FSOMS 2018 Legislative Day at the Capitol

January 24, 2018
FSOMS Legislative Day at the Capitol
Tallahassee, FL

More details coming soon.

About our Speakers

FSOMS 2017 Annual Meeting Speakers

Richard A. Mufson, DDS

Dr. Mufson is an oral and maxillofacial surgeon in private practice in North Miami Beach, FL A graduate of Temple University School of Dentistry in Philadelphia, PA, post-graduate residency training at Georgetown University Medical Center in Washington, D.C., and a Diplomate of the American Board of Oral and Maxillofacial Surgery, Dr. Mufson has lectured extensively on the topic of HIV/AIDS and other infectious diseases, in addition to other state-mandated courses—Laws and Rules of Dentistry, Medical Errors and Risk Management. He is also past president of the South Florida District Dental Association and Florida Society of Oral and Maxillofacial Surgeons.

Sundeep Rawal, DDS

Dr. Rawal graduated from the University of Florida College of Dentistry. He completed his training in Prosthodontics at the University of California San Francisco where he was exposed to the most current technologies shaping dentistry. He has worked extensively to utilize CAD/CAM technologies within the scope of clinical dentistry and enhance his patients’ restorative treatments. He has lectured extensively across the USA as well as internationally. He is currently in private practice in central Florida in Orlando and east to the Beaches.

Rui Fernandes, DMD, MD, FACS

Dr. Fernandes is a Board certified Oral and Maxillofacial Surgeon. He holds dual appointments in Oral and Maxillofacial Surgery and Surgical Oncology at the University of Florida College of Medicine – Jacksonville. Currently, he serves as the Chief of Head and Neck Surgery, Director of the Head and Neck/Microvascular Reconstructive Surgery fellowship and Associate Chairman of the Department of Oral & Maxillofacial Surgery. He received his undergraduate degree in Biology from Boston University and Doctorate in Dental Medicine from the Goldman School of Dental Medicine, also at Boston University. He is a graduate of the University of Alabama at Birmingham School of Medicine and completed residency training in Oral & Maxillofacial Surgery at the University of Alabama at Birmingham as well. Upon completion of his residency, he began a 2 year combined Head and Neck Oncology and Microvascular Surgery Fellowship at the University of Maryland College of Medicine. Since completing his fellowship training he has maintained an academic appointment at the University of Florida College of Medicine in Jacksonville. Dr. Fernandes currently serves as chair of the education committee of the International Association of Oral and Maxillofacial Surgeons. He has lectured extensively both nationally and internationally and has authored several manuscripts in the areas of head and neck oncology and reconstructive surgery as well a single author textbook in reconstructive surgery of the head and neck.

T.J. Tejera, DMD, MD

Dr. Tejera was born in Cienfuegos, Cuba and grew up in Miami, Florida, therefore, is fluent in both English and Spanish. He attended Spring Hill College in Mobile, Alabama before going on to earn both dental (D.M.D.) and medical (M.D.) degrees from the University of Alabama School of Dentistry and the University of North Carolina School of Medicine, respectively.Dr. Tejera completed an internship in General Surgery and residency in Oral and Maxillofacial Surgery at the University of North Carolina at Chapel Hill and UNC Hospitals. During his final year of surgical training at UNC, he served as the Chief Resident of the Oral and Maxillofacial Service.

Following residency, Dr. Tejera pursued fellowship training in General Cosmetic Surgery at Carolina Surgical Arts in Greensboro, North Carolina. During his subspecialty fellowship program, Dr. Tejera received extensive, formal, didactic and clinical training in Facial Plastic and Reconstructive Surgery.

After his fellowship, Dr. Tejera accepted a position at Carolina Surgical Arts where he practiced the full scope of Oral and Maxillofacial Surgery. Dr. Tejera maintained an active full scope practice with an emphasis in Facial Cosmetic Surgery, reconstructive surgery of the facial skeleton and corrective jaw (orthognathic) surgery. In 2003, he became Board Certified by the American Board of Oral and Maxillofacial Surgery.

Dr. Tejera’s current clinical practice is focused on cosmetic facial surgery, orthognathic surgery, facial reconstructive surgery, sleep apnea medicine and its related surgical treatments, and dental implants. Dr. Tejera is also very active in providing care to patients with facial trauma, including a broad range of facial fractures and soft tissue injuries, through the Lee Memorial Health System Trauma Program.

Ramon Ruiz, DMD, MD

Dr. Ruiz has joined the Department of Children’s Surgery at Arnold Palmer Hospital for Children. He is board-certified in oral and maxillofacial surgery and fellowship-qualified in pediatric craniofacial surgery. Dr. Ruiz serves as medical director of Arnold Palmer Hospital Pediatric Craniomaxillofacial Surgery and the Craniofacial Disorders Program. Dr. Ruiz maintains a full-scope surgical practice in maxillofacial and craniofacial surgery with an emphasis in reconstructive surgery of the facial skeleton, corrective jaw (orthognathic) surgery, repair of the cleft lip and palate, and management of patients with complex craniofacial conditions. He has dedicated his professional life to the care of individuals with facial differences.

Important Medical Malpractice Legislation Passes the House; Help Needed with Senate

On Wednesday evening, the House passed the medical malpractice legislation (HR 1215) that AAOMS has vigorously advocated. The near party-line vote was 218-210 with 6 members not voting.

One amendment was agreed to during the floor debate and was included in the bill. It does the following:

  • Allows a physician to apologize to a patient for an unintended outcome without having the apology count against them in the court of law.
  • Requires a plaintiff to provide a notice of intent to the physician 90 days before the lawsuit is filed.
  • Defers to sundry state laws regarding lawsuits and outlines requirements witnesses must meet for testimony during trial.

One amendment failed that would have given affirmative defense to defendants in health care liability cases if they can show they complied with clinical practice guidelines.

It will be an uphill battle in the Senate so our work is not done. We must support AAOMS’ legislative efforts.

TAKE ACTION NOW

Please click on this link to send a letter to your Senators:

Grassroots campaign aimed at the Senate.

Simply fill in your name and demographic information and the system will develop a letter to go to your Senators from you. Freely edit the letter or send as is.

Thanks for your help!

Raymon L. Ruiz, DMD, MD
President

The FSOMS Presents The 2017 Dr. Martin Lebowitz Award

 

       Dr. Richard Tamayo

On May 13th, 2017, the Florida Society of Oral & Maxillofacial Surgeons presented the Dr. Martin Lebowitz Award to Dr. Richard Tamayo. Richard Tamayo graduated from Southwest Miami High School, Suma Cum Laude, with a 4.55 G.P.A. While at Southwest Miami High, he assisted the Head Coach, Mauricio Diaz, in training student athletes on the volleyball team, helped run the drills and improve student techniques and was a member of their FHSAA State Volleyball team as they became the 2008 Champions. He was also a counselor at the Y.M.C.A. Summer Camp from June through August of 2011, supervising and escorting campers under the age of ten, and maintaining a safe and fun environment for the kids. Richard was a tutor in general chemistry from October 2011 – June 2012, instructing high school and college students in introductory levels of general chemistry, helping students solve chemistry problems and clarifying concepts of chemistry to improve their grades and performance in general chemistry.

Richard had matriculated at Florida International University, and received his Bachelor of Science Degree with a major in Biology and a minor in Chemistry, graduating Summa Cum Laude in May of 2013.   At FIU, he was on the Dean’s List for six consecutive semesters.

After college graduation, Richard became a student at the University of Florida College of Dentistry. While in dental school, he was a member of the American Student Dental Association, the Hispanic Student Dental Association and the Academy of General Dentistry.  He graduated with a D.M.D. degree in May of 2017, with a 3.73 G.P.A. Experiences during his dental education included the Co-Founding of the Equal Access Care Network Dental Clinic in 2015, where he was Electronic Health Records Manager from September 2015 until graduation. The EACN provides free comprehensive dental care to the local community. He was also an Extern at the University of Tennessee, Knoxville, OMS program, from February 27 – March 5 of 2016, attending the Head & Neck Cancer Clinic, the Tumor Board, and acquired hands on experience in wound debridement and laceration closure, and served on emergency call. He was also an Extern from August 24 – 28, at the University of Florida OMS program, attending TMJ seminars and acquiring O.R. experience in various OMS surgeries, and served emergency call. He spent 70 hours with Sclar Oral Surgery, learning the surgical techniques and helping transport fragile sterilized equipment. He volunteered from January – June 2012 for the Community Smiles Clinic at U of F, where he assisted dental residents with retrieving and sterilizing equipment, used his bilingual skills to communicate between the residents and patients, and also attended the resident lectures.

It is with great pride that the FSOMS has presented Dr. Richard Tamayo with the 2017, Dr. Martin Lebowitz Award! Thank you for your service, and we extend every encouragement for your future professional growth and service to the dental profession.

Lawrence K. Cook, Awards Chairman

Download Dr. Richard Tamayo’s CV

 

 

2017 Legislative Review

From: Mike Huey, Todd Steibly and Jessica Love

Following is a comprehensive review of the legislative session that just ended.
Thanks to our lobbyists from Gray-Robinson for another outstanding job.

There was a somewhat rocky end to what was perceived by many as one of the most dysfunctional Sessions in recent years. Due to many policy issues getting tied together with the budget, and a failure for House and Senate leaders to come to an agreement on time, the budget was presented too late to allow the Legislative Session to end as regularly scheduled on Friday, May 5, 2017. Due to the 72-hour “cooling off” period required by the State Constitution, the House and Senate were forced to extend the Session by three days. After approving the state budget, the Legislature adjourned sine die at 8:52 p.m.

The budget totals $83 billion, including funding a major Senate priority for an Everglades water storage reservoir to divert discharges from Lake Okeechobee which are often blamed for toxic algae blooms that threaten coastal estuaries. The budget funding provides $64 million, as well as $800 million in bonding authority to cover the state’s half of the $1.5 billion total cost. The budget also allocated more than $600 million to boost the academic quality and reputation of Florida’s higher education facilities, providing for an increase in Bright Futures scholarships and also requiring universities to offer flat-fee block tuition programs to students.

A major priority of the House, the budget funds “schools of hope,” which provides $200 million to attract charter schools to impoverished areas where traditional public schools are underperforming. The budget also significantly revamps and reduces funding for Enterprise Florida and Visit Florida, the taxpayer-funded economic development and tourism marketing programs, which was strongly opposed by Governor Rick Scott.

The Legislature also agreed to a $34.2 billion health care budget, which includes $100,000 for Donated Dental Services and $200,000 for community water fluoridation.

There were several high profiles, heavily debated issues that failed to pass this Session, including legalizing medical marijuana, repealing personal injury protection insurance, reforming the state workers’ compensation system and gambling.

Last Session, legislation was passed to separate dental services from Statewide Managed Medical Care (SMMC) programs. As required under the bill, the Office of Program Policy Analysis and Government Accountability (OPPAGA) report was presented to the Legislature by December I, 2016, which essentially indicated that there was insufficient data to determine the effectiveness of providing dental services through SMMC or separately. However, because the Legislature took no action this year regarding the contents of the report, as directed by the law, the Agency for Health Care Administration must now move forward with implementing a statewide competitive procurement for a separate dental program for children and adults with a choice of at least two vendors. AHCA is required to commence enrollment in the Medicaid prepaid dental health program no later than March 1, 2019.


LEGISLATION WHICH PASSED:

POMP Database HB 557 – Controlled Substance Prescribing (Rep. Nick Duran – Miami) SB 840- Controlled Substance Prescribing (Sen. Jeff Clemens-Lake Worth)

This legislation makes changes to the state’s prescription drug monitoring database (PDMP). The bills shorten the length of time from seven days to the next business day for a pharmacy or physician to report dispensing of a controlled substance, and requires that the information be reported via the DOH electronic system. The bill makes no changes to the PDMP reporting exemptions for hospitals. The legislation was supported by the Florida Behavioral Health Association and the Florida Chapter of the American College of Surgeons.

Rights and Responsibilities of Patients HE 1253 – Rights and Responsibilities of Patients (Rep, Shawn Harrison – Tampa) SB 1206 – Rights and Responsibilities of Patients (Sen. Bill Montford-Tallahassee)

This bill adds to the Patient’s Bill of Rights and Responsibilities, to allow a patient to bring any person of his or her choosing to patient-accessible areas of a health care facility or a health care provider’s office to accompany the patient while the patient is receiving inpatient or outpatient treatment or is consulting with his or her health care provider, The bill will also allow facilities to prohibit patients from exercising this right if doing so would risk the safety or health of the patient, other patients, or staff of the facility or office or cannot be reasonably accommodated, The bill requires health care providers and health care facilities to include this new provision in the summary of rights and responsibilities provided to patients.

Discount Plan Organizations
HE 577-DiscountPlanOrganizations (Rep.CaryPigman-Sebring) SB430-Discount Plan Organizations (Sen. Aaron Bean -Jacksonville)

Discount Medical Plan Organizations (DMPOs) offer discount medical plans, in
exchange for fees, dues, charges, or other consideration, which provide access for plan members to providers of medical services, including dentists, and-the right to receive medical services from those providers at a discount. This legislation renames a “Discount Medical Plan” and a “Discount Medical Plan Organization” as a “Discount Plan” and a “Discount Plan Organization” (DPO), and clarifies that the definition of a “Discount Plan” excludes any plan that does not charge a fee to members, The bill removes all rate and form filing and approval requirements for DPOs. The legislation also requires a member to receive a reimbursement of charges if the member cancels a plan in compliance with the rules, to increase flexibility in marketing, it allows a DPO to delegate functions to marketers and allows a marketer or DPO to commingle medical services and other services on a single page of forms, advertisements, marketing materials or brochures.

Impaired Health Care Practitioners HE 229 – Health Care Practitioner Licensure (Rep, Cord Byrd – Jacksonville Beach) SB 876 – Health Care Practitioners (Sen. Dana Young- Tampa)

This legislation updates the operation of the impaired practitioner program (IPP), The IPP assists health care practitioners who are impaired or potentially impaired as a result of the misuse or abuse of alcohol or drugs, or of a mental or physical condition which could affect the ability to practice with skill and safety. It allows certain licensed practitioners to report practitioners having, or suspected of having, an impairment to a DOH contracted consultant rather than to the department. To encourage self-referral, the bill prohibits a consultant from providing information to the DOH about a self-referring participant if the consultant is not aware of a pending action against the practitioner and the participant is complying and making progress with the terms of the IPP contract, unless authorized by the participant. A program referral or participant must enter into a participant contract with the consultant which provides the consultant’s requirements for the participant to successfully complete the IPP and monitoring plan. If a participant fails to complete the IPP for any reason, a consultant must notify the DOH for disciplinary action. If a consultant concludes that a practitioner’s impairment constitutes an immediate, serious danger to public health, the consultant must notify the department.


LEGISLATION THAT FAILED:

Certificate of Need
HB 7 -Availability of Health Care Services/or All Florida Patients (Rep. Alex Miller – Sarasota) SB 676 -Availability of Health Care Services (Sen. Rob Bradley- Orange Park)

These bills would have eliminated the Certificate of Need program at the Al-ICA which determines how many hospitals, nursing homes and hospices can be in one area at a time based on demand for their services. The House sent its bill to the Senate, however the Senate never heard the bill. We anticipate this issue will be filed again next Session.

Trauma Deregulation
HB 1077 -Trauma Services (Rep. Jay Trumbul1-Pcmama City) SB 746- Trauma Care (Senator Travis Hutson – Palm Coast)

These bills would have eliminated the 44-trauma center cap as well as the limits on the number of trauma centers permitted in each of the current 19 regions throughout the state. Like last Session, proponents of the bills contended that adding trauma centers helps save lives by reducing the time and distance needed to transport injured people for care. Near the end of Session, the Senate held a trauma workshop where Health Policy Chair Dana Young invited several trauma physicians and the Department to testify. Many of the physicians warned that adding new centers would dilute the patient population and staff from existing trauma centers. Although the House amended its bill to instead create a statutory minimum need for trauma centers within a trauma service area based on population, the legislation failed to pass both chambers.

Ambulatory Surgery Centers
HE 145 -Recovery Care Services (Rep. Heather Fitzenhagen -Fort Myer;)
SB 222 -Length of Time a Patient May Stay at an Ambulatory Surgical Center or Mobile Surgical Center (Sen, Greg Steube – Sarasota)

For the fourth consecutive Session, these bills would have allowed patients to stay in ambulatory surgical centers overnight, as long as it does not exceed 24 hours. The House bill would also have created a new license for a Recovery Care Center (RCC), defined as a facility that is not part of a hospital, to which a patient is admitted and discharged within 72 hours. RCCs must have emergency care and transfer protocols with at least one hospital. While the Senate Bill originally contained the RCC language, it was amended to only address the ASC 24 hour stay. Despite the legislation passing the House, the Senate refused to give further consideration to the bill. We expect to see this again in the 2018 Session.

Maintenance of Certification
HB 723 – Health Care Certification (Rep. Julio Gonzalez -Sarasota) SB 1354 – Medical Specialties (Sen. Dana Young- Tampa)

This legislation would have prohibited the allopathic board, osteopathic board, DOH, health care facilities, and insurers from requiring physicians to maintain board certification in a subspecialty as conditions of licensure, reimbursement or admitting privileges. The bill specified that this prohibition would not have impacted the boards’ ability to require continuing medical education. The bill allowed a physician whose board certification has lapsed to hold himself or herself out as “initially” board certified.

Personal Injury Protection
HE I 063 – Motor Vehicle Insurance (Rep, Erin Grall- Vero Beach) SB 1766 -Motor Vehicle Insurance (Sen. Tom Lee -Brandon)

The Legislature failed to repeal the mandate for Florida drivers to carry personal injury protection insurance. The House bill required $25,000 in coverage for damages due to the bodily injury or death of any one person and $50,000 for bodily injury or death to two or more persons. The Senate bill differed, most significantly, by replacing the PIP mandate with a requirement drivers carry $5,000 in “MedPay” which would cover 100 percent of covered medical losses.

Regulatory Boards
HB 1193 -Regulatory Boards (Rep, Dan Raulerson -Plant City) SB 582 – Regulatory Boards (Sen. Jack Latvala – Clearwater)

In 2015, the United States Supreme Court held that a state board on which a controlling number of regulatory board members are “active market participants” – members of the profession being regulated- must be”actively supervised” in order to seek immunity from federal antitrust laws. This decision obviously impacts our state professional boards. Legislation was filed to attempt to follow the direction given by the U.S. Supreme Court by requiring the Department of Business and Professional Regulation (DBPR), the Department of Health (DOH), and the Department of Financial Services (DFS) to review final decisions of all regulatory boards under their jurisdiction to determine if final regulatory board decisions constitute anticompetitive conduct. These bills required that the reviewing department officials not be active market participants and that the agency’s decision would not be subject to legal challenge. Further, the bills provided that legal defense costs of a board or board members for antitrust actions would be paid from trust funds under the appropriate agency jurisdiction.

Medicaid Managed Care
HB 7117 – Statewide Medicaid Managed Care Program (Rep. Travis Cummings – Orange Park) SB 916 – Statewide Medicaid Managed Care Program (Sen. Denise Grimsley-Sebring)

These bills would have made changes to the state’s mandatory Medicaid managed care program – both the long-term care program and the managed medical assistance component. It would have consolidated the number of regions across the state from 11 to 8 and restructured those regions to reflect enrollee utilization patterns and provider referral patterns and increased the minimum or maximum number of plans with which AHCA could contract to provide services. The bills would also have required AHCA to impose fines on managed care plans which failed to pay providers on time. The legislation was requested by AHCA, which wants changes made before it is due to rebid the Medicaid program next summer. We anticipate this legislation to be filed again next Session.

Retroactive Denial of Claims by Health Insurers
HB 579 – Payment of Health Care Claims (Rep. Bill Hager – Boca Raton) SB 102 – Payment of Health Care Claims (Sen. Greg Steube -Sarasota)

Current law prohibits a health insurer and a health maintenance organization (HMO) from retroactively denying claims because of insured ineligibility more than one year after the date the claim is paid. There is, however, no redress for erroneous authorization and an insured’ s reliance on that authorization. These bills would have precluded an insurer or HMO from retroactively denying claims if the insurer or HMO had previously verified eligibility at the time of treatment and provided an authorization number.

Health Care Access
HE 763 -Access to Health Care Practitioner Services (Rep. Mike Grant – Port Charlotte) SB 1432 -Access to Health Care Practitioner Services (Sen. Keith Perry- Gainesville)

These bills were intended to incentivize physicians to provide pro bono health care services to certain low-income individuals and provide an opportunity for retired physicians and physicians from other jurisdictions to provide health services to low-income and medically underserved individuals in this state. The bills would have authorized both the Board of Medicine and the Board of Osteopathic Medicine to issue a limited number of restricted licenses to physicians not licensed in Florida who contract to practice for 36 months solely in the employ of the state, a federally funded community health center, a migrant health center, a free clinic, or a health provider in a health professional shortage area or medical underserved area. Prior to the end of the 36- month contract, the physician would have been required to take and pass the appropriate licensing exam to become fully licensed in Florida.

Health Care Facility Regulation
HB l 195 -Health Care Facility Regulation (Rep. Alex Miller-Sarasota) SB 1760 – Health Care Facility Regulation (S en. Denise Grimsley- Sebring)

These bills would have amended various authorizing and licensing statutes for entities regulated by the Agency for Health Care Administration (AHCA). The legislation would have clarified existing licensure and enforcement requirements, amended certain provisions to eliminate conflict between part I of Chapter 395, F.S., Chapter 400, F.S., and Part II of Chapter 408, F.S., increased administrative efficiency at AHCA and repealed redundant or obsolete statutes. Although the legislation failed to pass this Session, we expect AHCA to file this bill again next year.

Patient Savings Act
HE 449 -Health Insurance (Rep. Paul Renner- Palm Coast) SB 528- Health Insurance (Sen. Greg Steube – Sarasota)

This legislation would have created the Patient Savings Act, which would have required health insurers to create a shared savings incentive program to encourage insured individuals to shop for high quality, lower cost health care services and share any savings realized as a result of the insured’s choice. The cash payment would have to have been at least 50 percent of the health insurer’s saved cost as compared to the average price. The bills required certain health insurers to provide a method for an insured to request information on the contracted amount with a health care provider for certain health care services, called shoppable health care services, and the average price for those same services.

Direct Primary Care Agreements
HB 161 – Direct Primary Care Agreements (Rep. Danny Burgess – Zephyrhills) SB 240 – Direct Primary Care (Sen. Tom Lee -Brandon)

Direct primary care (DPC) is a primary care medical practice model that eliminates third party payers from the primary care provider-patient relationship. Through a contractual agreement and a monthly fee, usually between $50 and $100 per person, a patient pays a monthly fee to the primary care provider to utilize defined primary care services. These bills provided that DPC agreements are not insurance and not subject to regulation under the Florida Insurance Code, nor are they workers’ compensation insurance. This legislation has been filed for several years in a row, and although the bill passed both chambers this year, a few Senate amendments were added on the last day of Session that caused the bill to ultimately die in the House.

ARNP Medical Directors
HB 129 -Advanced Registered Nurse Practitioners (Rep. Rene Plasencia – Titusville) SB 96 -Eligibility for Appointment as a Medical or Clinic Director (Sen. Greg Steube – Sarasota)

This would have allowed certain physician assistants and advanced registered nurse practitioners to serve as medical directors of clinics or facilities and authorizes them to sign, certify, stamp, verify, or endorse documents that require signature, certification, stamp, verification, or endorsement of physician. The legislation was intended to address incidents in rural areas where a physician is not readily available to sign off on required operational documentation.


NEXT SESSION

With the 2018, Legislative Session beginning on January 9, 2018, we anticipate committee meetings to begin this fall and look forward to summer discussions regarding your 2018 legislative priorities. As always, we have enjoyed working with the Society very much this Session and commend you for your untiring efforts and commitment to the process.

 

Position Wanted

There are no positions wanted at this time.

Important Update Regarding Conscious Sedation and Pediatric Conscious Sedation Permit Holders

fbd

Effective April 17, 2016, the Board of Dentistry’s revised Rules 64B5-14.009, Conscious Sedation Requirements: Operatory, Recovery Room, Equipment, Medicinal Drugs, Emergency Protocols, Records, and Continuous Monitoring and 64B5-14.010, Pediatric Conscious Sedation Requirements: Operatory, Recovery Room, Equipment, Medicinal Drugs, Emergency Protocols, Records, and Continuous Monitoring goes into effect.

These rules were amended to clarify language concerning standard equipment for the operating and recovery room and to add mandatory equipment.  A capnograph was added to the list of standard equipment that must be readily available to the operatory and recovery room and maintained in good working order. Additional clarification was made for continuous monitoring which requires a patient who is administered a drug(s) for conscious sedation must be continuously monitored intra-operatively by pulse oximetry and capnograph to provide pulse rate, oxygen saturation of the blood, and ventilations (end-tidal carbon dioxide).

Please click here for the full rule text of 64B5-14.009. Click here for the full rule text of 64B5-14.010.

For more the complete laws and rules booklet, please visit the Board’s website.

Making a Difference for the Specialty

An enthusiastic delegation of dedicated FSOMS members spent a day at the Capitol in Tallahassee making a difference for the specialty.  The day began with a meeting with our outstanding lobbying team at Gray-Robinson to review the current issues and the talking points to share with legislators during the day.  Senator Alan Hays joined the meeting to give his perspective on the key issues.  Then off to the third floor of the Capitol Rotunda where we positioned a large, multi-faceted exhibit showing the scope of the specialty, including a large FSOMS banner, scrolling videos from AAOMS and give-away gifts with the FSOMS logo. [Read more…]

Volunteer Teaching Opportunities

For years now, the AAOMS has recognized the importance of dental and resident education to the future of oral and maxillofacial surgery and has consistently promoted initiatives to support faculty recruitment and retention. Despite their efforts, faculty shortages exist throughout the country. Not only does this impact the quality of the education imparted to our residents, it also impacts the generation of new knowledge and advancement of the specialty that is vital to our long term survival. Attracting the best and brightest from among our dental students to become residents is also impacted by the faculty shortage, as it is difficult to expect faculty to devote significant time to predoctoral education when they are struggling to keep their residency programs fully staffed.

There are many reasons for the faculty shortage, not the least of which is the significant salary differential that exists. Being a successful tenure track faculty member at a university requires a significant amount of time devoted to academic pursuits such as research and publication, which must be accomplished while at the same time keeping their clinical enterprises in a financially viable state. Most residency programs are poorly supported by state revenues, and exist largely on clinical income generated. Add to this the disproportionate numbers of non-funded patients that are seen by our residency programs, and the strain on the system becomes apparent.

For these reasons, the FSOMS has made a priority of promoting active assistance from its members to the residency and predoctoral oral surgery programs in the state. The FSOMS encourages not only monetary support by way of donations and gifts, but active volunteerism to help support the programs.

Volunteer Opportunites

University of Florida, Gainesville
The University of Florida program in Gainesville has had an active volunteer program for a number of years. This consists of private practice OMS’s who have made a commitment to come to the university at least one day per month and cover the student oral surgery clinic. With the participation of junior and senior dental students on rotation, this is a walk in clinic which treats toothaches and infections and also involves the treatment of comprehensive care patients requiring multiple extractions and alveoloplasty. Usually staffed by an oral surgeon and a general practitioner, it is sometimes difficult to keep this clinic covered, as OMS faculty are pulled toward other responsibilities, so courtesy faculty coverage becomes an important part of the program.  It benefits not only the predoctoral students but the residents as well by freeing faculty to go to the OR or to perform other functions. Most volunteers relate that they enjoy the experience, as they work with students who are bright eyed, enthusiastic and eager to learn. Patients who come to the clinic often have interesting medical histories, and we emphasize medical evaluation and risk assessment in our teaching.  This promotes many “teaching moments” to help train our students to deal with medically compromised patients, but more importantly, when dental students see full scope OMS’s actually teaching them, it creates an opportunity to showcase OMS to the students and perhaps influence them to decide on an OMS career. They are very interested in talking with private practitioners and any down time quickly turns to a variety of discussions about practice in the real world, something the students relish. Whereas there are accreditation standards that require teaching basic oral surgery procedures, it is not the purpose of the clinic to make exodontists out of our students, and in fact impactions are not routinely performed in the clinic. When to refer and how to predict trouble are important aspects of the training which occurs.

Some volunteers express anxiety over their lack of teaching experience. Since you will be working with another faculty member, calibration is straightforward and you will rapidly become comfortable with the system. It has been our experience that the volunteer faculty members are usually pleasantly surprised in that all that is needed is the clinical knowledge that you already possess, a desire to share your knowledge with others, and the ability to accept the rewards that teaching has to offer.

Appointment is an easy process, and would result in a designation of Clinical Assistant Professor or above within the courtesy staff. Interested individuals should email the chair and attach a copy of their CV. You would then be contacted by a staff member to obtain some copies of license, etc and get you scheduled. Scheduling is flexible, however, most volunteers select a recurring time each month. We finalize the next month’s schedule on the 15th of the preceding month and we do ask that faculty try not to cancel after this as it could result in a clinic cancellation. Following this section is a listing of available recurring days within a month that are currently available for coverage.

Open days at University of Florida:
1st, 3rd Mondays; 1st 3rd 4th Tuesdays; 2nd Wednesdays, 1st 2nd and 4th Thursdays and 2nd and 3rd Fridays.

Faculty
A special thanks is extended to our current and past courtesy faculty who have supported the UF educational program in recent years. Your contribution to your specialty is very much appreciated:
Dr. Don Tillery Jr.
Dr. John Akers
Dr. Scott Wenk
Dr. Steve English
Dr. Bill Storoe
Dr. Sameer Hate
Dr. Vishy Broumand
Dr. Michael Digney
Dr. Doug Johnson
Dr Brad Cherry
Dr Bart Blumberg
Dr. Tom Troxler
Dr. Greg Bello
Dr William Lippisch
Nova
University of Miami
University of Florida, Jacksonville

Update on Rules for Written Dental Records

I wanted to provide our membership with a summary/update regarding proposed rule changes by the Board of Dentistry (BOD) governing the requirements for written dental records (Rule 64B5-17.002, Written Dental Records, Minimum Content, Retention).

As many are aware, a three member BOD Task Force had proposed adding new language, with more detailed requirements, to the existing rule. Several Task Force meetings were held, with discussions of the proposed changes, over a period of many months, since about the summer of 2013.

However, admittedly not until somewhat later in the process, several organized dental groups took notice and developed concerns regarding the proposed rule language.

Although some of the new requirements dealt with issues such as informed consent, record alterations, retention of one’s appointment book, and maintenance of electronic dental records – which were largely non-controversial – the portion of the new Rule language singled out as being the most objectionable or controversial had been limited to language added to Sections 1(a) through 1(e) (please see existing rule language, and the previously proposed new language, denoted by underline, at the end of this update).

Following a January, 2014 Florida Dental Association House of Delegates (FDA HOD) meeting in Tampa, in which BOD Chair, Dr. Joe Thomas, was present for a Q & A regarding the issue, I sent out an email to our executive board and other interested parties with information and concerns expressed. Soon thereafter, our president, Mark Braxton, appointed an ad hoc committee (composed of myself as chair, also Larry Nissen, Tom Bowers, and Mike Huey) to further study and discuss the issue. As a result, we voted to develop a position letter, which we then brought to our board for approval, and forwarded it to the BOD, in which we stated opposition to the addition of new language to the existing rule.

Soon thereafter, however, the BOD passed the new rule language at a May, 16 meeting. Following this, a greater level of concern developed among multiple other dental groups, and among grass roots dentists throughout the state.

The Florida Dental Association (FDA) then jumped on board and, at a
June 13-14 HOD meeting, passed a resolution to “oppose the recent addition of language within Rule 64B5-17.002, Paragraph 1(a) through 1(e), and take such steps as appropriate, up to and including, a challenge of the proposed rule.”

Soon thereafter, FSOMS and FDA sent letters to the BOD requesting an appearance to discuss the Rue language further at a planned “Rule Workshop” scheduled for August 22 in Orlando. Leading up the workshop, I had also communicated with all of the other specialty groups in Florida (excluding oral path, radiology, public health), and all of whom agreed to join us (FSOMS) in appearing before the BOD to express the same/similar message.

The August 22 Rule Workshop began with a brief presentation by the FDA liaison to the BOD, Dr. Don Ilkka. Following that item, Mike Huey and I both spoke before the BOD, and with reps from each of the other dental specialty groups sitting along side us at the table. A rep from AGD then followed us on the agenda.

As a result, the BOD voted to table the entire rule, and send it back to committee. Also, the previous chair of the BOD Records Task Force, Wade Winker, declined to continue his previous well-intended effort. Upon asking for another volunteer from within the BOD, the newest BOD member, and our own, TJ Tejera, agreed to be the new chair.

In search of a new direction, TJ decided to:
(1) do away with Section 1(a) through 1(e) which had caused so much consternation, and
(2) replace it with a paragraph of language, with some minor changes in wording, which had withstood the test of time, and had already been in place and in use since 1992 – by the Board of Medicine.

(Please see new language at the end of this update)

Upon seeing the new language – it appeared to help the BOD in terms of providing items which no doubt should be included within a dental or medical record, but yet with language which few, if any, could argue with or feel threatened by.

And for now – it appears to be a problem solved.

A meeting/teleconference of the BOD Dental Records Task Force was held last evening in which the new language appeared well appreciated and well liked by virtually everyone on the call. The rule would next need to pass through a vote of the Rules Committee (November 6), and then by the BOD at the next general meeting (November 21).

Anyone familiar with the rulemaking process would tell you that nothing is “final” at this point, as unforeseen changes may still occur. But in any case, this appears to be headed in the right direction, and we will continue to make every effort to keep you, our members, informed.

Respectfully,

Richard Mufson, DDS, Chair
FSOMS Task Force on Dental Records