law.
Clearly, monitoring equipment that captures information or behavior that is deemed private, such as employee break rooms, would pose a much higher legal risks. Monitoring that captures activity in restrooms and similar private areas could result in criminal prosecution as well as lawsuits for damages.
Discoverability
Keep in mind that surveillance records may be discoverable in the event of a lawsuit, such as a malpractice claim or a slip-and-fall. For example, records of an incident that results in an alleged injury to a patient, employee or other individual may need to be retained and turned over to the other side in the event of a lawsuit.
31. Should I Rely on Design Professionals, and What Should Their Contracts Include?
Consulting with design professionals is a good idea if warranted by the scope of your project. As any seasoned dentist knows, the days of dentistry being relatively unregulated have long passed. The importance of keeping up with regulatory developments cannot be understated. These developments will affect not only how you practice, but also the design elements of your practice environment. Relying on experts “in the know” about legal requirements and shaping your contracts with them to protect you and assure compliance is the best way for you to proactively address this important aspect of dental office design.
The interplay of federal, state, and local laws varies from city to city. A prudent dentist will want to consult and rely upon competent professionals for advice. Your lawyer can help you understand what is required, and draft contracts that obligate your architect and contractor to provide services and work product that meets the requirements of all applicable laws. In the best scenario for a dentist, these contracts will contain insurance requirements and indemnification provisions to help protect you if your design team fails to keep you “legal.”
32. Do My Exam Chairs Need to Be Accessible to Patients With Disabilities?
As this publication goes to press, the Architectural and Transportation Barriers Compliance Board, a federal agency that develops accessibility guidelines and standards, is developing accessibility standards for medical diagnostic equipment under the Affordable Care Act. Thus, new standards may eventually apply to equipment such as dental exam chairs to help facilitate the provision of care to individuals with disabilities.
Currently, federal statutes such as Title III of the Americans with Disabilities Act, which applies to “public accommodations” such as dental practices, and applicable state and local disabilities laws, provide requirements for accommodating individuals with disabilities and the removal of barriers to access for disabled individuals. State and local disabilities laws may be more stringent than federal laws.
Related References and Resources
• Question 21: What Does the American with Disabilities Act Require for Office Design
• Question 50: Does My Dental Practice Website Need to Be Accessible to People With Disabilities, Such As Someone Who Is Blind or Hard of Hearing?
• Question 164: Can I Claim the Americans With Disabilities Act (AwDA) Tax Credit for Purchases of Intraoral Cameras, Panorex Machines, New Chairs, Etc.?
• Americans with Disabilities Act Access to Medical Care for Individuals with Mobility Disabilities www.ada.gov/medcare_mobility_ta/medcare_ta.htm
• The ADA Practical Guide to Dental Office Design
adacatalog.org or 800.947.4746
33. Should I Have an Automated External Defibrillator (AED) in My Dental Office? If So, Where? What Legal Concerns Are There With Respect to an AED in the Dental Office?
Some dental office locations are required by state law to have automated external defibrillators (AEDs) on site; in some instances, the legal requirement may be contingent on whether the office provides deep sedation.
Regardless of any legal requirement, an on-premises AED may be a prudent investment. We are not aware of any incident where a dentist has been found liable for failure to have an AED on premises. However, if a patient expired from cardiac arrest in a dental office (or, to take another example, an allergic reaction — or even for no discernable reason), it is not farfetched that the decedent’s attorney would argue that such an occurrence was reasonably foreseeable, that proper use of the AED would have avoided the death, and that the dentist was negligent (failed to meet the “standard of care”) in not having available the AED. The trend towards requiring AEDs is clear — in many jurisdictions, they are required in locations such as health clubs, large office buildings, public transportation centers, schools, etc.
A prudent practice should assure that they are, at absolute minimum, in compliance with applicable law. The practice may wish to check with their insurance carrier regarding legal requirements in their state, coverage with respect to this equipment, and liability-related issues (e.g., the extent to which any risks associated with acquiring the AED may be outweighed by having the AED and trained staff on site, and the availability in your state of “good Samaritan” laws that might provide additional protection for an AED user in the event of a lawsuit). Your state dental society may also be able to provide some guidance in this regard.
The mere purchase of the equipment is not enough. The equipment should be stored in an easily accessible location. Training with respect to the equipment is critical, and in some instances may be legally required (likewise consider which — if not all — of your staff should be trained). Finally, make sure that the equipment is properly maintained. The manufacturer may be able to help you with respect to periodic testing and safety checks.
The trend towards requiring AEDs is clear — in many jurisdictions, they are required in locations such as health clubs, large office buildings, public transportation centers, schools, etc.
2 Source: Americans with Disabilities Act Title III Regulations. Part 36 Nondiscrimination on the Basis of Disability in Public Accommodations and Commercial Facilities (as amended by the final rule published on September 15, 2010), www.ada.gov/regs2010/titleIII_2010/titleIII_2010_regulations.htm#a402
3 OCR FAQ, “Is a covered entity required to prevent any incidental use or disclosure of protected health information?” http://www.hhs.gov/ocr/privacy/hipaa/faq/incidential_uses_and_disclosures/206.html
Chapter 7.
Practice Marketing
34. What Legal Limits Are There on Advertising My Practice?
Federal, state and sometimes local law laws govern advertising, which can include promotions offered via websites and social media. The central point for dentists is to make sure their promotional efforts are neither false nor misleading in any
