Peer Review: Resolving doctor/patient disputes


On October 11, the MDA will have its first Peer Review workshop webinar for its state and component committees.


The ADA’s Council on Dental Benefit Pro- grams conducts Peer Review training work- shops that consist of presentations on the Peer Review process, including the topic of mediation. Each component has a standing or ad-hoc committee on Peer Review or members who are called upon to review complaints as needed; at least one member will be repre- senting each of our eight components on the webinar.


To help you understand the Peer Review process better, we’ve included the following information. You also can learn more on the MDA website at www.modental.org/questions. Here you’ll find an overview of the MDA Peer Review process, including what matters are— or are not—accepted for Peer Review.


The Peer Review system is a voluntary process for resolving disputes between a patient and a dentist outside of a legal venue or the “court of public opinion.” The ADA promotes Peer Review as an option to the public at MouthHealthy.org—and as well, the MDA promotes it as such on its website and for in- quiries made by phone. Dentists may encour- age dissatisfied patients to consider initiating the process as a way of settling a disagreement.


INITIAL STEPS


The Peer Review process begins with media- tion. The process is not about determining who is right or wrong but rather to resolve the dispute with a solution agreeable to both parties. In most cases, mediation results in an agreement.


A THOROUGH REVIEW


If mediation alone does not resolve the dis- pute, a Peer Review committee may examine clinical records, talk to both the patient and the dentist, and may arrange for a clinical


Access all of the ADA’s Peer Review Resources, including the document How the Dental Peer Review Program Works and What You Can Expect From It at www.ada.org/1623.aspx.


Peer review is not a court of law, and does not award damages or impose punishments. A case in litigation generally won’t be accepted by a Peer Review committee, although cases where there has been a consultation with an attorney or a case has been referred to a collection agency are usually eligible. f


examination of the patient by members of the committee.


PEER REVIEW RULINGS


If the decision is in favor of the patient, the dentist may be asked to waive a fee, redo the dental work, or improve his or her knowledge and skills, perhaps through a CE course.


If the decision is in favor of the dentist, the patient may be requested to pay any outstand- ing fees. Sometimes patients have been asked to return a dental appliance or other device to the dentist.


Regardless of whether the committee finds in favor of the patient or the dentist, most dental societies request the two parties to consider the findings of the Peer Review committee and the subsequent agreement to be final.


WHO PRESIDES OVER PEER REVIEW?


Because every state has different laws and guidelines regulating dental practice, Peer Review is conducted at the state or local level. The ADA establishes guidelines for best practices. However, each state dental society is the highest authority for Peer Review cases in that state. Many state societies offer Peer Review as a member-only benefit, or charge a fee to non-member dentists who want to refer a patient to peer-review. In Missouri, it’s a free members-only benefit and costs $650 to non- members.


Participate in AADA Head-to-Toe Project in New Orleans this fall


Head-to-Toe (H2T), the Alliance of the ADA national service project is heading to New Orleans October 31 and Novem- ber 1, 2013 in conjunction with the ADA Annual Session. We’ll be collect- ing kits and supplies from convention attendees and contributing them to Metropolitan Center for Women and Children of Greater New Orleans, which provides services for victims of domestic violence (www.mcwcgno.org). Here’s how you can help us give back:


CREATE AN AGE-SPECIFIC CARE KIT Fill it with a toothbrush, toothpaste, floss, a hat, scarf, headband or bandanna, a pair of socks, and some fun stuff—like crayons, coloring book, comb, barrettes, lip balm, small handheld toy, crossword puzzles, a new pencil or pen, an informa- tional brochure on oral hygiene, a new notebook, something cuddly … it’s head to toe coverage. Label it age and sex specific. You can create more than one kit, and if your staff is coming, please encourage them to create a kit as well.


PACK KIT IN YOUR BAGS Bring it to the New Orleans Morial Convention Center and give it to one of the yellow-aproned volunteers with a big H2T button, or bring it to our collection center—just look for our logo! You’ll get a big ‘Thank You’ smile and a button! If you forget your kit, we accept donations.


SPOUSE COMING TOO Would she or he be willing to spend two fantastic hours with a group of dynamos? Contact Carol Reitz at diehard@ptd.net to volunteer to help. We need packers, kit receivers, greeters and etc. on Thurs- day, October 31 and Friday, November 1.


For more information contact Project Coordinators Carol Reitz (610-775-4585 or diehard@ptd. net) or Johanna Manasse (708-224-7199 or johanna4manasse@aol.com). AADA Director, Trish Rubik-Rothstein also can answer any questions at 312- 440-2865 or Trish@AllianceADA.org.


ISSUE 4 | JUL/AUG 2013 | focus 25


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48