It is possible that, by consulting with and/or providing diagnoses and treatment plans for a direct-to-consumer orthodontic company, you may not be in compliance with the Conditions of Coverage of your malpractice insurance. Your policy may state that orthodontists must have a doctor-patient relationship in order to have coverage.
For example, AAOIC malpractice insurance policies do require a doctor patient relationship.
The following excerpt is from the AAOIC Conditions of Coverage (emphasis added). This language may be similar to that of other malpractice insurers coverage.
“The insurance provided by this policy, other than for professional committee negligence, applies to an orthodontic incident only if the insured has performed a comprehensive examination of the patient, has obtained and studied appropriate diagnostic records on which any resulting diagnosis, treatment plan or treatment recommendation is based, and has monitored the patient’s progress regularly or reasonably attempted to do so. These conditions do not apply when providing care on an emergency basis, other than on a locum tenens arrangement, for another orthodontist’s patients.”
Therefore, consulting or otherwise enabling direct-to-consumer orthodontic treatment that does not include an in-person examination could result in a denial of coverage under your malpractice insurance policy.
Did you know that the AAO has published Teledentistry Parameters? The AAO Teledentistry Parameters require an in-person examination before beginning orthodontic treatment:
“The AAO believes there are certain diagnoses and evaluations that can only be performed in-person or are best performed in-person (x-rays, etc.). There are several categories of problems or conditions that many dentists typically look for as part of a physical examination at the outset of traditional in-person treatment. This can include potentially serious conditions, such as oral cancer, periodontal problems, advanced decay, gum disease, etc. With this in mind, and although it might make sense to perform an initial consult via teledentistry, the AAO believes teledentistry TREATMENT should not occur before a physical, in-person examination/evaluation of the patient has occurred by a state-licensed dentist.“
The AAO encourages its members to review and follow these recommended Teledentistry Parameters when providing any consultation or treatment through teledentistry. Thank you, as always, for your membership in the American Association of Orthodontists.