Re: Disappearing Nesbitt Bridge [longish tale]

Bill wrote:

John Keiser wrote:

I am a [California and Hawaii]  lawyer.  I would never sue a dentist
who (1)
gave me a product I specifically requested (2) provided warnings and
(3)
told me not to eat with the bridge.  Shame on those who would pursue
such a
case.



Thanks for your sentiments. As a California dentist, I am well aware
that many of the difficulties in dental practice stem from the actions
of California lawyers. I applaud your position that you would shame
those who would pursue such a case -- but so far, shame does NOT seem
to deter the endless supply of California plaintiff trial lawyers.

As you are probably well aware, California law does not allow a dentist
to "provide a product" to a patient simply because he requests it.
First, it is firmly established in case law that a dentist does not
"provide a product." Dentists provide a service. Any "products"
provided are simply part of providing a service.

Secondly -- and more importantly -- any service rendered by a dentist
MUST (according to the lawyers) meet the "standard of care," which is a
legal concept, not a dental concept.

It is a dental concept. And an insurance concept. It's not fair to accuse the legal profession of establishing a standard of care. You may fairly accuse them of utilizing the standard in law suits.
The legal profession didn't tell the insurance industry that unilateral bridges aren't the standard of care, but you well know how this intersects with the alternate benefits provision.


If a plaintiff's lawyer can 
establish in court (and they're very good at it) that any certain
treatment did not meet the "standard of care," then the dentist is in
jeopardy even if the patient requested that exact treatment.

The law (again, made by, and interpreted by, California lawyers) holds
that no patient can consent to any treatment that does not meet the
standard of care. Thus if the patient seems to consent to such
treatment, or requests the treatment on his own, or even if he signs a
stack of consent forms, the doctor is still required to render ONLY
treatment that meets the "standard of care."



	You do agree that patients cannot consent to substandard care?

Steve


This means, obviously, that even if the patient wants a Nesbit, the
doctor is still legally liable if the plaintiff's lawyer can show in
court that a Nesbit does not meet the current standard of care for a
missing single tooth.

It should not be very difficult for a smart California lawyer to
establish that in court. So a California dentist, in my opinion, is
asking for trouble, and is being downright shortsighted and foolish if
he agrees to make a Nesbit for a patient who wants one.



From a consumer's view point, I wanted a Nesbit because (1) similar 
device
provided 20 years of good service to my wife (2) I resent the effort to

steer me to an implant at 3X the cost (3) I didn't want to sacrifice a
good
tooth and a good crown for a permanent bridge at 3X the cost and (4)
the
Nesbit seemed a minimally invasive procedure which I could always
improve
upon later.


All those seem like reasonable positions to take. But for the reasons I
outlined above, no reasonable or knowledgeable California dentist
should make one. Perhaps a dentist in Hawaii could be persuaded to
undertake the task, if the laws are different there.

Best regards,
- dentaldoc



--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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