Professional Documents
Culture Documents
• PATIENT AUTONOMY
• NON-MALEFICENCE
• BENEFICENCE
• JUSTICE
• VERACITY
PATIENT AUTONOMY
“SELF GOVERNANCE”
• PATIENT SELECTION
• EMERGENCY SERVICES
• JUSTIFIABLE CRITICISM
• EXPERT TESTIMONY
• REBATES & SPLIT FEES
SCENARIO
Mother brings in her 8 year old son, Sami, to your office after he
chipped the mesial of #9 from chewing on ice. Sami has no
pain, no swelling in the region, but has mild sensitivity. Sami
seems to be fine, otherwise.
SCENARIO
The mother is concerned about her son, so you do a patient
exam. During the exam you notice a chip mainly in enamel with
some dentin exposure.
SCENARIO
Sami is not a patient of record and visits a different general
dentist regularly. His mother is requesting immediate treatment.
WHAT WOULD YOU DO?
A) Treat Sami and refer him to his general dentist for follow-up
care
B) Treat Sami and schedule 3 month follow-up appointment at
your office
C) Offer no immediate treatment and recommend follow-up
appointment with Sami’s general dentist
D) No immediate treatment is required and schedule 3 month
follow-up appointment at your office
ADA CODE OF ETHICS
4.B. Emergency Service. Dentists shall be obliged to make
reasonable arrangements for the emergency care of their
patients of record. Dentists shall be obliged when consulted in
an emergency by patients not of record to make reasonable
arrangements for emergency care. If treatment is provided, the
dentist, upon completion of treatment, is obliged to return the
patient to his or her regular dentist unless the patient expressly
reveals a different preference.
JUSTICE
“FAIRNESS”
The dentist has a duty to treat people fairly.
This principle expresses the concept that professionals have a
duty to be fair in their dealings with patients, colleagues and
society. Under this principle, the dentist's primary obligations
include dealing with people justly and delivering dental care
without prejudice. In its broadest sense,this principle expresses
the concept that the dental profession should actively seek
allies throughout society on specific activities that will help.
JUSTICE
“FAIRNESS”
4.A. PATIENT SELECTION.
4.A.1. PATIENTS WITH BLOODBORNE PATHOGENS.
4.B. EMERGENCY SERVICE.
4.C. JUSTIFIABLE CRITICISM.
4.C.1. MEANING OF "JUSTIFIABLE."
4.D. EXPERT TESTIMONY.
4.D.1. CONTINGENT FEES.
4.E. REBATES AND SPLIT FEES.
4.E.1. SPLIT FEES IN ADVERTISING AND MARKETING SERVICES
VERACITY
“TRUTHFULNESS”
• DUTY TO BE HONEST & TRUSTWORTHY
WHEN DEALING WITH PEOPLE
• RESPECTING THE POSITION OF TRUST
INHERENT IN THE DENTIST-PATIENT
RELATIONSHIP
• COMMUNICATE TRUTHFULLY AND WITHOUT
DECEPTION
• MAINTAINING INTELLECTUAL INTEGRITY
“TRUTHINESS”
“IF YOU LIKE
YOUR PLAN YOU
CAN KEEP IT”
SCENARIO
The fee for a patient without dental benefits shall be considered a dentist's full fee.
This is the fee that should be represented to all benefit carries. (ADA)
A 35 yo female comes to your office because she has noticed she has a cavity. Upon
inspection you determine that #30 is severely broken down and can only be restored
with a full coverage crown. Upon hearing this, she becomes very emotional and
begins sobbing as she explains that her husband recently lost his job, they are falling
behind on their bills already, and she can’t afford to do a crown. Your normal fee for a
crown is $1,000 (which is what you bill to the insurance companies as well). Because
you have a good relationship with their family and feel bad because of their situation,
you tell your pt. that you will do the crown for only $600 to help her out.
SCENARIO
Is the principle of Veracity violated if you are reporting to insurance
companies that your crown fee is $1,000 but you lessen that fee for
certain patients?
A: Yes
B: No
What if this patient had insurance that covered 50% of the procedure,
leaving her a $500 co-pay. Would the principle of veracity be violated if
you told the patient you would only collect $100 of their co-pay?
A: Yes
B: No
OTHER EXAMPLES
• ACCEPTED SCIENTIFIC KNOWLEDGE
• WAIVER OF COPAYMENT
• OVERBILLING/ FEE DIFFERENTIAL
• TREATMENT DATES
• DENTAL PROCEDURES
• UNNECESSARY SERVICES
• MARKETING