Congratulations to Dr. Harvey S. Nisselson for his excellent June JADA Ethical Moment, "What Ethical Considerations Are Involved in Offering Introductory Discounts to Attract New Patients?" (JADA 2008;139[6]:769–771). His column balances the rights and autonomy of individual dentists with the reputation and integrity of the dental profession.
Ethical dentists who advertise must agree to pay a certain fee in advance of a particular "job," regardless of how much new business it attracts. Advertising companies may offer to prepare an ad campaign (design coupons, lay out photos and text) and/or "run" it via mail, radio, TV, etc., for no money down, but then demand a certain dollar amount for each new customer or percentage of sales generated. However, such "percentage contracts" for advertising by doctors were found illegal in Illinois, New York and Florida for physicians and chiropractors. Courts said percentage contracts amounted to "fee-splitting" and were illegal under state medical practice acts.1
These comments are meant to supplement Dr. Nisselsons fine Ethical Moment column and remind JADA readers that fee-splitting is unethical and often camouflaged.