Dear John: Is My Dentist Drinking on the Job?
Tuesday, December 17, 2013
Let me start by saying that I am afraid of going to the dentist. But I started seeing one close to a year ago because I had to. I liked him because he was patient with me – I don’t think I make a very good patient because of my fears. But at my most recent visit, I am sure he smelled like he had been drinking. It was right after lunch and maybe he had a drink with lunch or whatever, I don’t care. I definitely don’t want to see a dentist who has been drinking. So I called and said I would be seeing a new dentist and would they send my records to him and the woman on the phone asked why was I leaving, was there anything they could do to make me more comfortable, etc. I didn’t know what to say, so I hung up. The woman I spoke to was always very nice to me when I was in the office, so my question is should I say why I’m leaving? Maybe she already knows he does this and it will take losing patients for them to take it seriously. I don’t know, and that’s what I would like to know.
Not Exactly Reassured
Dear Not Exactly Reassured,
You have every right to stop seeing any medical professional who makes you uncomfortable in any way, and you have no obligation to offer an explanation if you don’t want to. If your mind is made up, simply respond to attempts to keep your business by saying, “I’ve made my decision and I really just want to talk to you about having my records forwarded.” Having said that, however, I do think you should give this a little more thought and not act too hastily now that you’ve overcome your fear and found a dentist you liked until recently.
First, you’re absolutely right: any medical professional who consumes alcohol prior to seeing a patient has displayed an egregious lack of judgment. It would be completely reasonable to stop seeing such a professional if that were the case. But are you absolutely certain this IS the case? Medical offices have any number of things that could have an “alcohol-y” smell. Or maybe your dentist used a mouthwash containing alcohol prior to seeing you. I would look into this a bit more deeply before severing your relationship. Search for reviews of this dental practice online to see if others have the same complaint. Do you know anyone else who goes there? Ask what their experiences have been like.
As I said, if what you suspect is true, that’s a good reason to go elsewhere. If not, though, it would be a shame for you to stop seeing a dentist who has you smiling.
Today I got a Facebook request from my 11-year-old son's 11-year-old friend and I'm not sure what to make of this. On the one hand, I think the concept of a "friend" on Facebook is very different from the reality of what a friend is, so I'm inclined to accept. On the other hand I'm a little weirded out by it and think no 40-something-year-old woman has any business being "friends" with an 11-year-old boy who isn't related to her. I've made an effort to get to know my son’s peers through volunteering at school and coaching sports, but I don't want to be "that mom" who is buddies with all of the kids. Honestly, I want them to respect (and maybe even fear) me and I’m wondering if you think friending on Facebook is crossing that line or is a harmless way of connecting.
Not That Mom
Dear Not That Mom,
It sounds like you’re disinclined to accept this friend request, and that’s totally fine. (If you do ignore it, though, it would be nice to let this kid know it’s nothing personal, just your policy.) But if you’re truly on the fence about it, I don’t think this invitation is either of the things you speculate it may be at the end of your letter. I think to an 11-year-old who’s new to Facebook (and please tell me that at that age, he’s new to Facebook!), these virtual “friends” are simply something new to collect the way he was probably collecting Pokémons a year or two ago. And when kids are collecting something, the more, the better. No offense, but they’re not particularly fussy about the quality of the specimen.
So should you accept the invitation? It depends on the content of what your grown-up friends post. If they swear a lot or post things inappropriate for an 11-year-old to read, I’d say no. But if that’s all harmless, it’s fine to hit “confirm.” I certainly don’t think your friend status will have much effect on the esteem in which you’re held by your son’s peer group. Most likely, this new Facebooker invited everyone in the computer’s contact list, and you’re giving this invitation waaaay more thought than he gave to sending it.
I recently started dating a buddy’s ex-girlfriend. (We are all college students but at different schools.) To be honest, I was pretty crazy about her when they were together, but I never let either of them know. I didn’t give it much thought. But they split up, a couple months went by, I saw her at a party, and next thing you know, we’re spending all our time together this summer. My buddy – or former buddy – has been definitely cold towards me since he learned (from someone else) that we’re together. But what’s weird is that I am learning through her that he made up all this stuff about me (and another friend of ours) that I don’t even know where he got or what he was talking about. I mean TOTALLY made it up. I’m lucky she even gave me a chance with what she thought she knew about me. I want to call this guy out on what he was saying, but my girlfriend wants me to just forget about it. My only thing is, I want him to know that the stories have to stop. But I think she feels kind of bad about the way their relationship ended and she doesn’t want to stir up bad feelings. I’m in the middle of it and would like a take from someone a little more objective. Thanks.
Dear Fictional Character,
Wow. Are you sure you hid the fact that you thought your friend’s girlfriend was so great? Because on the surface, it sounds like your friend had a feeling that was the case and he was engaging in a little preemptive undermining.
At any rate, it sounds like your friendship is all done. Though you did nothing wrong, the love triangle put it on life support, and the stories pulled the plug. So assuming this was nothing more than a pretty pathetic attempt to make you as undesirable as possible, I’d put the whole thing behind me. If you learn that he’s still bad-mouthing you or the old lies spread farther than you realized, you can still get in touch and tell him to knock it off and set the record straight. But if the damage has been contained to just the three of you, there’s too much good stuff going on in your present and future to dwell on the past.
John is a middle-aged family man from Providence, Rhode Island. If you learn from your mistakes, he’s brilliant. Write to him at [email protected]. He's away from the advice desk this week, so he's chosen some of his favorite letters from previous columns to share.
Related Slideshow: Rhode Island Doctors Behaving Badly
Check out more Rhode Island healthcare professionals behaving in ways that have required suspension and other disciplinary actions from HEALTH.
B&E / Holding Marijuana
Roy M. Main, MD
The Rhode Island Department of Health suspended Dr. Main from practicing medicine in the State of Rhode Island indefinitely after breaking into a residence without permission at 3 in the morning and being in possession of marijuana.
Roy M. Main, MD, a physician licensed in the state of RI but with offices in Mystic, Connecticut, entered the home in Westerly, according to documents filed with HEALTH, on August 10 between 3 and 4 in the morning, calling out for a friend named Bill (whose house he thought he was in). The home's owner awoke, subdued Main and held him until police arrived.
Main was arrested for felony breaking and entering. He told police he mistakenly believed he had entered the home of a friend who'd instructed him "to enter a side door of that house." Main entered the wrong house, though, through its garage entrance "because it had no side door."
According to HEALTH, Westerly police found two bags containing about six grams of marijuana in Main's vehicle, which smelled of marijuana smoke.
The Rhode Island Department of Health suspended the license of a certified nursing assistant at the Charlesgate Nursing Home in August, following an incident involving missing drugs.
Erin Jeannine Blanchette, NA/MAD, allowed "one Joshua Roberts, whom the respondent had personally known and is alleged to have been involved in a relationship with" in a secured area with a secured medicine cart.
Staff at the Charlesgate Nursing Center reported a large quantity of narcotics missing to the Providence Police the same day. Upon investigation, Blanchette was "observed by the Providence Police to be incoherent and under the influence of narcotics."
EMT sexual harrassment
A Coventry EMT was suspended in July 2013 for sexual misconduct toward a fellow EMT, according to the Rhode Island Department of Health (HEALTH).
Randy Crowe was accused by a younger female coworker to have asked her to come inside a rescue truck at the Western Coventry Fire Department's Summit fire station so "he could practice placing ECG leads on her under the guise of teaching her how to do so properly."
According to documents filed with HEALTH, Crowe "placed two leads on her hips and collar bone [EMTs traditionally place four lines of their ECG marine on the wrists and ankles]." While placing the leads on her hips, Crowe pulled her pants down, according to the complaint. Further, "the Complainant also alleges that [Crowe] brushed her chest, told her to 'keep smiling' and pulled her face close to his in 'almost a kissing motion.'"
When the Complainant jumped off the vehicle and walked outside to her car, she alleges that Crowe "followed her, hugged her and kissed her on the side of the head."
HEALTH has suspended the EMT license of Randy Crowe indefinitely pending further order.
Chepachet-based physician Clayton Lanphear, III, DO, who had prescribed extremely high doses of Vicodin HP and Vicodin ES, as well as Percocet, without properly monitoring his patients' health, has had his license to practice medicine suspended by the RI Department of Health (HEALTH) in July 2013.
HEALTH also called Lanphear's medical records "often illegible and lack the minimum requirements of a bone fide medical record" in accordance with Board regulations and minimum standard of acceptable practice.
A review of Lanphear's prescriptions by HEALTH revealed three occasions of prescribing dangerous levels of the medications. His license is suspended until further review.
A Warwick dental practice was closed by the Rhode Island Department of Health (HEALTH), and two of its dentists cited for a number of violations regarding the storage and handling of controlled substances, according to HEALTH.
Frank Paletta, MD, DMD, and Mohammed Banki, MD, DMD, were both named by HEALTH as associated with practicing at 243 Jefferson Boulevard in Warwick.
According to HEALTH, dental inspectors learned that Dr. Banki used medications that were misbranded, did not check medications in syringes that were administered to patients intravenously, and left controlled substances in an unlocked cabinet, among other violations.
Morphine for babies
Pharmacist Leo Blais, RPH
Rhode Island pharmacist Leo Blais, RPH, was suspended in March 2013 for 2 years for dangerous and lax practices, including improper labeling and storage of medications that led to including morphine in omeprazole prescriptions for an infant and a toddler. Blais is also a former RI State Senator.
After the RI Department of Health announced the suspension, HEALTH director Michael Fine, MD, asked for the terms of the suspension to be reviewed.
UPDATE: Blais' license was revoked June, 2013.
Pharmacist Richard Mancini, RPH
Warwick pharmacist had his license suspended for a variety of unclean practices in January 2013.
Richard Mancini, RPH, the pharmacist-in-charge of Pharmerica, located at 83 Vermont Avenue in Warwick, was found to have allowed unlicensed individuals to practice as pharmacy technicians and engage in the compounding of sterile pharmaceutical compounds.
Malpractice in ER
Rita S. Kurl, MD
Rita S. Kurl, MD, was found guilty of unprofessional conduct arising from a malpractice litigation settlement, after having inserted a gastronomy tube improperly into a nursing home patient's abdomen, who later died as a result. Dr. Kurl's malpractice verdict was announced in December 2012.
Doctor Kurl, whose specialty is internal medicine, was involved in a case at Our Lady of Fatima Hospital emergency department on March 23, 2008.
Malpractice in ER, II
Joseph P. Turner, DO
The East Greenwich internal medicine physician was named guilty of malpractice after having underestimated the severity of a patient's condition who later died. His verdict was announced in December 2012.
Doctor Turner was the attending physician at Our Lady of Fatima Hospital in Providence on March 23, 2009, when a 56 year old male patient arrived, complaining of severe lower abdominal pain of "ten on a scale of ten." The patient had undergone elective gallbladder removal a week earlier on March 16.
Nursing Assistant Nathaniel Rodrigues
The nursing assistant at Rhode Island Hospital was suspended indefinitely in December 2012 after having sexually assaulted a female patient.
Nathaniel Rodrigues was employed as a Nursing Assistant at Rhode Island Hospital on September 24, 2012, when he assaulted a female patient by "digitally penetrating her vagina and sexually fondling her," according to HEALTH.
Nurse Practitioner Gerald Dornhecker
The nurse practitioner at Skin Essentials Spa in North Providence, RI, was suspended in December 2012 for violations concerning pharmacy items that were recalled because of potential contamination with fungal meningitis.
Dornhecker told investigators that the facility did not have any potentially infected pharmaceutical product, but then reversed his story when recalled lots of the pharmaceutical were discovered on the premises.
Frederick Lury, DMD
The Warwick dentist who had been suspended from practicing dentistry for controlled substances violations was caught continuing to practice in November 2012.
Frederick Lury, DMD was already suspended from practice when a female patient says that Lury saw her on November 1, 2012, for a filling, and she returned to his office on November 10 with a complaint of jaw pain. Lury examined her tooth and took an x-ray. Lury wrote a referral slip in her presence and she made another appointment for the week of November 26. The patient says she witnessed other patients and dental hygienists in Lury's office on or about November 10.
Bogus medical marijuana
Tom Folcarelli + Maria Petrucci/11th State Consultations
A Providence company that had been providing customers with medical marijuana authorization was ordered to cease and desist operations as they are not licensed to do so, in November 2012.
11th State Consultations, LTD, located at 400 Reservoir Avenue in Providence, was operated by Tom Folcarelli and Maria Petrucci was ordered to "cease marketing and providing patient consultations and assessment services to the public for the purpose of providing medical authorizations for medical marijuana," according to HEALTH.
Controlled drugs for wife
Arnold Rosenbaum, MD
The Rhode Island physician was suspended in November 2012 for prescribing controlled substances after prescribing those very medications to his wife that didn't meet standards.
Arnold Rosenbaum, MD, had already come to attention of the Rhode Island's Board of Medical Licensure and Discipline for doing the same thing in 2008, at which time he promised to stop prescribing his wife controlled substances and that she would be treated by another physician.
Psychiatrist Thomas Paolino, MD
The East Greenwich psychiatrist was suspended in October 2012 from prescribing controlled substances after it was discovered that he had prescribed benzodiazepine to a methadone user, a potentially dangerous combination.
HEALTH also found a pattern of "inadequate medical records" for four other patients, revealing "no evidence of diagnoses; undocumented controlled substance prescriptions; inadequate monitoring of controlled substance prescribing, prescription of controlled substances in a pattern that lack coordinated care with methadone clinics," and more violations.
Meds in sandwich bags
Pharmacist Christopher Rizzo, RPH, pharmacy technicians Roger Normand Croteau and Angelina Chanthearun Chea
Smithfield's Millennium Pharmacy pharmacy and three of its employees were suspended for numerous violations, including packing prescription medications in sandwich bags, in October 2012.
A series of violations were cited, including Rizzo being seen by an eyewitness hiding or conspiring to hide "suspected misbranded medications" prior to the arrival of Inspectors at the pharmacy.
Vicodin for family
Lisa Noyes-Duguay, MD
The Rhode Island physician was suspended from prescribing controlled substances after it was found that she had been improperly prescribing drugs for family members, including Vicodin and Klonopin.
Lisa Noyes-Duguay, MD, initially told investigators from the RI Department of Health's Board of Licensure and Discipline that she had never prescribed controlled substances for any family members. When asked again if she had ever prescribed Vicodin, Klonopin, Buprenorphine products or Hycodan syrup to a family member, she said she done so on two occasions. She then added that she had prescribed Suboxone to one family member twice about a year earlier.
Fondling elderly patient
Stephen R. Pezzullo, MD
The Rhode Island physician was suspended in August 2012 by the Board of Medical Licensure and Discipline for fondling a then-70-year-old patient.
According to the patient's written complaint, Dr. Pezzullo asked her to lie down and then he "started to examine my breast over and over" and "started to move his hands lower and lower pulling my slacks down as he moved toward my private (area)." While this allegedly was occurring, the patent stated she put pressure on her pants to stop Dr. Pezzullo from lowering her pants any farther, then he left the room.
OB-Gyn's opiates for men
Jorge Ruelos, MD
The Rhode Island OB/Gyn was suspended from prescribing controlled substances in July 2012 after having prescribed large amounts of opiates… to men.
Jorge Ruelos, MD, was found by the Board of Pharmacy to have been prescribing high-dose pain management medication to multiple male patients, "despite a specialty in obstetrics/gynecology."
Physician's assistant Michael J. Cobb
The Rhode Island physician's assistant had his license suspended in May 2012 for receiving payment in exchange for recommending a certain brand of bone stimulators prescribed by surgeons with whom he worked.
Michael J. Cobb engaged in unprofessional conduct by violating Federal Anti-Kickback laws. Cobb, who worked as a physician assistant to two surgeons in Rhode Island (not named in documents provided by HEALTH), had duties that "permitted him to choose which type of post-surgical bone stimulator would be prescribed for the patient," according to HEALTH. Cobb was "receiving kickbacks from one bone stimulator manufacturer from 2004-2011."
Erratic and distracted
Marvin S. Kerzner, MD
Marvin S. Kerzner, MD was suspended from his internal medicine practice for erratic and distracted behavior as well as failing to respond to complaints with the Board of Medical Licensure and Discipline, in May 2012.
Dr. Kerzner, who was then 81 years old and whose principal place of business is Summit Medical Group at 154 Waterman Street in Providence, was under investigation by the Board after the Physician Health Committee (PHC) of the Rhode Island Medical Society expressed concerns about the "status of [Dr. Kerzner's] clinical competency." According to documents filed with HEALTH, "another physician expressed concerns to the PHC after two of his patients told him of problems. Specifically, the concern expressed was that the Respondent seemed 'erratic and distracted.'"
Psychiatric nurse Lisa Marenaro
A psychiatric clinical nurse was suspended by the Rhode Island Board of Pharmacy in May 2012 for prescribing high dosages of generic Adderall, Ritalin, and Xanax without proper documentation.
Based on a complaint from the Director of the Town of Coventry's Department of Human Services, the Board reviewed five of Lisa Marenaro's patients Among the findings: one patient was prescribed a 180-day supply of Amphetamine Salts (generic Adderall) in 75 days, at 90 mg/day. According to the HEALTH, the usual dose is 40mg/day, and "there was no explanation in the records to explain the prescription of a dose approximately two and one-half times higher than the usual amount." Another patient was prescribed three times the recommended amount of the same substance.
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