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Navigating ethical dilemmas October 2018, Volume XXII, Number 4 as a new dentist Getting to Know You s it ethical to date a patient? What are the ethical Because of this caller, along with additional research and Why dentistry? My implications of using social coupons to expand my patient analysis, CEBJA proposed a resolution to the ADA House of father is a dentist Ibase? What should I do when I suspect a patient may be Delegates to replace “sex” with “gender, sexual orientation so I’ve always been abusing prescription drugs? Are you caught between a rock and gender identity.” The ADA Board of Trustees voted exposed to the and a hard place? unanimously to approve Resolution 6. It later passed in the profession, but There are always things that come up that make us do a ADA House of Delegates meeting in Atlanta. throughout most gut check,” said Dr. Lindsay M. Compton, member of the In addition to the hotline, CEBJA contributes a series of my life, I actually ADA New Dentist Committee and its new dentist member of articles discussing ethical dilemmas confronted in the wanted to be anything to the Council on Ethics, Bylaws and Judicial Affairs, or practice of dentistry to the Journal of the American Dental but a dentist. I knew I CEBJA. “Especially as new dentists, we’re still trying to fi gure Association. The articles are vignettes on ethics-based wanted to go into the things out.” situation and the appropriate manner to resolve them using health profession, and In the early years after dental school, Dr. Compton the code of ethics. I was extremely skilled said she shadowed in with my hands since several offi ces that she I was little. Dentistry respected and admired. ended up being the “However, I could tell Evaluate Think How many perfect match for Dr. Yige Zhao, an that employment wasn’t my interests and the facts. about the principles associate dentist in San always based on skill and strengths. conflict apply? Diego, and her husband, marketing tactics were more prioritized than Justin, stand at the top Why are you an ADA presented. patient care,” she said. of Observation Point at member? It is crucial Although ADA Zion National Park this for our profession resources are not summer. to have a voice in times of change. replacements for legal E T H I C S On top of all the tangible membership benefi ts resources and legal they offer, the advocacy that the ADA does on advice, they offer behalf of dentists is tremendous. Having lobbied member dentists, in Washington, D.C., as a student, I know how especially new dentists, important it is to speak to legislators to get what a service to help Identify Compare Select the we want. Having the membership count to back navigate and resolve applicable different best option ethical dilemmas. up the organization gives us a louder unifi ed codes and options. under the voice. These services include the ADA Ethics Hotline code sections. circumstances. What was your fi rst job? My fi rst job was at (1-800-621-8099), Subway. My offi cial job title was “sandwich which is designed artist.” I worked there for all of high school and to assist dentists during my college breaks. Ten years later I’ve just in managing ethical become a different type of artist, a tooth artist! challenges that may arise in day-to-day practice. Ethical dilemmas covered this year include: How to What has been the best time of your career A joint venture with the New Dentist Committee and ethically handle a patient who insists on making treatment so far? The best time of my career is honestly CEBJA, the hotline launched in February 2013 and is decisions based on incomplete, inaccurate or wrong right now. I’m grateful every day for our move available to member dentists. Members with ethics related information; should I be calling in sick?; and the ethics of to San Diego because it allowed me to pursue questions are matched with a CEBJA member who will using live patients for licensing board examinations. a lifestyle I thrive in. Working four days without provide consultation regarding the ethical issue being “Many of these scenarios are very topical for new the headaches of practice ownership allows me raised, while using the ADA Principles of Ethics and Code of dentists,” Dr. Compton said. “We encounter ethical to enjoy other aspects of my life stress-free. Professional Conduct as a guide. dilemmas every single day. I eventually want to own my practice but am “I will say that the number one reason to use the hotline “We’re always giving patients options, weighing risks and currently enjoying every day in the moment is that it’s anonymous,” Dr. Compton said. “As new dentists, rewards and ensuring we’re doing no harm. It never hurts to and learning as much as I can to prepare for the we think that if we ask a question out loud, will we sound ask. Having health conversations about ethics and ethical future. stupid? We feel everyone knows the answer but us. But dilemmas are always better than making assumptions.” sometimes, we just need to talk to somebody about it. To read JADA ethical moment When I’m not practicing, I’m: At the beach with That’s what makes the hotline a great resource.” articles, visit ADA.org and search my two dogs, bottle-feeding and snuggling foster In 2017, a hotline caller raised an issue with Section 4.A. “JADA Ethical Moments.” kittens or traveling with my husband. I also love of the ADA Code of Ethics, stating that it didn’t seem broad To contact the ADA Ethics Hotline, health and fi tness so you can often fi nd me at the enough to cover a patient’s gender identity and sexual call 1-800-621-8099. In addition, gym or in the kitchen. Last but not least I love orientation. the ADA Success program offers a arts and crafts, from calligraphy to water color to Previously, Section 4.A. of the code, which deals with module on Leadership and Ethics in customized gifts. I’m always working on a project! patient selection, provided guidance to dentists to “not Dentistry, which is available for free to One fun fact about me: I speak three languages: refuse to accept patients into their practice or deny dental dental schools and residencies, as well English, Chinese (Mandarin) and Japanese. service to patients because of the patient’s race, creed, as other venues if it is of interest. Sign color, sex or national origin.” Dr. Compton up at ADA.org/successprograms.

ADA New Dentist News is prepared by the ADA New Dentist Committee Top fi ve dental benefi t concerns of new dentists

ew dentists may have many Want more new Nconcerns when it comes to their patients’ dental plans, benefi ts and third- dentist resources? party payers, often because little of For more information about their dental school education relates to other ADA resources especially learning how to navigate these issues. for new practitioners visit Among the concerns are pre- ADA.org/newdentist or reach authorization requirements, delays in out to the ADA New Dentist processing claims, claim denials, refund Committee offi ce at requests and the lack of assignment of 1-800-621-8099 or by benefi ts to nonparticipating dentists. email at [email protected] Staff of the Center for Dental Benefi ts, Coding and Quality within the ADA Practice Institute continually receive and address a variety of dental claim Disclaimer submission and adjudication questions from member dentists and practice This publication of the American staff. While many times there are Dental Association is offered as unique concerns, there are often similar information only and does not questions — which the staff is happy to constitute practice, fi nancial, answer. accounting, legal or other The staff has come up with a list of professional advice. Persons the top fi ve concerns of dentists when it need to consult with their own comes to dental benefi ts, based on calls professional advisors for any received from dental offi ces. such advice. Reference herein to What follows is a brief description any products and/or services of of the top fi ve concerns, followed by a your staff on how to fi le a proper ADA Practice Institute to study how non-ADA resources is not to be resource that member dentists can turn appeal.” dentists could make the change in construed as an endorsement to for further help in those areas. Many • The related trio of bundling, their offi ces. “The ADA recognizes or approval by the American more resources are located at ADA.org/ downcoding and the least expensive that electronic funds is on the road Dental Association or any of its dentalbenefi ts, part of the ADA Center alternative treatment clause. to becoming the preferred payment subsidiaries, councils, commissions for Professional Success. • Coordination of benefi ts. “Increasingly, method of the future,” said Dr. Mark or bureaus, or of any state or The top fi ve concerns, in no particular the ADA receives calls from dentists Mihalo, chair of the council’s Coding local New Dentist Committee, of order, are: who want to know which plan is and Transactions Subcommittee. that product or service. Non-ADA • Provider contract issues. primary and want to know why the Staff from the Center for Dental resource manufacturers and service • Claim rejection. “I know that many secondary carrier refused to pay or Benefi ts, Coding and Quality can help providers are solely responsible for dental offi ces do not take the time paid very little,” said Dr. Snyder. “Calls new as well as more experienced the products and/or services they to appeal denied claims, and that’s on coordination of benefi ts are some dentists with their dental benefi t- provide. ADA is not responsible in unfortunate,” said Dr. Steve Snyder, of the most frequent calls staff at the related problems, questions and any way for any representation or chair of the Council on Dental Benefi t ADA receive on dental benefi ts issues.” concerns. The ADA Third-Party Payer warranty, guarantee or any claims Programs. “My recommendation is • Electronic fund transfers. The switch Concierge, a service of the center, can which may arise from the products that if you have a claim that you think to electronic reimbursement by some be reached at 1-800-621-8099 or at or services. The ADA specifi cally should be paid, take the time to teach third-party payers has prompted the dentalbenefi [email protected]. disclaims any and all liability for damages arising out of the use of the services or products, including special and consequential damages, expenses, or other claims or costs. Get involved with ADA dental standards development

New dentists who may in the Navy Dental Corps who graduated 100 national not have a lot of time but last year with a master’s degree in standards and are interested in getting oral and maxillofacial radiology from more are under more involved with The University of North Carolina at development. Sponsor the ADA may want to Chapel Hill School of Dentistry, said any Development consider joining a dental dentist has the expertise to be valuable of standards is an standards working group. participant in standards development. often-overlooked Wells Fargo Practice Finance The American National Standards “Working groups need all levels of ADA member is the exclusive corporate sponsor of Institute, or ANSI, accredits the ADA to experience to develop standards and benefi t. develop dental standards and technical technical reports that will have maximum “The ADA’s ADA New Dentist News. Dr. Kurzweg reports for products and information impact across the dental community Standards technology used by the dental profession and, especially in the case of technical Program establishes how dental products and consumers. The bottom line: these reports, are written in a way in which and technologies are made both in the standards and reports help ensure new dentists can appreciate,” she said. United States and internationally,” said safety and quality for providers and for Topics of standards and technical Dr. Kurzweg. patients. reports vary widely and include subjects Volunteering can be rewarding, she Dr. Brittany Kurzweg, a 2011 like secure electronic communication of said. University of Florida College of Dentistry health information, oral rinses and pit “You will develop skills as a leader, graduate, joined a standards working and fi ssure sealants. Participants choose provide valuable input on what clinicians Wells Fargo Practice Finance group last year after her research was the topic areas that are of interest to need for the products in their dental recognized with the 2017 Robert H. them. offi ces and collaborate with technical 2000 Powell Street Ahlstrom New Investigator Award for Volunteers review and comment on experts,” Dr. Kurzweg said. “Participation Emeryville, CA 94608 Dental Informatics. This annual award draft standards electronically; in-person will also allow dentists to develop as from the ADA is designed to encourage meetings are not required. Standards can professionals beyond dental school and wellsfargo.com/dentist dentists and dental students to take one to three years to complete and residency training.” conduct standards-based research and there are often several reviews required For more information on participating © 2018 American Dental Association participate in standards development. during this development period. in ADA standards committee working Dr. Kurzweg, a Lieutenant Commander Currently, there are more than groups, visit ADA.org/dentalstandards. Military provides pathway to dentistry

r. Rob Peterson bore three years as an infantryman and two children. started dental school at the Dwitness to war and with the 101st Airborne Dr. Browning studied civil University at Buffalo School wonder during his career in Division Pathfinders on a team engineering at West Point, of Dental Medicine and was the Navy but when the time that helped scout places for graduating in 2000. He accepted into the Army’s 2017-2018 came for him to re-enlist, helicopters to land. In 2000 earned the Ranger tab, and Health Profession Scholarship the veteran nuclear operator he received a scholarship was stationed at Camp Casey Program. ADA New Dentist opted for dental school to become an officer. While in South Korea on 9/11. He “My four years of dental Committee instead. completing his undergraduate deployed to the Middle East in school were filled with ups “I told my counselor my degree at Grand Canyon 2003 where his unit, the 3rd and downs but every step of Chair n plan was to return to college University, he discovered Infantry Division, spearheaded the way I was happy with the District 3 PA to ultimately earn a D.D.S. dentistry and went on to the invasion of Baghdad. career choice I had made,” Nipa Thakkar, D.M.D. degree,” recalled Dr. Peterson, graduate from the University Two deployments to Iraq said Dr. Gilroy, who became [email protected] who served six years of active of the Pacific, Arthur A. followed. Following his third a father in dental school duty and spent time in Desert Dugoni School of Dentistry. deployment, he decided to when he and his wife had two Vice-Chair n Storm. “He told me, ‘You will He has been serving as serve in a different capacity. In children. District 12 LA, AR, KS, OK be 40 years old before you get a dental corps officer since 2008 he entered the School After 20 years as an Raymond A. Jarvis, D.D.S. done with school. I told him, of Dentistry at aviator in the Navy and Naval [email protected] ‘I’m going to be 40 anyway.’ “ the University Reserves, Dr. Gail Tischke So began his journey back of Alabama at switched her career focus to Committee Members n to school. After receiving an Birmingham, dentistry when she enrolled District 1 CT, MA, ME, NH, RI, VT honorable discharge in March graduating in at the University of Illinois Andrea C. Fallon, D.M.D. 1995, Dr. Peterson began 2012. Chicago School of Dentistry at [email protected] taking classes part-time as “Dentistry the age of 43. n he juggled family and school intrigued me even Her military service District 2 NY and paying the bills. For 13 as a child, but it began with Aviation Officer Lauren E. Vitkus, D.D.S. years, he balanced the three was something Candidate School. From there [email protected] until graduating in 2008 — I never pursued she completed flight school, n two weeks before his 41st Dr. Peterson Dr. Marrs earned her Naval Aviator District 4 DE, DC, MD, NJ, PR, VI, birthday. “Wings” and became a carrier Federal Dental Services The Navy turned out to be pilot. She did two six-month Michael Saba, D.M.D. an ideal training background deployments on the USS John [email protected] for dentistry, said Dr. F. Kennedy and USS George n Peterson, now a general Washington before working District 5 AL, GA, MS dentist in Corning, Iowa. He as a station pilot in Key West, Britany F. Matin, D.M.D. described nuke school — as Florida, and becoming an [email protected] it’s called — as being the intermediate jet instructor. n equivalent of 35 semester While at UIC, she District 6 KY, MO, TN, WV hours in what was considered transferred her commission Emily A. Mattingly, D.D.S. graduate level physics, Dr. Browning Dr. Gilroy Dr. Tischke to the National Guard and [email protected] materials and reactor theory spent three years as a student n classes. 2010 and couldn’t imagine not until I discovered I could recruiter. After graduation, District 7 OH, IN “The Navy has a distinct being in the armed forces. continue my military service as she remained in the National Lauren M. Czerniak, D.D.S. advantage over college in “It was a privilege to serve a dentist,” said Dr. Browning, Guard Reserves before [email protected] that they can essentially with a bunch of dedicated who also spent two years in an retiring in December 2012 n force you to learn,” he said. and amazing soldiers, some Army Advanced Education in with 24 years of total military District 8 IL “This is done by placing you of whom paid the ultimate General Dentistry Residency. service. She is currently an Benjamin C. Youel, D.D.S. in an environment where you sacrifice in the wars in He is currently the chief dental endodontics resident at UIC. [email protected] only have access to course Afghanistan and Iraq. It truly officer of the 257th Dental “It’s always a challenge n material and by the way it is was a formative period of my Company at Fort Bragg, North changing careers, but I had the District 9 MI, WI all classified so you can not life that I look on with pride,” Carolina. full backing and support of my Colleen Greene, D.M.D. [email protected] take it from the room. This said Dr. McDaniel, now an Dr. Paul Gilroy enlisted in husband and all four kids,” said situation was what made endodontist mentor in Fort the Army directly after high Dr. Tischke, whose husband n me believe I could complete Bragg, North Carolina. school. During this time he is also a retired naval aviator. District 10 IA, MN, NE, ND, SD Sara E. Stuefen, D.D.S. the schooling necessary to Both Drs. Jeff Marrs and deployed twice to Iraq — once “The hardest part was getting [email protected] become a dentist.” Michael Browning attended in 2005 and again in 2007. through the first semester His experience in working the U.S. Military Academy He also went to Airborne because we went through n with teams also factored in. at West Point and were School, Air Assault School and three nannies. During that District 11 AK, ID, MT, OR, WA “The thing most stressed to commissioned as infantry received sniper training. first winter break we found Brittany T. Dean, D.D.S. us in the nuke program was officers before deciding to “My decision to leave the the best nanny ever and he [email protected] integrity,” said Dr. Peterson, become Army dentists. Army was based purely on became family. He’s still family n who married his high school “My desire to become the fact that I was so young to us today.” District 13 CA sweetheart, Lea Anne, and a dentist stems from my and had the GI Bill to use for Like Dr. Peterson, Jonathan Pascarella, D.D.S. has two children. “The idea deployment experiences to education. I never considered she credits her military [email protected] of doing the correct action Iraq and Afghanistan, and dentistry as a career. I had background with influencing n in absence of any witness. specifically, from the basic actually thought I might go in everything she does in life, District 14 AZ, CO, HI, NV, NM, UT, WY This could not relate better to need for dental care by the to medicine like my brother,” including dentistry. Lindsay M. Compton, D.D.S. dentistry. Of course the rigors men and women with whom said Dr. Gilroy, now stationed “The part that applies the [email protected] of military training all come I served,” said Dr. Marrs, who at Fort Sam Houston in San most to dentistry is being n with recognition of structure graduated from UT Health San Antonio. He also has additional organized and planning ahead District 15 TX within a system and the need Antonio School of Dentistry duties working for the Dental to make sure things get done Adam C. Shisler, D.D.S. to develop courtesy in dealing in 2017 with distinction Corps Chief’s Office as the when they need to get done [email protected] with others. The bond I made and recently completed an executive fellow. and in the manner that they n with my shipmates is not Advanced Education in General During a shadowing need to get done — I use District 16 NC, SC, VA unlike the bond I have with Dentistry residency program. experience at the Syracuse, checklists. Those skills were Daniel W. Hall, D.M.D. some of my dental school He is now a general dentist New York, VA Hospital, he essential in getting through [email protected] classmates.” stationed at Joint Base Lewis- came across an oral surgeon dental school with four kids District 17 n FL Army veteran Dr. Jason McChord in Washington, along in the operating room, which at home and an airline pilot Robin M. Nguyen, D.D.S. McDaniel can relate. with his wife, Esmeralda, an led to him shadowing general husband and they apply again Prior to undergrad, he spent Army Medical Corps officer, practice dentists. In 2013, he as an endo resident.” [email protected] Alabama dentist details challenges of motherhood, solo practice

r. Britany Matin’s each day. Getting the hang Dmaternity leave was a of breastfeeding while at 10 Under 10 Awards little unorthodox. While most home and pumping at work acknowledge new moms take at least six was also a struggle, she said. weeks off after having a But the hardest part, dentistry’s rising stars baby, Dr. Matin was back Dr. Matin said, was finding The American Dental Association to work two weeks after a babysitter to watch her is looking for new dentists who are giving birth. It was admittedly son during the day while already making a difference in the field quick, but the 32-year-old she worked. She ultimately to nominate them for the 10 Under 10 periodontist didn’t feel she turned to Care.com and was Awards. had a choice. able to interview candidates. Nominees must be active members Dr. Matin opened her “That’s the hardest part: of the American Dental Association Auburn practice from scratch leaving your two-week-old and graduated dental school between in 2015 and with few with someone you don’t the years of 2009 and 2018. Those periodontists in her area, let know,” Dr. Matin said. nominated should display excellences alone the state of Alabama, She’s also navigating a in areas such as philanthropy, science, there wasn’t anybody to good portion of her days Dr. Britany Matin smiles with her husband, Dr. Luis Guzman, and their son, leadership and advocacy. The deadline cover her patients for an solo. Dr. Matin’s husband, Luke Armour Guzman. for nominations is December 31, extended period of time. Dr. Luis Guzman, a duel 2018, and winners are announced in She didn’t want to leave her I were to have to be on bed rest, I don’t trained periodontist and spring 2019. The winners also receive patients in the lurch, so she came back know what we would have done. A lot of prosthodontist, is finishing up dental a $1,000 gift card. to work earlier than the average working disability insurance policies don’t cover school at the University of Alabama The 2018 winners will be invited mom might. that. I don’t know how the practice in Birmingham and drives two hours to accept their awards at the New Dr. Matin is among many dentist would have stayed open. We would have each way to school each day. Once he Dentist Conference at ADA 2019 moms — and working mothers in lost a lot of income. That’s something graduates in 2019, Dr. Guzman will join — America’s Dental Meeting, in San general — who struggle with balancing that people don’t talk about but it’s his wife’s practice. Francisco. their family and professional lives. And scary.” As if having a 9-month-old and a For more information and to submit the balancing act started when she was Dr. Matin worked up until a week husband gone for most of the day isn’t a nomination visit pregnant. before she delivered her son, Luke enough, Dr. Matin is also opening up a ADA.org/10Under10. “Early on with your first child, you Armour Guzman, in early January; a second practice in Columbus, Georgia, don’t know what to expect,” Dr. Matin busy time for most dental practices with about 30 minutes away from her current said. “There are so many changes with patients rushing to use the remainder of office. This one has a nursery. your body.” their benefits for the year. Despite the challenges of being She was lucky not to have any Since she’s a solo practitioner, Dr. tired and managing her family and her ADA Engage gets complications that forced her to stop Matin closed her practice for two weeks practice, Dr. Matin said she feels very members involved in working, but it was something always on after Luke was born. She allowed herself fulfilled as a mother and a dentist. her mind. a shortened schedule the first four “It is work and something that all legislative action “One of the hardest things is figuring weeks back; working 10 a.m.-3 p.m. working moms struggle with, but it is the Are you interested in staying updated out what to do if something were to every day. best thing I have ever done,” Dr. Matin on decisions made in Washington, D.C., happen during the pregnancy that would Being up multiple times a night with said. “I would do it all over again, and that affect the dental profession? The have forced me to go on bed rest,” Dr. Luke, she wanted her mornings free to I will hopefully be doing it again, God ADA Legislative Action Center created Matin said. “Being the sole practitioner, if get into a routine before going to work willing.” the website ADA Engage to inform members about governmental action and get them involved. Visiting ADA Engage offers members the opportunity to subscribe to ADA Action Alerts that will keep them connected to legislators and up-to- date in public policy issues. To get involved, visit ADA.org/engage.

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