Reporter uncovers ‘painful mistakes’ in one state’s handling of dentist errors Date: 01/14/20
By Mary Otto
Over five months, Arthur Kane, an investigative reporter for the Las Vegas Review-Journal, immersed himself in the workings of the Nevada State Board of Dental Examiners. Kane combed through state audits and internal documents and delved into the stories of patients who were left suffering by dentists who were allowed to keep practicing. He weighed troubling allegations raised by a local dental society. In October, he emerged with a six-part series, "Painful Mistakes."
In the wake of the project’s publication, more than half of the board’s members left or lost their seats and two professional staffers were terminated. Gov. Steve Sisolak has pledged reforms.
In this Q&A, Kane describes how he tackled the reporting for the series and worked with newsroom colleagues to bring the story to life. He also offers advice to journalists who may want to take a closer look at a professional board in their state.
Q: Your project chronicles a long history of allegations against the Nevada state dental board, including mishandling patient complaints, lax professional oversight, conflicts of interest, mismanagement and violations of the state’s open public meetings act. How did you decide to start your investigation?
A: I had been investigating problems at the UNLV (University of Nevada, Las Vegas) dental school and several of my sources complained about the way the state dental board operates. I looked at recent audits and saw that auditors highlighted some problems with paperwork and disciplinary processes, but never really looked at whether dentists were allowed to practice after a pattern of mistakes. So I decided to see if I could document those problems. Auditors also discussed conflicts of interest but declined to reveal which officials had the conflicts, so I decided to track that down. I wanted to make sure patients and the public knew all the issues facing the agency.
Q: You write that the series ended up taking five months to produce. Did you need to make a pitch to your editors before getting cut loose to pursue it? Did you work with them as your reporting continued? What was most helpful about the editing process?
A: I'm on the investigative team and my primary focus is government corruption and malfeasance. This is exactly the type of story I am supposed to produce, so getting the time to do it wasn't a problem. The project started about five months before it ran but I was also juggling other stories during that time. I think I had three or four large one-day pieces as I waited for records and data. My editor had left right before I started gathering records and sources for the project so I worked with the deputy ME to hash out the various parts and stories. A new AME of investigations, Rhonda Prast, started about a month before the stories ran and she jumped right in as the primary editor and was able to get the series online and into print by deadline.
Q: The project includes videos, documents and helpful resources for consumers of dental services in the state. It must have taken a team to select and integrate these elements into the series. Can you tell us a little about the teamwork that might have been part of the project?
A: When I started the project, I approached the head of the video department and he wisely decided to have one videographer work with me on the series. That allowed for continuity for the look of the videos as well as removed most scheduling issues. I had worked as a producer and EP at a local television station a few years ago, so I understood the process of producing the videos and had a pretty good idea of how I wanted the videos to come out. Rhonda and I produced most of the rest of the pieces of the project and layout staff put them online or into print.
Q: In your narrative, you reference findings from two state audits, patient complaints, and concerns raised by the Las Vegas Dental Association, a professional group that has been engaged in a longstanding feud with the dental board. What sources or resources ultimately proved most helpful to you in shaping the series?
A: I had a couple of sources that I can't reveal, but who helped me navigate some of the project's pitfalls. Obviously, dentists spend years in school and training. I had to make sure I understood the medical issues on top of the bureaucratic processes of the board. So having experts in the field, I could bounce questions off of was priceless and insured accuracy, which is always my first priority. The sources were also able to get me records — like the confidential ethics letters — that would have been denied under an open records request.
Q: The drama has continued to unfold since your project aired. The last time I checked, six of the 11 members of the state board of dental examiners had resigned or not been reappointed. The board’s executive director and counsel also were terminated and the governor has pledged reforms. Have you been surprised by the fallout and are you planning to follow up?
A: We knew we had to finish the project before the end of October because three board members' terms were expiring. That would force the governor to a decision about whether to reappoint those board members. But I was surprised that less than two weeks after the stories ran, three board members with questionable ethics actions resigned and the board fired the executive director and general counsel. Basically, the governor now has a free hand to approve a new board majority and make sure his appointees select leadership that implements reforms. I always keep on any investigation I produce until the problems are solved so I will continue to watch who the governor selects to replace the board members and how the agency functions. The governor is also likely to go to the legislature in 2021 (the next time Nevada lawmakers meet since we have an every-other-year assembly) to reform the processes of all the regulatory board and possibly put them under a cabinet agency. This will be something I will likely follow for years.
Q: Do you have any wisdom to share with reporters interested in looking into concerns and complaints about professional boards in their states?
A: In doing these stories, you need to show systematic failures in the system. The best way is to use lawsuits and public actions to identify professionals who repeatedly make mistakes. Anyone can have one bad outcome, especially in the medical field, because people are not machines and doctors can't save everyone. But if you see a professional with a number of egregious lawsuits that were settled, sanctions by the board and repeated complaints, it's worth digging into that person. If you find repeated examples of doctors or dentists with a number of mistakes still practicing, then it is clear the regulatory process isn't working.