Dentistry: The Law and Your Staff!

Does your dental team understand the law and how it applies to their job?  Before you assume they do- read on.   I overheard a conversation in an office yesterday that really shocked me, and I'm not easy to shock!

The dentist was out of the office and after we finished our training the team members were discussing a patient they had seen earlier in the week.  The patient had a lot of dental issues and many of his teeth were in trouble.

The dentist had done a full exam and had recommended full extractions and upper and lower dentures.

The patient called that morning asking if he could just have the few teeth that were hurting extracted. He wasn't ready to move forward with the full treatment plan.

The hygienist was complaining about the doctors treatment plan. In her opinion (based on a few years experience) he was over diagnosing and some of the patient's teeth were save able.  She had checked the bone health and felt the pockets around the teeth were not bad enough to warrant extraction.

One of the team members pointed out that the dentist wasn't going to want to do a partial treatment.  Both she and the hygienist expressed concern that the doctor would not listen to their opinions (a subject for another day). That is when a troublesome conversation turned for the worse.

The hygienist suggested that they alter the treatment plan, removing all of the doctors original diagnosis and change it to treatment planning just the few teeth that the patient wanted out. "He won't remember what he treatment planned anyway" was her justification.

     

I stood there stunned!  I didn't have words.  Did they not know that team members altering a dentists treatment plan without his knowledge is against the law? It is also wrong on every level! Did this hygienist not take an ethics class?

In her mind I think she felt she was doing right by the patient. But so much could go wrong in this scenario. What happens when the patient asks the doctor questions based on the original treatment plan?  At the very least he will appear foolish as he fumbles around trying to piece together what is going on.

But what if there are really important reasons he treatment planned what he did?  Bone health around a tooth is just one factor that goes into deciding if a tooth is save able.  What if there were infections on other teeth that she doesn't know about. Or what if extracting only a few of the teeth will cause a collapsed arch? And the list goes on and on. And he would be liable for everyone of them!

In truth it doesn't matter if she feels justified in altering the treatment plan. It doesn't even matter if her opinion is clinically right.  She is not the dentist and cannot legally diagnose or treatment plan. The end!

Her license as a hygienist is at stake here. His license is at stake. The health of the practice is at stake. And this team talked about altering the treatment plan as if it was common practice in dentistry.

So, I ask you again, do your team members understand the law as it pertains to their jobs and your license?

Before you answer yes- make sure.  I'm sure this dentist would say his staff knows the law!  

    Dentistry, The Law and Your Staff


    At your next staff meeting play a game and quiz your team.  You may be surprised.



    To keep everyone informed and on the right page plan for and each year have a staff meeting that covers             OSHA regulations and the law. The law is different in each state. Your state dental association will have a link       to it on their website. Print out some copies. Go over each section and make sure you and your team                   understand what it is saying. Have each member sign a paper stating  that they have read, understood and will       follow the law as it pertains to their job in dentistry. If there are things that the law allows but that you are not         comfortable in delegating make sure your team members know what theses are.  Post a copy of the law where       anyone can refer to it.



You may be thinking this is just for new staff members. Actually, speaking from experience, the longer we are in dentistry the higher the probability of becoming relaxed and forgetting where our boundaries lay.  It's time for a refresher for everyone!