Ethical Dilemma

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texasortho4

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This is a hypothetical interview question.. How would you handle a situation where one of your top referring dentists continues to send you patients with sub-par restorative work? Let's say you are brand new to the area/out of school and do not know the doctor well, but he is very well-established in the area/community and sends you a large proportion of patients. The obvious answer is to have a conversation with the doctor, but easier said than done given the situation where you are brand new to the community and this doctor is well known, highly liked, and well established.

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They cover this topic in great detail over at dental town. The general consensus is anything short of your referral being a sexual predator, say nothing to anyone. Otherwise, you would be throwing a colleague "under the bus" and kissing the referral goodbye.
 
It’s hard to offer a response for a highly unlikely scenario that you provided.

1. This dentist can’t be well liked and well known in the community if he consistently performs subpar restorative work. When patients realize that they can’t floss (overhang fillings), have food impaction (due to open contacts), or can’t eat (because a poorly prep/poorly retained PFM keeps on coming off), they won’t come back and won’t refer friends and relatives to his office. Without word of mouth referrals, his practice can’t survive.

2. It’s highly unlikely for a well established GP like him to refer his patients to an unknown new grad specialist. To continue to maintain the good reputation that he currently enjoys, he’d much rather refer his patients to another well known specialist, who has a long track record of doing good work.

I don’t like to judge other dentists’ work without knowing all the facts. What if the patient is dental phobic and is uncooperative? What if the patient doesn’t floss and brush his/her teeth and gets new cavities every 6 months? What if the patient has a TMD and can’t open his mouth wide enough? Etc.
 
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