On my Yahoo! home page recently, there was a story about a dentist who was raided by the health department. They found disgusting, dirty, unsterilized instruments and unclean conditions.
They suspect this dentist has exposed thousands of patients to blood-borne illnesses such as Hepatitis B and HIV. I read the story to find out who tipped off the health department; apparently it was a patient that had no other risk factors and had tested positive for one or both of these illnesses. I must say, I expected to find out that someone working in that dental practice tipped off the authorities, and I must also say, I’m a bit disappointed to find out that wasn’t the case!
There were obviously people besides this dentist that worked in that practice. Were THEY trained professionals, who would know the difference between "good medicine” and what this dentist was practicing? Did they know, and just choose not to tell for fear of being a "whistle blower”? By the way, "whistle blowers” have legal protection against retaliation; if you report an unsafe environment to OSHA, for example, your employer can not retaliate in any way, including terminating your employment. Although in my opinion, it’s up to you to decide if you really want to be working for that type of place.
It’s not uncommon for a veterinary professional to spend time in a practice that they do not feel is practicing "good medicine.” This is an ethical dilemma for the employee, who must weigh their values against having a job often times. Sometimes more knowledge is needed to understand why the veterinarians are doing things the way they are, or why the practice is supportive of certain actions. In other words, does it really qualify as "bad medicine”?
Even if medically speaking the actions are not wrong, an employee may decide that they just don’t support that type of action and cannot work in that environment. Examples? How about IV catheters placed in every anesthetized patient, or performing "convenience” euthanasia? Jim Wilson is his book on veterinary ethics also mentions the example of a practice who sterilizes instruments between surgery…hmmm, sounds like exactly what this dentist was NOT doing!
What did it feel like to work in that practice, if you knew he was wrong for what he was doing? How was it to know that thousands of people may not be sick because of his actions, or inaction? Or perhaps as I mentioned, these team members did not even realize what was happening and understand that sterilization was important. So where and how were they trained? How do they feel NOW, when the story is spreading across the country?
This is a perfect example of why veterinary professionals need to start conducting "employer interviews” when they are looking for a new place to work. Ask about the things that are ethically important to you, to find out where the practice stands even before taking your first paycheck. Once you’re on a team, it’s difficult to backtrack and figure out how to make it work, and what to do. Go in with your eyes wide open (and not your mouth! … dentistry pun, sorry!)