Part of the Fabric

Part of the Fabric

Michael A. Kurkowski, D.D.S.*:

With this issue, Northwest Dentistry welcomes Dr. Michael Kurkowski as its reporter from the Minnesota Dental Association Committee on Ethics, Constitution and Bylaws. A  general dentist in private practice in Saint Paul, Dr. Kurkowski recently completed seven years as the MDA Speaker of the House, and prior to that has participated at many levels  of the Saint Paul District Dental Society and the MDA. On behalf of Northwest Dentistry, the Publications Committee, and the MDA, we welcome Dr. Kurkowski to these pages, and invite readers to contact him with any ideas, questions, or offerings appropriate to the subject of ethics. 
The Editors
 
Organized dentistry has quietly been part of a renaissance in ethical discussion and priorities. Motivated by a combination of challenging “modern world” factors, the American  Dental Association and other related organizations have chosen to re-emphasize our ethical commitment. Some of the modern factors include the explosion of material choices,  the expansion of diagnostic capabilities, cosmetic options, growing school indebtedness, and a general erosion of civility. 
 
Dental educators were also in alignment with placement of a higher priority on ethics for their pre-doctoral candidates. The need for dental students to embrace an ethical  framework is evident to the been part of a renaissance in ethical discussion and priorities. Motivated by a combination of challenging “modern world” factors, the American Dental Association and other related organizations have chosen to re-emphasize our ethical commitment. Some of the modern factors include the explosion of material choices, the expansion of diagnostic capabilities, cosmetic options, growing school indebtedness, and a general erosion of civility. 
 
Dental educators were also in alignment with placement of a higher priority on ethics for their pre-doctoral candidates. The need for dental students to embrace an ethical  framework is evident to the profession. The dental schools needed to foster an ethical atmosphere throughout the educational process.  Ethics cannot be a toggle we flip upon graduation, itself certainly a time of less supervision and a greater number of distractions. 
 
The ADA, working with the American Student Dental Association (ASDA), has helped our profession to refocus on this fundamental tenet of our Association. All meetings now begin by reiterating our commitment to ethical behavior. Ethical training and decision-making are clearly delineated as “core competencies” eligible to fulfill Minnesota State Board continuing education requirements of thirty (30) hours for each biennium in that category. The 2011 ADA House of Delegates passed a resolution to encourage all state boards to  allow credit for ethics education. Our forward-thinking Minnesota State Board of Dentistry made that change beginning in January 2005. Providing dental care can be all- consuming. We can feel pressured by economics and dental consultants. We can be directed by dental manufacturers and the dental supply industry. We can be misled by seminars and dental laboratories, even when well intentioned. We cannot be distracted, however, from our ultimate responsibility for ethical decision making. To continue to place  our profession among the most respected, the ADA has realized these values must begin at the top of an organizational structure. For our offices, of course, that means it begins with us. Ethics need to start with the dentist and permeate the fabric of our offices. They must be adopted by the entire staff and influence all policy decision. By creating a  culture of ethics, the rewards of providing health care are easier to attain and appreciate. Commonality of purpose (patient first) leads to greater cooperation and less conflict. It  helps make every day a success and creates ripples of beneficial behavior.
 
The ADA Principles of Ethics and Code of Conduct were amended in 2010 by addition of Section 3F, PROFESSIONAL DEMEANOR IN THE PROFESSIONAL WORKPLACE, as follows: “Dentists have the obligation to provide a workplace environment that supports respectful and collaborative relationships for all those involved in oral health care.” 
 
An office known for its ethical, caring treatment engenders similar behavior from its patients. They desire to receive treatment at an ethical office and strive to belong to the “family” atmosphere created. Patients will respond in kind with greater responsibility and consideration. They will be unlikely to refer patients who do not appreciate or value that  type of practice setting. As a dental practice “family” grows, the atmosphere of mutual respect and care lends itself to the highest ethical behavior and outlook. Ethical behavior  begets more of the same.  
 
Making ethics a more prominent component of your practice is not a matter of grandstanding or marketing; it is simply a consistent undercurrent of how a business is conducted. Like all New Year’s resolutions, it is easier to resolve than to carry out any intention. This will likely not be a change for most offices, but a reminder and re-commitment to what we are already trying to achieve. 
 
This commitment to an ethical environment is a responsibility we accept as a profession in return for the self-governance dentistry is afforded.  Dentists need the latitude
this provides to develop creative treatment options and keep pace with an evolving dental field. Establishing our profession as an ethical domain allows us to work with legislators  and regulators with both increased candor and clout. It aligns the Dental Association more closely with our State Licensing Boards. Most importantly, it enhances our reputation with the general public. A superior reputation increases our ability to educate and improve public health. It increases our influence on the world around us. 
 
All professions are only as outstanding as the individuals who compose them. Maintaining high ethical standards elevates our profession and also attracts the highest caliber  individuals. Dentistry needs to attract and inspire students to continue selecting our profession from many competing career paths. This can only be done by setting the bar as  high as we can, not just for the students, but for ourselves. 
 
*Dr. Kurkowski is Chair of the Minnesota Dental Association Committee on Ethics, Constitution and Bylaws. He is general dentist in private practice in Saint Paul, Minnesota. Email  is mmkurkowski@msn.com.