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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 17. BUSINESS, OCCUPATIONS, AND PROFESSIONALS |
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Chapter 17-42. DENTISTRY |
Section 17-4213. STANDARDS OF CONDUCT
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4213.1A dentist shall not accept or perform professional responsibilities which the dentist knows or has reason to know that the dentist is not competent to perform.
4213.2A dentist shall not abandon or neglect a patient under and in need of immediate professional care, without making reasonable recommendations for the continuation of such care.
4213.3A dentist shall not willfully harass, abuse, or intimidate a patient either physically or verbally.
4213.4A dentist shall maintain a record for each patient which shall:
(a)Accurately reflect the evaluation and treatment of the patient and which may include the following:
(1)Patient's name and the date of treatment;
(2)Updated health history;
(3)Treatment plan;
(4)Informed consent document(s);
(5) Clinical findings, diagnosis and treatment rendered;
(6)List of drugs prescribed, administered, dispensed and the quantity;
(7)Radiographs;
(8)Patient financial/billing records;
(9)Name of dentist and/or dental hygienist providing service(s); and
(10)Laboratory work orders; and
(b)Be kept for three (3) years after last seeing the patient or three (3) years after a minor patient reaches eighteen (18) years of age.
4213.5Upon request of a patient or the patient's representative, a dentist shall make available to the patient or the patient's representative a copy of the patient's record in accordance with the following:
(a)A dentist shall provide to a patient or the patient's representative a copy of the patient's record within thirty (30) days of the request; and
(b)A dentist may charge a reasonable fee for duplicating records and the fee may be required prior to providing the records in non-emergency situations, but a dentist shall not refuse to provide the records on the basis of the patient owing payment for dental services.
4213.6A dentist shall respect a patient's rights to self-determination and treat the patient according to the patient's desires, within the bounds of accepted treatment.
4213.7A dentist shall inform a patient of the proposed treatment, and any reasonable alternatives, in a manner that allows the patient to become involved in treatment decisions.
4213.8A dentist shall protect the confidentiality of patient records and maintain patient records in a manner consistent with the protection of the welfare of the patient and all applicable District of Columbia and federal laws.
4213.9A dentist shall make every effort to refrain from harming the patient.
4213.10A dentist shall keep his or her knowledge of dentistry and skills current while he or she is engaging in clinical practice of dentistry.
4213.11A dentist shall know his or her own limitations and shall refer a patient to a specialist or other health care professional whenever the welfare of a patient will be safeguarded or advanced by utilizing those who have special skills, knowledge, and experience.
4213.12A dentist shall seek consultation with a specialist or other health care professional, if possible, whenever it would be in the patient's best interest.
4213.13When patients visit or are referred to specialists or consulting dentists for consultation:
(a)The specialists or consulting dentists shall, upon completion of their care, return the patient, unless the patient expressly reveals a different preference, to the referring dentist or, if none, to the dentist of record for future care; and
(b)When there is no referring dentist, the specialists shall upon completion of their treatment, inform the patient when there is a need for further dental care.
4213.14A dentist who is called upon to render a second opinion regarding a diagnosis or treatment plan recommended by a patient's treating dentist, shall not have a vested interest in that recommendation.
4213.15A dentist shall know when and under what circumstances delegation of patient care to auxiliaries is appropriate.
4213.16A dentist shall only assign to qualified auxiliaries those duties which can be legally delegated.
4213.17A dentist shall prescribe and supervise the patient care provided by all auxiliary personnel working under his or her direction.
4213.18A dentist shall not practice dentistry while abusing or using controlled substances, alcohol, or any other chemical agents, which impair the ability to practice.
4213.19A dentist shall urge chemically impaired colleagues to seek treatment, if possible.
4213.20A dentist with first-hand knowledge that a colleague is practicing dentistry when impaired by controlled substances, alcohol, or any other chemical agents shall report such evidence to the professional assistance committee of a dental society or the Board of Dentistry.
4213.21A dentist or auxiliary who contracts any disease, has a mental or physical impairment which affects his or her ability to safely practice, or becomes impaired in any way that might endanger patients or dental staff shall, with consultation and advice from a qualified physician or other authority, limit the activities of his or her practice to those areas that do not endanger patients or dental staff.
4213.22A dentist who has been advised to limit the activities of his or her dental practice shall monitor the disease or impairment and make additional limitations to the activities of his or her dental practice as indicated.
4213.23A dentist, regardless of his or her bloodborne pathogen status, shall immediately inform any patient who may have been exposed to blood or other potentially infectious material in the dental office of the need for post-exposure evaluation and follow-up and shall immediately refer the patient to a qualified health care practitioner who can provide post-exposure services.
4213.24In the event of an exposure incident as discussed in § 4213.23, a dentist shall provide information concerning his or her own bloodborne pathogen status to the evaluating health care practitioner, if the dentist is the source of the possible exposure, and submit to testing that will assist in the evaluation of the patient. If a staff member or other third person not regulated by the District of Columbia Board of Dentistry is the source of the possible exposure, the dentist shall encourage that person to cooperate as needed for the patient's evaluation.
4213.25Once a dentist has undertaken a course of treatment to provide services to a patient, the dentist shall not discontinue that treatment without first giving the patient adequate notice and the opportunity to obtain the services of another dentist and ensuring that the patient's oral health will not be jeopardized in the process.
4213.26A dentist shall not engage in interpersonal relationships with patients that could impair his or her professional judgment or risk the possibility of exploiting the confidence placed in him or her by a patient.
4213.27A dentist shall provide competent and timely delivery of dental care.
4213.28A dentist shall conduct himself or herself in a professional manner.
4213.29A dentist shall make the results and benefits of his or her research and development investigative efforts available to all when such are useful in safeguarding or promoting the health of the public.
4213.30A dentist shall not use patents or copyrights to restrict research or practice.
4213.31A dentist shall become familiar with the signs of abuse and neglect and report suspected cases to the proper authorities consistent with District of Columbia and federal laws.
4213.32While dentists, in serving the public, may exercise reasonable discretion in selecting patients for their practices, a dentist shall not refuse to accept patients into their practice or deny dental service to patients because of the patient's race, creed, color, sex, national origin, or sexual preference.
4213.33A dentist shall not refuse to provide treatment to an individual based solely on the fact that the individual is infected with Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus, or another bloodborne pathogen.
4213.34A dentist shall make reasonable arrangements for the emergency care of his or her patients of record.
4213.35A dentist shall, when consulted in an emergency by patients with whom he does not have an established patient-practitioner relationship, make reasonable arrangements for their emergency care. If treatment is provided, the dentist, upon completion of treatment, shall return the patient to his or her regular dentist unless the patient expressly reveals a different preference.
4213.36A dentist shall report to the District of Columbia Board of Dentistry known instances of gross or continual faulty treatment by other dentists.
4213.37A dentist shall inform patients of their present oral health status without making disparaging comments about prior services.
4213.38When informing a patient of the status of his or her oral health, a dentist shall make comments that are truthful, informed and justifiable.
4213.39A dentist issuing a public statement with respect to the profession shall believe as well as have a reasonable basis to believe that the comments made are true.
4213.40A dentist may provide expert testimony when that testimony is essential to a just and fair disposition of a judicial or administrative action.
4213.41A dentist shall not agree to a fee contingent upon the favorable outcome of the litigation in exchange for testifying as a dental expert.
4213.42A dentist shall not accept or tender rebates or split fees.
4213.43A dentist shall not represent the care being rendered, or that is needed, to a patient in a false or misleading manner.
4213.44A dentist shall not remove amalgam restorations containing mercury from patients who are not allergic to mercury for the alleged purpose of removing toxic substances from the body, when such treatment is performed solely at the recommendation or suggestion of the dentist.
4213.45A dentist shall not remove sound or serviceable amalgam restorations containing mercury, at the request of a patient who is not allergic to mercury, without first obtaining appropriate informed consent from the patient, which includes but is not limited to advising the patient that:
(a)The National Institutes of Health has determined that there are no verifiable systemic health benefits resulting from the removal of mercury amalgam restorations; and
(b)The removal of sound or serviceable mercury amalgam restorations may significantly affect the integrity of the tooth.
4213.46A dentist shall not represent that dental treatment or diagnostic techniques recommended or performed by the dentist have the capacity to diagnose, cure or alleviate diseases, infections or other conditions, when such representations are not based upon accepted scientific knowledge or research.
4213.47A dentist shall not represent the fees being charged for providing care in a false or misleading manner.
4213.48A dentist shall not increase a fee charged to a patient solely because the patient is covered under a dental benefits plan.
4213.49A dentist shall not misrepresent treatment dates for the purpose of assisting a patient in obtaining benefits under a dental plan which benefits would otherwise be disallowed.
4213.50A dentist shall not misrepresent the dental procedures performed to receive a greater payment or reimbursement or to make a non-covered procedure appear to be a covered procedure.
4213.51A dentist shall not recommend or perform unnecessary dental services or procedures.
4213.52A dentist who presents educational or scientific information in an article, seminar or other program shall disclose to the readers or participants any monetary or other special interest the dentist may have with a company whose products are promoted or endorsed in the presentation. Disclosure shall be made in any promotional material and in the presentation itself.
4213.53A dentist who, in the regular conduct of his or her practice, engages in or employs auxiliaries in the marketing or sale of products or procedures to his or her patients shall not exploit the trust inherent in the dentist-patient relationship for his or her own financial gain.
4213.54A dentist shall not induce his or her patients to purchase products or undergo procedures by misrepresenting the product's value, the necessity of the procedure or the dentist's professional expertise in recommending the product or procedure.
4213.55In the case of a health-related product used by or recommended by a dentist, it is not enough for the dentist to rely on the manufacturer's or distributor's representations about the product's safety and efficacy. The dentist shall inquire into the truth and accuracy of such claims and verify that they are founded on accepted scientific knowledge or research.
4213.56A dentist shall disclose to his or her patients all relevant information the patient needs to make an informed purchase decision, including whether the product is available elsewhere and whether there are any financial incentives for the dentist to recommend the product that would not be evident to the patient.
4213.57A dentist shall not advertise or solicit patients in any form of communication in a manner that is false or misleading in any material respect.
4213.58A general dentist who wishes to announce the services available in his or her practice may announce the availability of those services but shall not express or imply specialization.
4213.59A dentist shall not announce available services in any way that would be false or misleading in any material respect.
4213.60A dentist shall follow the Center for Disease Control's (CDC) guidelines on infection control and on universal precautions as they may be amended or republished from time to time.
4213.61A dentist shall not willfully harass, abuse, intimidate, insult, degrade, or humiliate a patient physically, verbally, or by any form of communication.
4213.62A dentist shall use a lead apron or its equivalent on all patients receiving an x-ray or radiograph, and when appropriate a thyroid collar shall also be used.
4213.63 Whenever an entire dental practice or office moves to a new location or ceases operation, the owner or responsible dentist shall not later than 30 days after the change or closing:
(a) Notify the patients of the change of address or closing by U.S. Mail, a note posted conspicuously on the door of the office that is closing for at least 30 consecutive days, telephone message on the office number activated for at least 30 consecutive days, or any combination of the above; and
(b) Notify the patients as to how they may obtain copies of their complete dental files, radiographs, and models, by any of the means set forth in subparagraph (a).