Dealing with an unethical boss

Can you help me find a way to professionally tell my boss that I am disappointed in his work ethic ...?

May 1st, 2000

Can you help me find a way to professionally tell my boss that I am disappointed in his work ethic ...?

Dianne Glasscoe, RDH, BS

Dear Dianne,

There is a serious problem in the office where I work. The problem is fraud! For example, one of my patients had quadrant scalings done early last year. However, 10 months later, the doctor wanted the same procedure repeated. Since the patient`s insurance would not cover quadrant scalings again, the doctor decided to charge out three restorations for each quadrant to fulfill the price of periodontal scalings. I saw what was done, but chose to ignore it. I have felt indignant since this happened.

Another example of deceit I have witnessed is the changing of dates of service just to get some insurance benefit for the patient. Just the other day, he did a crown preparation on a patient. He discussed holding the insurance until the next year since this patient`s benefits had been used for that year. The patient walked out to the front desk and announced for everyone, including patients in the reception area, "Dr. said to not bill this out until next year, since my insurance has run out this year." I thought this was bold, especially considering this particular patient is a police officer! Surely, he knows this is illegal.

Can you help me find a way to professionally tell my boss that I am disappointed in his work ethic and am not willing to jeopardize my license or moral values to make money for him? I think the doctor knows I am unhappy and that something is bothering me. Sometimes I get the feeling that the doctor thinks he owns me. Regardless of that, I do not feel I can continue.

Unhappy in Utah

Dear Unhappy,

What a sad, sad, scenario! Every time I hear something like this, it grieves me terribly. Dishonesty has a ripple effect that is expressed on a Semantodontics poster: "There`s a ripple effect in all that we do. What you do touches me, and what I do touches you."

This doctor obviously has come to feel that he can live above the law. I am sure he feels his dishonesty is acceptable, because it is for his patients` benefit. He simply feels it is all right to "bend the law" to help his patients.

A certain amount of indignation exists between dentists and insurance companies in general, because insurance companies have usurped much of the control in fee setting. Doctors tire of hearing, "Just do what the insurance will pay, Doc." Many doctors allow their practices to become insurance-driven and bow to the directives of third party payers. In these situations, it is not unusual for the doctor to find "creative" ways to beat the system.

However, this does not excuse this (or any) doctor`s dishonesty. The fact that a patient does or does not have company-sponsored dental benefits does not preclude the doctor from being ethical, honest, and moral.

In the example you gave, I would question why the patient would need quadrant scalings again so soon. Even if this patient is not complying with adequate home care, 10 months is simply too soon to require this procedure again on the majority of people. It sounds as if the doctor is trying to extract more money from the insurance than what is permitted under normal circumstances.

If this patient ever goes to another dentist, has radiographs taken, and the doctor finds some decay on any tooth that the former doctor has already billed for restorations, the radiographs will clearly indicate that no previous restorations were done. Then, the former doctor is flagged by the insurance company, investigated, and eventually charged with fraudulent billing.

Your example of the police officer being a partner in crime is common. While some people would never cheat another person, they do not think twice about cheating an insurance company. They simply do not see an insurance company as having a human element. They feel changing a date in order to get benefits is really no big deal.

My assumption is that this doctor has been doing business like this for a long time. At least, you know it has been going on for the 21U2 years you have been there. Since these dishonest and unethical business practices have become ingrained, I doubt that you could say anything that would change things. If you try to tell the doctor that you do not approve or that you are disappointed in him, you only will make him angry. No matter what you say, you cannot change his heart. He obviously has seared his own conscience.

My advice to you is to get out! The fact that this dentist has become quite indiscreet with his dishonesty spells trouble. The old saying, OGive a dog enough rope and he will hang himselfO applies here. It is just a matter of time before this doctor hangs himself. He is unethical, immoral, and dishonest. How could anybody have respect for a boss like that?

Dianne

Dianne Glasscoe, RDH, BS, is an adjunct instructor in clinical hygiene at Guilford Technical Community College. She holds a bachelor`s degree in human resource management and is a practice-management consultant, writer, and speaker. She may be contacted by e-mail at dglasscoe@northstate.net, phone (336) 472-3515, or fax (336) 472-5567. Visit her Web site at http://www.professionalden talmgmt.com

More in Radiology