Much has been written about patient’s rights with respect to medical and, occasionally, dental care. Congress has drafted a Patients’ Bill of Rights, as have other groups too numerous and varied to mention. These documents may never see the light of day in a final, approved form, but they have spurred much interesting debate, and have exposed deep and serious divisions on fundamental issues surrounding the rights and obligations of patients, doctors, insurers and the government.

Not surprisingly, and not inappropriately, there has been less passion devoted to the rights of the doctors (physicians and dentists) charged with the health of these patients. The doctor-patient relationship is manifestly not symmetrical—our decisions directly affect our patients’ health, and sometimes their very lives—so it is right that the patient receive the greater protection. Nevertheless, I think it would be useful to undertake a careful examination of what we, as dentists, consider to be our most fundamental rights.

To that end, there follows a first draft of a Dentists’ Bill of Rights. Apart from the title, it has little in common with that monumental document bequeathed by the founding fathers, offering neither stately prose nor great foundational principles. One significant difference is that each of these rights carries a corresponding responsibility, reflecting the fact that the practice of dentistry is a privilege conferred on a few qualified individuals, rather than a universal human right. It’s rough, it’s incomplete, and it’s only one person’s opinion but I offer it as a point of departure.

RIGHTS AND RESPONSIBILITIES
Every American dentist charged with the care of patients is entitled to certain rights, among which are:

1. The right to see any patient who chooses the practice. Questions such as insurance coverage, professional courtesy and provider networks may affect the affordability of care, but should not stand as absolute barriers against the patient’s freedom to choose a dentist.
   
2. The right to recommend and provide appropriate care, as informed by professional judgment and consultation with the patient, without interference by any third party. While the final choice of treatment may be dictated, in part, by cost, the range of options presented to the patient should not be censored to accommodate third-party payers. It is the responsibility of the dentist to base treatment decisions on evidence, personal experience and individual patient needs.
   
3. The right to offer an honest second opinion when consulted, without fear of censure or penalty if the opinion contradicts that of a colleague. Second opinions usually are an uncomfortable matter, but they are less so if we remember, first, that the patient’s welfare is paramount; and second, that there’s almost always room for honest disagreement in a complex case.
   
4. The right of an employed dentist to see patients in a clean, safe, accessible, up-to-date and properly staffed environment; to maintain a reasonable workload; and to be free of any pressure to promote products, recommend treatments or engage in activities not in the patient’s best interests. Many dentists are employed by large practices, government agencies, schools, hospitals and the military. While giving up some of the privileges of solo practice in exchange for other benefits, they do not abdicate their duty to treat patients properly. Their employers must permit them to meet this obligation, or face serious legal responsibility downstream.
   
5. The right to be paid for professional services as promptly and regularly as the patient would expect to receive his wages (or an insurer, its premiums).
   
6. The right to prompt attendance at scheduled appointments, or timely notice of a need to reschedule.
   
7. The right to a helpful and considerate team, compassionate and respectful toward patients, eager to offer constructive suggestions, scrupulous in providing notice of absence or departure. In return, dentists have the responsibility to treat staff with respect and honesty, to provide a good working environment and to encourage continuing education.
   
8. The right to have an individual practice or a practice setting that reflects the personality of the dentist consistent with delivering high-quality, caring and culturally sensitive patient care.
   
9. The right to be recognized as a professional with a specialty in the care and presentation of oral and craniofacial diseases.
   
10. The right to look toward the future—to explore new diagnostic and treatment modalities, innovative practice models, unexpected disease mechanisms and evolving patient needs.
    

Accompanying this right is the responsibility to be aware of, and prepared to assess, innovations in dentistry and beyond.

As individuals, dentists won’t always agree on priorities or mechanisms. Should fees be paid directly by the patient, or by a public agency or private insurer? What treatments should be viewed as "standard of care," or experimental or obsolete? How can the needs of indigent patients best be met?

But we can agree on, and always should focus on, our fundamental goal: providing high-quality, up-to-date, compassionate dental services to the patients who require and seek our care.

Our forebears faced a hostile and uncertain world when they drew up the Bill of Rights to defend the infant republic against tyranny. It would be absurd to compare our situation with theirs. In one respect, though, we share a common motivation in setting down what we will defend as fundamental rights: where power exists without restraint, it is certain to be abused. Let’s work to ensure that it doesn’t happen here.