Concise guide to practical information on dental law, ethics, and practice management, all tailored to any dental practice
Professional Responsibility in Dentistry, Second Edition is a clinically oriented guide to legal and ethical requirements in a dental practice. This thoroughly revised new edition takes a practical approach, providing examples and case studies of situations that dentists may face, with discussions of dental law, risk management, professionalism, and ethics as they relate to each situation.
Divided into four sections to allow for comprehensive and accessible coverage of the subject, the Second Edition adds new chapters on taking practices to the next level and how to read a profit and loss statement, as well as offering updates and new information throughout.
Professional Responsibility in Dentistry provides key information on: - Lawsuits, including the effects of losing one, the regulation of dentistry, and definitions of important legal concepts in the field - The doctor-patient relationship, refusing to treat, medical-dental history, child and elder abuse, informed consent, and record keeping - Statute of limitations, abandonment, standard of care, peer review, risk management, and managing employees and associates - Starting or buying a practice, marketing for a successful practice, multispecialty practices, and taking your practice from ‘better’ to ‘best’
Bringing legal and ethical issues to life with real-world clinical cases, Professional Responsibility in Dentistry, Second Edition is an essential resource for dental students, new dentists, and any practicing dentist.
Table of Contents
Contents
Preface xi
Acknowledgments xiii
About the Author xiv
Part I Legal Concepts 1
1 The Lawsuit 3
True Case 1: Miscarriage due to endodontics 3
The Complaint 3
True Case 2: Changing the chart 4
True Case 3: Saving the case for trial 5
Examination before Trial 5
The Results 6
References 7
2 The Regulation of Dentistry 8
True Case 4: Dental state board case of fractured porcelain 9
Federal Oversight 10
OSHA 10
True Case 5: OSHA 12
FDA/DEA/EPA 12
NPDB 13
HIPAA 13
True Case 6: Ransomware 15
TCPA 16
True Case 7: Unsolicited texts 16
Licensure 17
Continuing Education 17
I-Stop (Internet System for Tracking Over-Prescribing) 18
Permits 18
Professional Misconduct and Unprofessional Conduct 19
True Case 8: Forfeit of license 20
True Case 9: Lost his license 20
Auxiliary Personnel 20
True Case 10: Assistant extracted tooth 21
Advertising 22
True Case 11: Dental society denial 23
Federal False Claims Act 23
True Case 12: Fraudulent billing 24
References 25
3 Definitions and Legal Concepts 27
Negligence 27
True Case 13: Amalgam tattoo - melanoma 28
True Case 14: Divorce due to paresthesia 29
True Case 15 (True Case 1 Revisited): Lawsuit due to dentist’s criticism 29
Definitions 29
True Case 16: Tennessee case Tolliver v. Gamble 32
References 32
Part II The Practice of Dentistry 33
4 The Doctor-Patient Relationship 35
Basis for Relationship 35
True Case 17: Food for fillings 35
Fiduciary Duty 36
Types of Realtionships 36
When Does It Begin 37
Duties of Doctor and Patient 37
Patient Relationships 38
When Does It End 39
True Case 18: No pay, no crown 39
References 39
5 May You Refuse to Treat? 40
Pandemics (COVID-19) 41
True Case 19: Patient demand 41
References 41
6 The Medical-Dental History 42
True Case 20: Only Boniva 42
Other Needed Information 43
True Case 21: Only heart surgery 44
Barriers 44
Reference 44
7 Patient Abuse 45
Definitions 45
Reporting Child Abuse 46
True Case 22: Child neglect 47
Elder Abuse 47
Signs of Abuse 48
Failure to Report Patient Abuse 48
Domestic Partner Abuse 49
References 49
8 Informed Consent 50
What Needs to Be Done 50
True Case 23: Implants include the teeth 51
Information Needed 51
Consent 52
True Case 24: Signed consent? Forgery 53
Competency 53
True Case 25: Two for one 54
Exceptions 55
True Case 26: Teenage pregnancy 55
Types of Consent 55
True Case 27: Lawyer threatens: write off patient’s balance or be sued 56
References 57
9 Records 58
True Case 28: $300,000 Night Guard 58
Record Entries 59
Electronic Records 60
True Case 29: Corporate greed 61
Release of Records 62
Texting 63
Teledentistry 64
HIPAA 64
Retention of Records 65
References 65
10 Statute of Limitations 67
When to Tell the Patient 67
Exceptions 68
True Case 30: Never fitting denture 68
Reference 69
11 Abandonment 70
Types of Abandonment 70
Avoiding Abandonment 71
True Case 31: No Money - No Teeth 71
Proper Termination 72
Release of All Claims/Anti-defamation Clauses 73
True Case 32: Patient outsmarts dentist 73
References 73
12 Standard of Care 75
How It Began 75
Challenges 81
References 81
13 Peer Review 83
True Case 33: Peer review 84
References 84
14 Risk Management 85
True Case 34: Too many “near misses” 86
The Dos and Don’ts of Risk Management 87
Collections 90
If You Are Sued 91
True Case 35: (True Case 6 revisited): Dentist leaves state 91
True Case 36: (True Case 2 revisited): Changing the chart 92
Practice Enhancement Through Risk Management 93
True Case 37: Who knows what is going on? 94
The Examination 94
References 97
15 Employees and Associates 98
Hiring and Firing 99
True Case 38: Extra-long vacation 99
Unemployment 100
True Case 39: Just eight hours count 100
Staff Snafus/Problems 101
True Case 40: Embezzlement 101
Harassment 102
True Case 41: Looks too good 102
References 102
Part III Professionalism and Ethics 103
16 Professionalism 105
Professional Obligations 105
Learning Professionalism 107
Professionalism Boundaries 108
Leadership 109
References 110
17 Ethics 112
Code of Ethics 113
True Case 42: Patient doesn’t want referral 114
True Case 43: I don’t want my teeth 114
True Case 44: Fractured porcelain 117
Teaching Dental Ethics 117
True Case 45: No pay, no treatment 118
Ethical Challenges 118
Decision Making 119
References 119
18 Professional Ethical Situations Based on True Cases 121
Part IV New Dentist Issues 125
19 Associateships 127
Noncompete/Restrictive Convenants 128
True Case 46: Dentist reopened next door 129
True Case 47: Dentist takes all patient records to new office 129
Trade Secrets 129
Compensation 130
True Case 48: Buy what you built? 131
True Case 49: Earn your pay 131
Dental Service Organization (DSO) 132
References 133
20 Starting or Buying a Practice 134
True Case 50: Do you see me now? 134
Location 134
True Case 51: You can run but you can’t hide 135
Transfer/Setup Considerations 135
True Case 52: Poof! You’re moving 137
Show Me the Money 137
True Case 53: Bankrupt 138
Balance Sheet and Profit and Loss 139
Insurance Needed 141
References 143
21 Marketing for a Successful Practice 144
Ethical Advertising 145
Competition for Patients 148
Fee Splitting 149
True Case 54: Keeping it in the family 149
The Logo 150
True Case 55: Keep the patients coming 150
Preferred Provider Organization (PPO) 150
True Case 56: Insurance company approves treatment but then doesn’t pay 152
Collections 153
References 154
22 Social Media 156
Types and Characterizations of Social Media 156
You Posted It, You Own It 157
True Case 57: Can’t stop you from posting it 158
True Case 58: Oh yes I can stop you from posting it 158
Is It Working? 158
References 159
23 Co-diagnosing and Gaining the Patient’s Trust 160
Types of Patients 160
Making the Appointment 161
Patient Motivation 161
True case 59: Denture time 162
Co-diagnosing With the Patient 162
Reference 164
24 Employee Management 165
True Case 60: Please believe me 166
Testing the Waters 166
Office Culture Integration 166
The Paperwork 168
True Case 61: Dr. Chadwick v. Board of Registration in Dentistry (MASS) 168
Evaluation and Appreciation 168
Reference 171
25 Multispecialty Practice 172
The Set Up 172
Who’s Next 173
True Case 62: I want to pay more 174
Show Me the Money 174
26 Forms 177
General Release for Dental Treatment 177
Consent for Pulpal Debridement and Endodontic Treatment 178
Consent for Oral Surgery 179
Consent for Periodontal Surgery 180
General Consent for Surgical and Invasive Procedures 181
Refusal of Treatment / Referral 182
Termination Letter 183
What You Should Know about Financing Your Dental Treatment 184
Authorization for Release of Dental Records 185
Photography Authorization 186
Release of All Claims 187
Anti-defamation Clause 188
Epidemic/Pandemic Dental Treatment Information Form 189
Index 190
