While surfing the Internet, you decide to check the visibility of your Web site by typing “orthodontist” along with the name of your town. The first listing that comes up is that of a general practitioner whose Web site reads “Orthodontics provided by Dr Smith. Our objective is to provide the most efficient cosmetic orthodontic treatment available.” The esthetic orthodontic options offered by this practice are listed, and the ad urges: “To improve the appearance of your smile, orthodontic treatment may be the solution. Call for a free consultation.”
You think the advertisement is misleading. Irritating, in fact. It implies that Dr Smith is a specialist who is fully qualified to provide the listed services. What should you do? You know Dr Smith; should you approach him yourself, or should you report the advertisement to the state dental board?
Commercialism in promoting orthodontic care is becoming widespread. Because of the elective nature of orthodontics, highly productive marketing techniques are aimed at those with discretionary income or insurance benefits. Yet such commercialism erodes our reputation and the public’s perception by projecting a posture of greed. Inappropriate marketing can make a dental practitioner look more like a business entity than a professional service provider. Most importantly, advertising can expose patients to suboptimal levels of care because profit seeking can become more important than providing quality care.
Many patients and dentists are unaware of the educational requirements of a specialist, and few appreciate the benefits of board certification. Yet most patients are attracted by the allure of rapid, esthetic improvement.
A 1975 Federal Trade Commission ruling opened the door for advertising by dentists, as well as the ethical problems that accompany advertising. The AAO Principles of Ethics and Code of Professional Conduct, Section V-A, states: “Members shall insure that the public statements, announcements of services and promotional activities for providing information to aid the public, parents and/or other health care providers in making informed decisions are not false, deceptive, or misleading in any material aspects.” State dental boards also offer principles pertaining to advertising. For example, the Pennsylvania Code states: “Advertising is false, misleading or deceptive if it does one or more of the following:
Contains a material misrepresentation of fact, or omits a fact necessary to make the statement considered as a whole and not materially misleading.
Is likely to create an unjustified expectation about results the dentist can achieve.
Compares the advertising dentist’s services with the services of other dentists unless the comparison can be factually substantiated.
In the case of false or deceptive advertising, the offender should be reported to the state board’s professional compliance office. If the complaint is pertinent, the board will initiate an investigation to determine remediation or penalty.
There are differences between codes of ethics, such as those of the AAO, and specific legal statutes adopted by each state. Violation of a professional code of ethics could result in expulsion from the organization; violating a legal statute could carry much more serious consequences, including monetary fines or practice restrictions.
The guidelines for ethical advertising are clearly delineated for both the general dentist and the specialist. Although many general dentists provide some orthodontic care, the public should not be confused by semantics when choosing a health practitioner. Orthodontists should do whatever possible to minimize the exposure of prospective patients to misleading advertising. The choice of an orthodontic practitioner not only is the patient’s ethical right, but can also help ensure that the patient receives the best that dentistry can offer.
In addressing the problem of Dr Smith’s advertising, your best course of action is to let him know that his advertisement seems to imply that orthodontic care is offered by an orthodontist. In the words of the Pennsylvania Code, this creates an “unjustified expectation about results the dentist can achieve.” If he is unreceptive to your outreach, the state board should be contacted.