Standards Respecting Conflict of Interest
College Guidelines contain practice parameters and standards which must be taken by all Ontario dental technologists in the provision of their services. It is important to note that these Guidelines may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained.
INTRODUCTION
This document attempts to summarize and explain in simple language the College's draft Regulations on "Conflict of Interest for Members" which was circulated to members for information in July 1994. It should assist members to better address a range of potential conflicts arising from their practices and business arrangements. Members should always refer to the pertinent sections of the August 1994 draft regulations for specific details and further clarifications.
According to O. Reg. 798/93 s. 11, it is an act of professional misconduct for a dental technologist to practise the profession while in a conflict of interest.
CONFLICT OF INTEREST SITUATIONS
Simply put, a conflict of interest is created when you put yourself in a position where a reasonable person could conclude that the dental technologist is making arrangements that may compromise, or affect his/her professional judgement, or that of his/her client(s). In this context, a "client" of a dental technologist would include the referring health professional. Where a member directly, or through an affiliated corporation, offers financial or other inducements to a dentist to make a referral to the member, the interests of the patient(s) may become secondary to the self-interest of the referring dentist, the client. It is the College's function to protect the public interest by the elimination of arrangements of this nature. Whether actual or perceived, conflicts of interest give the public the impression that their care or the cost of their care may be compromised by you. It is for this reason that conflicts of interest must be avoided. As a result, acting while having a conflict of interest may constitute professional misconduct. 1.
Inappropriate "Arrangements" or "Business Relationships" with other health professionals
Dental technologists are entitled to profit appropriately from the use of their training and experience in providing professional dental technology services. Attempts to enter into any "arrangements" or "business relationships" with other regulated health professionals or providers or health care facilities for the purpose of inducing referrals, generating service volume, or any type of financial profit or material gain are likely to constitute conflicts of interest. For example, the following actions must be avoided:
◦offering quantity discounts or discounts for prompt payments to dentists;
◦offering gifts, airline tickets or air miles as incentive programs to dentists;
◦offering rebates, credit or other benefits to dentists;
◦making special arrangements to finance dentists' purchases of equipment, facilities and supplies;
◦providing benefits that do not directly benefit patients.
2.
Fee or Income Splitting
Dental technologists may not fee or income split with anyone other than
◦a dental technologist who engages in the practice of dental technology as an employee of yours;
◦another dental technologist who, while not employed, comes to your office to provide services as an independent contractor for your laboratory;
◦a dental technologist who engages in the practice of dental technology as your partner.
As a result, contractual arrangements, such as a lease or use of premises or equipment which provides for fee or income splitting, create a conflict of interest. This would prevent a dental technologist who rents space or equipment from paying rent based on his/her billings.
3.
Self-referral
In the process of a dental technologist's involvement in the treatment of a patient, it is a conflict for a dental technologist to refer a patient or a regulated health professional to individuals, facilities, services, or supplier without disclosing his/her ownership or controlling interest or from which the dental technologist, his/her family or corporation derives any financial or material benefits.
It is also a conflict for a dental technologist to exercise influence to promote the sale of materials, devices, products or other supplies without disclosure of his/her ownership or controlling interest and disclosure of the interest of a related person or corporation.
(To avoid problems that might arise from self-referral, members must ensure full disclosure to the prescribing health professional prior to providing the services; and that use of the product, device, facilities etc. is in accordance with the standards of practice of the profession and, in the circumstances, is appropriate.)
4.
Personal, moral or philosophical conflicts
A dental technologist's personal, moral or philosophical beliefs or practices must not impede patient's appropriate and timely access to services.
DEFINITIONS
For the purpose of understanding the scope and applicability of the guidelines and regulations relating to conflict of interest, the following definitions are used: BENEFITS "Benefits" means any benefit (financial or non-financial),gift, advantage or payment of any kind, whether direct or indirect, and, without limiting to the generality of the foregoing, includes:
a.any monetary payment;
b.any rebate, credit or discount on or reimbursement of the cost of goods or services;
c.the receipt of goods or services at no charge or at a cost which is less than prevailing market rates;
d.the payment or reduction of any amount of any debt or financial obligation;
e.the receipt of any consultation fee or other fees for services rendered;
f.any loan except in accordance with stipulations in the draft regulations of August 30, 1994;
g.the acceptance of credit unless the credit is extended in accordance with stipulations in the draft regulations of August 30, 1994.
RELATED PERSON "Related person" means any person connected with a member by blood relationship, marriage or adoption, or a business partner.
CONTROLLING INTEREST "Controlling Interest" means the interest that a member has in a corporation. The ability to control 10% of the votes of equity shares is deemed to be control.