Editorial: Ethics and Old Age

Editorial: Ethics and Old Age

William E Stein, D.D.S.:
 
 
As I reflect on my 30 years with Northwest Dentistry, I think about the many people who ask me how I got started with the magazine. It wasn’t pretty.
 
At the time, I was a young dentist practicing in the poor rural village of Aitkin, Minnesota. I was in my eleventh year of serving the people of Aitkin. When I started, there was no Medicaid. When you  wanted to treat the poor, you came up with a treatment plan and presented it to the county “Welfare Board”. They would tell you what they could afford, consider the merits of your treatment  plan, and we would proceed accordingly, like any other family would.
 
In 1984 the Federal Medicaid plan was firmly in place. One day our local school nurse brought in a young boy who had his lateral incisors growing in the middle of his palate. She had paraded him in front of his parents and taking a grade-schoolsized piece of chalk in front of a grade school blackboard exclaimed that the reason their son couldn’t be treated was: SURPRISE! She drew a big dollar sign. 
 
The young man then showed up in my office. As his occlusion was just fine, the simplest solution, knowing that orthodontics was out of the question, was to extract the offending teeth. An  appointment was made after assurances that he was indeed covered by Medicaid, and the teeth were extracted no problem. All was good.  
 
Not so fast. My trusted offi ce manager came to me saying we were one day off with his eligibility and would it be okay if she just changed the date of the procedure? I said “fine”. Big mistake.
 
At the time we had a state Attorney General with huge political aspirations. Also at the time there was a big abuse scandal going on, but instead of pursuing those perpetrators, he chose to pursue  the low hanging fruit of dental Medicaid fraud, and I was in his crosshairs. I was subject to an inquisition by the Welfare dental crew. They came up with several scurrilous charges, all of which proved to be false, but I was indeed guilty of the breach of ethics by sanctioning the backdating of the dental service rendered to the kid with the teeth growing out of the roof of his mouth. This  was and is a felony.
 
The AG pursued me with a vengeance. On the advice of my late lawyer, we reached a settlement: I would pay an exorbitant fee and admit no guilt, and the matter would be finished. Imagine my surprise and consternation when the day after signing the agreement, my name was being slandered (in my opinion) all over the local and statewide media. I had no choice but to defend myself. I  had always had a knack for writing, so I launched a rebuttal that appeared in my local paper, and in Northwest Dentistry. The response was most gratifying, and I was asked to become the  Northeastern District Editor for NWD.
 
And here I am 30 years later. I will always remember the wise words of my dad, the most ethical guy I have ever known: “If you were going to treat the poor, why did you feel you needed to be  paid? You should have just done it for free.” I was so ashamed. He was absolutely right. 
 
In this issue, we have three exemplary articles by three truly ethical dentists I respect so very much: Jack Churchill, Kim Harms, and Jeanni Foss. As an editor and writer it is always exciting for me  to see a young dentist hitting her stride as a writer, dentist, and very good person. I highly recomment you make it a point to read Dr. Jeanni Foss’ West Central District report. You’ll find it contains much more than local gossip! 
 
For ten years, Jack served as the MDA beacon of ethics as he wrote his excellent column “What’s a Dentist to do?” in Northwest Dentistry. In this issue we are blessed to read his reflections on ethics, faith, and life in general.
 
I was particularly struck by a story Jack tells of a builder laboring on a great cathedral. He was carving a bird inside a beam that would be covered by a roof. He was asked, “Why do you spend so  much time on something no one will ever see?” He replied, “I do it because God sees it.” What a wonderful example for us all. Thank you, Jack. 
 
Intertwining nicely with Jack’s musings on the pressures, moral and ethical dilemmas, and temptations facing the members of our profession are Kim Harms’ musings on the very menacing problem of depression. As always, when Dr. Harms takes on a challenge, she does so passionately and ultimately becomes an expert on the subject. 
 
Both Drs. Churchill and Harms address the sad fact of suicide being a major cause of death among dental professionals. Dentists in particular tend to be driven perfectionists in a profession where absolute perfection is seldom if ever attainable. Whether it be a diffi cult procedure or an ethical conundrum that doesn’t turn out well, we must be able to recognize our mistakes, learn from them, and move on in faith that we can and will improve, but we only will reach true perfection in Heaven. 
 
Well, anyway, that’s my faith, and I’m sticking to it! 
 
 
 
 
*Dr. Stein is Executive Editor of Northwest Dentistry. He is a general dentist in private practice in Aitkin, Minnesota, Email is AitkinDent@AOL.com.