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Ethics of Gaming the System.

Christopher Smiley

    The Journal of the American College of Dentists
    |August 29, 2018
    PubMed
    Summary

    Dentists and insurance providers face conflicts between patient care and reimbursement policies. Addressing this requires collaborative negotiation for mutually beneficial solutions, rather than exploiting system loopholes.

    Area of Science:

    • Dental Medicine
    • Healthcare Policy
    • Insurance Administration

    Background:

    • Dental practitioners often face conflicts between evidence-based patient care and insurance reimbursement policies.
    • Insurance providers aim to cover only contracted services, leading to disputes over necessary treatments.
    • This tension is exemplified by the practice of performing multiple quadrants of root planing in a single dental appointment.

    Purpose of the Study:

    • To explore the conflict between dentists' clinical judgment and insurance reimbursement rules.
    • To analyze the specific case of multiple-quadrant root planing as a point of contention.
    • To propose alternative approaches for resolving this professional and industrial discord.

    Main Methods:

    • Qualitative analysis of the dentist-provider conflict.

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  • Case study examination of root planing reimbursement practices.
  • Exploration of negotiation and ethical considerations.

    • Main Results:

    • Reimbursement rules can force dentists to compromise patient care standards.
    • Insurance providers incur costs for services not explicitly covered by contracts.
    • The practice of multiple-quadrant root planing highlights this systemic tension.

    Conclusions:

    • Negotiating a collaborative, win-win agreement between the dental profession and insurance industry is a viable alternative.
    • Exploitative practices ('gaming the system') by a few can hinder ethical consensus.
    • Resolving this conflict is crucial for maintaining ethical dental practice and patient trust.