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Peer Review Committees Ensure Quality Care for Patients
Be a Discriminating Consumer!
Virtually all ethical and conscientious dentists are members of the highly respected American Dental Association. While this in and of itself does not ensure quality care, the knowledgeable consumer is afforded some measure of protection against unacceptable dentistry.
State licensing boards customarily take action against health care providers who grossly violate standards of practice (usually related to illegal drug, fraudulent activities or sexual misconduct). Often understaffed and described as "paper tigers," consumer protection agencies often fail to provide appropriate safeguards when conflicts arise in the delivery of health care.
Fortunately, a little-known service is provided by most local components of the American Dental Association that fills this void, by providing patient, dentist or third party insurance carriers a means of amicable resolution of seemingly impossible problems. “Active Peer Review Committees” are staffed by volunteer dentists and offer professional, ethical and exceptionally fair arbitration of disputes that might otherwise wind up in court. The inquiries are always conducted according to very strict guidelines to assure reasonable and equitable solutions. Peer review committees pride themselves on confidentiality and the maintenance of good patient/doctor communications.
The dental society is quite responsive to consumer concerns and the quality of patient care.
Initiation of a Peer Review Inquiry
A fairly simple form may be obtained from the local component of the American Dental Association. You may call (800) 621-8099 for the society in your area.
Present your concerns and offer a resolution that seems fair. The committee addresses inquiries that range from the quality of care to insurance coverage conflicts.
The inquiry will be evaluated for appropriate action or referral (e.g., an ethics violation) and an appointment made for an examination by a minimum of three impartial dentists. You will be given an opportunity to express your concerns in a relaxed setting. You will not see or need to confront the dentist. No decision will be made at that time.
The peer review committee will examine all pertinent information and records, later affording the dentist an opportunity to present his standard of care.
After a review of the proceeding is made by the central committee to insure that all procedures were carefully observed, a notification will be sent to all parties.
If the committee determines that the standard of care was not rendered, it will order that a refund be made, or payment for corrective treatment, if necessary. Dentists must comply with the decision, or risk disciplinary action. Matters of inconvenience, lost time or wages or "pain and suffering" are not considered in the decision.
Avoiding Conflicts
Naturally, the avoidance of conflicts is best made by prevention. Determine a clear and concise understanding of your dental treatment program, scheduling, insurance benefits (if available) and financial responsibility. Good communication is most essential to the patient/doctor relationship.
Choosing a Dentist
For optimal dental health, it is important to have a family dentist who takes a sincere and personal interest in the patient's general health and well being. It makes sense to select and become acquainted with a dentist before a dental emergency arises.
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