It was not my intent to offend the readers by emphasizing the professional over the commercial aspects of marketing, and their application to busyness. It is unfortunate, but some dentists, in slower times, do tend to over-diagnose and oversell in an effort to cover expenses and maintain their lifestyle. Let me try to clarify a few points presented by the Advisory Opinions that are part of our Principles of Ethics and Code of Professional Conduct that I was trying to paraphrase regarding your issues. The Advisory Opinions are readily available on ADA.org at "www.ada.org/prof/prac/law/code/principles.asp".
The question of awarding gifts (flowers, gift certificates) for the referral of patients can be tricky, and, depending on the circumstances, these practices could be construed as either OK or as fee splitting. The main difference is the perceived expectation the dentist creates in the mind of the patient when he or she awards a gift for the referral of those patients. If the gift itself is not the reason for the referral, I do not think it is likely to be viewed as a form of fee splitting. On the other hand, if the dentist encourages referrals by promoting the awarding of gifts—meal vouchers or cash reductions on dental bills, etc.—then I think it may be crossing the line.
Having a column ghostwritten raises some issues also. Here again, is the perception created in the public’s mind misleading? Does the use of someone else’s words and ideas smack of plagiarism? Does the article give the public the impression that the dentist has more specialized knowledge than others (which may or may not be the case)? Disclosing the source of the article seems to be the best action to take, to avoid any possible misunderstanding by the reader. Doing so in a positive manner could go a long way toward both informing the public and preserving our image as professionals.
I personally still have a passion for practicing dentistry—and trust myself to cease practicing before I lose that passion. I thoroughly enjoy going to work in my 4
-year-old office. I still enjoy learning, taking classes and attending study clubs. And I incorporate new technology when I feel it will benefit the care of the patients who seek care from my team.
Competition can take many forms, including quality, as Dr. Knudson suggests. But oftentimes competition results in lower prices or, in our profession, reduced fees. Raising quality while lowering costs is difficult to achieve in any field, and I believe this holds true in dentistry as well. It is also true that not all individuals value their health as much as material items, and they never will. Part of our challenge as professionals is to educate our patients so that they may begin to see the benefit of investing in their oral health before, or at least in addition to, purchasing the latest competitively made electronic gadget. That, however, must still be their choice.
