Referrals Over Profit
Ideally, general practitioners should refer patients to specialists when they have conditions that they cannot address, such as wisdom teeth, temporomandibular joint disorder, “excessive cavities,” etc. (“Why a Good Dentist Will Refer You to a Specialist” 2018). Specialists, such as periodontists and endodontists, have additional training to treat more complicated conditions (“Why a Good Dentist Will Refer You to a Specialist” 2018). Dentists need to refer cases to specialists instead of keeping patients in their clinic for more business and risking the deterioration of their oral health.
General dentists need to refer patients to specialists when they detect several problems. For instance, in the dentists’ practice, if they are “unable to diagnose the patient’s condition” and/or “not competent to meet the patient’s clinical needs,” they should refer them to specialists (“The duty to refer” 2016). In addition, when the dentist’s treatments are not significantly improving the patients’ oral health, treatments provided by specialists may fare better for the patient’s condition, especially “[if] the patient’s pain can be relieved more quickly because a specialist can see the patient before [the dentist] can…” (Knowles 2014; “The duty to refer” 2016). Also, due to the Dentistry Act of 1991, “attempting treatment that is beyond a dentist’s expertise or competence is considered professional misconduct…” (“The duty to refer” 2016). Although dentists want to treat their patients to better their oral health, “develop expertise by taking on increasingly complicated cases,” or earn more revenue, specialists could provide higher quality of treatment based on their skills and experience (Knowles 2014; “The duty to refer” 2016).
Dentists should not keep their patients in their clinic, when a specialist could provide treatment that greatly benefits patients. Some dentists could keep them in the clinic for the sake of profit. For instance, for patients with periodontal disease, general dentists may perform soft tissue management (STM) procedures on them instead of referring them to the periodontist in order to make more money (Bleckstein 2012). However, if the patient’s condition is not improving with STM procedures, the periodontal disease would worsen, and patients have a higher risk of losing teeth and resorting to extractions (Bleckstein 2012). When the dentist does not refer patients to other specialists and instead monitors a condition, such as a lesion, the hygienist, who may have noticed it first, could voice his or her concerns about the condition (Watterson 2018). Consequently, the dentist could reevaluate the lesion, leading him or her to refer the patient to an oral surgeon (Watterson 2018). By not making a referral and possibly allowing the lesion to progress to something worse, “if the doctor is ever charged with failure to detect oral cancer, the hygienist who saw the patient can be named as a codefendant” (Watterson 2018).
While general dentists want to earn a lot of revenue to keep their practice running, they must put their patients’ needs first. Sometimes, they need to direct them to specialists who could treat them best.
Bleckstein, Ted. “Periodontal referral gone awry.” By Lynne Slim. RDH, March 1, 2012.
Knowles, Lisa L. “General recommendations for the general practitioner regarding endodontic
referrals.” DentistryiQ, April 11, 2014. https://www.dentistryiq.com/articles/2014/04/general-recommendations-for-the-general-practitioner-regarding-endodontic-referrals.html.
“The duty to refer.” Dispatch Magazine, May/June 2016.
Watterson, Dianne G. “Referral Controversy.” RDH, February 1, 2018.
“Why a Good Dentist Will Refer You to a Specialist.” Bauter Dentistry Aesthetics, January 1,