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Dentist Threatens to Report Parents for Neglect Unless They Bring in Their Kids (and Wallets)

Mandatory abuse reporting requirements lead to a novel marketing scheme.

Clown dentist with chainsawIgor Mojzes / Dreamstime.comA dental practice in Pennsylvania has a novel method for guaranteeing return business: Threaten to turn parents in for neglect if they stop bringing in their kids.

Smiles 4 Keeps, which has three offices in the state, insists that its threats are being misinterpreted. But the letter it sent out is pretty clear: Get your kids back in here.

Mom Trey Hoyumpa did not like the treatment she and her kids got at the Smiles 4 Keeps location in Bartonsville, Pennsylvania. In a Facebook post she claims that the practice wouldn't let her go into the patient area with her children, wouldn't let her meet with the dentist, and diagnosed but wouldn't treat more than one of her children on her visit. She decided not to go back. A few months letter she received this letter:

LetterFacebook

The letter says that neglecting a child's dental care can be considered child abuse in Pennsylvania and that dental providers are required to report it to the state. It notes that the dental office has not yet reported the parent, but she should schedule an appointment to have her children seen ASAP or else.

The letter concludes: "To keep your child as healthy as possible and to avoid a report to state authorities, please call Smiles 4 Keeps immediately to schedule an appointment." This is obviously going to be perceived as a threat.

Pennsylvania does indeed require that dental offices report to child welfare agencies any signs of abuse or neglect. But not taking your child to Smiles 4 Keeps isn't evidence of neglect.

When Local media and Yahoo Lifestyle started probing back, the dental clinic told them that letters aren't sent until multiple attempts have been made to communicate with the family, and that if parents seek business with a different dentist they should let them know. Hoyumpa told Yahoo that she has absolutely no interest in communicating with the clinic any further and and that she's looking for a second opinion. (She doesn't trust their claim that her two children had several cavities, and she says they refused to show her the X-rays.)

Remarkably, Ross Wezmar, the dentist who founded the practice, defended his letters on Monday, insisting that he regularly sees children with all sorts of medical problems because they missed a dental appointment.

Color me suspicious, but that's not the point. Smiles 4 Keeps is a private business providing a service, not a government agency. Neither Hoyumpa nor any other consumer has any obligation to communicate with Smiles 4 Keeps or to set foot in its offices if she doesn't want to, and she is not required to tell them why or where they've gone instead. Yet Wezmar and his offices are threatening families with government investigations for declining to do business with him.

I doubt lawmakers intended the reporting requirements to be used this way, but it's one of the side effects of mandating that private actors play tattletale to the government. Does he even care that he could upend families' lives by reporting them to the state?

It's bad enough that abuse fears have led some hotels and airlines to start calling the authorities simply for seeing an adult (usually male) traveling with a child (usually his). Citing this law to try to scare parents into patronizing your business is pretty damned low.

Fortunately, since Smiles 4 Keeps is a private business and not a government agency, the market can decide if it agrees with Wezmar's tactics. I suspect a business that treats its customers well doesn't have to threaten them to get them to come back again. But that's just me.

Photo Credit: Igor Mojzes / Dreamstime.com

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  • timbo||

    Another reason to move out of the north east. A much larger crowd of left leaning assholes clamoring to control other people. And they have less balls there. The unions took them.

    The south east is not nearly as authoritarian as the other populations of the country. Yet.

  • silver.||

    Yet.

    The exodus from the North East brings with it all of these inane policies, taxes, and regulations. And somehow all of the stupid bible-belt regulations don't get expunged.

  • sage||

    Fewer. It's *fewer* balls.

  • Chipper Morning Baculum||

    Get a load of Stannis over here.

  • cgr2727||

    Ser Davos Seaworth, actually, said the pedantic nerd.

  • Marcus Aurelius||

    Wouldn't that be Varys?

  • UnrepentantCurmudgeon||

    No. Varys' expertise was in ingratiating himself, not correcting others. Stannis didn't give a shit.

  • Scarecrow Repair & Chippering||

    Ya, as in fewer courage, ya got ya covered ya derp. You don't even metaphor.

  • Diane Reynolds (Paul.)||

    Only if you can count them.

  • Mark22||

    You'd think so. However, reality is much more painful than that. They don't remove the balls all at once, progressive piranhas nibble away at your balls, metric millimeter by metric millimeter, year after year, leaving people with less balls, rather than fewer balls.

  • brokencycle||

    As someone who moved to the Southeast from the Midwest, I don't know if the last sentence is true. Mandatory safety and emissions testing for cars and motorcycles. State run liquor stores. Gun purchase permits.

    At least here in NC, it is just a mix of Republican and Democrat authoritarianism than just the D authoritarianism running amok.

  • Libertymike||

    timbo -

    Alternative expression of the phenomenon: Massholes moving to New Hampshire. They have turned the granite state purple.

  • newlife3.0||

    It's everywhere. The only escape is expat. They've, (+ big gov), about ruined Alaska.

  • Chipper Morning Baculum||

    The southeast has other problems. Besides the soul-crushing humidity, ravenous mosquitoes, and lack of ski resorts, the southeast is full of religious busy-bodies who's first question to you is "What church do you go to?"

  • Elias Fakaname||

    Is that like in Mew Jersey where the first question asked when you say you live in Jersey is "what exit?".

  • Unicorn Abattoir||

    Actually when you say you live in NJ, the first question asked is "Why???"

  • Mark22||

    is full of religious busy-bodies who's first question to you is "What church do you go to?"

    They're really just trying to be friendly.

  • Rhywun||

    Another reason to move out of the north east.

    *rolls eyes*

    If it didn't state PA in the article, there is no way you could identify which region of the US this happened in.

  • Roger X||

    The area of PA where these practices are located voted +20% Trump in the 2016 election but please continue with your claims as facts are unlikely to change your opinions

  • TreyHoyumpa||

    I totally believe this…because I live here. It was my letter. Curious where you found the stat, though.

  • Longtorso, Johnny||

    I doubt lawmakers intended the reporting requirements to be used this way, but it's one of the side effects of mandating that private actors play tattletale to the government.

    *snort*

  • H. Farnham||

    Hey now, they only intended to secure further donations and support from the ADA and child welfare advocates... consequences be damned.

  • Trainer||

    Add to that feeding at the trough of public funds. See my post below.

  • SQRLSY One||

    If'n ye do NOT get aromatherapy and acupuncture and booger therapy and snooger therapy and professionally-licensed-and-degreed ass-scratching therapy and Scientology auditing and "clearing" therapy, for your kids and your cats and dogs and mice and lice and mouses and houses, gooses and mooses, geeses and meeses, ye are obliviously hatefully neglectful, and ALL of the providers of ALL of these services, shall be FORCED to turn ye in!!!!

    Ye have left them NO OTHER CHOICE!!!!

  • TrickyVic (old school)||

    Racketeering?

  • Unicorn Abattoir||

    Yes, looks a lot like extortion to me.

  • Kivlor||

    This really isn't a shock. I've seen people turned in to CPS for rescheduling a doctors appointment for their kids.

    It's inevitable that the dentists and everyone else in any similar field would start doing the same.

  • BYODB||

    Especially when the behavior is mandated by law. Even if the Dentist thinks this is a shitty thing to do, it's better than losing their practice.

  • Chasman1965||

    No evidence that this is required by law.

  • Pulpgrinder||

    http://www.pa-fsa.org/Mandated.....-to-Report

    This is what consequences are for nonreporting of neglect in PA for the dentist:
    Willful failure to report (having a reasonable suspicion of abuse and deciding not to report it) may be punished. The penalties for failure to report have been increased under the new CPSL amendments.

    The first offense of willful failure to report is a second degree misdemeanor. Penalties are increased to a third degree felony if the mandated reporter willfully fails to report child abuse that is a felony of the first degree or higher and the mandated reporter has direct knowledge of the nature of the abuse. For multiple offenses, a felony of the third degree is committed, increasing if the abuse of the child is a felony of the first degree or higher.

    If willful failure to report continues, while the mandated reporter knows or has reasonable cause to believe the child is being actively abused, the offense is considered a first degree misdemeanor except when the abuse to the child constitutes a felony of the first degree or higher. In this instance the penalty is a felony of the third degree.

  • Necron 99||

    Signs of neglect or abuse must be reported. If the kid is a no-show than what signs are they seeing? Jumping to conclusions is not evidence.

  • Pulpgrinder||

    In all likelihood a report would only be made after several consecutive examinations have revealed abscessed teeth or large cavities that will likely lead to pain if not addressed soon. If after that the parents refuse to schedule treatment for an active disease process either at my office or another then I can no longer ethically supervise neglect. Finances are often not an issue as over 80% of dental cavities are found in the lowest quintile of socioeconomic standing and these children would qualify for medicaid or the CHIPS program. Ability to pay is typically not an issue. However, if a child without dental insurance cannot pay then you can't site neglect even though parents/guardian have been made aware. But, that is an extremely rare occurence. Treatment plans can then be tailored to address the more pressing needs to avoid infectioin/pain, et cetera. Dental related pain causes 1/3 of kids to miss school and if untreated can lead to a host of other health related issues.
    If they no show for a cleaning a report for neglect is ridiculous in my opinion (disclosure--pediatric dentist practicing in GA, but I did practice for 3 years in PA about an hour from Wezmar's Wilkes-Barre location and interviewed with him).

  • BestUsedCarSales||

    The thing I wonder more is how many people AGREE with dentists and other such groups doing things like this.

  • Libertymike||

    You don't want to know, it will give you a toothache.

  • silver.||

    I actually didn't share this with my friends, because I have a very, very bad feeling that a few of them will say, "good," like they did with the California county plastic straw fines.

    They also don't have kids or remotely stressful lives, so they can't possibly imagine missing a dental appointment or absentmindedly offering a customer a straw.

    And they really think the ephemeral patriarchal hand of "the government" is a societal good.

    Even as Donald Trump is at the helm of that entity.

    I don't get it. Human psychology confuses me.

  • Curt||

    The psychology part is pretty simple actually... someone using authority to order me to do something = bad. Someone using authority to order someone else to do something that I think they should be doing = good.

    It only gets confusing when you start pointing out silly details (like who holds that authority).

  • UnrepentantCurmudgeon||

    Much the same conundrum as lefties who excoriate the police as violent, bloodthirsty, mouth-breathing racist butchers ... but want only the police not ordinary citizens to have guns (including assault weapons). It's best if one doesn't think on it too much

  • TreyHoyumpa||

    Hi! Source here! I can tell you what I've discovered as my letter gets shared across the world. The locals, who these letters were and designed and marketed for, think I'm a POS parent because I got the letter. They BELIEVE the letter and see nothing unethical about the actual language used in the letter. The twitterverse can READ the letter and see the actual legal issues with it…the teetering on extortion and fraud. Cause THAT is really what this is about. It's not about the actual "health care" of the practice (which in itself is questionable), but of THE LETTER.

    Further, if there's anyone who thought it was sent in good faith…they should totally do a google search for both "Smiles 4 Keeps" and Trey Hoyumpa.

  • Rich||

    "To keep your child as healthy as possible and to avoid a report to state authorities, please call Smiles 4 Keeps immediately to schedule an appointment."

    *** scheduled child sits in dental chair, and dentist starts work ***

    "Bad touch, Mommy, BAD TOUCH!!"

  • Chipper Morning Baculum||

  • Elias Fakaname||

    This is how you handle these dentists......

    https://m.youtube.com/watch?v=GDqRJvHdwqo

  • Citizen X - #6||

    I'm not sure what else one could expect from a place called "Smiles 4 Keeps."

  • Eidde||

  • Eidde||

    Don't assume these negative reviews are accurate...consult the dentist himself and he will tell you the true story!

  • Libertymike||

    I am suspicious of the one positive review.

  • Bongo Supreme||

    Wow. What a piece of shit. Thanks for this.

  • Fist of Etiquette||

    Fortunately, since Smiles 4 Keeps is a private business and not a government agency, the market can decide if it agrees with Wezmar's tactics.

    Is this a threat??? It looks like the state is simply going to have to mandate a yearly contract with your dentist of choice.

  • Unicorn Abattoir||

    yearly contract with yourtheir dentist of choice.

    How dare you attempt to overstep your masters!

  • Inigo Montoya||

    "If you like your dentist (or you don't), you can keep your dentist (and you'll have to)!"

    — The government

  • creech||

    Why not? SCOTUS says the feds can mandate you get health insurance or pay an additional" tax."

  • O Square||

    Should probably just shorten the name to "4 Keeps", cuz they'll have your business whether you like it or not, and if you don't come back, the big brother might try to "4 Keeps" your baby boo. And smiling is so 2008.

  • Elias Fakaname||

    The value of beating the shit out of people who narc you out is greatly underestimated.

  • Unicorn Abattoir||

    Don't want your teeth knocked out like a thug, get your teeth cleaned by a thug.

  • Unicorn Abattoir||

    Mom Trey HoyumpaMarcy Weinberg did not like the treatment she and her kids got at the Smiles 4 Keeps location in Bartonville, Pennsylvania.... A few months letter she received this letter:

    This would never happen.

  • Unicorn Abattoir||

    I'd also like to say that this is a nice article to have alongside all the 2A articles today.

  • Longtobefree||

    RICO

  • Curt||

    SUAVE!

  • DenverJ||

    I think you're supposed to be in the pool when you play that game.

  • Trollificus||

    Call: MARCO!!
    Response: RUBIO!!

  • BYODB||


    Pennsylvania does indeed require that dental offices report to child welfare agencies any signs of abuse or neglect. But not taking your child to Smiles 4 Keeps isn't evidence of neglect.


    Actually, I'm pretty sure in a post-ACA world this is exactly what it's evidence of. Well, that or they need to be fully nationalized. Hell, why not both?


    /sarc

  • Flinch||

    Well, the contagion of stupidity from NJ has spread to PA. We know where this is headed: parents are going to be afraid to take their kids to the dentist and get into the very trouble this law was alleged to prevent. I'm thinking...parents should visit a dentist out of state and get off the merry go round - nobody can spot a missed return visit but for your first appearance. So this is the new America the progs want? Forget going to Disneyland - your vacation time is going to get burned up by medical tourism, either in another state or another country, just to avoid opening the door to a physicians letter to some social worker about your kids. This has a deleterious and very mean side effect: poverty is now illegal in PA, and if you fall into it, pandoras box opens to consume more of your sparse cash on legal bills and interfacing with government pinheads. For some people, a day wasted on government will lose them their jobs, but that's what statists thrive on: pure misery.

  • Inigo Montoya||

    But it's progs who love the poor, don't you know? And Libertarians just want them to die!

    /sarc

  • Intelligent Mr Toad||

    Sounds like possible grounds for an extortion charge!

  • Chasman1965||

    I'd change dentists immediately if I had gotten such a letter. It borders on extortion.

  • ||

    #TeamWoodchipper

  • MaleMatters||

    The parents ought to sue the dentist for economic harassment.

  • Longtobefree||

    No, the parents should report the fact that he insists on having the child alone in an intimidating atmosphere, and wonder if perhaps there may something going on back there other than extortion.

  • StackOfCoins||

    Does he even care that he could upend families' lives by reporting them to the state?


    Haha, no.

  • Lana234||

    The author of this letter was obviously sick the day they taught law at law school... After reading Act 31, it appears that it simply mandates that mandatory reporters attending a training class. It does not lay out the statute that requires that the dentist act. Thus, I HIGHLY suspect that the training class focuses on making reports regarding children with visible bruises or other suspicious signs of abuse. It seems highly unlikely that any dentist has any affirmative duty to report parents to the state for simply refusing to return.

  • Pulpgrinder||

    http://www.pa-fsa.org/Mandated.....-to-Report

    Act 31 mandates continuing education but the above are the legal consequences that mandatory reporters face in PA for not following through. There is an affirmative duty to report; however, defining when to report becomes subjective.

  • UnrepentantCurmudgeon||

    The rule of thumb among all mandated reporters I know and have known is simple: when in doubt, report. If there is no there there, then no harm done (to you, at least, because most reports from mandated reporters lead to some level of children's services action). Better safe than sorry, and all that.

  • Emotional Opposition Animal||

    Fortunately, since Smiles 4 Keeps is a private business and not a government agency, the market can decide if it agrees with Wezmar's tactics.

    Sure, right after a jury decides whether Wezmar's tactics constitute extortion and/or solicitation of bribes. I'm not a lawyer but I would lean toward yes, especially for extortion.

    If the Wezmar interpretation of the reporting law is correct, the letter amounts to a proposition that they will ignore their reporting duties in return for payment, ie bribery solicitation.

  • James Pollock||

    " I'm not a lawyer but I would lean toward yes, especially for extortion."

    When you get to law school, they'll tell you that for a charge of extortion to stick, there has to be a threat to do something that they aren't allowed to do.
    "Give me money or I'll burn down your house" is extortion. "Give me money or I'll tell the truth about you to a government agency" is not extortion. This is doubly true if the law actually requires the reporting, as it apparently does.

    "the letter amounts to a proposition that they will ignore their reporting duties in return for payment, ie bribery solicitation."
    This one is closer, but still no.
    Here's an analogy:
    Suppose a person has parked on your property without your permission. You are within your rights to have the car towed, and the towing company may charge fees to cover the towing, and storage on their property of the offender's car. You could say "pay me $50 to park here, or I'll call the towing company and they'll charge you $500". (They also have the choice to drive away, paying neither you nor the towing company, but you aren't going to say THAT.) Nothing illegal here, because both options are legal... you CAN charge really high parking fees, and you CAN have unauthorized parked cars towed away at the owners' expense.

  • UnrepentantCurmudgeon||

    It would make for a great law school lesson, and you're probably right. But even if you're wrong, there's no DA in the country that would try to make the case. It probably gets thrown out before trial, if appealed is probably lost, and one way or another never makes it to the courtroom. It's a lot of time, energy and money to spend on a practice that is, after all, "for the kids!"

  • James Pollock||

    I am right.
    It's a crappy business practice, and one they deserve to be called on, and to lose business over. But it isn't a crime.

  • TreyHoyumpa||

    You don't need an analogy. You just need this:

    The letter literally says, "To…avoid a report to state authorities, please call Smiles4Keeps."

    That, friend, is teetering on fraud, extortion and blackmail.

  • NoVaNick||

    You should have seen the look my kids' dentist gave me when I told her that I don't always have them brush in the morning too (in addition to before bed, which I always ask them to do). Think she was ready to report me to CPS...

  • Trollificus||

    But you killed her then, right? I mean, better safe than sorry...

  • Trainer||

    My guess is that they get a lot of medicare patients. I don't know a single pediatric dentist who has clients paying with private funds (insurance or personal) who wouldn't let parents back with their child- they actually encourage it. And the parents often feel vulnerable and don't have money to hire an attorney or just check on whether the office can do this or not.

    Dentists and doctors who rely on public funds are often very aggressive in getting and keeping young patients. When we moved to Houston's 5th Ward when my husband was in law school, my kids and I were walking down the street and a Hispanic woman and child came running out to greet us. He interpreted for her as she told us how she transports kids to the doctor for free and they get Happy Meals afterwards. Found out later this was legit in that she was working for the doctor who wanted kids in as often as possible to get Medicaid money. Dentists were doing the same thing.

    This was a time when Medicaid dentists in Houston were taking kids with baby teeth and cover all the teeth in metal to "prevent cavities". This was a long, drawn out process that was very expensive and was done on perfectly healthy teeth. Part of that scandal were the dentists who, it turned out, were tying kids down and doing work without painkiller. That's why parents weren't allowed back with their children.

  • James Pollock||

    "My guess is that they get a lot of medicare patients"

    Medicare patients are all over 60. Not much call for pediatric dentistry among them.

  • Trainer||

    Medicaid, darn it! I used it for the rest of the post.

  • James Pollock||

    Granted.

  • Longtobefree||

    Nice little dental practice you got here; be a shame if anything happened to it - - - - - - -

  • TxJack 112||

    The company should be sued and the people sending these letters charged with making terroristic threats. How do they know the parents have not taken their children to other dentists? Sorry, if I was reported to the state by clowns like this for not lining their pockets, someone would get a serious beat down in a variety of ways.

  • Mike da tiger||

    Dr Ross Weimar

  • James Pollock||

    "not taking your child to Smiles 4 Keeps isn't evidence of neglect."

    It sure can be. It's not conclusive evidence (by a long shot)... is that what you meant?

    " Neither Hoyumpa nor any other consumer has any obligation to communicate with Smiles 4 Keeps or to set foot in its offices if she doesn't want to, and she is not required to tell them why or where they've gone instead."

    True. The government agency that IS tasked with investigating child neglect should give the report all the weight it's due. If the report is that an appointment was missed (or not set) but there's no claim of serious and immediate need of care, the report should be filed under W for "whatever, dude". and that should be the end of it. If the report does actually claim that there is a problem that needs care, now, then there should be an investigation. If the investigating agency calls up and says "dentist X says your kid needs (whatever procedure)", and the parent says "yeah, but dentist Y says he doesn't", and dentist Y confirms, the investigation is complete.

    When this dentist follows through and reports all the parents who didn't like the practice, the investigatory agency will take action... against the dentist.

    This is only a problem if there's some other problem... is another agency steering kids to this dentist? Is there insurance fraud? Is the investigatory agency inept and oppressive? If not, you just have a dentist with an appointment-setter whose quota is set too high.

  • Pat001||

    "If not, you just have a dentist with an appointment-setter whose quota is set too high."

    What if you have a Child Protective Services investigator with a quota set too high?

  • James Pollock||

    "What if you have a Child Protective Services investigator with a quota set too high?"

    Perhaps re-read the entire paragraph, from start to finish?

  • NCCPR2||

    Here's where things get even scarier. Had this happened in, say Pittsburgh, Pa. in the western part of the state, and had the dentist followed through with his threat, the report alleging child neglect automatically would go into a massive county-run database that is used to predict who is likely to be a child abuser. The family would have no way to get the report expunged.

    And the mere fact that a report was filed, even a blatantly false report, raises the "risk score" assigned by Pittsburgh's predictive analytics algorithm. That increases the chances of an intrusive government investigation of the family – and possibly removal of the children to foster care.

    So why did Reason, which rightly condemns the behavior of the private dentist in this case, devote a huge story in the magazine to singing the praises of Pittsburgh's big government exercise in forced data gathering and intrusion into families? Details here: http://bit.ly/2pZws9N

    Richard Wexler
    National Coalition for Child Protection Reform
    www.nccpr.org

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