Transcript The State Regulation of Dentistry

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The State Regulation of
Dentistry
Law and Ethics
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What is the State Dental Practice Act?
• state law which controls the practice of dentistry
• contains legal restrictions and controls
• only applies to that particular state in which it is
written; each state has its own dental practice act
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What is the purpose of the state
Dental Practice Act?
• protect the public from being mistreated or misled by
incompetent practitioners
• The primary function of the state dental practice act is
to define and regulate the practice of dentistry
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Provisions of Dental Practice Act:
• Licensure
– Eligibility, methods, requirements for licensure
– Grounds for suspension or revocation of license
• Defines the practice of dentistry within the state
• Provisions for establishing and maintaining an
administrative board to supervise practice of dentistry
• A means of controlling the assignment of duties,
including extended functions to auxiliaries (DA, Dental
Hygienist, Lab Tech)
What is the State Board of Dentistry?
• aka: State Board of Dental Examiners
• Administrative Board of the state in which it exists
• responsible for administering and enforcing the Dental
Practice Act
– Examine applicants and grant licenses
– Deal with misconduct, incompetence, and related matters
– Establish and regulate the functions assigned to dental
auxiliaries (clinical staff who have a supporting or supplementary
role i.e. DA, dental hygienist or lab tech)
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What is a License?
– legal permission to engage in a profession or business
• Licensure= the act of granting licenses expressly to practice a
profession or business
• Purpose: protect public from mistreatment by unqualified practitioners
– To obtain a license in the dental field, one must:
• Apply to the state Board of Dentistry
• Meet the educational and moral requirements
• Pass an examination in theory and practice as specified by the state
Dental Practice Act
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Who must be licensed?
• 1) Dentists
• 2) Hygienists
– Both must be licensed by the state in which they practice
• 3) Dental Assistants are not licensed, though some
states do require registration (RDA)
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• a mutual agreement between two or more states to
allow an individual who is licensed in one state to
receive, without further examination, a license to
practice in another state
– **still need to apply for license in each state
that is a reciprocal state**
even if
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State Board of Dentistry may:
• Suspend: to temporarily stop or interrupt
– Dentist cannot practice during this time
– License is reinstated after specified time and dentist can
resume practice
• Revoke: to take away
– Dentist is no longer licensed to practice dentistry in that state
– Dentist may petition to have license reinstated
Professional licenses can be revoked due to:
• Conviction of a crime
• Unprofessional Conduct
• Personal or Professional incapacity
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Conviction of a crime
• Being charged with a crime doesn’t automatically lead to suspension
or revocation
• Fraud: intentional misrepresentation of the truth in an
effort to deceive
• Misdemeanor: any offense other than a felony, is less
than a felony
• Felony: a serious crime, such as rape or aggravated
assault
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Unprofessional Conduct
• Permitting unlicensed personnel to perform dental procedures
normally restricted to dentists
• Failure to supervise personnel properly
• Sexual advances toward or involvement with patients
• False or inaccurate patient records
• Fraud involving reimbursement of patient expenses by insurance
companies or government programs
• Giving or receiving rebates related to patient fees (discounts)
• Transmission of disease by improper infection control
• Improper communication of confidential patient information
• Improperly prescribing, handling or selling controlled substances
(drugs)
• Patient neglect or abandonment
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Personal or Professional Incapacity
• Addiction (abuse of narcotics or alcohol)
• Severe physical or mental limitations that prevent
adequate patient care
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Certification
– voluntary program that verifies standards for qualified DA
– NOT a form of registration or licensure (required by law)
• DANB certification is recognized in some states, but
not in all of them
DA’s Responsibilities to Dentist
• Always treat the dentist
with respect
• Support the dentist in any
decision made for the
patient
• Perform only those tasks
that are delegated to you
by law
• Conduct yourself
professionally in the
dental office.
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Respondeat Superior
“let the master answer”
• Dentist/employer is held liable (responsible under law) for acts
of his/her employees
– If wrongdoing was committed within the scope of their
employment
– Not liable if wrongdoing not within scope of their
employment
• IF you do something wrong while working properly, Doctor is
liable; if you are working improperly, you are also liable
– Dentist/employer is liable EVEN if employee is a licensed
individual
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Why Respondeat Superior??
• Employer has the right to direct and control employee;
must exercise this right and be responsible for
employee’s actions
• Employer has exposed patient to hazard of employees
and must suffer for the negligent acts
• Employer has the assets (financial resources) to compensate
the patient for the injury.
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If YOU are called into court
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• You may receive a subpoena
– Court order commanding you to appear in court; cannot be
ignored
• You may have to give a deposition
– Statement made by witness; you will answer questions under
oath; takes place in lawyer’s office before the trial
• You may have to give testimony
– Evidence given by a competent witness under oath during a
trial
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What to do if the Dentist is sued
• Say nothing: don’t discuss case with anyone without doctor’s
permission
• Be Supportive
• Be Cooperative with dentist and lawyer
• Ask before acting do not give information to any other lawyer
or show the patient’s records to anyone without the doctor’s
permission
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You can still be sued!
• Usually it is the dentist who is sued
• The dentist’s liability insurance will not cover the
auxiliary if she/he is sued for negligence
• A dental assistant who is guilty of negligence is
responsible for his or her own actions, and the injured
party may sue both the dentist and the assistant
• Some auxiliaries carry liability policies of their own
– ADAA membership includes liability insurance but this does
not cover negligence
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Levels of Supervision:
• 1) Direct: The dentist remains in the room while DA
performs task
• 2) Indirect: dentist remains in office while DA performs
task
• 3) General: dentist is not required to be present in office
when task is performed
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Expanded Functions for DA
– aka: extended functions or EFDA
• Assignment to DA of tasks of greater skill and
responsibility which were formerly performed only by
the dentist
• Not available in all states (CT= no; MA = yes)
• Governed by Dental Practice Act:
– Allows dentist to delegate duties; very few states
– Includes specific listing of functions; some states
– State Board of Dentistry has authority to establish rules and
regulations for EFDA; most states
Your responsibilities as a dental assistant:
• Be careful! Do not allow yourself to do things which
are improper or illegal.
“a dental assistant who performs extended functions that are not legal is
performing an illegal act: the unlicensed practice of dentistry” This is a
CRIMINAL ACT.
 if the dentist instructs the DA to perform this act, he/she is
also guilty
if the dentist does not know of the act, he/she may still
be liable
• Know:
– who is permitted to perform a particular function in your state
– what education or training is required
– what level of supervision is necessary
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