| Popis: |
Overservicing or the acceptance of unnecessary, inappropriate, excessive or fraudulent treatment is regarded as sanctioned lying, cheating or stealing and thus constitutes unethical conduct and a breach of the integrity of the profession. During the past year the media have repeatedly reported that the private sector is bloated with overservicing: one of the most important factors contributing to the increasing inflation of health care costs. Overservicing is an ethical problem presenting with a conflict situation among the interests of the patient, the provider and the funder. For example, since dentists are in a position to gain financially from their professional recommendations, they are at risk of having a conflict of interest: by overservicing they collect more fees. Low medical aid tariffs, delayed payment of benefits, oversupply of dentists, decreasing business and the spiralling costs of dental materials and equipment are the primary causes of high practice overheads and low cash-flow levels. Dentists may seek alternatives such as overservicing or unnecessary treatment to generate income and to improve their cash flow and/or profit. The main motives for overservicing are economic survival and financial gain. Some dentists may overtreat unintentionally due to out-dated treatment philosophies or where criteria for diagnosis and effective care are not clear, leading to variation in treatment decisions. Some overservicing may be due to patient-initiated demand. Dentists are largely unregulated as to the appropriateness or necessity of treatment decisions because of their professional status. Society trusts that their professionals will put the benefit of those they serve above their own self-interests. The aim of this review is to provide dentists with some guidance to the process of ethical decision making, the ethical principles involved, moral rules, and guidelines for professional standard of care. Business considerations whether profit, financial gain or economic survival should never justify overservicing by the dentist. If the patients' best interests are always considered, the profession of dentistry can ethically exist within a business structure. |
