Thursday Troubleshooter: Dentist insists hygienist administer anesthetic illegally
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QUESTION: I’m a dental hygienist, and one of the doctors I work for wants me to administer anesthetic when he’s not in the office. I know this is wrong and we’ve had many arguments about it. I called the dental hygiene board and talked to someone there about it, and I also asked the speaker at the last California law class that I attended. The doctor still insists that I can legally administer anesthetic. I’m worried that I could lose my job over this and that I’d be risking my license.
ANSWER FROM DIANNE WATTERSON, MBA, RDH, founder of Watterson Speaking and Consulting LLC:
Shame, shame, shame on the doctor who’s asking you to break the rules set by your state. Since you’ve already done the things I would have suggested—called the board for a clarification and sought expert opinion—the only other thing you could do is ask the board for something you can print to show your boss. If the doctor continues to press you to break the law, you could make big trouble for him by filing a complaint.
I believe the board would see this as a public safety issue. If you administer anesthesia with no doctor present and your patient has an untoward reaction, your patient could suffer dire consequences and you could indeed lose your license. (I expect it is permissible for you to use a topical anesthetic in the sulcus. That's often all that’s needed to keep a patient comfortable unless the person has hypersensitive root surfaces.)
If you lose your job by refusing to break the law, you can file a wrongful termination complaint with your Equal Employment Opportunity Commission. Although every state is an "at-will" state, meaning employees can be fired for any reason or no reason, there are also several exceptions to that doctrine. The most common exception prevents terminations for reasons that violate a state’s public policy. Asking you to break the law would certainly violate public policy.
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