on a practice’s website could go a long way in promoting goodwill. ● Encourage satisfied patients to write reviews on specific websites. On the surface, this strategy may sound awkward or coercive, but there is nothing wrong with asking satisfied patients to spread the word to other potential patients. At the end of an office visit, personnel can offer cards to satisfied patients asking them to share their thoughts on specific websites. This can help build a positive online reputation more quickly than simply waiting for it to evolve on its own. ● Accept the reality of negative comments and be prepared to respond to them. Some patients will post negative comments. When they do, dentists should be prepared to respond in a respectful and thoughtful way. As mentioned above, it is important to avoid HIPAA violations. Providers should also trust that prospective patients can spot trends
in reviews. A few negative or lukewarm comments are not likely to sway a patient away from a practice if most feedback is positive. In fact, a few negative comments may lend credibility to the review process itself. Providers should also consider responding to positive comments and thanking those patients for their loyalty. ● Consider improving the practice in areas frequently reviewed as negative. Online review websites may serve as a kind of “focus group” and help providers assess their performance. Such feedback could be a practice asset in disguise. Getting past the emotional aspect of consumer review websites may be a challenge for some. People do not like to see their work criticized. However, if providers can overcome this obstacle, they may actually be able to use these websites to their advantage.
ETHICAL DECISION-MAKING MODELS
Ethical problems are complex and constantly changing. For example, the notions of cyberbullying and social media couponing were unheard of until the early years of the 21st century. The dental practitioner has an obligation to navigate through complex ethical problems and come to reasonable solutions. Reliance on a set of ethical principles greatly aids this process of ethical decision making. In navigating through the process of solving ethical dilemmas, it is important to take a systematic approach. This practice helps the professional avoid overlooking an important aspect of the case as he or she formulates a solution. Ethical decision-making models provide a framework for case-by-case ethical reasoning. One of the most difficult ideas to grasp about ethics is that ethical decision-making is rarely black and white; in fact, it is mostly gray. This apparent ambiguity does not mean that there is not a best answer for any particular situation. Dental practitioners must formulate a solution and be willing to act on it to properly perform their duties. An ethical dilemma occurs when competing obligations confront the provider and he or she has to weigh two or more options to resolve it (Beemsterboer, 2017). Weighing the options involves a moral evaluation, not one based on clinical skills or scientific judgment. Ethical decision making is multifaceted. Dental providers do not function in a vacuum. They bring to their practices of dentistry a personal world that influences perspectives and decisions when dilemmas occur. It is important to acknowledge the existence of potential bias resulting from these personal experiences and perspectives. By consciously making this acknowledgment, the dental professional may gain a more objective view of the particular scenario and eventually come to a more logical conclusion. Personal experiences that may influence ethical decision making include, but are not limited to, the dental provider’s: ● Upbringing. ● Religious or faith-based influences. ● Professional training or codes of ethics. ● Practice type and location. ● Patient expectations.
Many ethical decision-making models are available. All of them aim to guide the user to the most beneficial outcome of any scenario. Dilemmas are often complex and convoluted. In any case, it is important to consider: ● The professional relationship involved. ● The ethical principles involved. ● The professional obligations and conflicts involved. ● The central values of the dental practice. ● Potential personal biases. ● Alternative courses of action available. ● Appropriate actions to take. The ACD Ethics Handbook for Dentists (2016) offers several user-friendly ethical decision-making models that provide a useful quick reference for dental practitioners. (A PDF version of the book is available at https://www.dentalethics.org/ ethicshandbook.htm). To resolve the ethical dilemmas in the case studies presented later in this course, readers will use the decision-making model shown in Table 5. This same decision-making model also appears in the Appendix. Learners can photocopy the model and use it as a helpful tool when working through the ethical dilemmas they will encounter in their practices. Steps 1 and 2 in the ethical decision-making model in Table 5 help define the problem, clarify the facts, and identify potential bias. This process enables the decision maker to be as objective as possible while navigating through the case. The purpose of steps 3 through 5 is to gather and direct thoughts and information into potential courses of action that ultimately lead to an ethically defensible solution to the problem. By using this approach, the dental practitioner will have completed the necessary due diligence regarding the particular ethical dilemma, ultimately arriving at a decision that is well-considered and appropriate. Table 6 presents an ethical dilemma and decision-making solution using this five-step approach. After reviewing this case scenario, the reader should be able to work through the remaining case studies in the course. Solutions to these cases are not absolute. The cases are meant to be thought-provoking exercises that provide the dental practitioner with an opportunity to practice the skills learned in this course and ultimately apply them to dental practice. Work through each case independently, then read the discussion that follows.
● Social customs. ● Societal norms. (Beemsterboer, 2018)
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