Dentists across North Texas trying to attract new patients promise everything from deep discounts to retail store gift cards for referrals.
But a top official at the state regulatory agency that oversees dentists says many promises appearing in advertisements in newspapers, magazines and telephone books are improper and unethical and violate state rules and even state law.
The problem is particularly widespread, the state regulator says, because as of March 1, the Texas Health and Human Services Commission is changing the way young people up to age 20 enrolled in Medicaid or the Children's Health Insurance Program will receive dental care. Recipients will have to choose a primary dentist.
This has caused a flurry of advertising by dentists seeking new patients, and with that comes a flurry of violations.
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The widespread use of improper promises to prospective patients came to The Watchdog's attention after an anonymous person sent me a thick envelope filled with dozens of dentists' ads from the past year.
When I showed them to Joy Sparks, general counsel of the Texas State Board of Dental Examiners, she taught me which ones are clear-cut violators -- and why.
Many of the most basic promises in the ads aren't allowed. So why do dentists do it anyway?
"Sometimes in the economy, like it is, people are desperate for business," Sparks said.
The dental board investigates after someone complains, she said, and "we get a lot of complaints."
The main goal of the rules is to make sure that when a new patient, lured by an ad, walks into a dental office, there are no surprises. The ads must not be false or misleading, and they must be subject to verification.
Here are examples:
Ads that promise "free braces" are misleading, because braces are never free. They are paid for by Medicaid or a third party.
An ad offering "free teeth whitening/restrictions apply" is also false and misleading. What are the restrictions? They must be spelled out.
Ads that lure patients with promises of "free teeth cleaning" without offering more specifics are wrong. "What if you don't need a basic cleaning?" Sparks asked. "What if you need a deep cleaning because you haven't been to a dentist in 10 years? It has to say also, 'Appropriate to your diagnosis.' Some people need root cleaning and scaling of teeth. The promise has to be diagnostically appropriate."
Similarly, an ad offering "Free store gift card upon completion of treatment" is also false. What is the definition of treatment? The answer must be clearly explained in the ad.
Ads promising "20 percent discount off for patients with CHIP" are false because the ad should explain what the discount is for. Specifics are required.
"They need to tell how much the coupon is for," Sparks said. "If you get a coupon for a free cleaning, and they get you in there and they say, 'You have to get an X-ray before the discount,' people get mad and say, 'You didn't tell me I had to have X-rays.' But that's right. They do need to get X-rays. That's the most basic diagnostic tool."
Rules forbid health providers in Texas from paying a third party to solicit new patients. Many dental ads promise people who refer patients a retail store gift card. Not allowed. But a new patient can receive a gift card for coming in.
One ad I saw states, "Free gift card and much more for all patients and new patient referrals after completion of exam and X-rays."
That's almost OK for new patients ("and much more" needs to be spelled out) but not OK for the patient referrals. Plus, the value of the exam and X-rays has to be explained.
When complaints come to the dental board, advertisers are given 30 days to fix problems. If they don't, they get an administrative citation with a fine. Ultimately, they could face further action ranging from a warning or a reprimand to a public disciplinary order, which may include required continuing-education courses.
An advertising committee is reviewing the marketing rules and expects to propose changes that include helping dentists understand how to use social media marketing tools. Those are expected to be released in April, with approval as early as August.
Coming Sunday: The Watchdog hears a travel club sales presentation.
The Watchdog column appears Fridays and Sundays.
Dave Lieber, 817-390-7043