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OPINION: Do dental chains need more regulation?

3/22/2012

By WILLIAM B. RISK, DDS

IDPAC Chair

A little over a year ago Allcare Dental was closed nationwide on New Year’s Day. Their dentists and auxiliaries were notified the day before that the doors would be locked, and the business was closed forever.

This left many unanswered questions, especially including, What about malpractice liability? Who or what is protecting the practitioner, and what recourse is left for the dental consumer? 

This closure caused the patients to be abandoned. All treatment in progress was stopped. Suddenly temporary restorations became more permanent. Patients with post-operative complications were forced to seek treatment at other locations.

This corporation tended not to provide professional services without upfront payment. Consequently, many patients paid for services that they never received. The Indiana Attorney General’s Office received over a thousand complaints, many of them made in the name of a specific dentist who had provided treatment or had the title of clinical director (but they had been abandoned also).

In Indiana dentists are required to have a license to practice dentistry. Dental corporations are not licensed. Essentially there is no oversight of dental corporations, how they manage the dental practice, or how they directly affect the dental care received by the patient.

In Indiana pharmacists are licensed, but pharmacies must also have a license. Pharmacy chains, such as Walgreen’s or CVS, must also have their own licenses. In the license application for each pharmacy location, a licensed pharmacist must be named, and a pharmacist can only be named for one location. This individual is responsible for all of the pharmaceutical activities at that location.

Tip O’Neill used to wisely say, “All politics is local.” That is also true in the drugstore world. Each location is individually responsible for how it is operated and who is in charge of the operation. Because of this, there is a certain standard of care that can be maintained for the consumer.

So shouldn’t dental chains be licensed? Each dental office in the chain would be required to have a dentist with an Indiana license named for that location. Similar to pharmacy, a licensed dentist could only be named for one location. This would provide local responsibility. 

The question might be raised about individuals who have multiple sites for their practice. What if they are incorporated? A distinction could be made between a professional corporation or entity and a management corporation.

A management corporation would not be allowed to own patient records or make any type of policy that would directly affect the direct professional clinical diagnosis or treatment of the patient. This responsibility would fall directly to the named Indiana licensed dentist at that location.

It is time for dentistry to once again step forward on behalf of dental patients and ensure that the treatment they receive is up to the standard of care as determined by the Indiana State Board of Dentistry. There must be a local individual responsible, because when something goes wrong—and this will happen from time to time—the patient and the dentist need to be protected. Unlicensed out-of-state entities should not be making dental decisions for the citizens of Indiana that require professional skill and judgement.

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