Re: Husband's Bridge - Ethical can of worms leading to unfounded legal hassel.

From: Dr. David Leader (leaderdmd_at_juno.com)
Date: 06/13/04 

Date: 13 Jun 2004 13:46:32 -0700

> Well, you might say that I do not agree with the American Dental
> Association with many of their principles. In fact, they have done
> little to defend the dentists against the badmouthing by dental
> insurance companies. For years, the insurance companies have created
> problems for the dentists ... now where was the ADA when that went on?
>

The ADA has settled one court case with Aetna and is in the process of
suing three more insurance companies under RICO. It's been in the
works for a while, but it is about time. As a member of our state
society's Council on Dental Care and Dental Benefit Reimbursement I am
in meetings on this issue 5 times a year. If you would like to foward
specific issues along with eob's, claims and any other documentation I
will be happy to foward the info to the appropriate parties. Last
month we decided to contact two ins co's that still have the old
"charges above Usual and Costomary" language on their EOB's.

> FURTHER, ADA's Principles of Ethics and Code of Professional Conduct
> from Section 4.C. JUSTIFIABLE CRITICISM. "?Patients should be informed
> of their present oral health status without ..."
>
> has nothing to do with LAW. There are no statutes or case law that
> support this position.
>

These are the Ethics of your profession. They make sense. Without
knowing all of the facts you can't judge the previous dentist's
treatment. If you or I feel that a dentist is acting wrongly there are
ethical ways to handle the situation. You may contact the dentist
directly. You may contact the State society. You may contact the
state board. None of these contacts cause a violation of our Ethics.
All of these actions are more effective than advising someone that
what their dentist did is illegal in your state. The ADA and the state
society will support you.

What can we do in this forum? Give the advice that the patient should
discuss this situation with their dentist; if they are not satisfied
speak with another dentist who can examine them.

> If you want to discuss LAW, okay. If you want to discuss ETHICS okay.
> But why confuse the two?
>

Let's do both.

> By the way, are you suggesting that the ADA is telling us to cover up
> illegal activity? Should we gloss over the fact that dental assistants
> are specifically prohibited from taking impressions for crowns in
> Pennsylvania?

If you think that this happened, you are free to report the offender
to the board or the dental society. The ADA and state society will
back you up.

 
> Are you saying that a patient who specifically asked, "Can the D.A.
> take the impression?" should be lied to?
>
> Its either a YES answer or a NO answer.
>
> He is not asking for a ***-foot answer now is he?

No, neither is the patient asking for a half thought out answer. In
this case, we don't even know what imression the 1st party was talking
about with his wife who sent the original e-mail. Also, this is a
question of legality. I would refer the patient to the licensing
Board of their state to get accurate information. I assure you that
they will not give advice without mentioning the different types of
impressions. They would never tell a patient that what a dentist did
may be illegal without some investigation. (Just thought of something
else, what if the "assistant was a new associate Dr. and not a DA?)

> >
> >Since we got the information 2nd hand, 2nd lay person hand, it is
> >difficult to asses the reliability of the information.
>
> We agree.
>

I hope that you will also agree that poor advice can cause our
collegues a lot of "tsouris".

David Leader, DMD

PS Sorry my postings have been long. I write a column for a local
newspaper.

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