This morning Marc received a lovely message from Dr. Blair Barnett of Avery Orthodontics via Facebook. We have no words to adequately describe it so have a look for yourself:

While we realize that most orthodontists are professionals and act as such, this kind of thing is becoming more and more common. This message leaves us wondering when this type of behavior became acceptable and where it will lead. Do those of you who disagree with the opinions we hold truly believe you have a right to say and do whatever you like in an attempt stop us from saying and doing what we believe is correct? Do you believe that this is building up “your profession” and giving you the moral and ethical high ground? We realize that by having contrary opinions we put ourselves in a position to be targeted and accept that but it is amazing to see some of our fellow “professionals” act like spoiled children while claiming God is on their side. The University of Texas Health Science Center in San Antonio must be proud to have one of their faculty so vocally defending the profession. We wonder if The Harvard School of Dental Medicine will ask this guy to come and show them how to properly educate?

P.S. If this doctor is willing to come to Dallas, we’d like to offer him a scholarship to MKS so he can see Neal Kravitz talk about professionalism…

Marc Ackerman

Ben Burris

30 thoughts on “We Are Going to Hell!

  1. Let me say that this should in no way reflect students coming from Harvard School of Dental Medicine. This is disgraceful. While we are allowed to have our own opinions, we definitely need to respect one another.

    1. Agreed. I know lots of Harvard grads and they are all excellent people and clinicians. The claims this doctor makes needed to be addressed. Thanks.
      Ben

  2. Plus Harvard’s clinicial education and standards are one of the top notch in the country. People assume that b/c of the “research” year that the school had back in the 90s, that the clinical training is substandard. I wrote an article in ASDA 10 years ago stating that we had the same clinical requirements (if not more) than many schools in the country. We have a high pass rate on the licensure exams – which test the clinical competency before embarking in real world practice.

  3. Speaking of professionalism, is it appropriate to post a private msg sent to one of you with none of the details redacted? Doesn’t seem like a step in the right direction either….

    1. Of course it is. This person admits that he doesn’t know Marc and sent this in a FB messenger request. There is no expectation of privacy. Furthermore this person proceeded to bad mouth both of us and Harvard with zero first hand knowledge. He’s lucky I only posted the photos and didn’t put his name in the key words for the article to make it show up when his name is searched. A point that I can easily change. Your outrage at us posting this message is comical. This guy put his thoughts in writing and shared them. He should say what he means and mean what he says. We do. Orthodontists in general are about to find out that just because keep something “secret” or “private” doesn’t mean it’s not discoverable. It’s going to be fun to watch.

  4. No outrage at all, just an interesting observation. The truth always outs though, doesn’t it 😉

  5. I certainly apologize for the harsh words but I will stand by my overall message besides the Harvard part as that is certainly not the views of the University but my own and that was a dig I would gladly take back.

    The fact that you would take what was a private message between professionals and post it publicly baffles me and I find it quite childish.

    I have zero intentions of publicly bashing anyone. Those words were my thoughts in response to one of your latest posts and again the school has nothing to do with any of it. I am sure you will keep this up as another cog to your crusade but anyone else reading this should understand that I would have gladly held a private conversation on this matter as befits professionals in a disagreement.

    1. Thanks for “clarifying”. Interesting how you try and couch what you said as a “conversation among professionals”. Are you saying that it’s ok to message people you don’t know and say horribke things to them and about them and their friends and other institutions? Are you familiar with the idea that actions have consequences? Are you willing to back up the claims you made as to the size of the “pile of shit” that you say I am or any of your other claims? Do you not see the irony in claiming to be a professional and acting this way? I find the whole thing amusing – your arrogance, your assumptions and your lack of remorse. The only thing you’re sorry about is putting this in writing so you can’t squirm out of it.
      Ben

  6. And for those who don’t know me, the one part of my message that best explains where I am coming from was “kids deserve our best”. Think about that as you decide who is guided by professionalism and integrity.

    1. That’s funny! You don’t know us but you certainly saw fit to pass judgement. I love your plea for sympathy… classic.

      Ben

      1. That’s the thing though, Ben, we do know you since you have become a very active and public voice in the profession. I also don’t disagree with a lot of your views. Essentially it was the public rebuttal article of the AAO which got me frustrated enough to send Marc a message to add my voice to the thousands of others who disagree with your stances related to those issues. Like you I am also not afraid to stand up for what I believe in.

        1. I see that. You made you stance very clear. VERY clear. Now you can own it. I think you overestimate the number of those who agree with you and of those who are sympathetic to your clearly delineated views on me, Marc and Harvard School of Dental Medicine. Keep talking. I find this very interesting. BTW I just have to ask, what’s changed between 1:40 am when you messaged Marc and now?

  7. Finally, the part about Harvard I truly do apologize for. That was a little joke we used to have as residents a long time ago. That has never been an actual policy and I do not want anyone to think that. I gladly respect any of us out there really trying and doing our best regardless of what school they went to.

    1. A little joke? So this is not the first time you’ve said this about Harvard??? Wow. I’m interested to hear what the Omnibudsmam at UT will think about this? I have an idea of what the folks at Harvard will say.
      Ben

  8. ******NOTICE******
    If you don’t provide your real name and email address we will not approve your comments. Period. So waste your time trying if you like but either have the courage of your convictions or you won’t get to post here.
    Thanks so much.
    Marc and Ben

  9. I also find it interesting that others are afraid to post their real names here. It is a good excuse and way to control the message though. What does that say about you that colleagues won’t post their own names?

    I actually did have the expectation that a private message would be kept private as I thought I was dealing with a fellow adult.

    I would also like everyone here to know that I noticed that you attempted to send a link to this discussion to everyone who follows my office page on Facebook. I guess I do see why others are afraid to deal with you. Pretty low move considering the public has no context on the background of this discussion.

    Otherwise enjoy Dallas and perhaps someday these issues will be moot anyway.

    1. I sent a link to the OrthoPundit story as a MESSAGE to your fb page. I had no expectation of privacy when I did so and I’m cool with you sharing that here though it would be nice if you told the truth rather than saying I tried to post it… Seeing how I’d blocked you on Facebook over a year ago because of the way you acted, sending you a message to your office FB page was the only way I had of letting you know about the story and I wanted to make sure you knew. I also made sure the chair at UT knows about this and now since you want to keep pushing it I’ll be sure that Harvard knows about this AND I’ll add key words and your name to the article so that it comes up when people search you or your practice name. I’ll also send this to your local paper and probably retain a lawyer. Keep talking. I am really enjoying this. YOU ARE IN THE WRONG HERE. No matter what you do or say or how much you try to blame me. Keep it up buddy.

  10. So yes, I am Ben’s wife and am obviously biased but would love to give my thoughts here:
    Blair you called my husband terribly insulting names, you say that he is only out for his own financial gain, you insult both him and Marc as being terrible orthodontists, you insult a very credible university and on top of that you imply that they are both going to hell! Do you have any idea how incredibly offensive this is? How would you like it if some stranger who “doesn’t really know you” writes a message to your best buddy making these claims against you as if they were fact? I cannot imagine that you would take that calmly.
    I am a very rational adult that is not quick to anger or quick to action and when I read this message this morning I was horrified at the incredible gall and utter lack of humanity never mind professionalism. This is a blog that Ben owns, if you don’t like his or Marc’s opinions you are not forced to read this particular blog, that is your right. I have never seen someone make it this personal! You should be ashamed of yourself! I personally am mortified at your arrogance and continued obstinance. In no way does Ben need me to defend him as he is a big boy but perhaps consider that there are real people behind these blogs and your actions are the epitome of a lack of professionalism.
    An angry wife

  11. For what it is worth, I do appreciate you not deleting my responses and allowing me to better explain myself.

    The particular article that upset me enough to message Marc with my displeasure was the following:

    https://smiledirectclub.com/blog/protecting-public/

    I certainly crossed the line with my language but you guys have crossed the line by going to the media and public with your attacks on the AAO which is in reality an attack on all orthodontists. The general public does not look at the AAO and orthodontists as separate entities, they see both as being one in the same. Therefore, when you begin to publicly make claims that orthodontists are in collusion together which is blatantly false since I have never once sat down with my neighbor orthos and discussed what our fees are with each other, you are essentially eroding public trust with orthodontists the vast majority of whom run an ethically driven practice each and every day. You have no right to erode the trust I have earned with my community and I will protect what I have built as vehemently as you crusade against organized dentistry and try to make your millions off Smile Direct Club.

    This public attack on the AAO or in reality all orthodontists is essentially an attack on me, my practice, every orthodontist and their practices, our teams and even our families. So your shock and surprise that someone could be upset enough to send a message with as colorful language as I did is pretty laughable. For other orthodontists reading this exchange, this particular statement is the best example of what I am speaking of:

    “Long story short, The American Association of Orthodontists and other organized dentistry groups along with State Dental Boards want to protect their bottom lines at all costs. This is a very old story and why the Sherman Act is in place. Dentistry is one of the few true guilds left in America and they will fight hard to maintain monopolistic control as long as they can. It will be fun to watch this play out in the courts and in the court of public opinion. Americans are smart and will see through to what is actually going on here.”

    The average person reading that statement is going to think, “yeah, I always knew dentists were crooks.” What an awful statement to put out there if you are still calling yourselves our peers.

    The second part of your article that I also have a major problem with is your mention and inference of what the fees are in mine or any other orthodontic practice. At least in Texas it is either illegal to infer what another providers fees are or at least highly frowned upon by the Board. Here is the specific section:

    “ASSUMPTION #1 -Orthodontists in traditional orthodontic practice (where braces and clear aligners cost 4000-8000 dollars) act like every case they have ever treated gets a perfect finish and that every patient they have ever seen is happy.

    TRUTH – You don’t have to take our word for it, just search your local orthodontists on Yelp, Facebook, Google or any other site and you’ll see that no one can make everyone happy.”

    I have many many many cases below $4000 and my Invisalign Express cases are below $3000. Therefore you are lying to the general public and you don’t think I have a right to be upset with this?

    Besides the fact the rest of your rebuttal to the AAO is childish and half of the points actually pointless, believe it or not I was never threatened by Smile Direct Club and have been a neutral observer of your fights with Boards, other orthodontists, etc. I actually agree with you that the vast majority of SDC patients would not be prospective patients in my office and that you are potentially providing a market for additional people to straighten their teeth who would not have ever had treatment.

    That said, if SDC could show a history of refusing complex cases and suggesting a visit to an orthodontic office instead then I would have zero issues with SDC. The problem is that everyone I know myself included who has done the “Smile Assessment” and entered the most severe problems possible (crossbites, class III, severe crowding, gum recession, etc.) were all told they would be a great Smile Direct Club candidate and to send in $100 to get your kit mailed to you. To say there are potential ethical problems here is an understatement. I also still wonder at how these cases will actually finish considering we are talking no IPR, no attachments and old aligner material but that is why I would never consider being a provider. People who spend $1500 will still want their teeth to be straight and you can’t simply say, “well for that price you just get sort of straighter”. These were the points I made in a previous “discussion” I had with you before you decided to block me and delete my posts because I stongly disagreed with you.

    Again, your public attacks on the AAO and thus all orthodontists have crossed way over the line. You should be having these battles with us privately and with Dental organizations in court and not use the media to generate public support for you and sew distrust of orthodontists.

    You are offended? How do you think I feel? You can’t essentially attack our practices, our livelihoods and our families and expect no response, especially when in my opinion your public articles are filled with a lot of half truths and a whole lot of misleading information . Again, I have no plans or desires to discuss this publicly nor would I attack you or Smile Direct Club publicly.

    I do appreciate you allowing me to explain myself since you made this public. I most certainly regret my language in the message but after the outpouring of supportive messages, texts and calls I received from so many friends and colleagues I do not regret letting you know exactly how I feel.

    – Blair

    1. Blair,

      As a practicing orthodontist for 37 years, an associate professor at the Case Ortho Program for 27 years, ABO in 2007 (didn’t bother to renew in 2012 – too busy burying my father in law), graduate of both Ricketts and Roth long courses (and a dozen others that we all aspire to emulate), a reviewer and author for the AJODO, contributing editor for Ortho Practice US, consultant to Sirona on CBCT for 10+ years, a KOL for 3M and others over the years, Top 1% Invisalign provider, national and international lecturer and blah, blah, blah. I feel that I have the basis for evaluating your arguments and responding.

      I agree with Ben. And I do so freely, not as an acolyte or supplicant. But as a realist, a pragmatist. And absolutely as an ethical, highest standard acheivable, practicing orthodontist.

      I am not happy about how most of this is transpiring at many levels.

      But more importantly, I acknowledge the world that I practice in and the future that my residents will have to practice in.

      Ben is not creating the future, he is just reporting on it, commenting on it, and hopefully precipitating the discussion that is coming even though many of us don’t like it. Had the national orthodontic association and/or the constituent societies addressed these issues in the past, maybe things would be different. But they didn’t. Look at how orthodontic education has changed over the past 3-4 decades. Show me the battle lines over who should treat malocclusion and what constitutes appropriate and sufficient training. When did the AAO stand up and say to the public and the ADA that a weekend orthodontic course was a substitute for 2+ years of specialty training. We need to stop complaining about maintaining our virginity after giving birth to our second child.

      Our culture is changing and there are forces at work that are so much bigger than our specialty. We can either come to grips with that and try to bend the trajectory on behalf of our patients and “the greater good” or just complain about. We obviously don’t make the rules, society does.

      I know Ben personally, he would genuinely like to see orthodontic care available to a greater audience – wouldn’t we all. To reduce the financial barrier that prevents families from walking out the door wishing that they could afford to get their teeth fixed, knowing that it is not going to happen. That was me in my teens.

      Do I like being hugely well compensated for decades of hard work and dedication, for 60 hr work weeks, million$ invested in my practice. – OF COURSE!

      Do I strive to deliver the best orthodontic care possible – ABSOLUTELY!

      But am I entitled to being the only orthodontic provider on my block – NO!

      Are we entitled to being the only venue for improvement of tooth alignment and occlusion – NO!

      Is “good enough” for those who can’t handle the burden(s) and cost of “the best” better than nothing. And letting the market place and those that we care for make that decision for themselves – WHICH THEY ARE GOING TO DO ANYWAY!

      I applaud that you chose to stand for something when so many others stand for nothing. I just feel that just because “Cassandra” proffers an uncomfortable truth and points out that “we” might not be looking at this with unbiased perspective, that anyone needs to go beyond acknowledging the perspective and engaging in intelligent discourse.

      John White

      1. I greatly respect your opinion John, agree with 95% of it and love doing as much Invisalign in my practice as possible. Again, where I believe Ben and Marc have crossed the line as fellow specialists is by no longer just “reporting” on trends in our industry in blogs or articles that honestly only we would read but writing articles for SDC that are then released to the press by the company such as the AAO rebuttal which straight up belittles those of us who have tried to do our best for our patients day in and day out with both fixed appliances and clear aligners. To me there really is no excuse for that other than wanting to make sure the company they invested in stays afloat. As I read the current reviews on Yelp that Smile Direct Club has received (2 stars that would be a 1 star average if they factored in all the hidden reviews), I can’t help but marvel at their audacity.

        https://smiledirectclub.com/blog/protecting-public/

        1. Soooo…. your stated mission to “protect the specialty” has no financial bias? You aren’t trying to protect what you believe you’re entitled to and what you’ve invested in? You say you’re doing what you think is correct and right, but so are we! You say we are not but how do you know the minds of people you’ve never even met? We simply disagree with the way you see things but apparently that is one of the unforgivable sins in your book? Again, here, you attack us personally by name and malign our actions and motives and then justify this attack by saying that you pure of heart and true of purpose? Don’t you see the irony? Apparently not and it’s all too humorous. Mel (a past president of the AAO BTW) is correct in pointing out that your unbelievable actions and statements make it much more difficult for rational orthodontists to have a logical discussions on topics of substance so in a big way you are helping Marc and I much more than you are hurting us (not that we want someone like you on our team, mind you). I just love how you will not admit that you are in the wrong here and are giving every conceivable excuse to avoid that fact. If you put half this much effort into your practice you’d be way more successful!
          Keep it up man, this is terribly entertaining.
          ben

  12. Just got a promotion e-mail from SDC announcing a 50% sale. The promotion has the following statement. “No human should ever wear braces. They are terrible. Trust us.” Is that a message to the public that Marc and Ben want to support and believe is in the public’s interest? What should be the penance for those of us that have put those terrible things on humans.

    For Blair, it is even more disturbing that you have received support from “friends” for the worst personal attack that i have ever witnessed in a long career in orthodontics and organized dentistry. You single handed have moved the discussion and debates on orthodontic delivery systems from what is best for patients to a gutter level personal attack rather than an issue debate. Those that do differ with Ben;s and Marc’s contention for example that radiographs are not essential for diagnosing and monitoring orthodontic treatment in “simple” cases now have the burden when disagreeing with that to prove that we don’t have the same harsh eternity judgment that you do for people that disagree with you. I don’t wish the same harsh judgment for you that you wished for Ben and Marc and hope that you can come to a better way to deal with life’s frustrations. Understanding that you were just wrong would be a good start.

    1. Mel
      Thanks again for the insight. Did you take a screen shot of the email you mention? Can you forward it to me? I’d like to see it before responding. That being said I’d be surprised if there are not studies showing patients prefer aligners over brackets and wires. It will be an interesting debate – and I love a good debate!
      ben

      1. You have my e-mail address. Send your e-mail address to it and tI will forward it to you. The key word in the ad is that NO human should wear braces and they are terrible. That patients would prefer aligners over braces is not the same as a position that no human should ever have to wear braces and that they are terrible. There are still many patients that can’t be treated by aligners alone and those patients and orthodontists should not be stigmatized by such a statement. It is a self serving statement for SDC without regard to the needs of all of the public.

        1. Fair enough. Not everyone can be treated with aligners though that day will come! I’ll send you an email. Thanks.

    2. Mel:
      It was no shock to have received an ad hominem attack rather than an ad rem debate.
      There is some literature out there that quantifies patient’s experience/gingival health with Aligners versus Fixed Appliances. Here is a well done study:
      Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden CJ, Willershausen B.
      BMC Oral Health. 2015 Jun 24;15:69.
      They found that patients had much better gingival health and satisfaction with Invisalign.
      I think that the traditional paradigm of consumers seeking orthodontic treatment for promoted oral health benefits is dying on the vine. We do not have evidence to honestly support many of the things stated on orthodontists websites and in particular the AAO myths campaign. Consumers seek orthodontic treatment for enhancement of appearance with relatively few seeking it for “medically necessary” reason.
      Thanks for your well written and balanced comments.

      Marc

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