Internecine Warfare
I was talking recently with an orthodontist who has a strong prejudice against a particular method of orthodontic treatment currently advocated by many non-orthodontists. He told me how much he would welcome the opportunity to joust with these practitioners in a courtroom, so that those who use this treatment method would be beaten in court, see the error of their ways, and give up their orthodontic foolishness. When I told him that such a case has already been taken to court and that the jury had found for the accused practitioner of the allegedly dubious treatment, he was speechless. He couldn't believe that a jury was capable of such ignorance and misjudgment.
People are mesmerized by TV shows in which the truth is always obvious and justice is meted out within 30 minutes. Unfortunately, in real-life courtrooms, justice is often elusive and truth is often obscured. A court of law is an especially poor place to settle a scientific dispute-- Galileo would attest to that. By the time attorneys get through with arguments, objections, and befuddling witnesses, the facts get a little fuzzy and even knowledgeable people begin to stagger beneath the weight of legal technicalities. How is a jury of laymen supposed to arrive at a reasonable and just conclusion about a complicated dental subject when there is much disagreement among professional experts?
The other side of this coin is the prevalence of criticism of one dentist by another. We have often been accused by the public of running a closed shop in which incompetent practitioners are protected by their colleagues. Perhaps it is frustration with the ineffectuality of our internal grievance system that causes some zealous practitioners to want to nail an incompetent colleague in a court of law. More often, it is a professional psyche that makes us all self-appointed judges of the work of others. This attitude often leads to offhand critical remarks or attacks on the work of others that may directly or indirectly encourage a patient to sue the previous dentist.
Sometimes professional disagreements are argued in the public media. Another colleague sent me a newspaper clipping in which a self-styled expert was inveighing against any dentist who advocated the removal of bicuspids in connection with orthodontic treatment. He was quoted that such a treatment plan doomed the patient to future TMJ problems. The clear inference was that the removal of bicuspids was tantamount to malpractice, and anyone guilty of such malfeasance should be tried, quartered, and hung. This kind of remark is not only unethical, but is based on a profound ignorance of the TMJ anatomy and physiology. It flies in the face of current orthodontic practice, and it can only confuse lay persons.
It is said that most dental malpractice suits are encouraged by dentists. Typically, a patient changes dentists, with or without a complaint about the work of the previous dentist. The second dentist may incite or support dissatisfaction with the previous treatment, and even offer to testify on the patient's behalf. Such a case occurred in my community. The first dentist was guiltless, but
because of a disparaging remark by a dental colleague he found himself in court trying to answer false charges. Fortunately, he was exonerated, but not before becoming terribly stressed.
It is just too easy to sit in judgment of the work of others. "Judge not, lest ye be judged" might be a good axiom to follow, especially in the absence of all the facts. The public deserves to be protected from malpractice, but any practitioner assuming the role of protector ought to be very sure of the facts and not just prejudiced against an appliance or the qualifications of a fellow practitioner. More than one crusader has had the tables turned on him.
If you are giving a second opinion on a case that has been less than successfully treated by another practitioner, the first thing to do is call the first practitioner to discuss the case. You might find out about some extenuating circumstances that you ought to know. You might spare a colleague unwarranted criticism or a lawsuit. You might even spare yourself an unfortunate repetition of the same experience.