Cent4dent Blog

May 5, 2008
Judge James P. Jones
Chief U.S. District Judge
180 West Main Street
Room 104
Abingdon, VA 24210

Dear Judge Jones:

I read with great interest the information regarding Dr. Shelburne on the website http://www.medicaidruinsgooddentist.com/ and have a number of questions and comments about it.

Foremost in my mind is the fact that the system that provides dental care to the poor in this country is a travesty, and that is why it is so difficult for people working under these government stipends to find a dentist who accepts it. In my own practice, rather than participate with this penurious program, I prefer to select deserving individuals, and render pro bono care to them. Why then, did the prosecutor choose to go after such small potatoes? Aren’t there larger fish to fry?

In 2000, C. Everett Koop, MD, the Surgeon General released a report talking about the deplorable state of dental health in the underserved population. I would never elect to participate in this government run program for many reasons:
• The patients miss a lot of appointments
• The patients have a lot of needs because their diets are improper
• The patients have horrendous home care because parents don’t emphasize the importance thereof
• The payment is typically about ten cents on the dollar for treatment we would deliver in our office.
• The children tend to be very difficult to work on because they are not being treated in a preventive (as opposed to emergency) situation.

So, I would ask you Judge, if the judicial system told you that any case where there is going to be a public defender, and a defendant who really needs to be shackled to behave was going to cause your per diem salary to be decimated, how would you handle it? Would you round your hours up to the next highest number? Would you take sick days, which would be paid at the normal rate? Would you rush through the trial trying to end it as quickly as possible? Would you allow attorneys to produce inflammatory remarks that would cause the jury confusion? Or would you run it as efficiently as possible?

What if several times, the defendant or the PD didn’t show up for court? Could you throw the case out? Remember, you’re not being paid for the time you sit waiting or on no-show days.

I have always read, with interest stories about professionals whose undoing was the participation in the welfare system. I know, in fact, a family whose estates were built using the welfare system. Abuses are rife. What I read on the website about abuses of Dr. Shelburne, unless I’ve been misled are tantamount to padding the bill slightly to extract his pound of sweat, but in my mind a white collar crime of this small amount (I recall $8000 over 5 years) did not build an estate, purchase high-end vehicles or vacation homes, did it?

I also read where the claims reviewer was not working with loupes or illumination to determine whether treatment had been billed, but not performed. I have personally gone through something akin to this with an insurance company that was refusing to authorize needed fillings. You see, there are two ways to diagnose the need for decay:
Visual examination
Tactile examination (today we use a laser, not a hooked explorer to find decay)

Insurance companies don’t want to hear this. They are in business to hold onto their money, and so claims are denied without cause, and the populace is faced with the decision of trusting their doctor, or believing the insurance company is right. Most of our patients understand the adversaries in this, and take the dentists’ side.

I believe that the Constitution calls for a jury of peers to adjudicate a case. My understanding from reading the website was that these were poorly educated jurors, hardly peers. Might I suggest that this case deserves some judicial review, and perhaps a panel of dentists from around the nation (I know many who would volunteer) could come in a review what went on and make recommendations to you so that you might perhaps set aside this verdict. It certainly seems to me that the punishment should fit the crime.

The crime here was what? $8,000 in disputed charges. I think that Big Brother has certainly overstepped. What was the sentence for the toilet manufacturer that was selling parts to the Air Force for ridiculous sums of money? How much money does our government waste on pork barrel projects? I would love to see what the government alleges as their loss in this case. I can certainly tell you that once this letter is widely disseminated the loss will be more intolerable. The welfare recipients will find fewer caring practitioners willing to participate in a program that carries with it a significant disincentive to continue to do so.

I await your reply, and would like your permission to disseminate it to my peers, who are aghast at this travesty (as presented by the friends and family of Dr. Shelburne).

Respectfully,

Steve Markus, DMD FACE