October 6, 2015
Question:

Jennifer,

I am curious about your response to this doctor. (From Thursday's newsletter)

As far as my understanding goes, it is illegal for a certified dental assistant to fabricate a denture for a patient. I believe this treatment goes way beyond what the law allows. To me, this is a much more serious problem than billing or fraud issues. For a licensed dentist to allow a non-licensed dental assistant to be performing as a dentist in his facility, I would assume that OPD would have the ability to take away his license and fine him heavily.  

In addition, if the patient were to sue the office for malpractice, the doctor would be ultimately responsible. I assume that he would have no defense and would lose the case outright.  

Thoughts?

Thanks,
Dr. C

Answer:
 
Dr. C, Thank you for the follow up!  Yes, it seems I missed a glaring question at the start of my assessment on Thursday - is the individual rendering services authorized to perform such a service????  If not, that person would be engaging in the unauthorized practice, which would impute liability to the "supervising" practitioner for - aiding the unauthorized practice of dentistry - as it is here.  Now, I am not a doctor.  I do not take on the responsibility of knowing what services are appropriate or not for lower level licensees.  With PAs and nurses, the rules are they are authorized to provide those services the supervising practitioner believes them capable of.  Unlicensed individuals by law are not authorized to treat, diagnose (basically touch) a patient. 

If the fact pattern presented on Thursday amounted to an unlicensed person essentially practicing dentistry, yes, we have a whole other bag of worms to consider, with additional ramifications potentially being loss of licensure, malpractice exposure (which you may have without proper consent even if the individual is licensed but not identified properly).  

To address defensibility - here we have a supervising doctor claiming knew knowledge of his/her name being used to cloak services rendered by an alleged unlicensed person.  This activity would be fraud as against the practitioner.  This is actionable and reportable to licensure, and criminal.  If the claims are true, immediate steps should be taken to show the practitioner acted as soon as the truth was uncovered - and the paper trail of such actions would be this practitioner's defense to his/her involvement. 

Dr. C, thanks again. 

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