPL, that your complaint should really be with the State of Utah rather than going to your own public awareness campaign?
I would agree with that.
But, if you don’t get response from the state, you see that a harm is being done, and patients not being treated properly, then at some point you feel like you have your own professional obligation to ..the public’s best interest kicks in.
You have to say something.
I went to the DOPL website and actually looked at whether Dr. Hendrickson has had any disciplinary action against his license and there is nothing there. Do you know of any patient complaints are in the mix? Or, have there been any malpractice judgments against him?
I don’t have that information.
Let me play Devil’s Advocate for a minute, because people in your community are going to say this and dentists are going to say this as well.
They are going to say this is a “TURF WAR.” And, I have characterized this as a “TURF WAR” in my first post.
You have some very highly educated oral surgeons and they are going against another highly educated general dentist who extracts teeth and he does it at a reduced fee and oral surgeons don’t like it.
Oral surgeons don’t like the fact that he is stealing business away from them.
What do you say?
Well, I would just emphasize that this is not about revenue. It is about ethical behavior as a professional, representing yourself properly to the public.
He can do whatever he wants.
And, charge whatever he wants.
But, he needs to represent himself truthfully to the public.
And, that is our main complaint.
I, personally believe, if you are a good surgeon, if you take good care of your patients and charge a fair fee, you will stay busy. I have found this to be true throughout my whole career.
If someone wants to save some money going to their general dentist to take out their wisdom teeth, then that is there choice.
And, in our view there is some risk to that. Which I think you would agree.
But, this is not about a “TURF WAR.”
Now, if he was doing what he was doing and not advertising at all, and this was all word of mouth, then I think we have less of an issue with it. But, he is very, very aggressive and prominent in the advertising. And, so that kind of puts him in the limelight.
And, makes us more interested to make sure people know what they are doing when they go to see him.
In my next post, I will wrap up my interview with Dr. Nicholls.We will discuss the Federal Trade Commission.
Then, I will look forward to Dr. Hendrickson’s response – keeping in mind that his wife is due to deliver twins at any time.
Below is the Trooth.Com billboard found along I-15 in Utah:
David Nicholls, Dentistry, Heath Hendrickson, Trooth.Com