Bracken Killpack

In Support of the Whistleblowers: A Troubling DSO Complaint

A courageous whistleblower, a former office manager for a clinic operated by Lone Peak Management Group, LLC, recently reported a corporate scheme designed to wring out minor cost savings at the expense of patient safety.
“Why are we here?” is a question we ask ourselves routinely as we work together to establish priorities, plan programs and identify issues to be addressed.

The answer boils down to a simple statement: WSDA exists to support its member dentists and their patients.

Central to that mission is protecting the doctor-patient relationship in every practice model that dentists choose. That is why, in 2017 we pushed hard for legislation to prohibit corporations, including dental service organizations (DSO), from practicing dentistry and to establish strict prohibitions on non-dentists interjecting themselves into the doctor-patient relationship. 

As a result of its passage, Washington law now expressly and explicitly defines actions that constitute the unlicensed practice of dentistry. These unlawful practices include directing a dentist’s treatment plan; limiting or imposing requirements on how a dentist uses equipment or materials in providing treatment; or limiting or imposing requirements on the materials, supplies, instruments or equipment a dentist deems necessary for diagnoses or treatments consistent with the standard of care. This list is not exhaustive.  

Providers and patients alike have raised concerns that agents of some DSOs were doing just that, making decisions and establishing “business” policies that interfere with the doctor-patient relationship. Upon passage, we noted that the new law gives state regulators powerful tools to protect patients and that strict enforcement would be important.

Recent developments provide state regulators the chance to use those tools. A courageous whistleblower, a former office manager for a clinic operated by Lone Peak Management Group, LLC, recently reported a corporate scheme designed to wring out minor cost savings at the expense of patient safety. According to the whistleblower’s complaint, Lone Peak Management Group has been directing its staff to reuse Isolite dental mouthpieces that are specifically designed and intended for single use only.  

Lone Peak Management Group operates 12 clinics in Washington under various names and is owned by private equity firm Tailwind Capital.

The whistleblower filed a complaint with the Department of Health and, as we head to print, DOH has already authorized a high-priority investigation of that complaint.

WSDA has supported this whistleblower complaint because we immediately recognized that this practice exposes children, a high percentage of whom come from low-income, Medicaid-eligible families, to serious risk of infection and other complications.

We also engaged to support our member dentists who are working in a DSO environment. Regardless of their choice of practice model, dentists should always have full authority over the treatment of their patients.

The complaint indicates this is not the case at Lone Peak Management Group clinics. Internal emails quoted in the complaint describe how Lone Peak Management Group ignored concerns raised by a clinic dentist about reusing these single-use mouthpieces. In response, Lone Peak Management Group agents directed dental office staff to deceive that dentist: “We should probably hide our open Isolites on the days we know she is coming in,” wrote a Lone Peak Management Group agent. “In the meantime, just make her happy when she is around, and then go back to business as usual when she leaves.”

This cynical response demonstrates blatant disregard for the professional opinion and ethics of a licensed dentist. It speaks volumes about what can happen when corporate representatives are allowed to direct, question and overrule the decisions dentists make related to patient care.

It’s never an easy decision to engage in a complaint when one bad actor’s misdeeds could cast a broader cross-section of the dental profession in a negative light. But when we become aware of egregious behavior like this, we all have a duty to protect public safety.  

For our part, WSDA remains ready to support whistleblowers who come forward with legitimate complaints about similar violations in other office settings. We believe that such efforts serve the interests of the public, the dental profession and our members.  

It is why we are here.

The views expressed in all WSDA publications are those of the individual authors and do not necessarily reflect the official positions or policies of the WSDA.