Dental Standard of Care
“The standard of care is the level at which the average , prudent provider in a given community would practice. If treatment for which a recognized specialty exists is in question, then the standard of care is defined by the level at which an average, prudent specialist would practice, even if the treating doctor is a generalist.”
Or is this really the definition? It is the legal definition, but 99% of the dentistry performed in this country is never reviewed in a court of law. Ninety-nine percent of the dentistry performed in this country is accepted by dental consumers but is never bench-marked, is never judged, never graded on its technical merits. As a colleague once quipped, “Our patients judge us only by the experience.” Is there a more valid means of discussing Standard of Care?
AIDA wishes to highlight, in all of its educational materials, a consumer driven model of dental organizational theory. Dentistry as an institution has two consumers—patients (external) and dentists (internal). Consideration of any issue of import to dentistry must recognize the positions, perceptions, and needs of each of these markets to achieve organizational effectiveness.
The “true essence” of the Standard of Care as seen from outside of our profession is that it is whatever the public will accept.
Doesn’t that burst a lot of bubbles? How many of you are still working on that concept of, “If you build it, they will come.”? (Big business has dropped this premise, by the way, many years ago.) How many of you are taking the courses, investing in the technology (like clear aligners), changing management experts, redecorating, and all of those other customer-experience things? They all work, don’t they, to a certain extent? But have you seen a fundamental, earth shattering change in your practice because of these changes? Have you seen fundamental change in your industry? Has there been a mass effect in raising the public’s IQ with the advent of intraoral cameras? Do you have patients calling up asking for crowns because they noticed a fracture line across a marginal ridge, although asymptomatic? We as a profession have done a lousy job of educating our patients. In marketing parlance, we have not created value. We have over-concentrated on adding value to services which themselves are not understood. Picture the executive using his new dental plan, “just to check it out”, and realizing that, “Well, the staff didn’t offer me a cup of coffee, but the cleaning was free, and it sure didn’t take very long. I got back to the office fast!” Patients have not been educated to value our services as they should.
The cynical among you are now asking, “OK, so what is the answer?” And, like most awesome endeavors, the answer is not easy or well defined. But we can learn together how to address the dilemmas posed by educating patients to demand Optimal Dentistry. Let’s examine patients’ belief systems about dentistry. Let’s see how the true essence of dentistry is defined, in the minds of patients.
The True Essence Of Dentistry
The true essence of our profession is defined by public opinion, which in turn is formed by:
- Today’s Media
- Today’s Third Parties
- Today’s Employers
- Society’s Collective Memory/History of Dentistry
- Today’s Government
- Today’s Organized Dentistry
- Today’s Dentists
The essence of dentistry may only be directed by understanding and addressing each of these seven factors. Organized dentistry may or may not understand this, but has been remarkably reactive, rather than proactive, in all of the biggest issues to come before dentistry. Consider the AIDS crisis, the amalgam question, hand piece and waterline safety, OSHA, decline of the traditional doctor/patient relationship, the malpractice crisis, etc. To think that you define your own essence is a basic but common organizational flaw. Dentistry exhibits this flaw. Customer (patient) perceptions define the true essence of dentistry.
Do your part to increase the standard of care in dentistry, like this Beaufort dentist does. But also understand that your part should not be confined to the chair-side aspects. If you demand a practice of excellence in dentistry, your wish cannot and will not be achieved without organizational excellence in dentistry. If you expect it, and vote so with your hearts and your wallets, then it will be so, sometime. If you vote with your time and your talent, it will be so in your lifetime.