by Cat Zermatt Schmidt, RDH,
Someone in your office — your friend, your employee, your boss — is breaking the law. You have two choices: ignore it, or Do the right thing
In the amplified silence of the empty office, Helen distinctly heard movement in the operatory. Her heart sank. It was lunchtime, and Dr. McDreadly was taking his break, enjoying yet another hour-long session of self-medication. As the staff left for a Chinese buffet down the street, Helen strolled out with them, but then doubled back to see the scene first-hand. Her employer had a drug problem, and Helen could not stomach his nitrous-laden activities. This time, she'd have to report him.
The first time she caught him in the act, he was stealing codeine from the locked drawer. He claimed he'd injured his back playing racquetball, and promised to put the pills back. The next time, his excuse was that he was "filling a prescription for a patient he was meeting for golf." He blamed the substantial nitrous consumption on a faulty gauge, and attributed the bottles of missing painkillers to lock-picking maintenance personnel. Though he'd fooled the rest of the office, his excuses failed Helen's internal lie detector and she told him so. He was to quit all drugs now, or else.
As she stepped up to the stuporous figure in the dental chair, the "or, else" part of her stance seemed like a moral directive. It was; she had a duty. She was a health-care professional. His last office high would bring him crashing into sobering reality. Helen had done her homework; she'd gotten the phone numbers of the proper agencies to report her boss's illegal activity. It would take only minutes to shut him down.
Unfortunately for Helen, those minutes were the worst of her life. She'd never been hit before, especially not in the face and not by a man. The blow came from nowhere, knocking her to the ground. Stunned, Helen scrambled off of the floor. The impaired doctor was no match for a sober, quick-thinking woman who did aerobics three times a week. Fear and adrenaline propelled her out of the office, to safety and the police.
Helen suffered only minor physical injuries. She filed assault charges against the dentist; however, they were eventually dropped in a maddening legal tangle. The injuries to her reputation, however, as well as to her psyche, were only just surfacing. For her part in ridding the dental profession of an irresponsible drug addict, Helen received anonymous hate mail, veiled threats on her answering machine, and the loss of employment in her hometown. She was blacklisted: denied work from other area dentists because she'd turned in "one of their own."
The case against the dentist was flimsy at best. Interestingly, none of her former co-workers backed up her story of the missing drugs. The office manager stated that all drugs, prescription or otherwise, were accounted for. Mysteriously, documented evidence for the distribution of a good majority of the prescription painkillers appeared as if by magic. Helen's nightmare continued for months; people who sided with the dentist claimed the two of them had engaged in an affair. He tried to break it off; she fabricated charges against him in retaliation. Helen's reputation was ruined, but her conviction never wavered.
"If I had to do it all over, I would've done the same thing — reporting him, that is," Helen states solidly. "I just wish I'd gotten some evidence that would have proved my side."
Helen's case is thankfully atypical of the average whistle-blower. Most whistle-blowers don't have to endure public humiliation or physical assault as a result of their actions. Most whistle-blowers don't become blacklisted or have lies told about them in legal proceedings. Most don't, but some do! How can you protect yourself from ending up in Helen's position?
It takes courage and conviction, but you'll have to also defend yourself in the process. You must gather the courage to tell the truth regardless of the outcome. Plus, you'll need to learn the personal and professional risks associated with your particular situation and determine ways to lessen those risks. When reporting can't be anonymous, you must protect yourself. Such protection includes collecting proper documentation and following protocols for reporting the infraction. Use Helen's experience as a warning; you can never have too much evidence, or plan too far ahead.
A prototype of courage
Whistle-blowing takes courage. It goes without saying that those who embark on this crucial path take the profession seriously. Like all of us, the whistle-blower has a keen sense of right and wrong. It is the injustice of a moral dilemma that compels whistle-blowers to ignore the personal ramifications of revealing infractions. They forge ahead because they believe the profession deserves better.
Irene's story is one for the record books. She mustered up the courage to take on an entire state dental board. Certain complaints were "mysteriously" disappearing from board proceedings. Irene learned those complaints were against dentists who had buddies on the board.
"The board members concealed their friend's files and never brought them up for review. It was disgusting — that old boys' network displayed in its full glory, and no one saw it."
No one, that is, except Irene, who vowed to stop the unscrupulous activity. She knew that fighting not only a dental board, but also the "old boys' network" would be nearly impossible. The consequences could be life-altering, and, as it turned out, they were. However, her anger over the flagrantly unethical behavior empowered her to begin an arduous journey, one that led to a three-year legal battle.
Irene suffered terribly for exposing the dirty little secret of her state dental board. She was threatened, at one point needing around-the-clock police protection. She suffered from physical exhaustion due to the experience, and still has recurring health problems due to stress. Her husband filed for divorce during the worst of it, after ten years of marriage. He simply couldn't take the pressure of the investigation and legal issues, and decided life outside the constant glare of the local media was better than life with Irene.
Irene suffered a grave financial toll as well, due to lost work time. She managed to stay employed during this time, thanks to a thoughtful employer who sided with her—not all dentists belong to the old boys' network! The board members even brought a spiteful lawsuit against Irene for an outrageous sum of money. The suit was eventually dropped; however, her legal bills were staggering. Financial ruin was a constant fear.
Years later, Irene still can't talk about the ordeal without emotional distress apparent in her voice. It was the worst time of her life. Her entire story has a made-for-TV-movie feel to it, as one can almost picture the Erin Brokovich-type hygienist fighting the state dental board with underdog might. Such was Irene, battling healthcare injustice against a dental board without a conscience.
In the end, Irene was victorious. Her vigil was responsible for reforms that brought the old boys network to its knees. Though she can't even think of going through it again, she would change nothing. "I knew at the outset it was going to be a tough road. I understood that my chances were slim, and that I would be hated, perhaps blackballed from dentistry because of it. But, I had to stop them. I had to." She has no regrets.
An ounce of prevention ...
The women profiled in this article knew that failing to take action against these illegal activities made them equally culpable. This is what motivated them to muster the courage and endure the risks of becoming whistle-blowers. Each of these women learned that you can't walk into this type of situation haphazardly. It's necessary to protect yourself in the process of ridding our ranks of the pests that degrade our profession.
"When you flee from an illegal or unethical situation, you are just as culpable," says George, a whistle-blower from the Midwest. He reported his employer to the board for abusive behavior toward patients. He states that the dentist he worked for was under immense economic pressure and routinely vented his anger at his staff. However, when the dentist began using patients for target practice, George thought it necessary to step in. He says he was compelled to report the abusive behavior; otherwise, he would play party to the injustice. He heeded his responsibility to his patients, especially the children and seniors who didn't understand they could be treated differently, and was determined to take care of them.
George realized that he would probably lose his job — albeit illegally — for turning his in boss to the board. "But I needed to leave anyway. I couldn't continue working for Attila the Hun." George planned ahead and secured his next position before disclosing to his boss his intention to report him for such highly unprofessional behavior.
George's method of reporting the unethical conduct of his employer is a textbook approach to protecting yourself from backlash. First, he confronted his employer on each abusive episode, while documenting the incidents in private notes. The dentist failed to alter his behavior, continuing to abuse his patients both verbally and physically (his dental procedures were unnecssarily rough).
Meanwhile, George kept careful records, and began interviewing for a hygiene position elsewhere. Finally, at the same time he gave his three-week notice, he also informed his boss that he was reporting him to the board. George followed the correct courses of action, and was able to protect himself while notifying the board of an abusive dentist.
What should you do, if you find yourself in George's shoes, or Irene's, or Helen's? It's imperative to take care of your own needs while helping others. We can't provide excellent service to our patients if we're not in top form. Likewise, we can't better our profession if we can't safely report those who commit violations. Simply "watch your back," is what one whistle-blower advises. By taking careful measures, you can do the right thing and keep your peace of mind.
Initially, when you discover an infraction, speak directly with the person involved. Tell her what you've observed; ask if she's noticed it as well. The reality of the situation may not be what it seems. Privacy is preferable as you determine the true nature of the situation. Use diplomacy when you confront the guilty party. Ask if something can be done to correct the infraction and/or alter future behavior. Take into account that this person may not be aware of any wrongdoing. Give the benefit of the doubt, initially. Be courteous and respectful; the golden rule definitely applies in these situations. If the outcome is less than you had hoped, or if the accused fails to react honorably, then it's time to take the problem to the next level. If the perpetrator is an assistant, then go to the dentist. If it's a dentist, you may choose to go to the state dental board or other agencies. Know your options before taking action.
Most whistle-blowers insist the best method for protecting yourself broadly is to document the incidents. Be sure to take detailed, descriptive notes. Include as much information as possible, including dates, times, places, actions, and parties involved. Don't forget to mention the time you brought the infraction to the violator's attention, and to the attention of the supervisor. The more data you collect, the stronger and more credible your case.
Another important point: Stick to the facts; leave your emotions at the door. This is the time to use your left brain. Logic and reasoning make your point more convincingly than drama or hysteria. Let the novelists handle fiction; legal proceedings and depositions require precision.
Kristine Hodsdon, RDH, a former board member from New Hampshire, recommends, "Report the incidents in a well-thought out, accurate manner with no emotion or malicious intent." She notes that if the truth is brought out without ulterior motives or heavy dramatization, the complaint will be taken seriously. State boards, she says, can usually tell if a whistle-blower is out merely for revenge or to get even with an employer. So, center only on the facts, and make certain all of your statements are truthful and unaltered.
Be careful that you don't embellish upon or alter your story to help make your point. This actually does the opposite! If any of your "elaborations" come to light, you'll end up looking like a liar, and all of your statements thereafter will become suspect. Simply tell your side of the story and let the truth speak for itself. If the situation was bad, it will show. You don't need to help it along.
Also, make sure you follow the proper reporting guidelines for your particular instance. A protocol exists for every step of your journey, so learn the correct method for your particular case. You certainly don't want to waste your time with one agency, when you should have been speaking to another. Or, you don't want to spend time filling out Form A, when Form B is the correct one for the incidents. Learn what needs to be done, and then give it your all.
Don't converse with anyone in the dental field about the impending report. This includes even your closest friends! Gossip wreaks its own havoc, sometimes innocently, but most often not. You don't want to be persecuted as a result of doing what's right for yourself, your patients, and your profession. Let your own personal satisfaction become the reward; don't look for kudos from your friends or the support of fellow dental professionals.
Plan ahead for alternative employment if you're turning in your boss. Secure your next position before reporting your employer, or anyone who could put your job — or the comfort level of your job — in jeopardy. Gauging the effects of your actions on the work environment can be tricky; you may find yourself in a deteriorating atmosphere.
"Until your office is split into factions of some siding with (the employer) and some siding with you," says one whistle-blower, "you don't know the meaning of the word uncomfortable." It's vital to keep your work situation in mind. Everyone realizes the importance of the person who signs the paycheck; so don't automatically expect support from your co-workers. It could never be forthcoming. Whistle-blowing is a solo fight.
In some instances, you may want to obtain legal advice before taking action. A lawyer can discuss any repercussions to consider before going through with a report or complaint. If you are illegally dismissed for whistle-blowing activities, you'll definitely need to seek counsel. It is illegal to be fired for turning in your employer for violations, but that doesn't mean you won't be given a pink slip anyway. Someone might fabricate a few things to push you out of the door, or use other clever tricks to get you out. Be prepared for anything.
Whistle-blowers must get the facts first. Do your homework, and then protect yourself by proceeding with caution and care. You will lessen the risks and hopefully prevent the foul consequences that befall many who tread this path. As dental professionals, we need to police our profession so that we can take pride in it. Without the dedication and fortitude of those who stand up and fight for what is right, we are left working in a profession unworthy of our time and talent.
Author's Note: The facts in this article are true, though some stories are a representative collage of various individual experiences. Identities and details have been altered to protect the anonymity of those who shared their stories.
Cat Zermatt Schmidt, RDH, is a freelance writer living in San Jose, Calif. Her book, "Not Just the Cleaning Lady: A Hygienist's Guide to Survival" is available from PennWell Publishing at 1-800-752-9764. You can email her at cat [email protected].
Protect yourself
Confront the guilty party first. Diplomatically ask if something can be done to correct the infraction and/or alter future behavior. If not, move on to a higher authority.
Document, document, document. Take careful notes; use as much detail as possible including dates, times, places, actions, and parties involved.
Stick with the facts. Keep your emotions out of it. Use logic and reasoning to make your point, not drama or hysterics.
Follow the proper reporting procedures. There is protocol for every step of your journey, so learn the correct method for your particular case.
Keep mum. Don't speak to anyone in dentistry regarding the incident, even your closest friends. Some whistle-blowers encounter ramifications because of gossip spread by co-workers or colleagues in the field.
Don't embellish your story. Let the truth of the incident speak for itself.
Make alternative employment plans. If it seems inevitable that blowing the whistle will put your job in jeopardy, secure another job before making any accusations.
Seek legal advice. You may want to seek the advice of a lawyer before taking action. There could be legal repercussions you haven't thought about.
