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ADA member complaints prompt action on case volume requirements

Honolulu—In response to company decisions to impose case volume and education requirements, the ADA House of Delegates passed a resolution that prohibits the Association from permitting the exhibition, sponsorship or advertising of any products or services that impose such requirements—unless the promoter has justified the specific volume requirement to the satisfaction of the ADA with scientifically sound data.

Resolution 61H-2009 also states that the ADA "is opposed to any corporate-mandated volume requirements which inappropriately interfere with the dentist's judgment regarding treatment of a patient or which adversely affect the quality of patient care."

"We have a responsibility to the patient to do the right thing and we have a responsibility to the members to do the right thing," said Dr. Sally Cram, a Washington, D.C.-based periodontist and delegate who co-authored the amendment for the 4th District.

Dr. Cram said the resolution was prompted by complaints from members who were upset that they were being required by certain companies to meet the demand for use of a product in a specified time period, retake introductory courses and/or fulfill certain continuing education requirements to provide their product or service to patients—even if they had been providing and working with the company's products for years.

In some cases, these dentists have expended considerable funds to acquire the knowledge required to become proficient in the use of these products and services.

"It's ethically wrong," Dr. Cram said. "If considered necessary by a manufacturer, volume requirements should be based on clinically relevant and scientifically-based treatment outcomes that demonstrate a measurable benefit."

While all dentists have an ethical responsibility to provide appropriate care, the Association believes that company-imposed volume mandates could lead to some dentists making treatment decisions based upon their ability to continue to use the product or service, or based upon recouping their initial investment, according to the House report on the resolution.

For more information about resolutions passed during the 2009 House of Delegates, ADA members may visit