Dental Practice Ethics: Where Have All the Ethics Gone?

Perhaps you heard the shocking and disturbing news about a Knoxville, TN dental practice that violated basic dental practice ethics by sharing a video on social media. This incident parked widespread concern about professionalism and patient confidentiality in the dental field.

The Erosion of Customer Service

Some people blame such atrocities on COVID; there’s a certain air of rudeness that infiltrated into our culture. Others blame it on a generational gap caused by the disconnect resulting from people being glued to their phones and social media. Call it what you will, but we have definitely slipped into the pit of undesirable customer service—whether it’s a healthcare facility or Walmart.

HIPAA and Privacy Rule Basics

Anyone associated with the dental field is knowledgeable about the basic core principles of HIPAA’s Privacy Rule. However, videos continue to be made and posted on social media exposing protected health information. Despite the characters being the staff, computer monitors may display a patient’s radiographs. Content may expose someone’s personal notes and conversations that took place with a clinical provider.

Importance of HIPAA and Ethics Training

It’s important to provide training on HIPAA and being specific about Privacy Rule violations and how to avoid them. It’s equally important to train on the principles of dental practice ethics.

Ethics Requirements in Professional Settings

As a matter of fact, some states such as Alabama require an ethics course as part of the CE mix. As a lawyer, I’m required to complete 2 CE credits on ethics annually. We continue to receive training on how attorneys can easily violate an ethical principle and how we can successfully avoid such a blunder.

Ethical Principles in Dentistry

It’s good use of your time to train your team on the principles of ethics as it relates to dentistry.

Patient Autonomy

• The principle of patient autonomy involves the concept that dental professionals have a duty to treat the patient according to the patient’s desires, under the standard of care and also protecting the patient’s privacy. One of the number one HIPAA violations is not providing a copy of the patient’s record in a timely manner, according to federal and/or state law. The code of conduct also requires the protection and confidentiality of such data, not discussing this information beyond the dental office and certainly not on social media.

Nonmaleficence

• The principle of nonmaleficence expresses the concept that dental professionals have the obligation to protect the patient from harm. We keep our education and training current, know when to refer the patient out, and prohibit personal impairment of the dental team. The code of conduct includes how to terminate a patient properly and avoid allegations of patient abandonment.

Beneficence

• The principle of beneficence is the duty and obligation to do good. Regardless of the insurance carriers’ benefit package, we have the ethical duty to put the patient’s welfare first. It requires the obligation to provide a workplace environment that supports respectful and collaborative relationships. Although silly videos can be entertaining, does it project the level of professionalism you want your dental office to be branded with?

Justice

• The principle of justice requires us to treat patients fairly, never refusing a patient based on race, creed, color, gender, sexual orientation, gender identity, national origin, or disability. Our job is to treat the dental needs of people, not judge their personal lives. Be kind, caring, and extend a helping hand to those who have special needs.

Veracity

• The principle of veracity is that of truthfulness. Never make unsubstantiated representations just to make a buck. This principle also involves the code of professional conduct not to engage in overbilling or a waiver of insurance copayments—yes, this is an ethics violation. The ethical impropriety is misrepresenting a fee, telling the insurance we charge one fee and then only anticipating another from the patient. Make full disclosure.

Avoiding Fraudulent Practices

Never incorrectly report to the insurance payor a dental procedure that receives a higher reimbursement than the actual procedure. This is fraudulent.

Building a Culture of Ethics and Communication

Sometimes we can summarize ethics as “just do the right thing.” If you work with a team member who does not have good customer service skills, teach them. Train them to be kind and respectful. Look at the patient when you’re talking to them. Pepper your words with kindness and understanding.

Investing in Training and Communication Skills

We spend a lot of money to market our practices. Perhaps we should carve out some of this budget for training on communication skills. Practice your skills with each other. The results will be well worth it, both for their professional lives and interpersonal skills.

Upcoming Resources

Tune in for a podcast I’m moderating with The Compliance Divas on this subject matter. I’m also pleased to announce a new CE course we at Modern Practice Solutions are offering on Dental Practice Ethics. The strength and skill of our team hinge on the level of training we are willing to provide.