Ethical Dentistry Isn’t Old School

Kelsey CreehanFeatured News

By Lisa Fox, B.S.N., D.D.S., CDA Ethics Council
From the Winter 2020 Journal of the Colorado Dental Association

What does it mean to practice honest and ethical dentistry?  And why does it matter?

Think about this common situation: you take your car to the repair shop for an oil change and the accompanying “free” 20-point inspection. How many times has that “free” inspection found two, three or 10 things wrong with your car? Brake pads need to be replaced, transmission fluid needs to be changed, a belt is about to break, the tread on your tires is pretty worn down and winter is coming! Most of the time these additional repairs are shared with you over the phone—what do you do? And if by chance you waited at the repair shop for the oil change, and the mechanic showed you a sample of your transmission fluid to “prove” that the fluid needed to be changed, what would you do then (fully realizing that you wouldn’t know what transmission fluid looked like if your next meal depended on it)? If the mechanic isn’t your son or daughter or your Uncle Ned, you may feel a little queasy in either scenario—like you’re about to be ripped off. You may feel that way even if it is Uncle Ned!

That’s how some patients feel when they leave a dental office! And if patients leave an office with the feeling of, “I’m about to be ripped off,” they won’t refer their friends and family to that practice! Nor will they run to the front office to schedule their next recommended treatment appointment. So how do you get a patient to trust you and be fully invested in your recommended treatment? How do you get that patient to respect your practice to the point they would refer a family member to you?

At my pediatric dental practice, we have a massive 250-gallon salt-water fish tank in the middle of our clinical area. Nemo and his friends live in that tank, of course, and children love to run from the reception room to the aquarium leaving toys, half-finished video games and books in their wake. And let’s not even talk about the frenzy that happens with patients if they happen to arrive when it’s feeding time for Nemo…  Not far from the tank are brightly colored benches and walls, a selfie photo booth, video games and different movies playing on the multiple monitors mounted on the ceiling. We have a state-of-the-art practice with lots of patient perks and technology. But are these amenities what brings patients to our office? Is it our marketing efforts? What about our location? Or is it that we’re in-network with several insurance plans? Don’t get me wrong, while Nemo and friends are very cool, they are not what brings our patient families back every six months. Nor is it because we sponsored a booth at a local community event. Families come back to our practice because they know that we will always do the right thing for their kids. We stand for honest and ethical care EVERY SINGLE DAY, and our patients and parents expect this from us.

Consistent, high ethical standards are not only the “right thing to do,” they are, in fact, good for business! Reassuring patients and demonstrating that you and your entire staff are partnering with them for their best outcome, in the most honest and ethical way, will give your patients piece of mind and trust in your practice. Have you ever heard someone say, “you should go to my dentist, she has the greatest fish tank and my kids love the video games”? Probably not the best pitch for a healthcare referral. However, if someone came to you and said, “you should go to my dentist; she takes her time to explain everything, she is honest with her assessment and provides options for us to discuss next steps,” you would most likely consider making an appointment.       

As we move into 2020, take the time to review your ethical standards with your staff and examine where improvement can be made. Have you talked to your staff about why forgiving an insurance co-pay or deductible is unethical? Or why implying that a previous provider has performed poor dentistry on a patient is unethical? Not to mention telling patients that your practice provides superior care compared to other dentists in the area. What about talking to your colleagues about your fees? Or complaining about a tough patient on social media? These are just a few examples of modern ethical issues that we all face regularly. While most of us spend a significant amount of time, effort and money to acquire the latest skills we need to provide exceptional dental care to our patients, how much time and effort are we spending to ensure our patients are receiving expert care in an ethical environment? I’ve seen the two brown smears of liquid at the repair shop and I still don’t know if that means I need to change my power steering fluid! Don’t create an environment where your expertise leaves your patients feeling uncertain about making a decision. Our patients deserve to know and feel that their dental providers are doing the right thing.

It is our responsibility, as dental professionals, to have the highest ethical standards and always “do the right thing” for our patients. When we respect our patients and colleagues, our businesses thrive! At the end of the day, I want my patients to leave my practice with peace in their minds, a smile on their faces and thoughts about Nemo for the rest of the day.


Lisa Fox, B.S.N., D.D.S., is a pediatric dentist in Highlands Ranch, CO. She is a former member of the Colorado Dental Board and currently serves on the CDA Ethics Council.