 |
Q
|
|---|
Recently, I terminated the contract of one of my employee dentists after 20 years in the group practice. She has set up a solo practice several miles away. Now I’m afraid that when her patients find her gone, almost all will follow her to the new location. What are my ethical obligations?
|
A
|
|---|
In this case, you may have both legal and ethical considerations.
Legally, some issues you and your ex-employee may address include noncompete agreements, the Health Insurance Portability and Accountability Act, patient notice, transfer of record requirements, potential interference with business relationship issues or contractual matters. For these issues, you should consult an attorney who is familiar with your state’s dental practice act and employment law. Resolution of these issues will be between you, your ex-employee and, perhaps, the courts.
The principle of autonomy provides that "the dentist has a duty to respect the patient’s rights to self-determination and confidentiality." Advisory Opinion 1.B.1 addresses patient records as follows:
"A dentist has the ethical obligation on request of either the patient or the patient’s new dentist to furnish in accordance with applicable law, either gratuitously or for nominal cost, such dental records or copies or summaries of them, including dental X-rays or copies of them, as will be beneficial for the future treatment of that patient. This obligation exists whether or not the patient’s account is paid in full."
The principles of veracity and justice impose on members of our profession a requirement of truthfulness and fair dealing. Try putting yourself in the patients’ and the ex-employee dentist’s shoes and deal honestly with questions such as these:
- – Is it fair and honest to schedule patients for their recall appointments and imply (by omission) that the ex-employee still is there and still will be treating them?
- – Is it fair and honest to treat and charge patients or deplete insurance benefits before informing patients that someone else will be their treating dentist?
- – Is it truthful to leave the former employee’s name on letterheads, signs and other advertising after she has gone? (See Advisory Opinion 5.G.1 of the ADA Code.)
- – Is it fair to delay the transfer of prior treatment records? Will this delay needed treatment that the patient expects from your ex-employee?
- – Do you have a right to coerce a patient to receive treatment from a certain dentist or facility?
And as ego-diminishing as it may be, always remember that dentists do not have patients—patients have dentists. Ultimately, it’s what’s right for them that must dictate our actions.
Noncompete clauses commonly are included in dentist employment agreements. Such clauses can be helpful in protecting an employer from the deleterious economic effects of an employee’s departure. Generally, courts will enforce noncompete covenants as long as the clause is narrowly tailored to protect the employer’s practice sensibly and does not unreasonably prevent the departing employee from earning a living. Dentists who have entered into covenants not to compete may be ethically challenged to reconcile their contractual obligations with the ethical duties they owe to their patients.
TOP
Q
A
