Tricky Interview questions

[golfinpanda]

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• There is a 20-minute saliva test that checks for HIV. Millions of patients don't know they are at risk for HIV contraction. Should dentists offer this service?
- I can't really see the negatives in HIV testing besides confidentiality, and even if that's a problem, couldn't they just sign something that would protect them



• Insurance companies (who follow HIPAA) collect practice data from dentists and pass the info on to third party companies (who don't necessarily follow HIPAA) so they can analyze the data. What are the pros and cons of this?
- I don't know how to answer this one >_<

 

[Stacker]

• There is a 20-minute saliva test that checks for HIV. Millions of patients don't know they are at risk for HIV contraction. Should dentists offer this service?
- I can't really see the negatives in HIV testing besides confidentiality, and even if that's a problem, couldn't they just sign something that would protect them

http://studentdoctor.net/2012/03/hiv-testing-in-the-dental-setting/

• Insurance companies (who follow HIPAA) collect practice data from dentists and pass the info on to third party companies (who don't necessarily follow HIPAA) so they can analyze the data. What are the pros and cons of this?
- I don't know how to answer this one >_<

You cannot breach patient confidentiality, without repercussions, to any third party, including insurance companies, without the patient's consent.

 

[aznboi89x]

http://studentdoctor.net/2012/03/hiv-testing-in-the-dental-setting/



You cannot breach patient confidentiality, without repercussions, to any third party, including insurance companies, without the patient's consent.

Do insurance companies release your info like what credit card companies do when you apply. Does this really happen? Is there a way to really stop this? I don't know much about this matter but would like to find out.

 

[golfinpanda]

http://studentdoctor.net/2012/03/hiv-testing-in-the-dental-setting/



You cannot breach patient confidentiality, without repercussions, to any third party, including insurance companies, without the patient's consent.

So is there no positive in giving the info to the third parties?

 

[Stacker]

So is there no positive in giving the info to the third parties?

Patient comes in with AIDS (prior to HAART) and you ask him/her to refrain from sexual intercourse and to inform his/her spouse of the infection. Patient refuses and shows no intent to inform the sexual partner. You weigh the likelihood that the patient will infect the third party and the consequences of not breaching the doctor-patient confidentiality. In this situation, it is highly probable that the patient will infect the third party and the consequences for not breaching the doctor-patient confidentiality is severe and it is appropriate to breach the agreement. In the hospital setting, there is usually an ethics committee that you can bring this up with and have them deal with it.
In another, more common case, is where a family member seeks to know the patient's condition. Even if you feel that it would emotionally benefit the patient to inform his/her family of the patient's condition, you cannot breach the confidentiality without prior consent. To avoid this it is best to always ask the patient beforehand if they would like you to inform their immediate family members.

 

[Fifimiki]

• There is a 20-minute saliva test that checks for HIV. Millions of patients don't know they are at risk for HIV contraction. Should dentists offer this service?
- I can't really see the negatives in HIV testing besides confidentiality, and even if that's a problem, couldn't they just sign something that would protect them



• Insurance companies (who follow HIPAA) collect practice data from dentists and pass the info on to third party companies (who don't necessarily follow HIPAA) so they can analyze the data. What are the pros and cons of this?
- I don't know how to answer this one >_<

I read this article today and thought about this question. I know it has nothing to do with dentists but I guess it would be a good reason NOT to provide HIV testing. It seems like you would need to be able to provide the proper counseling for those who do test positive.

http://www.nydailynews.com/new-york/surprise-hiv-test-shocks-woman-article-1.1174548

 

[Stacker]

I read this article today and thought about this question. I know it has nothing to do with dentists but I guess it would be a good reason NOT to provide HIV testing. It seems like you would need to be able to provide the proper counseling for those who do test positive.

http://www.nydailynews.com/new-york/surprise-hiv-test-shocks-woman-article-1.1174548

HIV education could be integrated into the standard dental school curriculum. Patient should still be referred to physician.

 

[USUAg2012]

Were you asked this question at an interview? If so, at which school?

 

[RSalha17]

• There is a 20-minute saliva test that checks for HIV. Millions of patients don't know they are at risk for HIV contraction. Should dentists offer this service?
- I can't really see the negatives in HIV testing besides confidentiality, and even if that's a problem, couldn't they just sign something that would protect them



• Insurance companies (who follow HIPAA) collect practice data from dentists and pass the info on to third party companies (who don't necessarily follow HIPAA) so they can analyze the data. What are the pros and cons of this?
- I don't know how to answer this one >_<

There is a great article I read (that might have been on SDN) about the potential drawbacks of this. Not everyone is a good communicator and by administering these tests, you have to be ready and willing as a healthcare provider to deal with a potential positive patient. The doctor must be ready to provide counseling, or refer the patient to counseling, and be ready to deal with the burden of being the one who tells someone they have HIV. This isn't really an easy thing to do for anyone, but especially a dentist who isn't as socially competent or knowledgeable on HIV as someone who has dealt with this before. Personally, I think it is a good idea but not for every dentist office.

 

[Stacker]

There is a great article I read (that might have been on SDN) about the potential drawbacks of this. Not everyone is a good communicator and by administering these tests, you have to be ready and willing as a healthcare provider to deal with a potential positive patient. The doctor must be ready to provide counseling, or refer the patient to counseling, and be ready to deal with the burden of being the one who tells someone they have HIV. This isn't really an easy thing to do for anyone, but especially a dentist who isn't as socially competent or knowledgeable on HIV as someone who has dealt with this before. Personally, I think it is a good idea but not for every dentist office.

I remember that article too. Here it is. http://studentdoctor.net/2012/03/hiv-testing-in-the-dental-setting/
You would really need a big push for dental schools to integrate relevant HIV patient training into their normal curriculum (I don't think it's going to happen anytime soon). It might be a difficult prospect of pushing HIV screening into a dental setting considering how there are less and less HIV-infected patients (as compared to the 80's and 90's), increased public awareness, and considerable advances in anti-retroviral drug therapies which ultimately makes dental schools to not see a significant need for integrating such training into their curriculum. We don't have to make this mandatory as a part of normal check-ups. Instead, we could simply offer the screening if the patient chooses. That way patients would consent and understand that the first health-care professional that they would be discussing this issue with, if they are HIV-positive, is the less appropriate dentist. As healthcare professionals, I think we do have an obligation to have a reasonable understanding of major diseases outside of the oral cavity or at least be able to provide the patient with supplemental information if the dentist doesn't know off-hand and obviously be able to send referrals to physicians who can manage their overall health much better than any ordinary dentist can. I'd rather leave this screening issue with the physicians. They are obviously much more appropriate and are actually trained for this.

Were you asked this question at an interview? If so, at which school?

And no, don't expect any question about this issue to be asked at the interview.

 

[dentalWorks]

• Insurance companies (who follow HIPAA) collect practice data from dentists and pass the info on to third party companies (who don't necessarily follow HIPAA) so they can analyze the data. What are the pros and cons of this?
- I don't know how to answer this one >_<

I've underline'd the problem with the above. Basically, patient's private information is.... up for grabs and guess how helpfull it is for various companies to get a hold of your phone number, date of birth, and type of medications you use / need to use? Plenty of market for such.

Basically, the patient's confidentiality is going down the drain cause the 3rd party isn't HIPAA compliant (most likely, a company thats not in USA)