Conflicts of Interest in Dentistry

July 5, 2012 BY danariely

According to an article in SmartMoney, as many as 48% of U.S. dentists have seen their profits plummet thanks to the recession.

In and of itself, this isn’t a particularly remarkable statistic – after all, most of our wallets have taken a hit this past year – but what follows is an interesting discussion:  how are dentists coping with this drop in income? Angie C. Marek reports a variety of tactics in her article (including lowered rates, freebies, eliminated IOUs, etc.), most of which benefit the patient – but they don’t all. Some dentists are softening the financial blow by upselling and overtreating patients.

One example came from a woman who, upon switching cities and dentists, was surprised to learn that her hitherto problem-free mouth was suddenly rife with problems: several cavities required coatings and two veneers needed replacement. Or so her dentist told her. However, this turned out to be just another case of overtreatment.

The problem here is conflicts of interests (COIs), which are instances when professionals are pulled in two directions, torn between personal gain and the good of the patient. And the sad news is that when faced with COIs dentists (or physicians) sometimes end up going the self-interested route, and this can have undesirable consequences for the patient.

Conflicts of interest are nothing new, they have been a problem for as long as there have been professions, and they are very pervasive. For instance, there’s the doctor who at accepts consulting fees from a drug company and studies their drug, the one who prescribes the treatment a drug rep pushed on him the week before over a free lunch, and even the doctor who urges a treatment on a patient in part so that he can use his costly new medical equipment.

This isn’t to say that these are dishonorable people who only see dollar signs and say to hell with the patient. Rather, COIs can deeply color the person’s perception, and thereby end up leading even the most upstanding citizens astray, and this happens often.

The long and short of it is, next time you are at the dentist’s office – think about your dentist’s conflicts of interests.