Conflicts of Interest Act vs ADA&C

 

November 25, 2019

 

Dear Alberta Health Minister,

RE: Suspected violations of the Conflicts of Interest Act by the Alberta Dental Authority

Reference: https://www.alberta.ca/assets/documents/pas-conflicts-of-interest-act-at-a-glance.pdf?fbclid=IwAR0SK2EQTaJx2Q76UNjw_63uVBxS6K27P_9VOQJaOUfhtSFbG-5Smz8PHiw

Concerns about the activities within the dental authority of this province have been mounting over the past decade. To help make a difference I ran for and was elected to ADA&C council a few years ago as the representative for central Alberta but was effectively frozen out of any meaningful participation and asked to leave due to my pro-advertising advocacy after one year. From that time on I have been working tirelessly to bring attention to serious issues that affect the integrity of the profession and safe treatment for the public.

While on council the consulting firm which was hired to help revise the organization commented the ‘tail was wagging the dog’ inferring that the former CEO was controlling what was done by the elected officials. A former ADA&C president referred to him as ‘the puppet master’ and stated change will not happen from within. The ‘Old Boys’ certainly were not ready for change.

At no time did I see any effort for council to address conflicts of interest, except when it affected those Executive council did not agree with. After leaving council I discovered there were even more conflicts than I had learned about while on the inside. I am not in a position to judge or make changes to the ADA&C but when I review Alberta’s Conflicts of Interest Act I would point out the following:

The ADA&C does not appear to have a comprehensive code of conduct for itself. The past CEO had been in office about 20 years and the main rule council had to remember was whatever was decided your own position on the matter had to be kept confidential.


The ADA&C is currently working on an update to its code of ethics, but the people on the committee are unknown to the general membership. Without transparency we are unable to judge whether the members making decisions have clear histories or are they using connections to protect insider interests.


Council members have NOT disclosed real and apparent conflicts of interest. Examples include a paid consulting position for a dental insurance company, linked to a large corporate entity that was buying dental offices in the province at a time when it was a violation of the rules, and a relationship with a dental broker.


Accepting gifts from parties that benefited from contracts/interaction with the ADA&C included golf from a law firm, free courses from a ‘Botox’ training program which was seeking endorsement from the authority and alcohol/dinners/both from a national dental insurance program (CDSPI).


Concurrent employment – as mentioned included a council member who did not disclose a consulting relationship with a dental insurance plan (CDSPI). It is suspected a number council members had consulting/franchising relationships with a dental corporation and at least benefited financially by selling their practices to ‘DentalCorp’ prior to approval of the business model.
The process for receiving and investigating complaints is seriously flawed. The prime investigator had no prior dental experience and many of the secondary investigators were not skilled in the area of concern. An example of the risk occurred when Amber Athwal was injured during dental sedation and the authority reportedly used a dentist with no sedation certification to initially investigate the incident- and the office continued to treat patients for weeks afterwards which put other children at risk of the same injury. Ultimately the cause of the brain injury to Amber appears to be the lack of skills of the recovery nurse, but one may ask if the $330,000 investigation necessary when the same one in BC cost 1/5 that amount. The authority bungled the investigation and the response to the incident, initially refusing to consider changes to the sedation protocols which I had warned Minister Hoffman six months prior could lead to a child’s death. An uncomplicated advertising complaint recently took four years to complete, and in appeal it was judged to be flawed.


(It should be noted that the head of the sedation review committee may have had personal bias as his clinic used a model that competed with other approaches)


Complaints about insiders rarely even get a response, and in one example the organization appeared to use authority resources to support a defamation lawsuit against a dentist who reported a possibly intoxicated former president unzipping the pants of a council member at a social gathering at an ADA&C Jasper convention. The former CEO was accused of threatening an expert witness (Dr. Tom S____) for a dentist within the tribunal process and seemed to use his position to extract revenge out of professional jealousy against a prominent dentist who had a service for dental seniors that competed with a project he had initiated with the ADA&C.


It is estimated that the ADA&C invested over one million dollars in legal fees to attempt to block the influx of corporate dentistry. Two council members were posted as dentists in the tribunal process when many others had also already sold their clinics to DentalCorp. What was not widely known was the council members who were tied to this corporation, and even less well known was the former CEO had one or more children working for Tier Three Dental Brokers. Tier Three helps sell dental practices and is in competition with DentalCorp which prefers to buy direct from a dentist. Following his departure from the ADA&C as CEO, Dr. ____ assumed a role in Tier Three and continued in a consulting role with the ADA&C. If ____ had any influence on blocking DentalCorp this could have been a serious conflict of interest that was never openly revealed.


Conflicts of interests may have been involved when the Complaints Director, Colleen Wetter, was acting as a legal adviser to the advertising review committee, as her interpretation would have a detrimental effect for dentists under investigation which could have benefited from less aggressive application of the general ethics guide. As she participated the advertising rules became synched tighter to a point where photos of teeth were banned and offering free consultations were not permitted. It took several years of lobbying and the threat of a Class Action to reverse some of the overly strict guidelines.


The Complaints Director used ADA&C funds to pay for a defamation lawsuit against a dentist who criticized her qualifications. At the same time Ms. Wetter was suing the dentist she also continued to investigate the dentist’s advertising and publication of a book about over-treatment. In another case, involving a complaint against her own dentist, Wetter had the common sense to step away from the investigation. She did not step away from the case against a dentist she was suing for $3,000,000. While the lawsuit was recently dropped, the effect on the dentist’s investigation will always be in question and as it stands is arguably the most expensive investigation in Canada’s dental history that does not relate to a patient injury.


ADA&C committees were often selected by former presidents – and at least in the case of the advertising committee were populated with children of former ADA&C presidents (and no public member). It is now believed three children of former presidents were on the same advertising review committee. Could this be a conflict of interest? It would have been easier to tell if the members were listed for review inside of being kept a guarded secret.


Would it be a conflict of interest to have Dr. ‘Jack’ ____, a long time friend of the former CEO, form part of a tribunal, even more concerning ‘chair’ the committee against an individual the CEO is also suing for defamation with funds from the ADA&C? Would it be a conflict that the term limits of 5 years do not seem to be respected when friends of the former CEO are involved?
Requests to change tribunal members on grounds of bias are always refused by the ADA&C.


There examples appear to be related to ‘furthering private interests’ and ‘restrictions on using influence’ (no restrictions if we are considering what has been going on at the ADA&C).


‘Restriction on using Insider Information’ may have been breached when the former CEO used information from the one defamation lawsuit to be shared with one that was launched by the ‘unzipping’ former president. There may have even been a coordinated legal attack against the whistle-blower – possible abuse of power.


At an ADA&C visitation to central Alberta the new CEO was asked which

council members had ties to Dental Corp. He refused to disclose the information to the dentists attending. It is believed the current president, Dr. Troy Basarab, has also may have sold his clinic to this large corporate entity.
No known restrictions on concurrent employment are known, and during a court deposition it was discovered that the former CEO had recommended a specific council member be hired to work for CDSPI as a consultant. This was kept secret from most on council.


There is no ethics commissioner at the ADA&C. Concerns about the authority itself and its personnel are not officially investigated would be the case with general members. Blatant violations of tribunal members and council are posted online on a lobby website for public viewing to protest the uneven application of the rules.


In what may be the profession’s greatest shame- gross over-treatment linked to corrupt dental lab-sponsored dentist continuing education- the ADA&C has refused to address the root of the problem possibly due to a previous business relationship with the dental lab. Ontario and Manitoba have banned the approach taught by this seminar series which has been identified as contributing to dental malpractice. The Calgary dental lab continues to promote the shame treatment and the ADA&C continues to grant continuing education for these seminars. It awarded the lab owner-seminar promoter an honorary membership in the Alberta Dental Association. Is it a conflict of interest to ignore concerns related to a seminar program that encouraged Alberta dentists to fly Albertans to Las Vegas for drilling lessons where their liability insurance could have been void simply because the promoter was their biggest advertiser (paying for the distribution of the ADA&C membership newsletter)?


The Canadian Dental Association granted Dr. _____ the ‘Award of Honour’. He used this award to support his integrity in a defamation lawsuit against a critic who published a cartoon (he was operating a puppet Dr. ____, an ADA&C president and having him explain why a lawyer was the complaint director). No other CD's for other dental colleges/boards in Canada are known to lack dental backgrounds. 


Should authority lawyers argue for ignoring limits on investigation costs when they stand to benefit?


Are any of these examples of conflicts of interest? If so, the ADA&C isn’t likely going to care. It never does want to have itself investigated…and does not want to divide the association and college. They claim to be ‘better’ together…others beg to differ.


(Final sent to Health Minister may contain additional information not shown here)