Plenty of Room for Physicians and Dentists to Collaborate
By Ericka L. Adler
Dentists and doctors working together professionally is hardly a new concept. Collaboration between the two professions has occurred in many different areas. For example, in sleep medicine, physicians and dentists often work together as a multi-disciplinary team to treat patients who might benefit from a dental appliance as an alternative to a continuous positive airway pressure (CPAP) machine.
Another area in which dentists and physicians work together frequently is with chronic illnesses, such as diabetes. Though doctors are often the ones treating diabetic patients, because diabetics commonly encounter issues such as gingivitis, periodontitis, saliva problems and nerve problems, dentists are in a unique position to identify patients at high risk for diabetes during a regular dental exam. Using a simple in-office test for patients suspected to be potential diabetics, dentists can even test patients who might need diabetic care and refer them to an appropriate healthcare provider. At the same time, dentists have also developed expertise in handling patients with diabetes and can serve as an appropriate member of the diabetic patient's healthcare team.
There are many other areas in which dentists and physicians collaborate. With a shortage of physicians increasing in many communities, dentists will play a growing role in spotting healthcare issues such as blood disorders, cancers, and other conditions that present evidence through the teeth and gums. This presents an excellent opportunity for physicians and dentists to find ways in which to effectively join forces to create a successful business.
Although a unified practice approach between physicians and dentists can work successfully, it is important to note there are some legal limitations that may need to be observed. For example, in some states, physicians and dentists cannot practice together in a single entity based on state law and even if they can practice together, fee-splitting rules may prevent the sharing of any income. There are certainly other ways to structure the relationship between these two professions, but it is important to be aware of state law limitations.
It is also essential that neither dentists nor physicians overstep their boundaries into an area of practice in which they do not have expertise or are not licensed to practice. Sometimes the lines can blur when these types of professionals practice together. A good example of this is the foray of dentists into the use of Botox. Under some state licensing statutes, Botox can be used by dentists related to dental care. However, many dentists are now interested in expanding the use of Botox for patients related to cosmetic use. In most states, the use of Botox for cosmetic purposes is limited to licensed physicians and even trained advanced practice providers when supervised by a physician whose expertise includes the use of Botox for cosmetic purposes. Practitioners must always be careful to not push their practice boundaries beyond that which is legal. As the use of Botox grows, and the independence of advanced practice providers gains greater state support, we may see changes in this conclusion. However, it's not unusual that state laws limit novel ideas of how to practice medicine or dentistry! Physicians and dentists working together need to understand that non-compliance by one party can impact the other as well as the joint practice entity, if applicable, and find ways to work together until the law matches their desired business model.
Professional collaboration between physicians and dentists is expected to increase in the future. The shortage of primary-care practitioners is already pushing dentists into the role of being a more significant team member in the care of patients with chronic and acute healthcare issues. From a business perspective, creating a joint model can be of benefit to both dentists and physicians, as long as appropriate precautions are taken. If you are considering a relationship with a dentist, explore the very real benefits, but make sure you seek appropriate legal guidance before launching your venture.