Let’s set the scene: you’re looking for a new job and you land a working interview at what seems like the perfect practice. Not only is it close to home, but it also boasts state-of-the-art technology and an ideal salary. You start the working interview and see that everything is not as it seems. It has 30-minute recare intervals and one-hour full-mouth nonsurgical periodontal appointments—questionable, but you go with it.
The big hit? They cut polish paste in half to cut costs.
Deep down, you know that insufficient appointment times could compromise the quality of care you provide, and you also know that cutting sealed polish paste is a safety issue and poses cross-contamination risks for patients. The practice manager says the paste is covered in the drawer, and they’ve been doing this for years.
At the end of the working interview, they offer you a position. You bring up the ideas of having more time to treat patients and reviewing infection control as a team, but they’re too set in their ways. Your values are being challenged for the sake of landing this job.
As a licensed health-care professional, you must to uphold strong morals and values, even in the face of professional challenges or pressures to be complacent. It can be tempting to turn a blind eye for the sake of landing or keeping a job. This could affect not just your license, but also patients' safety and health.
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Core values of dental hygienists
We all remember taking ethics and practice management courses in dental hygiene school, as well as the state law and ethics exam. As a reminder, here are the core values of our profession.
- Veracity: This means we are honest with our patient and others.
- Autonomy: We honor patients’ right to informed consent and full acknowledgement of treatment so they can make informed decisions about the care they’ll receive.
- Confidentiality: This means you keep the patient’s information private and do not disclose it to others without legal justification or permission.
- Societal trust: We should value that patients trust our care based on how we behave and approach their health needs.
- Beneficence: This is doing good unto others, including contributing to the well-being of our patients and the public.
- Justice: This is providing accessibility of high-quality health care to all, regardless of who they are, what they can afford, where they come from, etc.
- Nonmaleficence: We do no harm and avoid causing injury to patients.
These core values seem fairly easy to follow in theory, but how many horror stories have we heard from other hygienists who warn us to steer clear of working with “Dr. X”? And how often have we heard a hygienist tell a colleague, “That’s just how we do it here”?
Here’s something to consider: Is that how you truly want to practice?
Turn the tables
Revisiting the working interview, let’s identify the red flags: you know as a trained clinician that you need reasonable time to provide high-quality care to your patients, and 30 minutes is not enough. What corners will you cut to stay on time? Instead of completing periodontal charting, do you spot probe? Do you rush through the extraoral and intraoral assessment? Do you throw out the vital signs screening and medical history update?
Another red flag is cutting the polish paste in half. Regardless of whether you only use half when you perform selective polishing on a patient, the paste is a disposable, single-use, per-patient product. Dental hygienists are infection control experts, and we know better than to cut sealed products in half.
Perhaps these examples aren’t enough to convince you that this isn’t the right job for you. Put yourself in the patient’s position. Is what they don’t know not going to hurt them? How would you feel knowing a loved one is being mistreated by a licensed professional for the sake of money?
According to the policy manual for the California Dental Hygienists’ Association, dental hygienists believe that dental hygiene care is an essential part of a patient’s overall health, and that they are responsible for the actions and quality of care they provide.1 As such, it is our responsibility to put the patient’s care over costs or convenience.
Additionally, violating those values can damage a patient’s trust in the dental hygiene profession. We know that compromising patient care poses the risk of legal implications—disciplinary action, legal charges, even revocation of your license that can impact your professional future. After investing time, money, emotions, and heart into your education, is this one job truly worth the risk?
When you know better, do better
As many hygienists are aware, both patients and professionals can search public documents online to read why certain clinicians lost their license. It's scary to know the world can read your decision to compromise the well-being of patients. In the honorable profession that is health care, we’re called to higher morals and decision making for patients, and they trust us with that responsibility.
If a workplace is asking you to do something that does not align with the values of the health-care profession, you can decide whether to enable this. You can also choose to work there or find a setting where you and your team provide care at the highest level without cutting any moral corners.
- California Dental Hygienists’ Association Policy Manual. California Dental Hygienists’ Association. 2022. cdha.org/resources