March Came in Like a Lion ...

This play on a familiar refrain is symbolic of a rather turbulent month for organized dentistry, a month that is only slightly beyond two-thirds completed as this is written. To be candid, the significant happenings in the world of dentistry in March 2002 demonstrated more vividly than ever before the importance of organized dentistry to its members.

For years, organized dentistry has stressed the benefits of membership such as educational opportunities through continuing education, including ADA and CDA Scientific Sessions; access to business and personal insurance programs designed for the dental practitioner; publications; peer review; legislative representation; and the list goes on. We recall that at one time a number of years ago, a list of CDA member benefits totaled 31. The happenings in March vividly illustrate the emergence of a very different kind of membership benefit.

The year 2001 provided notice that the 21st century would be furnishing the organized profession increased opportunities to defend the science upon which dental practice is based. As reported previously, two legal matters facing the California Dental Association and its members commenced in the early months of 2001 and are still active at the time this is written. We refer to the Proposition 65 matter and the suit against both the American Dental Association and CDA regarding mercury in dental amalgam.

The year 2001 also signaled a new attitude at the American Dental Association with the filing of a legal challenge against Aetna Insurance Company in August. Many colleagues found this pursuit of principle a refreshing change.

But the month of March 2002 would place a new importance on membership in organized dentistry. The chronology of events reads like this:

* March 6 -- The American Dental Association announced that a suit had been filed against WellPoint and its Blue Cross subsidiary alleging unlawful interference in the dentist-patient relationship.

* March 15-19 -- Two legal actions against CDA and its component societies alleging misrepresentation of the peer review system were filed. During this five-day period, CDA and 20 of the 32 component societies were served in this matter.

* March 20 -- A lawsuit was filed in California Superior Court against ADA, CDA, and "more than 20 corporations that deal in materials used to produce amalgam." The suit alleges that mercury in a mother’s dental fillings caused autism in her 6-year-old son.

Obviously, the circumstances in organized dentistry’s action against WellPoint and the suits against the profession are quite different. The ADA suit pursues a matter of principle that dentists believe insurance companies have been abusing for many years. Many colleagues have been urging their professional organizations to be proactive against the business practices of insurance companies perceived to be unfair. In the past year, ADA has asked members to forward information and evidence demonstrating some of these unfair practices so that an appropriate response from the profession could be developed. It is too early to predict what outcomes will be achieved, but the suit does illustrate the value of organizational activity to pursue decisions on issues that would be impossible for the individual practitioner to address.

The suits against organized dentistry over amalgam and peer review represent the continuation of a different, but extremely serious, trend that surfaced last year. At first glance, these suits have the feel of an assault on organizations perceived to have "deep pockets." We doubt that it is any accident that the case alleging that a child’s autism resulted from the mother’s dental amalgams names ADA, CDA, and 20 corporations, accusing them of fraud, negligence, and illegal and deceptive business practices. And the case involves a legal firm active in the 2001 cases, a fact that strengthens our suspicions about the monetary motivation for the filing of this case.

The suits involving the peer review process, while quite different in purpose, cite CDA and all 32 component societies in a class-action lawsuit that occurred in the jurisdiction of only one society. These suits also appear to have a "deep pockets" motive.

Earlier, we commented that these events illustrated the importance of organized dentistry to its members. Whether proactive efforts, or defense on behalf of individual dentists, these activities reflect a new type of membership benefit. It is a membership benefit that potentially is more important to protecting the business interests of member dentists than any more-traditional member benefit.

In reviewing these pending legal matters, it must be remembered that individual dentists could be targeted by such actions and accused of negligence and fraud for utilizing what has been a well-accepted dental restorative or procedure when a patient in their practice has a medical problem that can be linked (even if remotely) to either the materials or to the procedure. Therefore, what is important to the dental profession in the current case is that it be won on the basis of science, and that it sets a precedent that will discourage future attacks on practicing professionals, either individually or collectively.

The peer review matter alleges among other things that misrepresentations by organized dentistry forces patients to undertake peer review for their complaints in lieu of filing malpractice actions against dentists. The outcome of this suit will be extremely important to members because it will reinforce the value of membership if defended successfully, yet could increase the likelihood of frivolous future liability actions against dentists if the defense is unsuccessful.

The bottom line is that in the practice environment of today, legal activity by our professional organizations -- whether proactive or in defense of the materials, procedures, or systems that we utilize to conduct or support our business -- is a most important form of membership benefit. It should be considered a major reason for dentists to join or to retain their membership in organized dentistry.