CE Dojo, Raleigh, NC (2026)

04/15/2026

Had an interesting emergency case today.

Patient came in with pain in the upper right molars that had been coming and going for a couple of months, but got worse overnight.

No hot or cold sensitivity. Just a throbbing pain.

X-rays of the upper teeth showed fillings, but nothing that clearly explained the symptoms.

The actual problem?

A lower right wisdom tooth ( #32) with significant decay.

After numbing that area, the pain completely went away—which confirmed the diagnosis.

This is a good example of referred pain. The brain doesn’t always localize dental pain accurately, especially when signals from different teeth share the same nerve pathways.

Extracted the tooth today. Expecting full resolution.

04/15/2026

Here’s the digestible breakdown of how Utah’s AI Healthcare Refill Pilot (Doctronic + new Legion Health program) actually works:

**✅ What it CAN do**
- Refill **stable, low-risk, non-controlled maintenance medications** only
- Covers ~15 specific psychiatric meds (e.g., Prozac, Zoloft, Wellbutrin, trazodone) for patients already on a steady regimen
- 30/60/90-day supplies

**❌ What it CANNOT do**
- No new prescriptions
- No dose changes
- No controlled substances
- No complex or unstable cases (suicidality, mania, pregnancy, side effects → immediate human escalation)

**The 8-step safety-first process (visualized in the flowchart below):**

1. Confirm you’re physically in Utah
2. Verify identity (photo ID + selfie)
3. Upload photo of your current medication bottle or label
4. AI checks Surescripts national pharmacy network to confirm you actually had the prescription filled before
5. Structured clinical questionnaire (adherence, side effects, interactions)
6. AI approves the refill **only** if everything checks out
7. Sends e-refill to your chosen pharmacy (CVS, Walgreens, etc.)
8. Pharmacist does final safety review before dispensing

**Why this matters in Utah**
With 27 of 29 counties designated mental-health shortage areas and some of the highest per-capita psychiatrist wait times in the U.S., this pilot is designed to cut refill friction, free up human clinicians for complex care, and improve access — especially in rural areas.

Built-in guardrails: mandatory human oversight sampling, monthly state safety reporting, and full HIPAA compliance.

**Big picture:** This isn’t replacing doctors — it’s giving the existing (limited) workforce breathing room while stretching care further.

Would you feel comfortable using an AI for routine refills if it meant faster access and lower cost? Or does this still feel too futuristic?

Drop your thoughts below 👇
(And yes — I created the flowchart above specifically for this pilot so you can see the full algorithm at a glance.)

04/14/2026

Medication Reconciliation: The Most Common (and Dangerous) Omission in Dentistry

As a dentist, how often do you truly reconcile medications — not just glance at the form, but actively verify and update them?

In the era of the oro-systemic axis, skipping this step is no longer acceptable.

You cannot meaningfully engage in oro-systemic dentistry without rigorous medication reconciliation and health history updates. Liver and renal function, bleeding risks, drug interactions with anesthetics, antibiotics, and analgesics — they all matter.

The good news? Tools like Epic Community Connect now make real-time verification of labs, meds, and specialist notes possible in daily practice.

This isn’t extra paperwork.
It’s patient safety.
It’s risk management.
It’s modern, evidence-based dentistry.

If we’re serious about treating the mouth as part of the whole body, medication reconciliation must become non-negotiable.

What’s your experience in practice? Is this step being treated with the rigor it deserves, or is it still frequently overlooked?

Let’s discuss 👇

04/13/2026

We tell clinicians all the time:

“Take care of yourself.”
“Ask for help when you need it.”

But what if asking for help puts your career at risk?

A resident physician (Dr. Patel) did exactly what she was supposed to do. After a setback, she sought support.

Instead, she was routed into a system that:

• Pulled her out of work
• Took her off her medication
• Subjected her to extensive testing
• Gave her a serious diagnosis

That diagnosis turned out to be flawed.

An experienced neuropsychologist later found significant errors and cleared her to return to work.

Her program agreed.

But the system she had entered—the Physician Health Program—would not release her.

Why?

An unresolved $350 bill.

Without clearance, she couldn’t return.
Without returning, she lost her position.

This isn’t just one story.

It highlights something uncomfortable:

Not all “wellness” systems are purely supportive.

Some function as gatekeepers—with the power to decide if and when a clinician can return.

And once you enter…

You may not control the exit.

04/08/2026

I recently published a piece on KevinMD about an experience that completely changed how I think about risk management, documentation, and professional responsibility.

Years ago, I was pulled into a case involving a patient death—one I had no involvement in. Within days, I was being positioned as the responsible surgeon.

What ultimately clarified the situation wasn’t testimony or internal review.

It was data.

My phone’s GPS timeline.

The broader takeaway is something I don’t think most clinicians fully appreciate:

Risk management is not there to protect the individual provider. It protects the institution.

And in high-liability environments, documentation isn’t always just a reflection of events—it’s also shaped by process.

I wrote about the full experience here:

👉 https://kevinmd.com/2026/04/physician-legal-protection-surviving-academic-medical-center-blame.html

04/03/2026

There’s something important about “wellness” that’s easy to miss.

It doesn’t appear randomly.

It shows up when something else changes first.

Capacity increases.

Throughput expands.

Incentives align with operating at that level.

And then—

the strain starts to show.

Fatigue.
Cognitive overload.
Burnout signals.

That’s when wellness enters the system.

Not as a contradiction to what’s happening—

but as a response to it.

A way to help people continue functioning
within the new baseline.

Seen this way, wellness isn’t separate from the system.

It’s part of how the system adapts
when pressure increases.

03/31/2026

Asymmetric Reporting

Not all information in a system flows equally.

And what gets reported… isn’t always what happened.

When we talk about “reporting,” this isn’t about charts or documentation.

It’s the everyday flow of information inside a practice:
what gets said
what gets repeated
what gets passed along

In many settings, that loop doesn’t end with the clinician.

It closes somewhere else.

By the time something reaches a point of decision, it’s often been filtered, simplified, or reshaped.

Not necessarily intentionally—just structurally.

Over time, the system begins to respond
not to what actually happened…
but to what was reported.

And those aren’t always the same.

That gap creates tension.

Because clinicians are still accountable for outcomes—
but don’t fully control the narrative that defines them.

This isn’t just communication.
It’s structure.

03/31/2026

I’ve been thinking a lot about the role of “wellness” in healthcare.

And I don’t think it’s as simple as we usually make it.

A lot of what we see—resilience training, mindfulness, support programs—is genuinely helpful.

But it also seems like it’s happening alongside increasing workload, not instead of it.

Which makes me wonder…

is wellness actually reducing pressure?

or helping us keep functioning under it?

Not a criticism—just something I’ve been thinking about.

03/29/2026

Control Mismatch

I’ve been thinking about something that shows up a lot in clinical practice, but we don’t always put words to it.

You’re responsible for the outcome…
but you don’t control all the inputs.

The schedule is set.
The pace is set.
Staffing, flow, timing—most of that is decided elsewhere.

But when something goes wrong, the responsibility doesn’t move with those decisions.

It stays with you.

Over time, that creates a kind of tension that’s hard to describe.

Not because people aren’t working hard.
Not because they don’t care.

But because they’re being held accountable for a system they don’t fully control.

I’m starting to think this is part of why “wellness” can feel so elusive in certain environments.

Not just an individual issue…
but something structural.

Curious if others have felt this, or see it differently.

03/29/2026

I’ve been thinking more about how AI is changing clinical workflow.

The obvious part is documentation—it’s getting easier, faster, less intrusive.

That’s been a real improvement.

But there’s another layer I didn’t fully appreciate at first.

When things get more efficient, they don’t usually slow down.

They speed up.

More patients.
More decisions.
Less time between them.

And then something subtle happens.

The increased pace doesn’t just get expected…
it starts to get rewarded.

At that point, it’s not just external pressure anymore.

You’re incentivized to operate at that level.

Which raises a question I don’t think we talk about enough:

If efficiency gains are always tied to more output…
does anything ever actually slow things down?

Or does the baseline just keep moving?

03/28/2026

I’ve been experimenting with AI scribes in my clinical workflow lately.

One thing I didn’t expect…

It doesn’t just save time.

It changes how you experience the patient encounter.

When documentation fades into the background, you can actually stay fully present.

And that part has been great.

But it also got me thinking…

If AI starts helping not just with notes—but with decision-making too—
what happens then?

Because the system doesn’t slow down.
It speeds up.

More patients.
More decisions.
Less time between them.

At some point, the limiting factor isn’t the chart…

it’s us.

03/26/2026

Most dentists are still doing notes the same way we did 10 years ago…

Typing. Clicking. Finishing charts at night.

AI scribes are starting to change that.

But here’s the part I think matters more:

AI doesn’t actually reduce work.
It creates time.

And what happens to that time depends on your practice model.

In a corporate setting, that extra time often turns into:
➡️ more patients
➡️ tighter schedules
➡️ higher production expectations

In an independent practice… it can look very different:
➡️ more time with patients
➡️ better documentation
➡️ getting home earlier
➡️ or yes—more production (if you want it)

Same tool.
Very different outcome.

So maybe the real question isn’t “Do AI scribes work?”

It’s:

👉 Who controls what happens after they do?

Curious—anyone here actually using one yet?

CE Dojo

04/15/2026

04/15/2026

04/14/2026

04/13/2026

04/08/2026

04/03/2026

03/31/2026

03/31/2026

03/29/2026

03/29/2026

03/28/2026

03/26/2026

Address

Telephone

Website

Alerts

Contact The Practice

Shortcuts

Share

Category