Rosemary's Baby
A couple of friends of mine recently built a new orthodontic office. They and their architect were well aware of OSHA, EPA, and Americans with Disabilities Act requirements, and they expended a great deal of thought, effort, and money to satisfy these federal standards. Once they had moved into their beautiful, safe, and politically correct building, they decided to invite OSHCON, an arm of OSHA, to conduct an on-site inspection. OSHCON evaluates your compliance with OSHA regulations at your request, without charge or penalty.
My friends' self-satisfaction began to melt away quickly under the OSHCON inspector's scrutiny. The office's exit doors were well marked, but the other doors were supposed to be labeled either "Not an Exit" or by function ("Doctor's Office", "Exam Room 1", "Lounge", etc.). When the inspector wanted to see documentation of personnel injuries over the past year, she was told there had been no injuries. That, of course, was no excuse. A document stating that no injuries occurred in 1994 was supposed to have been kept on hand for five years. Although there was no food in the refrigerator, a sign was required notifying people that no food was allowed in it. The bottle of x-ray chemicals needed to be labeled "Not for Drinking". There was an eye-wash station in the sterilization room, but there should have been another one in the x-ray developing room. Instructions for the eye-wash station had to be posted in the open, rather than inside a cabinet door. The office's Hazard Communication Program, Emergency Action Plan and Standard, Personal Protective Equipment Policy, and Drug and Alcohol Policy were found wanting. Every employee should have had a tuberculosis test (at the doctor's expense), and the method of exposure should have been posted. There was more, but I think you get the idea. Violations such as these could have brought $17,000 in fines.
You probably react to this kind of bureaucratic nonsense, as I did, with an intense private rage that soon mutates into a form of disgust and finally disappears into a thankful resignation over the thought that OSHA hasn't yet discovered you. But these governmental departments have gone beyond being persistent and expensive nuisances that raise our overhead without affording our staff members any greater safety or comfort.
In fact, they have become instruments of punishment to be wielded by any disgruntled assistant or former employee who wishes to make a maximum of mischief. Kathleen Todd, general counsel for the American Dental Association, reported in December 1994 that eight out of every 10 dental office inspections were prompted by complaints from employees. Such a complainant is often dissatisfied with something entirely unrelated to office safety and health--hours, duties, wages, relations with other employees. Ms. Todd says staff members have been reporting their employers so frequently that dentists who have been having staff problems should review their compliance, on the assumption that they will soon be hearing from OSHA.
Given the number of materials and situations that OSHA has assumed responsibility for in the orthodontic office, I doubt that anyone could ever be in 100% compliance. No matter how conscientious one might be, there would always be a certain vulnerability to vindictive behavior. God help us if patients discover this kind of federal billy club to beat up on orthodontists who have the temerity to insist they pay their debts or who somehow disappoint them with treatment.
I never felt that our professional organizations were vigorous enough in protesting these half-baked schemes. Thankfully, there now is evidence that they are finally responding to their members' legislative concerns. Not that dentistry was encouraged to offer much constructive criticism when bureaucrats decided that they alone knew the direction the nation's health care should take.
At this moment, some of the people in positions of leadership in Congress feel the way dentists do about over-regulation. Rep. Tom DeLay, the new majority whip, is the point man for the Republican regulatory reform that is gathering steam and for the broad, business-backed assault on the federal bureaucracy. We even have three dentist-congressmen--Drs. John Linder, Charlie Norwood, and Ron Packard--who understand exactly what we are going through. If we want to restore a semblance of sanity to health care, we had better work closely with legislators who share our views, rather than consorting with the enemy in hopes of lessening the impact of bad laws. The last AAO lobbyist I spoke to was advocating raising money for one of the architects of our current misery. Dental leadership needs to correct its priorities and do it quickly.
Dentists are few, and orthodontists are even fewer, but friends in Congress tell me that hundreds of personal letters or faxes get their attention, and that thousands of messages on the same subject constitute a bona fide wake-up call. Now that we have leaders in the House who want not only to bring attention to all this irrational legislation, but perhaps even to cancel it altogether, I think we need to let them know they can count on us. I encourage you to write or fax Rep. DeLay and the others, as well as your own representatives and senators, and let them know that this outrageous regulatory control of our professional lives needs to end--now--not after months and years of review and consultation. The fax numbers are: Rep. DeLay, (202) 225-5241; Rep. Linder, (202) 225-4696; and Rep. Packard, (202) 225-0134. Rep. Norwood's phone number is (202) 225-4101.
For those who fear throwing the baby out with the bathwater, I suggest that this baby needs discarding. What we've got is the legislative equivalent of Rosemary's Baby--a devil's child, if you will, ill-conceived and raised without discipline, guidance, or accountability. No one can convince me that these agencies have improved public or professional safety and health. What they have done is to raise the cost of dental services to the public without any improvement in such services. Oscar Wilde had it right when he said that the worst work is always done with the best intentions.
If you agree with my premise that we need immediate change, I hope you will send faxes and letters until we get the attention and sympathy of our elected officials. We may not have as good an opportunity again in the near future, so we'd better strike while the iron is hot.