NBDE Professional Ethics and Management 4 — Questions and Answers
Question 1: A dentist learns that a patient's employer is requesting dental records without patient authorization. The dentist should:
- Release records as a professional courtesy to the employer
- Refuse to release without written patient authorization or a valid legal order (Correct answer)
- Release records but redact radiographs
- Notify the state board before taking any action
Correct answer: Refuse to release without written patient authorization or a valid legal order
HIPAA prohibits disclosure of protected health information to an employer without the patient's explicit written authorization or a court order.
Question 2: In a dental office, the primary responsibility for ensuring OSHA compliance rests with:
- The dental hygienist as infection control coordinator
- The practice owner or employer (Correct answer)
- The state dental board
- The front desk office manager
Correct answer: The practice owner or employer
OSHA places the legal responsibility for workplace safety compliance on the employer, which in a dental practice is typically the dentist-owner.
Question 3: A patient asks whether a proposed amalgam restoration is safe. An ethical dentist should:
- Refuse to discuss the topic to avoid legal liability
- Provide balanced, evidence-based information and respect the patient's choice (Correct answer)
- Tell the patient amalgam is being phased out and recommend composite only
- Defer entirely to what the patient has read online
Correct answer: Provide balanced, evidence-based information and respect the patient's choice
Veracity and patient autonomy require that dentists provide accurate, evidence-based information about treatment options so patients can make informed decisions.
Question 4: Which scheduling method is most effective at reducing patient wait times and maximizing production in a dental practice?
- Open scheduling (first come, first served)
- Wave scheduling
- Fixed-interval scheduling for all appointments
- Modified wave scheduling with staggered arrival times (Correct answer)
Correct answer: Modified wave scheduling with staggered arrival times
Modified wave scheduling staggers patient arrivals within each hour, reducing bottlenecks while maintaining high production and minimizing wait times.
Question 5: Under the Americans with Disabilities Act (ADA), a dental practice must:
- Provide treatment to all patients with disabilities regardless of clinical complexity
- Make reasonable modifications to policies and physical access for patients with disabilities (Correct answer)
- Hire a minimum number of employees with disabilities
- Waive fees for disabled patients
Correct answer: Make reasonable modifications to policies and physical access for patients with disabilities
The ADA requires places of public accommodation, including dental offices, to make reasonable modifications to ensure equal access for individuals with disabilities.
Question 6: A dentist who charges different fees to patients based solely on their race or ethnicity violates which ethical principle?
- Veracity
- Nonmaleficence
- Justice (Correct answer)
- Beneficence
Correct answer: Justice
Justice requires the fair and equitable treatment of all patients; discriminatory pricing based on race violates this core ethical principle and civil rights law.
Question 7: A dental practice's overhead percentage is calculated as:
- Net income divided by gross production
- Total expenses divided by total collections, multiplied by 100 (Correct answer)
- Gross production minus adjustments
- Total payroll divided by number of employees
Correct answer: Total expenses divided by total collections, multiplied by 100
Overhead percentage = (total operating expenses ÷ total collections) × 100, and a typical healthy dental practice targets 55–65%.
NBDE Professional Ethics and Management 4
A dentist learns that a patient's employer is requesting dental records without patient authorization.
The dentist should: