Articles You May Use

Opinions in these articles are those of the author only, and are not necessarily the opinions of the Board of Directors of AIDA or its membership.  Feel free to duplicate and use these articles for your local newspapers, as press releases, or for you local dental society newsletters.  Permission is assumed for any pro fee-for service use.  Please submit your own articles via e-mail to include here to improve the template.

The Patient Bill of Rights

K. Randall Groh, DDS

Printed by the Coral Gables Gazette

In these days of managed care, which is almost ubiquitous in medicine and growing at a rapid rate in dentistry, a common complaint is that patients feel "lost in the system".  Truly, many forces, both financial and social, are coalescing to cause health care to feel "commoditized"- in other words, to make one doctor or one hospital appear equal in quality and value to another.  The social observers among us realize that, like our education system, this means that some doctors and hospital will actually be improved under such a system, while others will be forced to conform to lower common standards.

Those standards are loosely defined today, and many doctors, insurers, hospitals, and health care organizations are under scrutiny for paying more attention to their fiscal rather than their physical responsibilities.

Today, more than ever, as a patient you must be your own advocate.  No one can pick a good doctor for you.  You can’t expect that the insurance chosen for you by your employer will pay for anything more than minimum standards of health.   Understand what that means!  Most insurance these days, medical or dental, is not intended to help you achieve or maintain optimal health.  It is only intended to keep you from falling apart.  Optimal health?  It’s not in the contract!

As a patient, how do you act as your own advocate?  What are your rights?   What basic services and attention should you expect from any doctor or hospital, regardless of insurance coverage?  What should you expect?  Where should you draw the line and look elsewhere?

The American Independent Dentist’s Association has proposed the following Patient Bill of Rights for its membership to ascribe to. This is not legislated, nor is it in anyway contractual with insurers.  It is the Association’s opinion that these are the minimum standards to which health care providers should practice. They are specific to dentistry, but should be easily extrapolated to physicians, hospitals, and insurers.

1) You have the right to: Complete and Understandable Diagnosis and Treatment

Every new and routine examination should include a screening for oral cancer and anomalies, gum disease, and bite problems, as well as for cavities and tooth problems.   Your dentist should make sure that you understand your diagnosis, and all treatment options regardless as to whether or not they are covered under your insurance policy.   You have the right to know your dentist’s experience and qualifications to provide a given procedure.  You have the right to request a specialist to provide a given procedures if applicable.  Insurance contracts and exclusions should not be allowed to dictate your treatment. You have the right to be heard- your dentist should be interested in your concerns.

2) You have the right to: Second Opinions

You have the right to a second opinion should you or your dentist feel that it is in your best interest. This opinion may be used to confirm your diagnosis, your proposed treatment, or your understanding of the original opinion.

3) You have the right to: See the Dentist You Signed Up With

It is very common in today’s new health arena that a new patient does not get to be treated by the dentist whose name they saw on the insurance plan list.   Instead, treatment is provided by an employee dentist who has little or no long term stake in the practice.  In some offices, patients are seen by a different dentist at each visit, allowing a potential lapse in the continuity of care, and no possibility for a long term relationship.

4) You have the right to: Rapid Emergency Care

Pain, bleeding, and swelling emergencies should be seen and evaluated as quickly as you can arrive at the office, definitely on the same day.  If your doctor is not in the office, another equally competent doctor must be left on call.  If your doctor does not feel qualified to treat the problem, then a referral must be given to a competent specialist who will see you that same day.

5) You have the right to: Timely Preventive Care

Dental cleanings and routine diagnostic appointments should be scheduled within one month of your due date.  Cleanings should be thorough, generally forty-five minutes or more for an adult, and should include hand and or ultrasonic instruments- more than just the "rubber cup polisher".

6) You have the right to: Have Your Time Respected

You should be seen within thirty minutes of your appointed time, except if your dentist is caring for another patient with an extreme emergency.

7) You have the right to: Continuity of Care

Your treatment should not progress with months between appointments unless that is your desire.  Most dental work with laboratory components requires no more than two weeks between visits.

8) You have the right to: Full Financial Disclosure

You have the right to know the cost of your treatment and a reasonable approximation of insurance coverage if necessary.  You are obligated to provide the dentist with appropriate insurance information and notify the office of any changes.   You have the right to understand what financial options are available to you for large amounts of treatment.

9) You have the right to: Appropriate Infection Control and Office Safety

The staff should be knowledgeable and obvious in their infection control efforts.  Gloves should not be washed or reused.  Masks should be worn.   All possible instruments should be steam sterilized, and the others should be high level disinfected.  Be suspicious if your questions regarding infection control are taken lightly or ignored.

10) You have the right to: Comfortable Care

Your treatment should be accomplished with sensitivity and concern toward your comfort. Patients with special needs or apprehensions should be made aware of the full spectrum of pain and anxiety control modalities that are available.

11) You have the right to: Legal Treatment

Dental auxiliaries are allowed to provide only certain services.  For instance, a dental assistant may not provide a dental cleaning that goes below your gumline.  Only a hygienist may do that.  You should feel comfortable that each person in the dental team is practicing in accordance with his or her qualifications and legal limits.

12) You have the right to: Know Who Owns the Practice

Not every dental practice is owned by the dentist who practices there.   More and more practices are owned by insurance companies and/or Wall Street entrepreneurial management firms.  You have the right to know with whom or what you are actually contracting services, and where and how to place your allegience.  Many people prefer to build a relationship with an owner/dentist rather than an employee.

13) You have the right to: Choose Your Own Dentist

And remember that you do not have to choose a dentist from a list given you by your employer. Experience dictates that many people’s out of pocket expenses are actually less when they choose a private dentist, because the insurance excludes so much of their necessary treatment, or if their dental needs are so few that it would actually be less expensive to pay out of pocket than to pay a dental insurance premium.   Indeed, even with the least expensive policies, two exams and cleanings a year are often less expensive than he cost of the insurance!

Not every patient wants or understands Optimal Dental Health.  For many patients, good enough is good enough.  This is true for many dentists as well. T oday’s problem is matching patients with dentists who practice at the level of quality which they desire. Wherever you fall in the spectrum of health appreciation, these rights apply to you. Fight for them. Revere them. Insist on them.

 

K. Randall Groh, DDS is a practicing dentist in Coral Gables
and is the Acting Chairperson of
the American Independent Dentist’s Association.

K. Randall Groh, DDS
Acting Chair
The American Independent Dentist’s Association
2745 Ponce De Leon Boulevard
Coral Gables, FL 33134
E-Mail feeforserv@aol.com
March 21, 1998

© K. Randall Groh, 1997

Please use the "BACK" button on your browser, or select to return to the Navigation Page.

Last Update03/22/98