Letter from a Dentist going out of business to patents: Screw The Perverted Incentives of Insurance Funded Dentistry! Screw some guy on Yelp 5 years ago! Screw free speed, the constitution and HIPPA! Screw it all, I'm starting a website

gistfile1.txt

Dear Patients,

October 5, 2014

After nearly a decade of practice in the office I set up from scratch,
I have made the difficult decision to close my doors.  This letter
will set forth the steps I have taken to ensure your continuity of
care, as well as steps for you to take.  Additionally, because I care
deeply about you as patients, I will also share with you a high-level
overview of the series of events that led us to this point.  It is my
hope this is not a good bye, just a transition, as your relationship
is of paramount value to me.

....

The confluence of many factors led to this day; including the burdens
of overhead costs and taxes, the business aspect of dentistry and how
that is pitted against preventative dentistry; as well as the modern
court’s interpretation of the First Amendment’s Freedom of Speech
clause in the U.S. Constitution to allow defamatory internet speech to
go unpunished, leaving a wreckage of damaged, honest, competent small
business owners in the wake.

The business model I established for my practice has been to adopt the
very latest technological procedures and equipment, and to provide
preventative education and tools, despite the unfortunate fact that
these investments can only be offset by remedial procedures- drilling
and filling.  This business model is consistent with my values, and
earned me great success in the early years of my practice.  By word of
mouth alone, I received 60-70 new patients per month.  I had gone to a
top dental school, earned top marks and honors, and ultimately earned
the trust of patients to successfully provide all the education,
prevention and limited procedures, yet still grow as a business.  This
is unique, and my reputation for trust and not over-treating teeth was
winning in my community.

However, the whole house of cards started to come down when one
specific Yelp review, a Yelp review that is false, and damaging, and
still posted 5 years later, managed to destroy my business.  Since
that review, my new patients per month dwindled down to around 10 or
nearly none.  The legal battles are a story in and of themselves, but
from a business perspective, I will never compromise my ethics and
style of care.  I will not refrain from focusing on prevention and top
technology.  I will not over treat a tooth to keep the lights on.  I
would rather succumb to bankruptcy than compromise my ethics.  The
oath I took as a doctor I will never forsake.

Bankruptcy is surrendering to the battle that I could not win against
the business side of dentistry, against the Yelp reviewer’s free
speech rights and the corresponding lack of speech a doctor has under
the Federal HIPPA regulations.  At this time, it is an unwinnable
battle.  However, I plan to leverage the de-facto legal education I
have acquired through this unfortunate experience to organize a
campaign to bring justice to honest, competent small business owners;
like myself, maybe like you, or someone you know.

I humbly ask three things of you. 1: Let me know if I may remain in
touch and include you in my campaign for fair Internet speech.  2:
Although I leave you in competent hands, the most competent of all is
you- I ask that you listen to your body, take good care of it, and
brush, floss, and wear your night guard.  3: Finally, smile (show off
those teeth!).  This is the end of one phase, but the beautiful
beginning of something new.

This is the end of one phase, but the beautiful beginning of something
new.  I am planning to utilize my skill set in a new way now; virtual
dental 2nd opinion.  I am in the process of planning and implementing
a website where patients can get a dental second opinion from the
comfort of their homes and without the trouble of investing additional
time and effort.  This is a new model of delivery of dental care and I
am very excited about executing it.  It enables me to be mobile,
travel and explore and share my expertise with anyone who would
benefit from it.  I have registered the following domain:
www.mydentalsecondopinion.com but the site is not up yet.

...

yelpreview.txt

The Yelp review in question is below.  Note: at the time of taking this,
the overall Yelp ranking of the business was 4.5 stars.

---
DON'T GO HERE. MOST PAINFUL DENTIST EVER. unless u like mouth torture.

a) the MOST PAINFUL cleaning i've ever had. before seeing dr. X,
  i didn't know how important it is to find a dentist who can do as
  pain-free a treatment as possible.

b) [s]he filled a cavity, & it was scary b/c [s]he KEPT GOING BACK IN
   WITH THE DRILL AGAIN & AGAIN. this seemed odd to me. surprise,
   surprise, i had MAJOR TOOTH SENSITIVITY afterwards that never went
   away. his/her solution? now i have to get a crown. so i went in
   with a small problem, & now i have to pay for an even bigger
   problem brought on by their solution & fork over $1000...whaaat?!

c) to fix problem b, [s]he said i'd have to get an inlay, which is
   kinda like a partial crown. i asked him/her if [s]he'd credit me
   for the filling since that didn't fix my initial problem. [s]he
   said [s]he would. again, during the "inlay" procedure, [s]he KEPT
   DRILLING & DRILLING AWAY, for what seemed like FOREVER. drilling
   away potentially healthy tooth!  makes me sick. i heard their
   hygienist say "uh, so i guess it's a crown now?" after the
   procedure, dr. X never mentioned to me that [s]he had gone past an
   inlay & actually did a whole crown. in fact, [s]he disappeared. i
   asked to see him/her, & when [s]he finally showed back up, [s]he
   seemed impatient & copped an attitude (seemed guilty to me). [s]he
   said, yes, it wound up being a crown b/c things had changed from
   when i had my x-ray 2 weeks prior. WHATEVER. y did [s]he run away?
   i think [s]he should keep their patients informed every step of the
   way b/c dental work is serious & i'll have to live with it for a
   lifetime. looking at my crown, it is humongous & way bigger than my
   other teeth. [s]he didn't even do a good job on it. to top it off,
   when i got the bill, there was no notation for the credit for my
   previous filling as was promised, only one line item billing me
   $1000 for the crown. when i called to ask if the credit was
   deducted, they said they'd check with the doctor, & said oh yes,
   the credit was applied. well, honies, that needs to be noted on the
   bill, should i just take ur word that u remembered from several
   months ago that u owe me a credit? i still don't believe it & will
   battle this.

d) [s]he kept trying to push a nightguard on me. yes, i need a
   nightguard, but do i need a $400 one?! the answer is NO. i used to
   see their neighbor dr. polly rivas (who's excellent) until [s]he
   stopped taking my company's dental insurance, & dr. rivas told me i
   could get the doctor's nightguard for $25 at walgreens. & u know
   what? it works great. when i showed it to dr. X, [s]he replied
   weakly, well, there's extra plastic here (on the roof of my mouth
   where i won't even notice). yes, dentists want to MAKE MONEY.

yes, dr. X can turn on the charm & be sweet when [s]he wants, but it's
all an act, & as a dentist, [s]he's simply untalented & not as good as
other dentists. who cares about a massage chair & lip balm? is that
truly important when it comes to a dentist? think about it. all this
fluff & stuff is just smoke & mirrors to distract u from the fact that
[s]he simply doesn't get the job done right. i'm forced to carry
around these sad reminders of their shoddy work my whole life.

& the whole billing issue? SHADY.

most of the good reviews on here are by people with barely any reviews
or friends...ahem can we say "dummy reviews"? look @ my profile & u'll
see i'm very credible. i know dr. X is a big yelp fan & a smart
marketer & knows to regularly post positive reviews to inevitably
garner business.

i read about the angry message to the other negative reviewer on here,
& dr. X, don't contact me, i'll just ignore it. i have a right to
voice my opinion, & i'm legitimate. i will not be bullied. if u
contact me, this review will only get worse.

Ironically, I picked this dentist in ~2012 because she had the best yelp reviews. Perhaps she was asking her customers to rate her highly or something. I would have stopped going more because of the smell of garbage in the foyer of the building than the dentist being bad.

Funny thing is, I actually had the same thing happen to me as this reviewer: a very deep filling which seemingly took over an hour of drilling. More than once. At the end of one the Dr was like, "I'm so happy, I saved your tooth". To someone who doesn't know much about dentistry, this might seem like a painful waste of time; many dentists might just say sod it and do a root canal with very deep decay. I appreciated it, knowing that saving the root can put off by years or even avoid entirely much more expensive work such as implants as the tooth deteriorates even further; the blood supply in the pulp nourishes what remains of the tooth. But I already knew this: she didn't really explain that. Had I not known, I might have been annoyed, or felt like I was kept in the dark as well. And contrary to this reviewer's opinion, teeth can rapidly decay, and X-rays are not perfect: you never really know what you'll find until you start drilling. And it does sound like she cut the reviewer a deal on the crown: $1000 is lower than is typically accepted by Delta Dental et al.