WSDA ACTION: Corporate Practices in Washington
The following letter was sent to all four caucuses this past week regarding the WSDA's policy on corporate ownership of dental practices. The same letter was sent to all four caucus leaders. The WSDA sent the letter at the recommendation of Brad Boswell and Vicki Christophersen, who want to ensure that all legislators are aware of our position on this issue well in advance of the legislative session. We will be following up with individual communications between key legislators and our lobbyists and grassroots dentists.
October 17, 2014
The Washington State Dental Association wanted to make you and members of your caucus aware of a policy issue that will likely arise in the upcoming legislative session. Two out-of-state organizations, the Association of Dental Support Organizations and Pacific Dental Services, have retained contract lobbyists and intend to support legislation to amend current state law which only allows licensed dentists to own, maintain, and operate a dental practice (RCW 18.32.020 (3)). WSDA strongly supports current state law and will fervently oppose any legislation which introduces corporate influence into the patient-doctor relationship. We fundamentally believe that dental treatment decisions should be made by patients and dentists without influence from outside parties.
The Department of Health (DOH) and the Dental Quality Assurance Commission (DQAC) share our concerns in this important matter. DQAC’s concerns about corporate practice are clearly articulated in a draft report from their Corporate Practice Committee:
The commission’s concerns [about corporate dental practice] rise from both observation of national trends and from experience in reviewing discipline cases involving corporate or complex group practices. In the commission’s discipline caseload, commission members and DOH staff have reviewed cases involving:
• Patient abandonment when a corporate dental practice closes a location without notice or referral to patients at that location
• Patient and subsequent provider inability to obtain treatment records from the corporate practice
• Corporate policies influencing the level of care provided
• Failure to complete treatment plans and provide continuity of care as a result of company policies controlling which dentists a patient sees or as a result of staff changes at a location
• Non-dentists exercising ownership and control of a dental practice
Proponents of amending this section of the definition of dentistry will state they are simply attempting to “modernize” an “unclear” statute. They will also say that Dental Support Organizations only want to provide consulting and supportive services. However, current state law does not prohibit dental offices from obtaining consultants or Dental Support Organizations to assist with bookkeeping, marketing, or other clerical functions so long as these consultants are not compensated with profit sharing or ownership equity in the practice.
Changing state law to allow ownership of dental practices, directly or indirectly, by non-dentists will present unwarranted intrusion on the dentist’s diagnosis and professional judgment.
To be clear, WSDA has no issue with licensed dentists organizing themselves into a group practice or a single licensed dentist owning several dental offices. WSDA does have serious concerns with non-dentists acquiring ownership stakes in dental practices whether overtly or more subtly. We believe all dental practices should be owned by licensed dentists and, therefore, be regulated under the control of DQAC and DOH.
We look forward to further discussions with you and members of your caucus on this important matter. Please let us know if you have any questions or would like any additional information.
Gregory Y. Ogata, President
Stephen A. Hardymon, Executive Director