Ethics — Everything You Wanted To Know About Ethics in Dental Marketing but Were Afraid To Ask

Ronald V. Surdi, DDS

Now that I’ve caught your attention, I will attempt to provide some insight on current marketing in dentistry and some of the history in light of the celebration of 150 years of the California Dental Association. Change is good, change is inevitable. Dentistry as a profession is being challenged. We make a commitment to stay up with the times as stated in the CDA Code of Ethics. Besides learning new procedures, keeping up with the ever-changing world of technology is essential. How technology affects our profession and businesses is also part of this whole new world equation.

As a former member of the investigative panel subcommittee of the CDA Judicial Council, I observed a number of dentists’ websites. Many of these websites were welldone professional advertising masterpieces. Therein lies my realization about new-age marketing. When advertising exaggerates the truth and complicates or muddles the public’s opinion with claims of superiority, it could be in conflict with the Code of Ethics, Section 6, Representation and Claims. This section states:

“In order to properly serve the public, dentists have the obligation to represent themselves in a manner that contributes to the esteem of the profession. It is unethical for a dentist to mislead a patient or misrepresent in any material respect either directly or indirectly the dentist’s identity, training, competence, services, or fees. Likewise, it is unethical for a dentist to advertise or solicit patients in any form of communication in a manner that is false or misleading in any material respect.”

The Judicial Council further interpreted this section in an advisory opinion: “Subjective statements about the quality of dental services can raise ethical concerns. In particular, statements of opinion may be misleading if they are not honestly held, if they misrepresent the qualifications of the holder or the basis of the opinion or if the patient reasonably interprets them as implied statements of fact. The fundamental issue is whether the advertisement, taken as a whole, is false or misleading in a material respect.”

It was obvious that most of the websites I observed were created by marketing firms versus by the dentists themselves. It is imperative for us as accountable professionals to evaluate the information being put on our own websites. For example, utilizing suffixes after one’s name, whether easily recognized or not, implies superiority. Also, it is unlikely that you are or were “the best cosmetic dentist” in your city. If you are sharing a patient’s opinion that you are the best dentist, the ad should indicate that it’s a patient’s testimonial.

Another commonly made claim for “painless” dentistry reminds me of the historical figure Painless Parker from the early 1900s. Way back when dentistry was first becoming a profession, Painless Parker was a street dentist described as “a menace to the dignity of the profession” by the American Dental Association. His office building became adorned with nightmares of alliteration: “Proclaimed by Public, Press and Pulpit;” “Painless Parker Is Positively Perfect.” According to a New York Times article: “A quintessential snake-oil salesman in goatee, top hat and cutaway coat, he established the first — and presumably last — sidewalk dental show. A brass band would play, spangled girls would wiggle and contortionists would perform sideshow acts to drum up a crowd; Dr. Parker would orate on the horrors of tooth decay then ask for customers. A stooge would volunteer, and Parker, operating at his portable dental chair, would pretend to yank out his molar effortlessly, displaying to the audience a tooth he had already palmed. Did that hurt? Didn’t feel a thing.” [1]

More recent history of advertising in dentistry is exclusively from my perspective. Having graduated from dental school in 1984, the goal of many graduates back then was to just “hang a shingle” in a good location where there was a need for a new dentist. The paradigm was that you would soon be discovered as being an ethical provider exhibiting the principles of competence, compassion, veracity, professionalism and beneficence. Community involvement and personal recommendations provided a tried and true internal marketing methodology. High-visibility locations and ads with numbers like 123-BESTDDS and catchy fictitious names became trendy external marketing practice.

Clearly, times are no longer as simple as this and websites, advertising and reviews have become accepted methods to attract patients.

The story of Painless Parker is something I will leave for you to ponder as you research your own professional ethical online presence.

REFERENCE 1. Pollak M. Was Painless Parker a Vaudeville Joke or a Real Brooklyn Dentist? The New York Times Sept. 26, 2014.

Ronald V. Surdi, DDS, is a member of CDA and the Harbor Dental Society. He volunteers at the Ostrow School of Dentistry of USC and served on the CDA Judicial Council.