Paul Casamassimo, DDS, Attending Dentist at Nationwide Children’s Hospital and Professor Emeritus at Ohio State University

The Risky Health Care Business

What he does: Dr. Casamassimo is a board-certified pediatric dentist, Professor Emeritus at the Ohio State University, and an attending dentist at Nationwide Children’s Hospital, in Columbus, OH. Dr. Casamassimo currently is Chief Policy Officer at the American Academy of Pediatric Dentistry's Pediatric Oral Health Research and Policy Center, as well as a past-president and editor emeritus. He is a past-president of the Ohio Dental Association and currently serves on the American Dental Association’s Council on Advocacy for Access and Prevention as well as the Dental Quality Alliance. He is author of over 450 publications on pediatric dentistry and care of patients.

On risk: "The patient is at the center and around that patient are layers like an onion and within each layer there is the potential for risk and also opportunities to mitigate or prevent risk. There are risks based on inadequacies in our training, inadequacies in our insurance coverage, our lack of continuing education in some cases, the challenges of mastering new equipment, and other areas that really enter new risk into the environment … Dentistry has barely scratched the concept of risk and safety. And so we really have to do the same thing that medicine did and look more closely at what we do. And to determine what is preventable risk. What are the challenges that we face, some of which can be pretty significant, and try to identify those … One of the things that we don't really appreciate is hidden risk … There has to be a culture that encourages people within the system to be willing to say this is not right, this is a risk, what you're doing is not safe for the patient. And that's a huge, huge step … It's really understanding risk, the different layers of risk, and to begin to ask yourself am I covered, am I protected, what is my risk, what is my exposure, and to really get a global picture of what risk is … It's almost impossible for the individual dentist to think of everything that could possibly happen"

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