 Today is Dr. Victor Lucas' first day as an associate with a large dental group practice. He is a recently graduated dentist and has been hired by the group's office manager, Diana Leland. Diana has spent the last few hours orienting Dr. Lucas to the practice and he is now finishing some of the paperwork required for newly hired employees. Any other questions about these forms? Um, no. I don't think so. Looks pretty straight forward. I'm tired of sitting down. Are you tired of sitting down? Let me show you around the office. Sure. I'd love to meet the other doctors. The doctors are not in today. They're attending a marketing seminar. It helps to remind them that this practice is a business too. Some of the staff are working today. Let me introduce you to them. Yeah, cool. And this is our in-house lab. If we need a temporary crown or retainer done quickly, one of the auxiliaries can do that here. And this is Kerry. He's one of our dental assistants. I know Kerry. He actually met while working a volunteer in downtown. Small world. It's Vic, right? You graduated. Are you going to be the new dentist? Awesome. I hope you like it here. What are you working on now? Coronal polishing then sealants. I didn't know you did expanded functions. Well, I kind of get to do a lot of things around here. Well, I better get to it. We'll chat more about this later. For sure. Thanks, Kerry. Kerry is great. He does so much around here. It's people like him that help us manage our overhead. And it allows doctors like you to focus on doing the procedures diagnosed by the senior staff. You won't do any child prophesies or sealants here. Oh. Okay. Dr. Lucas is settling into his position, adapting to seeing a steady stream of patients and carrying out the treatment plans that have been drawn up for him. His initial concerns about lack of independence in managing patient care decisions waned over the first few weeks until seeing his current patient. Mr. Wells is supposed to have several teeth restored with crowns, though the patient's chart does not document the rationale for this treatment plan. As he examines the patient, he is puzzled by the planned transition to full coverage crowns when the existing conventional fillings present with only minor recurrent decay. Hey, Diana, can I talk to you for a minute? Sure. What's up? So I just took a look at Perry Wells and he has existing direct restorations while hardly any decay present. And the treatment plan is calling for crowns? Well, let me pull them up real quick. There's nothing out of the ordinary here. Dr. Latter just saw him, and this is the treatment plan that's been developed. His insurance is going to cover the bulk of the procedure. You need to work on your trust level, Dr. Lucas. Remember, you're senior staff are the ones with the experience. For right now, your role in this practice is to follow their lead and do the procedures. What are the ethical and professional issues raised by this scenario? You may pause the video to consider this question. Consider these possible options for addressing this situation. You may pause the video after each possible solution to consider the implications of each option. Should Dr. Lucas follow the directions given to him by the office manager and perform the treatment prescribed by the senior dentist in the practice? Bring his concerns to the dentist who prescribed the procedure. Question the patient about his understanding of the proposed dental treatment. Present a modified treatment plan to the patient. Quietly advise the patient that he should seek care elsewhere. Report the situation to the State Board of Dentistry. Now let's look at potential contributing factors as you weigh what's important in your decision about an appropriate course of action. The laws governing care by auxiliary team members, the prior authorization received for crowns from the patient's dental insurance, the parameters outlined in the new dentist's employment contract, a duty to educate the patient about treatment options, a responsibility to consult with a colleague about treatment plan concerns, the ethical obligation for self-regulation of the profession. Many dental practitioners face ethical dilemmas such as this one on any given day, anticipating how you might deliberate to find a suitable resolution to any such dilemma is good preparation and can aid each practitioner to find appropriate solutions to the challenges they sometimes must face.