FDA MEMBERS’ FREQUENTLY ASKED LEGAL QUESTIONS

Our newest member resource is the FDA Member Legal FAQ sheet. This list of popular questions includes answers provided by FDA legal counsel, in an easy to use online format (click any question below to be taken directly to the answer).

Copyright © April 2007. Graham H. Nicol, Esq., Don A. Dennis, Esq. and Florida Dental Association, Inc.  All Rights Reserved. This site does not provide legal, risk-management or any other advice.  The site and its services, including the information above, are for informational purposes only and are not a substitute for professional legal or risk-management advice.  Always seek the advice of your attorney or other qualified legal professional before changing or implementing any of your office practices and procedures.  Do not delay seeking or disregard legal and risk-management advice based on information on this site. Legal and risk-management information changes rapidly and while the Florida Dental Association, Inc. and its content providers make efforts to update the content on the site, some information may be out of date. No legal or risk-management information on this site is approved or evaluated by the Florida Board of Dentistry and therefore the information should not be used by you to interpret regulatory requirements without the supervision of an attorney experienced in health law.

Q:  How long must I keep patient records ? back to Top

The Board of Dentistry minimum is four years from the date of the patient’s last treatment or appointment.  Rules for Medicaid/Medicare and managed care providers are set forth in the provider handbooks and participating provider agreements.  Rules for hospital-based providers are set by the hospital and are typically longer. See generally Board of Dentistry Rules 64B5-17.001-002 

Q:  How long should I keep patient records ? back to Top

Risk-management principles dictate that records should be kept in perpetuity (if space permits) or at least until the statute of repose for medical malpractice has expired, which is, in general, seven years from the date of the incident in question.

Q:  Can I keep digital or electronic records ? back to Top

Certainly, just be aware that your software must be able promptly to locate and print copies of written records and digital radiographs.  Also, there is no consensus as yet on electronic format so that dental records can be provided electronically to hospitals, managed-care payers and insurance companies.  Despite federal HIPAA regulations, security and data integrity are also issues that present liability risk.

Q:  How do I destroy old patient records ? back to Top

Any manner that protects patient confidentiality is acceptable.  Your practice should have a written policy on records retention and management that must be followed in every case.  Acceptable methods include shredding, burning, etc.  Unacceptable methods include putting them in the dumpster or a garbage (because publicly accessible).  Also, if you hire a shredding service expect them to prepare a Business Associate agreement to comply with HIPAA.

Q: Another doctor has requested my patient records.  What exactly do I give them ? back to Top

Assuming they provide you with a properly signed authorization form from the patient, you should give them everything they ask for.  The general exception to this rule is that you should ask for specific written authorization before disclosing super-confidential information such as a patient’s HIV status, psychiatric treatment, and certain other personally sensitive information.  Remember that the right of privacy is that of your patient even though you may be the “records owner” under Florida law.

Q:  How do I end the doctor/patient relationship ? back to Top

Make it office policy to provide written notice or confirmation of termination.  Retain a copy for your records.  Make sure the termination is not made “effective immediately”—you must give the patient a reasonable amount of time to locate another doctor willing to provide treatment.  Also, realize that you are at increased risk for improper termination if you haven’t completed your treatment plan.

Q:  Are there improper reasons to terminate the doctor/patient relationship ? back to Top

Definitely.  Remember that most dental practices are places of public accommodation.  Do not terminate or refuse to treat a patient based solely on actual or perceived disability such as HIV/AIDS, deafness, blindness, or obesity (contact the chair manufacturer for recommendations if you think your patient is too heavy).  Also, termination or refusal to treat based solely on age, race, sex, national origin, marital status, etc. is morally reprehensible and may violate the ethics of the profession.

Q:  What is the domestic violence minimum continuing education requirement ? back to Top

The course is no longer required for initial licensure but you must complete a 2-hour course every third renewal.  In other words, you have to take a 2-hour course once every six (6) years. 

Q:  What is the HIV/AIDS minimum continuing education requirement ? back to Top

The course is no longer required for initial licensure but you must take the course before your first renewal.  Thereafter, there is no longer a requirement that you complete the course every two years.

Q:  What is the laws and rules minimum continuing education requirement ? back to Top

The course is no longer required.

Q:  What is the medical errors minimum continuing education requirement ? back to Top

A 2-hour course is required for initial licensure.  Thereafter, you must take it again every two years (in order to renew your license).

Q:  Are the continuing education rules different if I have an anesthesia permit ? back to Top

Yes.  Anesthesia permit-holders must complete at least four (4) hours of continuing education relating to anesthesia every two years in order to renew their permits.  Also, the four-hours should include two-hours on management of medical emergencies.  Also, anesthesia permit-holders are required to take a CPR course at the advanced, rather than basic, life support level. See Board of Dentistry Rules 64B5-14.003-004

Q:  Who should I call about unlicensed practice of dentistry ? back to Top

This is a felony in Florida and should be reported immediately to 1-877-HALT-ULA (1-877-425-8852) or via the internet at the Department of Health which has pages in English and Spanish.

Q:  Do I need to register as a dispensing practitioner in order to write prescriptions ? back to Top

No.  A dispensing practitioner is one who fills their own prescriptions.  If all you do is write a prescription to be filled at a pharmacy, you are not a dispensing practitioner.  Also, if you dispense from your office only fluoride and chlorohexidine rinse solutions, you do not need to register as a dispensing practitioner.

Q:  What duties can I delegate to my hygienists and assistants ? back to Top

Delegating duties improperly is one of the most serious Board of Dentistry violations.  It carries a six-month mandatory minimum suspension.  Remember that the only intra-oral tasks that can be delegated are those specifically listed in the law.  If the task is not specifically mentioned in the rule, you cannot delegate it.  Also, the list of delegable duties changes frequently as new technologies and treatment modalities arise.  If you have any question, contact the Board of Dentistry and get the current list or view the Rules on Delegable Duties online.

Q:  What is the “13-month rule” in connection with delegable tasks ? back to Top

The 13-month rule is actually Florida Board of Dentistry Rule 64B5-16.001.  It says that before dentists can delegate oral prophylaxis (or other delegable duties) to a hygienist, the dentist must conduct an oral examination.  The oral examination, which usually include x-rays, must occur at least once every thirteen (13) months in order for the delegation to be lawful.  The rule also applies to tasks delegated to dental assistants. 

Q:  Where do I get dental lab pads ? back to Top

Every time you send work to a dental lab, you must include a dental lab work order.  You can order the pads from any printer you choose—you no longer need to get them from the Department of Health.  But remember that certain information must be on the work order, for example, you must include the lab’s registration number (assuming you use a Florida lab).  The original should go to the dental lab and you should retain a copy as part of your patient records.

Q:  Do I have to have an automatic external defibrillator in my office ? back to Top

Yes.  The Florida Board of Dentistry has ruled that you fall below the minimum acceptable standard of care if you do not. See Board of Dentistry Rule 64B5-17.015

If you have a question that is not addressed above and you feel it would benefit other FDA members to have the question answered submit it to the FDA Legal Department for review at: legalfaqs@floridadental.org