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.
Last week, I conducted an interview with Utah Oral Surgeon Dr. David Nicholls about Trooth.Com and its public awareness campaign. The interview was posted in four parts.
Prior to beginning Dr. Nicholls’ interview, I reached out and attempted to contact all of the oral and maxillofacial surgeons on the Board of Trooth.Com. Dr. Nicholls was the first to contact me and later in the week, Dr. Tate Viehweg of Alpine Surgical Arts consented to an interview.
I continue to seek the other oral surgeon’s comments and there is an open interview request for them.
Dr. Viehweg and I began the interview on Friday and is continuing after a break (that I requested) for the weekend. I will undoubtedly break the interview down into a number of posts, since there is much material.
Who is Tate Viehweg, D.M.D.?
Here is a graphic from his website:
This interview is being conducted via E-mail vs. Dr. Nicholls’ interview which was over the telephone.
You are a Board Member of Trooth.Com. Why did you feel posting a billboard and a website Trooth.Com. featuring Dr. Heath Hendrickson was appropriate? Why are you participating with this organization?
Billboard and website - I feel that the website and billboard, with the purpose of educating the public regarding their healthcare and more specifically their surgery, is necessary given the current climate surrounding dental care in the state of Utah. The public is bombarded with countless advertisements making claims of being “experts” and practicing in “unique sub-specialties of dentistry” that are confusing and misleading. (quotations are directly from Dr. Hendrickson’s marketing efforts). In light of the many complications that we see as oral and maxillofacial surgeons as a result of general dentists performing procedures that might be better suited to having them performed by a specialist, our group has become concerned with this growing trend.
Certainly Dr. Hendrickson is not the only offender, but he is easily the most widely known given his extensive marketing efforts. In addition, many in our group have seen a disproportionate number of patients with complications from these types of practitioners and it is alarming to see the severity of the complications.
Is this appropriate? I think if you asked the patients who have seen me with complications following surgery performed by someone they thought was a specialist, they would answer in the affirmative.
My participation – I am participating because I have a moral obligation to my neighbor to help him or her avoid something that could prove harmful. The state professional licensing board is failing the public by not enforcing the laws and regulations that are known among practitioners and blatantly disregarded.
The public deserves to be educated.
Do you think Dr. Hendrickson’s advertising is the main problem?
If so, what corrections would you like him to perform on the ads that would satisfy you?
- I’m not really certain what the main problem is. I do know that the patients/consumers/healthcare recipients in Utah are confused and often times ill-informed.
The deceptive marketing tactics that are being practiced both externally and internally (within dental offices) are making the confusion and misinformation worse.
Dr. Hendrickson may or may not be the worst offender. He may or may not be doing it intentionally.
However, if a member of the lay public were to follow his advertising, they would be hard pressed, in most cases, to be able to ascertain if he was a general dentist or a specialist.
Here is an exerpt from one of his websites copied 30 seconds ago from his website:
“Some people are confused by our internet advertising under “Dr. Wisdom Teeth.” Patients and friends in Utah know us as “Wisdom Teeth Only™” WE ARE ONE AND THE SAME!”
-The Wisdom Teeth Only website proclaims services are provided by an oral and maxillofacial surgeon. The Dr. Wisdom Teeth website proclaims
what you see above. By his own admission, the internet advertising is confusing. Yet it continues unchanged.
We as a group are trying to educate and inform the public because we feel it is a public safety issue. The public is certainly entitled to making their own informed decisions regarding their healthcare. As professionals, we are obligated lawfully, ethically, and morally to provide this information and education prior to performing any services for a patient. This includes the health care provider informing the patient that the proposed procedure is often referred to, and performed by, a specialist. It is then incumbent upon the patient to decide if they are comfortable with their provider, or would prefer to be seen by someone with specialized training.
We are absolutely not trying to restrict practice. There are many, many general dentists who do excellent specialty work and have great results. That is fantastic. There are many who do excellent specialty work that have an occasional complication, as would be expected. Our contention is that, as provided by law, the public – the patient, should be advised and informed that they have options for specialty care, if they desire.
That is all we ask.
Many of my colleagues, myself included, have seen patients with complications from Dr. Hendrickson and other practices that insist that their doctor was/is a specialist, when in fact they are not.
One might say that the burden is on the patient to ask questions and inform themselves, however the courts and the law say otherwise. The individual providing the service is obligated to inform their patient in clear terms – both within the confines of their offices as well as without, regarding the services provided, and by whom they will be provided.
I’ve included below the portions of the Utah Dental Practice Act and the Utah Consumer Sales Practice Act – both elucidating the standard to which our profession is held regarding advertising and deceptive practices.
Our group is simply asking that everyone in our profession who is not abiding the standards as set forth in the State regulation, do so. Bring your practice into basic compliance with State law. Plain and simple.
After that, do what you’d like within your practice. But, uphold your legal and ethical obligation to inform the public-your patients, that they have options when it comes to specialty care being provided either by a generalist or a specialist.
Utah Dental Practice Act – May 8, 2012
58-69-502. Unprofessional conduct.
(1) “Unprofessional conduct” includes,
(b) making an unsubstantiated claim of superiority in training or skill as a dentist or dental hygienist or in the performance of professional
(2) For purposes of Subsection (1)(b), an unsubstantiated claim of superiority:
(a) includes for the practice of dentistry:
(i) advertising or otherwise holding oneself out to the public as practicing a dental specialty in which the dentist has not
successfully completed the education specified for the dental specialty as defined by the American Dental Association; and
(ii) using the following words in advertising “Endodontist,” “Orthodontist,” “Oral and Maxillofacial Surgeon,” “Specialist,”
“Board Certified,” “Diplomat,” “Practice Limited to,” “pediatric dentist,” “periodontist,” or “Limited to Specialty of” when the
dentist has not successfully completed the education specified for the dental specialty as defined by the American Dental
(b) does not include a dentist who advertises as being qualified in arecognized specialty area of dental practice so long as each such
advertisement, regardless of form, contains a prominent disclaimer that the dentist is licensed as a general dentist or that the specialty
services will be provided by a general dentist.
Utah Consumer Sales Practices Act Section Deceptive act or practice by supplier. 13-11-4. Deceptive act or practice by supplier.
(1) A deceptive act or practice by a supplier in connection with a consumer transaction violates this chapter whether it occurs before, during, or after the transaction.
(2) Without limiting the scope of Subsection (1), a supplier commits a deceptive act or practice if the supplier knowingly or intentionally:
(a) indicates that the subject of a consumer transaction has sponsorship, approval, performance characteristics, accessories, uses, or benefits, if it has not;
(b) indicates that the subject of a consumer transaction is of a particular standard, quality, grade, style, or model, if it is not;
(e) indicates that the subject of a consumer transaction has been supplied in accordance with a previous representation, if it has not
Have you brought or filed your complaints about Dr. Hendrickson’s websites to the Utah Dental Board or the Utah Department of Public Licensing (DOPL)?
If so, when?
Have you had any response from them?
In April of this year, a contingent of oral and maxillofacial surgeons from across the state made a formal presentation to the Utah Dental Board regarding advertising. The response was that DOPL is too understaffed to enforce the regulations.
I, personally, have not filed a formal complaint with DOPL or the Board, but I have submitted several specimens of advertisements that are in clear violation of the regulations that I included previously, with no response from DOPL. Several of our colleagues have made multiple complaints and have essentially been told that nothing would be done because of the lack of resources.
The regulations are there in name only, unfortunately, with no enforcement.
Are you referring to the June DOPL meeting where Dr. Jason Chandler made a presentation representing the UAOMS?
Or, was there another presentation?
Why have you not filed a formal complaint with the Utah DOPL?
Correct, it was the June DOPL meeting.
With little reassurance that my complaint would be reviewed and evaluated appropriately, I haven’t filed a formal complaint outside of my aforementioned appropriation of samples of various advertisments.
Where you aware that there was discussion at the March 2012 Utah DOPL meeting about the AADB advertising guidelines/regulations and that it was suggested by the Bureau Manager, Ms. Taxin, that the Dental Board might seek either a rule change or a change in the state law itself?
Have you ever expressed your concerns directly to Dr. Hendrickson – either by letter, in person or by telephone?
I wasn’t aware of that DOPL meeting in March. I’m unclear as to how a rule change is needed, given the rules are already set forth.
I have had limited correspondence with Dr. Hendrickson. It has primarily been regarding the treatment of his patient(s) in my office, with little exchange over the appropriate nature of his or anyone else’s marketing practices.
Given the history of the multiple times DOPL and Dr. Hendrickson have been contacted directly with formal complaints, with no material changes in either enforcement on the part of DOPL or compliance on the part of Dr. Hendrickson, speaks to the likelihood that little would change by following the same course.
How many times would you bother to call the fire department before you would start spraying water on your neighbor’s burning house because there were no firetrucks and firemen there?
The interview continues and we will discuss patient care and patients of Dr. Hendrickson that Dr. Viehweg has seen for post-operative care.
I am waiting for Dr. Hendrickson to either write a response to Dr. Nicholls’ interview posts from last week or to consent to telephone interview. However, it is my understanding that Dr. Hendrickson’s wife will today or soon deliver twins.
We, all, wish them congratulations.
Heath Hendrickson, Tate Viehweg, Trooth.Com