We have discussed this both with the BOD and in our VDA Board of Directors meetings.  Ignorance of the law is no excuse.  Why subject those of us who comply with the law with another layer of red tape and expense because a few people violate the statutes and then fall back on the lame excuse of not knowing the law.  In an increasingly complex world, where more and more time and expense is needed to run a small business, I plead with you to not increase our load in a situation that does not need to add regulation and expense.  Please, please listen to the doctors of our state who are bending over with the extra burdens that are put on us each day.

My name is Dr. VaCora Rainey and I am a general dentist from Stafford. I am in agreement with the Board on the issue of requiring an exam for initial licensures. However, I feel that an "open book" exam every 3 years is unnecssary for renewals. While I appreciate your proactive approach to reduce complaints and eliminate violations, this will be a time and financial burden for practitioners. I recommend you send a document to all licensed dentists every year with the information you feel would be helpful to us. We can all benefit from your guidance on how to prevent common violations.

Thank you for your time

The establishment of a regulation requiring initial licensees and established dentists to take a jurisprudence exam would seem, on first blush, to be a great idea.  Who would deny that "knowing the law" is good thing, and for initial licensees, it is a probably a valid approach to establish baseline knowledge of legal issues and the laws governing the practice of dentistry.  For the practicing dentist, to cause this to rise to the level of proposing a regulation, however, the Board of Dentistry must have certain violations in mind that they see over and over, situations that they feel that with better understanding of the law would decrease over time (and yes, I agree that decreasing the workload of the Board is a very reasonable goal because one interpretation of that is that patients are being better treated within the parameters of Board rules and regulations).  Would it not be a better approach to create a document (newsletter, mailer, etc.) that outlines the Board's concerns?  This would have the dual effect of 1) not adding another regulation to the many thousands on the books already in the Commonwealth, and 2) not burdening the established practitioner with a time-consuming test.  The Board could tailor their information to those topics that would have the most impact on the knowledge base of practicing dentists. 

 Just another waste of time and money for a problem that does not exist.This is so typical of goverment bodies.

Dear Board,

It is apparant from Board meetings that some dental practices do not follow the law. They use the excuse of not knowing the law. These dental practices need to be educated not tested.

Routine testing on the laws of dentistry does not insure dentists understand the laws. It only insures they took the test and passed the test. It will be equivalent to the standard of learning tests in education. Dentists will study quickly or use open book if allowed to most efficiently pass the exam. They will not remember or actually use the material in a beneficial way. 

I suggest bringing back the old system when all dentists were educated with a newsletter which informed dentists on all the reprimands, penalties, fines or loss of license in any given period. This type of education is not forgotten when dentists see what actually occurs when the law is not followed. 

When the newsletter was distributed, our office would key on the information. All staff would read it and pass it around to be certain we were not violating any laws. It was extremely effective. I do not remember if the newsletter listed names but it would work with names or without.

I assume a law test would mean another unnecessary fee for dentists. It would also allow the Board of Dentistry to say "You took the test and passed. You should have known better." 

The more effective way to get dentist to do the right thing would be to educate them on what dentists are doing wrong. Please send us a newsletter. Don't give us more unnecessary requirements and charge us more fees.

I am writing concerning the propposed Regulatory Action requiring a dental jurisprudence exam.  I believe that all initial licensees should be required to pass the exam prior to licensure.  I feel requiring licensees to repeat the exam every three years is a burden that is being forced on the backs of 95% of the licensees that abide by the laws of the commonwealth, and are paying for the sins of repeat offenders.  I feel the Board of Dentistry to should keep licensees informed of changes in regulations, and interpretations of the regulations through e-mail newsletters.  I would be interested to know if the Board has looked at other states to see if three year testing has greatly improved licensees compliance with the law.   I know the Board has a thankless job and I appreciate their efforts to protect the citizens of Virginia.  I feel that timely communications will go further to help us remain compliant rather than a test every three years.  To illustrate the importance of communication, I learned about this regulation only through our Virginia Dental Association leadership.  The average dentist and hygienist are unaware of this proposed regulatory action.  All licensees should have been informed by the Board before the comment period.  Communication always inproves governance.

I believe that we, as dental professionals, hold ourselves to a higher standard than the average individual. Continuous education is the hallmark of our profession. There are a small percentage of individuals in our profession who do not adhere to this principle; however, trying to catch the 10% of the violators while punishing 90% of all licensees, is not right.  While there are constant changes in the regulations governing Dentistry, ignorance of the laws by a few is not a reason to punish those who do keep up to date. Improving compliance with the rules lies in the communications from the Board of Dentistry; therefore, I challenge the Board of Dentistry to improve its communication with your licensees. Currently, the Board of Dentistry acquires the e-mail address of each licensee at renewal. Why in the 21st century can’t the Board communicate to each Licensee regarding any changes in the regulations instead of interested third parties?  Why is there no hotline to help licensees better understand questions regarding the statutes and regulations?  This type of dialogue should be improved when the Board of Dentistry knows that there is a problem.  Previously the Board of Dentistry published a printed quarterly newsletter with up-to-date guidelines, policy decisions and infractions that have occurred to licensees and mailed it to all Dentist and Hygienist. This type of communication was extremely helpful in understanding the type of infractions, rationale and the sanctions that were being imposed by the Board of Dentistry. I know your website contains the newsletter, statutes and regulations of Virginia. However, as a licensee who pays a fee to a governing Board, we should receive correspondence from that Board! The quarterly newsletters were discontinued several years ago due to budgetary concerns. We encourage the Board of Dentistry to bring back this type of interaction by electronic means to all Dentists and Hygienists in Virginia. I personally believe this can be accomplished by sending e-mail notices regarding, Board actions, infractions that occurred, NORA requests and any other pertinent communication to all of its licensees. This type of communication will help each licensee to better understand the statutes, rules and regulations governing Virginia’s dentists and hygienists. Furthermore, the Board of Dentistry will receive more communications from the licensees than it currently does. Plus the Board has yet to answer several questions that were made in open forums. Who can own a dental practice? Can your hygienist charge out an examination when the Dentist is not present? It’s not the fault of the licensee that you have not decided on the answers to the above questions.

 What we need is better communications from the Board of Dentistry. Your vote was unanimous without any discussion by a single Board member. Since there was no discussion at this meeting, maybe you can show me the data that backs up your claim that a test will improve compliance by your licensees? Who will pay the cost of developing this test every three years? Who will pay for administering this test? Is there any concern by our Board of Dentistry about increasing the cost to your licensees? Therefore, I strongly oppose a mandatory test for all Licensees every 3 years.

I am in support of assuring dental professionals of the Commonwealth know and understand the statutes that regulate dental practice through an initial examination.  However, requiring a test every 3 years is a poor method for achieving this goal at this time.  First, there has been no promotion of the existing rules to practicing dental professionals by the BOD.  In  fact, I have been aware of no regular communication from the BOD to practicing dentists in recent years.  We used to receive regular newsletters by mail, which one would think would be even more efficient by email, but this has not been the case.  Second, the BOD has been reluctant to clearly define their positions re: important areas of the professional code relating to the ethical practice of dentistry and the ownership of dental practices.  Third, it is not clear how this unproctored examination is going to solve a problem, which has not been clearly identified.  I would suggest considering the following, prior to instituting this triennial examination:

1.  Identify the areas of the regulatory codes in which the BOD has determined poor understanding and/or adherence by dental professionals of the Commonwealth.

2.  Reinstitute regular communication with licensed dental professional in order to promote understanding of the regulatory codes.

3.  Communicate directly with the VDA and other dental organizations in order to facilitate the education of dental practitioners re: the regulatory codes.

4.  Reassess the necessity for an examination or other means for assuring understanding and adherence to the regulatory codes after the above steps have been followed.

Thank you for your consideration,

Guy Levy

Mandatory jurisprudence examinations, whether open-book or not, will not serve to increase compliance with Board of Dentistry regulations.  There's been no evidence that this approach has succeeded in other states.  Doctors who are non-compliant, even if they profess ignorance, have failed their profession and their patients.  Should a doctor fail his or her test, what will be the sanctions?  We know that the Board elects now to enforce continuing education requirements only as a "secondary offense", much like the enforcement of seat belt laws.  Let's not add one more feel-good administrative burden to the vast majority of Virginia dentists who make it their professional responsibility to be in compliance with all laws and regulations.

I strongly oppose mandatory testing every 3 years for jurisprudence examination for the following reasons:

1.Repetition of the tests which I passed after graduate school is an unnecessary financial burden  and takes me away from my office.

2.The process by which this recommendation has occurred would have benefitted by input from the VDA who shares the concerns of the Board of Dentistry that all dentists understand the regulations governing the practice of dentistry.  Other means can achieve this goal whether it be email communications, Board guidance on trends noticed, or printed quarterly mailings.

3.I ask the Board to delay implementation of this in order to discern together if there is another way to achieve the goal we all desire-well trained and ethical dentists.

Thanks you for your consideration.

I oppose the proposed requirement of a jurisprudence exam every three years. I agree that there is a lack of understanding among dentists about the current Board of Dentistry regulations, but I believe the problem is the consequence of poor communication from the BOD rather than willful ignorance on the part of Virginia dentists. 

Within my group practice, we have made considerable effort to design and enforce our internal guidelines to meet or exceed the state regulations. In doing this, we found the written regulations were not clear as to how they should be implemented. In those situations we turned to the state board for clarification, and in every case, the board refused to offer any guidance in reading the vague language that they wrote. I find it troubling that the instincts of the state board is to punish Virginia dentists rather than improve its efforts to clarify and educate.

I think a reasonable compromise is to create a jurisprudence exam to be taken before a license is initially granted. This could be implemented along side a renewed effort to educate existing dentists. 

Tyler Perkinson DDS

I feel this is an unecessary process. We complete 15 hrs of CEU yearly and as dental professionals should be capapble of knowing the laws surrounding our profession without monitoring.

I oppose this idea!     Should we require lawmakers to take a  test on the Constututiion every three years?

If there is to be a recurring jurisprudence examination there would need to be a well written,definitive source to use as a reference.

Please Stop burdening Dentists with additional layers of requirements.  Enough is enough. You must do a better job at educating.  For example, create a top 10 List of infractions, disclose typical fines for those infractions, then explain how these infractions can be avoided or corrected. Utilize examples.

It is imperative that each and every licensed provider is knowledgeable (and is in compliance) as to the requirements setforth by the board.  Any violation could, and perhaps should, necessitate a mandatory remediation of the regulations with an examination, but do not impose such a hardship on those that are and continue to be in compliance.  

I oppose testing every 3 years to promote adherence.

I agree with some of my fellow dentist that EDUCATION is KEY here, Not a test.  I would suggest the following:  Just like we do with OSHA, have a 1-2 credit mandatory per annual license renewal to go towards JP.  Dentist can read online or attend a course. 

I oppose the proposal for a mandatory jurisprudence renewal exam! We are kept abreast of any changes in the regulations and laws via email and mail. As dental professionals, it is our duty to adhere to the regulations and laws and make changes to our practice when necessary. A mandatory renewal exam is not necessary. 

A solution would be to offer an online CE course with jurisprudence information to review recent changes. Perhaps you could require 1 hour of Jurisprudence CE rather than a mandatory exam. 

I oppose the proposal for a mandatory jurisprudence renewal exam.  A mandatory renewal exam is not necessary since we are notified of any changes in the regulations and laws via email and mail. As dental professionals, it is our duty to adhere to the regulations and laws and make changes to our practice when necessary. A mandatory renewal exam is not necessary. 

I disagree with retaking a laws and regulation exam every three years.  If there seems to be an issue with the small percentage of law breaker; look for a solution to address those individuals, and not the majority that follow the laws and regulations.

If the goal is to try to reduce the jurisprudence problems due to new or misunderstood current laws, you could have a mandatory meeting where all the new laws are presented and questions answered once a  year which would be much more effective than some type of written exam every three years. I am opposed because I think there are better alternatives. Dale Rogers

Please let's not start penalize us dentists who care and love our patients because of some bad eggs. I strongly object to this. 

Communication between the Board and dentists seems to be a clear theme when reviewing the comments in this forum, and I agree wholeheartedly.  Often times, it seems as though there is a disconnect between the Board and its actions, and the dentists/hygienists of the State, even though our missions are essentially the same-- to ensure and provide the hightest quality dental care for our commuinities.  There is an opportunity here for the Board to create an athmosphere of mutual benefit rather than promulgate the perceived ominous relationship that exists today.

If the intent of an exam is to educate, then why not simply educate.  An online CE module to be completed prior to license renewal seems not only logistically easier, but less expensive to administer.  This sends a positive message to providers opens communication in a constructive way.  I would respectfully ask the Board rethink the proposal of a mandated exam.

I don't believe that it's fair to make the mistakes and poor practice of a few dentists affect all others.  If a dentist has legal/ethical problems then they should be made to retake the legal/ethics exam every 3 years.  As the saying goes, "do not let a few bad apples ruin the whole bunch"

Object

I thought that a suggestion by another posting would possibly be more useful and timely:
Jurisprudence Exam

Communication between the Board and dentists seems to be a clear theme when reviewing the comments in this forum, and I agree wholeheartedly.  Often times, it seems as though there is a disconnect between the Board and its actions, and the dentists/hygienists of the State, even though our missions are essentially the same-- to ensure and provide the hightest quality dental care for our commuinities.  There is an opportunity here for the Board to create an athmosphere of mutual benefit rather than promulgate the perceived ominous relationship that exists today.

If the intent of an exam is to educate, then why not simply educate.  An online CE module to be completed prior to license renewal seems not only logistically easier, but less expensive to administer.  This sends a positive message to providers opens communication in a constructive way.  I would respectfully ask the Board rethink the proposal of a mandated exam.

Are we not capable to read the laws that change without creating another layer of regulation?  Maybe we should be more concerned about continuing education, helping our fellow man and sustainability?

Strongly opposed to a mandatory test every 3 years.

I believe that we, as dental professionals, hold ourselves to a higher standard than the average individual. Continuous education is the hallmark of our profession. There are a small percentage of individuals in our profession who do not adhere to this principle; however, trying to catch the 10% of the violators while punishing 90% of all licensees, is not right.  While there are constant changes in the regulations governing Dentistry, ignorance of the laws by a few is not a reason to punish those who do keep up to date. Improving compliance with the rules lies in the communications from the Board of Dentistry; therefore, I challenge the Board of Dentistry to improve its communication with your licensees. Currently, the Board of Dentistry acquires the e-mail address of each licensee at renewal.   Why is there no hotline to help licensees better understand questions regarding the statutes and regulations?  This type of dialogue should be improved when the Board of Dentistry knows that there is a problem.  Previously the Board of Dentistry published a printed quarterly newsletter with up-to-date guidelines, policy decisions and infractions that have occurred to licensees and mailed it to all Dentist and Hygienist. This type of communication was extremely helpful in understanding the type of infractions, rationale and the sanctions that were being imposed by the Board of Dentistry. I know your website contains the newsletter, statutes and regulations of Virginia. However, as a licensee who pays a fee to a governing Board, we should receive correspondence from that Board! The quarterly newsletters were discontinued several years ago due to budgetary concerns.I encourage the Board of Dentistry to bring back this type of interaction by electronic means to all Dentists and Hygienists in Virginia. I personally believe this can be accomplished by sending e-mail notices regarding, Board actions, infractions that occurred, NORA requests and any other pertinent communication to all of its licensees. This type of communication will help each licensee to better understand the statutes, rules and regulations governing Virginia’s dentists and hygienists. Furthermore, the Board of Dentistry will receive more communications from the licensees than it currently does. The Board has yet to answer several questions that were made in open forums. Who can own a dental practice? Can your hygienist charge out an examination when the Dentist is not present? It’s not the fault of the licensee that you have not decided on the answers to the above questions. The few times I have contacted the BOD for an interpretation of a statute I have been told by the BOD's Executive Director the she and the Board could not and would not comment or interpret. I feel communication and education  from the BOD is what is needed, not every three years testing of Virginia's Dentists.

 What we need is better communications from the Board of Dentistry. Your vote was unanimous without any discussion by a single Board member. Since there was no discussion at this meeting, maybe you can show me the data that backs up your claim that a test will improve compliance by your licensees? Who will pay the cost of developing this test every three years? Who will pay for administering this test? Is there any concern by our Board of Dentistry about increasing the cost to your licensees? Therefore, I strongly oppose a mandatory test for all Licensees every 3 years.

The problem is the lack of clear and concise communication from the BOD, rather than publishing statues in arcane legal language, the regulations should be clearly stated, in plain English.

Email updates and newsletters would better inform the dental professionals in Virginia than a test every 3 years.

We already have a continuing education requirement; it makes more sense to have a Jurisprudence and Ethics C.E. requirement rather than an examination.

I oppose the proposal for a mandatory jurisprudence renewal exam! A mandatory renewal exam is not only unnecessary, but also a waste of resources as it will require time and money to administer and regulate. 

I support the proposal made for an online CE course with jurisprudence information to review recent changes.

Test is not necessary.  One more layer of govt regulation which I'm sure will have a fee to cover the administrative costs.  It would be more cost effective to just mail a reminder to all licensed dentists every three years.  Also it would be very helpful for notices sent to dentists with board actions regarding lack of compliance with the laws and regulations governing  the practice of dentistry, which would be regular reminders of violations if this is really a problem and not something the board staff have just suggested. over this text and enter your comments here. You are limited to approximately 3000 words.

The BOD means well, but again is misguided;  I am not opposed to the review of the ever-changing Board of Dentisry interpretations of the "Code",  but a re =exam every 3 years is overkill;   I would suggest the time be reduced to every 6 or 8 years.    The BOD is tired of having comlaints directly related to dentists who  incorrectly interpret the ever -changing  "CODE";  perhaps the BOD should accept some of the responisblity for what is happening by stepping up their efforts to educate the dentists  of VA  about how the BOD interpretes the "Code" more often...by pointing out where  dentists are overstepping the legal line. 

I am opposed to any additional regulation.  I feel a module to review or a quarterly newsletter highlighting various regulations would be more productive and require less administrative burden on the Board of Denitisry than requireing an exam every three years.  

It is time to educate rather than regulate. 

I agree with the overhelming whole of the group that a manditory Jurisprudence exam ever three years is unnecessary. I agree that an online CE module would be more efficient way to educate us and keep us up to date on regulation changes.

I, too, feel that a CE module with license renewal would address the problem of communication and knowledge of laws without putting the unnecessary financial burden of testing on both the board and dentists.  Please reconsider.

I feel required CE as is necessary for sedation is a better solution than requiring testing and financial obligation for the board and practicing dentists.  Please reconsider this legislation.  Thank you.

I am opposed to an exam.This put more workn on the Board. If you feel it is necessary to bring people up to date on the laws then a required continuing education course could be offered on line or at a local component meeting. However,having served on my local as well state peer review committee I still feel that this is not neessary. Few cases involved problems of this nature.

I am strongly opposed to any additional regulation.  I feel a module to review or a quarterly newsletter highlighting various regulations would be more productive and require less administrative burden on the Board of Dentistry than requiring an exam every three years.  

In other states where this is mandatory, there is no direct benefit to the dentists or the patients that they treat. 

The issues that the Board of Dentistry are concerned about would be better managed by improved communication from the Board.  Quarterly emailed newsletters would be an option.  This is how I share my information with my patients instead of having to pay printing and mailing charges. Certainly the Board can do it if I can.

I think the Board of Dentistry should have better communication with us at practioners.  One option would be via email notifications.  Keeping the lines of communication open regarding updates or changes to rules and regulations should eliminate the need for additional testing. 

Rather than a mandated jurisprudence exam consider sending more "guidance documents". The resposibility of knowing and understanding the current the rules and regulations including the new chapter 21 falls upon the dentist. Most dentists get into trouble because of infractions in these areas, R&Rs, not the information presented in the current jurisprudence exam given at intial Board exam for state licensure.

Why are the masses being punished for the few that do not obey the regulations? 

I Strongly oppose a juris prudence exam every 3 years. We would be much better served by periodic updates regarding regulation changes.

Sincerely,

Jay K. White, DDS

I stongly oppose the proposed new regulation. 

This requirement would place the burden of a few on the majority of dentist that are in compliance.

The problem of compliance with regulations would be better solved by requiring initial licensees to pass a jurisprudence exam and then providing communication, either by mail or E-mail about various regulations on a timely basis.

I believe this to be undo burden to have to do this every three years. The dentists applying for initial licensing should have to pass an initial jurisprudence exam. The existing dentists should be e-mailed all of the law changes directly. I would read them and abide by them as I believe most dentists would. I believe it is difficult enough to run our practices without additional layering of administrative requirements.

I fully agree with the majority of the commentary on this forum that a repeating jurisprudence examination is not only unnecessary, but unnecessarily cumbersome to providers as well. Providers must take some responsibility in keeping apprised of what is going on in our profession. There is no need to bog down those of us who have taken the necessary steps to stay current with an examination.  If there are concerns over providers getting into trouble regarding certain rules and regulations, perhaps only those who have gotten into trouble should have to prove their knowledge of policy updates. For the majority of us, the time spent on such an examination would be better spent keeping apprised of current treatment modalities and recommendations for our patients. The idea of quarterly updates to providers in the form of a newsletter is a good one that would allow practitioners to stay up to date with reduced time commitment.