Reducing Risk Through Efficiency

Molly PereiraFeatured News

By Greg Hill, J.D., C.A.E., CDA Executive Director
From the Winter 2021 Journal of the Colorado Dental Association 

During the past few years, the Colorado Dental Association has evaluated many of its existing programs and services and has made changes to them to keep them current and able to serve members’ needs efficiently and effectively. Recently, the CDA Board of Trustees made modifications to two of its programs: Peer Review and Ethics.

The most substantial change was with Peer Review. First, the CDA Board of Trustees ended Peer Review as a stand-alone council and moved the program under the Membership Council from a management and budgeting standpoint. Secondly, the board renamed the program CDA Mediation Services to focus on the mediation aspect of the program. This will allow program volunteers to talk with a patient prior to any formal concern being filed with the CDA. We have found that in most cases, the patient is simply looking for an explanation from a third party of why or how a procedure was done the way it was done and not to launch a formal complaint that creates a conflict where mediation is needed. Volunteers can discuss the concern with the patient with the hope of it never advancing to the mediation stage, effectively reducing or even dropping the need to engage the treating dentist since no complaint is ever filed. This, likewise, removes the necessity of the treating dentist to notify their malpractice carrier as there is no grievance.

This new model brings the management of CDA Mediation Services to the CDA and greatly reduces the administrative work that also creates risk to the organization in managing the program. Consequently, the necessity for component level peer review committees and the ongoing training has been eliminated as the mediation will be managed by a core group of volunteers. In-person arbitration proceedings will no-longer take place.

As part of our due diligence, we reviewed the number of cases the program was seeing each year and that number was down to about one case per month. We also reviewed the types of calls we were receiving and most of those complaints were outside the scope of peer review. We also discussed with other states how they were handling their peer review programs and found that several had either dropped their programs or substantially modified them to be more efficient. We do not expect any change in the number of dentists we will serve through the program. However, we will rely more heavily on dentists recognizing the need for mediation in a case and notifying their patients of the program or reaching out to us directly.

Likewise, we have gone through a cleanup of the Council on Ethics and Professional Conduct, ensuring that the due process is properly followed when discipline of a member is proposed. The council can lead its stated goal of the CDA being the most ethical organization in the world. A substantial part of that goal involves ethics education and the CDA has published a series of ethics related articles in this journal.

As part of this procedural cleanup, the CDA House of Delegates formally recognized the Code of Professional Conduct’s application to the CDA and empowered the Board of Trustees to create the disciplinary process for cases where a member is accused of violating the CDA Bylaws, the Principles of Ethics, the Code of Professional Conduct, or a Member Conduct Policy. The Board of Trustees has formalized a Judicial Procedure that sets the framework under which all matters for discipline are reviewed.

The purpose of the Council on Ethics and Professional Conduct is not to add disciplinary penalties to members for minor infractions. It strives to ensure that the organization has a means and a procedure for subjecting members with major infractions to discipline that would prohibit them from serving in elective or volunteer offices of the organization, subject them to membership probation, or, in extreme cases, remove their membership from the organization. This is consistent with the organization’s Bylaws, created by the membership through the House of Delegates.

We believe these changes will allow us to better serve our members, enable these programs to run more effectively and reduce risk to the organization. As always, we are happy to discuss these programs in further detail.