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Ombudsman scrutinizes NPR use of professor's quote on dental diagnosis

Washington—Dentists have been rallying to the defense of their profession ever since a National Public Radio guest claimed that dentists misread radiographs half the time and frequently place restorations in healthy teeth out of a desire to make more money.

And now, the NPR ombudsman who serves as the public’s representative to NPR and an independent source for programming has validated those concerns.

“Unless the professor could provide a specific source or study that listeners could independently check, he shouldn’t have said that on the air,” wrote Alicia C. Shepard of NPR on her blog Nov. 8. “[The] unsubstantiated assertion unfairly hurt the reputation of many honest dentists and planted a seed of distrust with patients.”

In an Oct. 5 episode of the NPR show “All Things Considered,” guest Dan Ariely, Ph.D., a behavioral economics professor and author of the best-seller, “Predictably Irrational: The Hidden Forces That Shape Our Decisions,” explored the relationship between the length of time a patient sees a dentist and the kind of treatment chosen. He said that if two dentists were asked to identify cavities from the same radiograph of the same tooth, they would agree only 50 percent of the time.

“And here is what happens,” Dr. Ariely said on air. “Imagine you’re a dentist, and you see a patient, and you really want to find a cavity because you get paid more if you find cavities and you can fix them. And the patient is already on the chair. He’s already prepped. You might give them the treatment right now, really good marginal income for you.”

Going into the interview, NPR had no reason to question the credibility of Dr. Ariely, who holds the James B. Duke Professor of Behavioral Economics chair at Duke University. His source on misreading radiographs, Dr. Ariely said on air, is Delta Dental. Problem is, Delta Dental does not collect data that could lead to that conclusion.

“We’re normally fans of Dr. Ariely’s work, but he should not have made reference to Delta Dental when stating that 50 percent of the time dentists will interpret X-rays differently,” wrote Chris Pyle, a spokesperson for Delta, in a letter read on NPR Oct. 13. “Delta Dental has no data that could lead to any such conclusion. Delta Dental processes 84 million claims a year for 54 million customers, so obviously we’re interested in making sure those claims are accurate.”

On Oct. 8, then-ADA president Dr. Ron Tankersley sent a response letter to Robert Siegel, host of “All Things Considered.” The ADA distributed his letter to members in an e-gram and encouraged them to add comments to the NPR site in an effort to “respond to this kind of unfair, unsupported accusation in every way possible.”

“Modern pain and anxiety control techniques have all but eliminated the discomfort that older patients may have encountered as children,” wrote Dr. Tankersley in the letter. “Patients are loyal to their dentists not because of any peculiar psychological phenomenon. It is because of the special trust that is built over time in the doctor-patient relationship, driven primarily by the patient’s sense of health and well-being.

“Much in the same manner, ‘All Things Considered’ has earned the trust of millions of listeners. NPR shouldn’t squander that trust for a few cheap laughs at the expense of thousands of doctors and the patients we serve,” wrote Dr. Tankersley.

In the NPR ombudsman’s blog post, Ms. Shepard said that Ariely “got that 50 percent figure from a Delta source who told him about ‘some internal analysis they have done and they told me the results. But they didn’t give me the raw data. It’s just something they told me.’ ” He did not identify that source.

“Ariely offered information certain to unnerve listeners and anger dentists—information based on a fact that he cannot back up,” wrote Ms. Shepard, adding: “NPR can’t re-report and check out everything that an on-air guest says. The difficulty is compounded when the interview is live and the host asking the questions might not have access to the information necessary to challenge a false or exaggerated statement.

“Siegel might have asked the basic question that journalists always need to ask: How do you know that? And he could have pushed Ariely to back up his claim,” she said.

“At the very least, [“All Things Considered”] should correct the online story to make it clear that Ariely cannot back up—with a specific study or named source—his accusation that if you ask two dentists to identify cavities from the same X-ray, they agree only half the time,” said Ms. Shepard. As of Nov. 12, the online transcript had not been corrected.

Following distribution of the ADA e-gram, hundreds of dentists contacted NPR to complain. On Oct. 13, NPR hosts read excerpts from letters from Mr. Pyle of Delta Dental and dentists who were offended by Dr. Ariely’s assertion.

“I am a dentist and I have firsthand experience with reading X-rays and making a correct diagnosis on behalf of my patients,” wrote Dr. William Vargo of Salt Lake City, whose letter was read on air. “It is not a responsibility I take lightly or, as implied in Mr. Ariely’s comments, I do not read X-rays with the thought in mind to make money.

“I find it very offensive that NPR would promote the misrepresentation that dentists in American are out to rip off the American public.”

“After practicing dentistry for 35 years, I never had to make up cavities so I could profit from doing a filling,” wrote Dr. Lynn Shuler of Newport Beach, Calif. “Believe me, there’s more legitimate dental disease out there than any dentist can treat. Mr. Ariely’s sorry attempts at humor do a disservice to a profession I’ve been proud to devote my professional life to.”

“To be sure, there are differences in treatment philosophy from one dentist to the next, and within an individual dental practice, from one patient to another,” wrote Dr. Matthew Messina, an ADA consumer advisor, whose comments were not read on air. “Another dentist might approach the same case in a different manner. This approach, based on individual patient’s risk of disease and the personal relationship that a dentist develops with his patients, is one reason Americans have access to the best oral health care in the world,”

Read Ms. Shepard’s report here.