False Assumptions that Dental Offices Make About Compliance
& How to Correct Them
By Russell Kane, Compliance Consultant
Dental Office Compliance of New England LLC
Compliance, admittedly, is a dry topic and it’s not the reason you decided to become a dentist, RDH or DA in the first place. Nevertheless, every industry – particularly healthcare – has its own rules and regulations and non-compliance simply is not an option.
I spent most of my professional career (25+ years) as a legal and compliance officer in the financial services industry (which, along with healthcare, is among the most heavily regulated) but I’m amazed by how similar the workplace dynamics are between the two. Regardless of whether you’re drafting contracts or treating teeth, professionals need to understand their roles and obligations with respect to compliance. False assumptions will increase risk, both for you and your patients.
Below are three false assumptions I’ve observed in dental offices (as well as in offices in which I’ve worked in my former professional life):
False Assumption #1: False Assumption #1: “I can outsource compliance”
Reality: Reality: No, you can’t. Compliance is the business’s responsibility.
Some practices hire consultants like us to “take over” compliance. While we are certainly capable of that and believe we can play an important role in helping dental offices comply with the law, we cannot step into your shoes. At the end of the day, compliance is the business’s responsibility (and, more particularly, the responsibility of the dentist who owns/runs the practice). We can give you the tools to succeed – templates of forms and procedures, guidance on how to comply, alerts as to what’s changing, etc. – but it’s your responsibility to implement these tools. Unlike us, you’re in the office every day, can determine staffing needs and responsibilities, can (and should) discipline staff for noncompliance, have relationships with your patients, and care most about your reputation to such patients as well as to the community in which your office sits.
Advice: Take ownership of compliance. It’s your responsibility as a business owner.
False Assumption #2: False Assumption #2: “I have written procedures, so I’m all set”
Reality: Reality: Procedures are useless if they aren’t tailored to your office, nobody knows about them, and nobody understands them.
When I teach HIPAA continuing education classes to our dental office clients, I describe to them the topics that their HIPAA Compliance Manual covers (e.g., limiting the use and disclosure of patient health information to what’s “minimally necessary for the purpose,” effective workstation and cell-phone policies, training, etc.). However, I always explain that effective policies and staff training have to be tailored to what actually happens in that particular office. For example, who’s the Privacy/Security Officer in charge of implementing these policies (and does everyone know who that person is?) What data does the office collect from patients and employees, where is it kept (hardcopy and/or electronic) and what does the office do to keep it safe? Who handles patient requests as permitted by your Notice of Privacy Practices? I can tell you what HIPAA requires but only you can implement office-specific policies and procedures that describe how you comply.
Advice: Use staff meetings to review key office policies with employees. Make sure they understand the purpose of such policies as well as their roles and responsibilities in implementing and enforcing them.
False Assumption #3: False Assumption #3: “It’s always been done this way, so we’ll just keep doing it.”
Reality: Reality: There often is more than one way to comply with a given requirement and an office that encourages new ideas will have more engaged employees.
There are two things (among others) that can kill the morale of an employee: (1) the employee doesn’t understand the purpose of a task or the way that it’s being done and so the employee finds the task to be drudgery; and (2) the dentist(s) and office manager are set in their ways and unwilling to listen to new ideas so the employee feels like s/he has no control. Unfortunately, employees often feel this way and the dentist(s) and office manager do not do anything to improve the situation – either because they don’t care or they lack the skills or resolve to have substantive discussions on these types of matters.
If employees understand “why” a given task is necessary and have some ability to influence “how” it is implemented, they likely will be more engaged in the task and perform it more effectively. It’s up to practice leaders to create an office environment in which employees are encouraged to share their ideas on what might work better, the relevant staff can openly discuss these ideas and, if the idea is not implemented, the employee who raised it understands why.
Advice: Be open to new ideas. Recognize and reward employees who are constantly looking for ways to work smarter rather than harder.