In this month's dental practice management series, we discuss dentistry, profits, and ethics. 

Distrust is running rampant in today's world. Distrust of the government, journalists, the pharmaceutical industry, sports referees, etc. And now distrust for doctors, dentists, and other medical care providers is all too commonplace—and in some cases, it's merited and valid. 

We had the opportunity to sit down with Dr. Dan Fischer, founder and CEO of Ultradent Products, Inc. and a practicing dentist, to discuss dentistry ethics and running a profitable practice. We talked about his beliefs and philosophies regarding patient care, trust, and how to gauge if you're really doing what's best for the patient. Here are a few of his personal credos, in his words. 

Principle #1—Minimally Invasive Dentistry is Patient-Centered Dentistry

Dr. Fischer: "When it comes to practicing dentistry, the first and foremost belief upon which I center all of my other ethical standards is that one of the most important opportunities we have as dentists is to be the guardian of the oral cavity. I believe that the more we respect the natural tissues and actively preserve them as much as is reasonably possible, the better it is for the patient. 

Preserving and protecting the patient's natural dentition with a minimally invasive approach is the value around which Dr. Fischer centers all else.

"Many call this 'minimally invasive dentistry.' I believe minimally invasive dentistry not only involves avoiding cutting the enamel and tissues wherever possible, but it encompasses preserving the tooth that has perhaps already been compromised or cut in some way. In these cases, we must do everything we reasonably can to rehabilitate it to the best of our ability. 

"All in all, I've come to believe that the more we cut the tooth, the more we weaken the tooth. The more of the tooth we cut and the more times we cut the tooth, the sooner we kill the tooth, because trauma to the tooth is additive. Our opportunity as dentists is to respect the natural tissues, preserving them as much as possible and whenever possible, with the ultimate goal of keeping our patients healthy with their natural dentition throughout their lives. I believe that if we keep this ultimate goal on the top of our mind, we will be practicing not only minimally invasive dentistry, but patient-centered dentistry as well." 

Principle #2—Ethical Dentistry and Profitable Dentistry do not Have to Compete

Dr. Fischer: "Dentistry is not only a 'care' profession, but it is also a business. I'm often asked how I balance doing what's best for the patient and still maintain profitability, when some dentists out there are placing often expensive crowns, porcelain veneers, etc., that are often unnecessary because there are less expensive (and less invasive) solutions in many cases. 

Doing what's best for the patient creates loyalty and referrals, which in turn, lifts your practice's bottom line.

"While I do not condemn the placement of porcelain veneers in cases where it is absolutely what the patient wants, or where no other option is logical, I do not believe in taking advantage of a patient's lack of dental expertise to recommend surgeries and procedures that aren't necessary. 

"I think something that is important to remember, that is not only applicable to this, but to all areas of life is the saying, 'Don't let the wrong things other people do keep you from doing the right things that you know you should do.' 

"Also, I believe that if we gain the trust of our patients and always do what's best for them, a profitable practice with loyal patients and referrals will surely follow." 

Principle #3—Gain Patient Trust Through Prevention

Dr. Fischer: "Gaining your patients' trust is a big deal. In my many years as a dentist, I've come to realize that the best way to gain patient trust is by putting an emphasis on prevention—be it their hygiene, their diet, by placing pit and fissure sealants, and by demonstrating to your patients that you are there to help them avoid problems before they happen to the best of your ability. 

An emphasis on prevention helps to gain the patient's trust and good will.

"Emphasizing prevention goes a long way in creating trust and gaining their assurance that you have what's best for them in mind before anything else. You must communicate and demonstrate that you want them to have good oral health. You want to help them prevent caries. You want to help them avoid surgeries and more invasive interventions in every way possible by preventing the problem in the first place. That is how you earn trust." 

Principle #4—Practice the "Golden Rule," or Better yet, "The Daughter Test"

Dr. Fischer: "I often say that we should treat our patients the way we would want to be treated. That's the golden rule of dentistry. However, another nice, and perhaps even more powerful check is what I call the 'daughter test.' I like to ask myself (and I encourage other dentists to ask themselves), 'Is this something I would do on my daughter or son?' There's no one we are more protective of than our children. In fact, I would dare say most people are more protective of their children than they are of their own well-being, so applying that litmus test is always a nice reminder to me of what's best for the patient." 

Practicing the "Daughter or Son Test" is a good way to gauge whether you're doing what's best for the patient.