Large dental groups can sometimes impose quotas on dentists who work there. Sometimes those quotas include procedures that may be beyond the training and experience of the dentist. In one particular claim, a patient was scheduled for one surface composite restoration. The treatment plan included the extraction of #17, but the patient was supposed to be referred to an OMS for that extraction. The dentist was “pressured” by the employer to extract tooth #17 on the day the patient presented for the surface composite restoration. Concerned that refusing to perform the extraction might have led to consequences in the practice, the dentist extracted the tooth. It was a difficult procedure, and a paresthesia resulted. The dentist was sued, and the lawsuit alleged the dentist performed a procedure beyond his training as well as a lack of communication – the patient thought she was only going to have a restoration.
This case highlights the potential problems that can occur when the limits of practice and training are not fully discussed and set forth with the employer. This, as well as quota requirements, could potentially impact the care you render. When setting up the terms of your employment, it is important to be clear about issues such as quotas and types of procedures you will be asked to perform. Will there be a transition period during which you will master the performance of “difficult” procedures before you are expected to perform them on your own? Will you be expected to hit quotas so that you are limited in time to perform procedures?
You may not be able to set your own terms when entering practice with a small or large group. However, you should be aware of potential pitfalls to raise questions to your employer so they know you have them on your radar. Practicing as safe as possible is preferable, but even more so when you begin your career as a new practicing dentist.
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~Eastern Dentists Insurance Company
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