[Music] this video is sponsored by bootcamp.com check it out for iron bde prep and use coupon code mental dental for 10 off hey everyone dr ryan here and welcome back to our ethics video series in this video we're going to talk about veracity so veracity is the fifth and final principle of ethics that we'll discuss and it's also referred to as truthfulness so under this principle the dentist's primary obligation is to be honest in their dealings with people and this includes communicating truthfully and without deception in order to respect the position of trust inherent in the dentist patient relationship and i will warn you this is the longest principle of ethics in the ada code but like always i'll try to break it down for you as best as i can so the first code of professional conduct for veracity is representation of care so this is saying that dentists shall not represent the care being rendered to their patients in a false or misleading manner and one example of this is explained in the first advisory opinion telling a patient that their silver amalgam fillings should be replaced because they're toxic is unethical because that's not what the data suggests amalgam has some shortcomings yes but based on current scientific evidence it's not toxic to patients the same goes for any dental material like porcelain gold glass ionomer composite if a restoration is failing or a tooth is cracking then there's good reason to replace something but just because the patient has metal in their mouth isn't reason enough to replace them unless the patient has an allergy or aesthetic concerns by the way this one does come up on the board exam quite frequently so definitely be ready for that and then the second advisory opinion under representation of care basically says that you can't make any claims about diagnosis or treatment that are not backed up by evidence so you can't say that fixing your smile with braces will magically heal all of your tmd symptoms or placing crowns on all your teeth will prevent you from ever getting cavities again or replacing your teeth with implants will guarantee you never have any gum disease ever again you get the idea those would be unsubstantiated claims all right get ready for a big one similar to the previous code of professional conduct dentists shall not represent the fees being charged to their patients in a false or misleading manner and there's a bunch of advisory opinions as you can see to give us plenty of examples of this the first one is waiving co-payments this one's kind of confusing but bear with me let's say the dentist does a 500 crown procedure the insurance company only covers 400 so the dentist decides to waive the copayment of a hundred dollars for the patient so it's essentially free for the patient but they lie to the insurance and pretend that that patient paid the copayment although the dentist loses that co-payment the patient is very motivated to go ahead and get the crown because they didn't have to pay anything out of their pocket and the dentist still gets the bulk of the reimbursement at four hundred dollars over billing is the second one and that would be unethical to increase a fee to a patient just because they're covered by a dental benefits plan so you can't pick and choose patients to charge more than you typically would we have to submit the correct fee to the insurance company as well so the third advisory opinion here is called fee differential and basically what it's saying is however much you decide to charge someone without any dental benefits what your out-of-pocket fee would typically be is considered your full fee and that's what you must represent to all dental benefits programs you cannot alter that amount for the purposes of your fee representation similarly the fourth advisory opinion says you must submit the correct treatment date to the insurance company so if someone's dental plan expired already you can't back date a procedure to help out the patient also you have to submit the correct dental procedure that's the fifth advisory opinion so if you did something that's not covered under a dental benefits plan you can't lie and say you did something similar that is covered under that plan to try to help the patient out you get the idea and then the last one is really important for the board exam and can come up in several cases it's unethical to recommend or perform unnecessary dental services or procedures now while autonomy was all about informing the patient about your diagnosis and your treatment plan and respecting their wishes after having been informed veracity comes into play when the dentist actually recommends and performs treatment so if you recommend that the patient get fillings on a bunch of teeth that have these little tiny incipient carious lesions because you tell them otherwise they could lose all their teeth that would be a violation of veracity you would be recommending something that is completely unnecessary so the takeaway for this entire slide is you don't try to steal money from patients or insurance companies and don't try to make your fees seem lower than they actually are to attract patients to see you all right this next one i've also seen come up on exams and thankfully it's very straightforward if a dentist is presenting information in an article or a seminar on let's say invisalign if they're endorsed and getting paid by invisalign to give that talk or to write that article they would have to disclose that as part of that presentation all right the main idea with this code of professional conduct is to use drugs and dental devices that are proven and safe to use in the dental profession probably the most important part of this whole slide is the first advisory opinion because i've seen this appear on the board exam word for word if you suspect an adverse reaction to a drug or a dental device you would have to communicate that to the fda and that is the food and drug administration the second advisory opinion here states that dentists should not force their patients to buy certain products if there's a financial incentive there for example maybe a dentist has a bunch of electric toothbrushes that they bought at a good price and they're selling them to patients for a slight markup there's nothing wrong with that in theory but you can't tell patients that this is the best toothbrush ever made and you'll never get cavities again if you use this toothbrush in other words you can't misrepresent a product just because you're selling it all right we'll kind of skip through this one because it's covered a lot in the next code but you want to represent your training and your competence to the public truthfully false or misleading is basically means you cannot misrepresent facts or omit facts in a way that might mislead the public alright here's another big one advertising so there's nothing unethical about advertising or promoting your brand on social media in tv commercials all of that's absolutely fine but it must be done truthfully and honestly in the vein of veracity for example you can't fund or publish an article on dental health and then trick the public and trick the readers of that article to use the services of the sponsoring dentist you also can't advertise that you're better than other dentists any subjective statements like that are unethical you shouldn't use unearned academic degrees that means awarded by an educational institution that's not accredited or non-health degrees in your advertisements the next one is referral services and referral services are absolutely okay to use basically you pay some annual or monthly fee to be listed in a search engine if patients or even doctors are looking for a dentist or a specific specialist some commercial referral services though advertise that there's no charge for the use of their service and they paint themselves as this kind of free public service but they ask the dentist for a payment based on how many patients are referred to them with their service so this would be lying to the public and a violation of veracity so just be careful about how you're paying that referral service the next one has to do with test results so an advertisement to the public of hiv negative test results conveniently leaves out the fact that that does not guarantee you are currently free of hiv so you just have to disclose that to the public if you got hiv negative test results you'd also have to include that does not guarantee i don't presently have the hiv virus and the last one has to do with seo which is search engine optimization so basically you can't hide keywords on your website that attract a wider audience if those keywords have nothing to do with your practice and your credentials so the overarching idea for this slide is you can't try to attract more patients to your practice on the basis of partial truths or spinning your words in order to appear more favorable all right the name of your practice so since the name under which a dentist conducts their practice can be a factor in the patient selecting that practice it must be truthful for instance you cannot call yourself lakeview endodontics if there are no endodontists in that practice and we'll talk more about that in the next slide an important point here use of the name of a dentist who is no longer actively associated with that practice may be continued for a period not to exceed one year so some practices do this because the previous dentist built up this great reputation over the last several decades but you can only leave their name on the building and attached to the practice for a one year grace period after they leave after that point you need to post a sign or send a letter to the public that that dentist is no longer practicing with you all right specialization and limitation of practice so it's absolutely fine for a dentist to do root canal treatments to do extractions all that's fine however you cannot announce yourself as an endodontist or as an oral surgeon and make the public believe that specialty services are being rendered in that office by qualified specialists when that's not the case the same is true for a dual degreed dentist practicing medicine if you have a valid state license and you're offering both services then great you can absolutely advertise yourself that way also you can only announce a specialty that you have an advanced degree in and that's recognized as a specialty area by the national commission on recognition of dental specialties and certifying boards that's quite the mouthful in the jurisdiction in which you're practicing otherwise you would have to outright specify that your specialty is not recognized as an official specialty area all right in the very last one of veracity i promise this code of professional conduct is almost identical to the last one so we'll go through it quickly once again to really hammer this home general dentists who wish to announce the services they provide can do so as long as it's clear the services are being provided by general dentists and not by specialists you also cannot call yourself a diplomate that's the highest award within a specialty without having the proper credentials and the use of abbreviations to designate credentials should be avoided when such use would lead the reasonable person to believe that it's something that represents a higher academic status or some higher fellowship so basically don't try to make yourself seem cooler than you really are it all goes back to telling the truth and being honest to the public so a summary of veracity you cannot remove any good dental material like amalgam unless it's clear that that filling is failing you cannot do unnecessary treatment you have to disclose conflicts of interest you should report adverse reactions to the fda you should advertise honestly not claiming specialty if you're not a specialist you have a one-year grace period for a retiring dentist before you have to remove their name from the practice and send notice to the patients and the public and you can't claim an unearned specialty diplomate or fellowship status that's it for this video thank you so much for watching please like this video if you enjoyed it and subscribe to this channel for much more on dentistry if you'd like to support me please check out my patreon page and thank you to all of my patrons for their support you can unlock access to my video slides to take notes on and practice questions for the board exams so go check that out the link is in the description thanks again for watching everyone i'll see you in the next video [Music] you