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2018-05-10 / Voices

The System is Broken at IHS Dental: Two things are needed to fix it.

Ask The Dentist
By David McGuire, DMD

Gallup Indian Medical Center (GIMC) Dental Director told me that New Mexico Medicaid pays per visit and not by the procedure; therefore, I am to spread out the treatment into as many appointments as possible. Having my doubts on this, I called New Mexico Medicaid who completely contradicted him. The reason for his lies is that multiple patient visits look better on our statistics; the downside is that patient care suffers. Numbers are what matters to the bureaucrats. To me, patient care is what matters. In other words, the bureaucrats are milking the system, mismanaging government funds and they abuse their patients to achieve this.

The only way this will be fixed, the only way change will occur, is when people begin suing GIMC and the IHS for mistreatment and abuse, for malpractice, and for mismanagement of government funds. To accomplish real change, many people need to start suing for cause.

When GIMC failed Joint Accreditation inspections due to two people needlessly dying which was due to the nursing shortage, IHS went into high gear to prevent lawsuits. They made some minor changes, hired a new Chief Executive Officer and said all was fixed; it wasn’t. A Band-Aid on a festering wound only allows the wound to continue to fester. They fixed nothing, but that was not their goal; their goal was to make the people believe the problem had been fixed so as to avoid litigation for criminal negligence. My issue with this sorry state of affairs is that for several years they have known of the nursing shortage and they did nothing. My question then; how many more Native Americans need to die before real change occurs?

I truly wish there were alternatives to lawsuits, but I do not see any. The bureaucrats are too well entrenched within their incompetence to allow real change to happen. Upon initiation of litigation, the first to go must be the bureaucrats and the freeloaders. My wife’s hospital went into bankruptcy when they lost their government handouts, because the administration was incompetent. When LifePoint Healthcare bought the hospital, they restructured. They took providers off of payroll and put them on production, and so Maria’s income increased while the lazy providers took a cut in pay. The same must be done at GIMC and the IHS. Providers need to have a basic salary with the option of pure production when their production levels increase. Lazy providers will never see more than this basic salary, but others will see their incomes double.

In this regard I am willing to put my money where my mouth is. Have IHS set up a satellite office even here in Gallup, to perform prosthodontics (partial and complete dentures, dental implants, full-mouth rehabilitations), and set up an in-house lab. I will donate all my equipment and materials (nearly $40,000 worth), and then they should employ lab technicians as well as clinical staff. In return, I am willing to be paid on the basis of production only, meaning if I do not work, I do not get paid. This is how it is done in the private sector.

David McGuire, DMD, has practiced dentistry in the private sector for more than 20 years, including in corporate dentistry. He also served as Acting Dental Director at Tohatchi Indian Health Clinic in New Mexico.

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