Political challenges and ethics in the office

Abstract

Q: A personal and professional friend of mine is in a group practice with 5 dentists. They have practiced together for several years with much success. The last election cycle, 2 of the dentists did not agree on the candidates nor the outcome. This situation grew steadily worse and began to affect the dental team, patient care, and the trust between the dentists. How does the American Dental Association code of ethics apply in this situation? A: There are many advantages for the dentists, team members, and patients in a group practice setting. The ability to develop stronger collegiate relationships with peers usually leads to great relationships. Separating personal opinions from practice relationships, however, may raise challenges. In the past few years, there has been an increase in people voicing political opinions and their level of political engagement. The question you raise has become a serious concern throughout many industries, with dentistry being no exception. The issue of political opinions may become entwined with diversity, equity, and inclusion concerns and can escalate into a human resources nightmare. This can lead to a dysfunctional team and ultimately affect patient care. The American Dental Association Principles of Ethics and Code of Professional Conduct (ADA Code) can guide you through some of these concerns. The situation you describe is addressed in section 3.F. (Professional Demeanor in the Workplace). It states, “Dentists have the obligation to provide a workplace environment that supports respectful and collaborative relationships for all those involved in oral health care.”1American Dental Association American Dental Association principles of ethics and code of professional conduct, with official advisory opinions revised to November 2020.https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/ada_code_of_ethics.pdf?rev=86aeaa6fb0d0467f8a380a3de35e8301&hash=89BAA88FB9305B8F134414E337CAE55ADate: 2020Date accessed: April 1, 2022Google Scholar Keeping political discussions out of the workplace is increasingly difficult. According to a survey conducted by the Society for Human Resources Management, 26% of workers discuss politics at work regularly.2Milligan S. How should HR handle political discussion at work? Society for Human Resource Management.https://www.shrm.org/hr-today/news/hr-magazine/spring2020/pages/political-talk-in-the-workplace.aspxDate accessed: April 1, 2022Google Scholar Given that such discussions are likely to occur, having a culture of respect is critical and, as the team leader, you may need to develop ground rules. A 2020 Harvard Business Review article recommended that leaders stress respect, promote self-reflection, and try to understand differing viewpoints.3Knight R. Managing a team with conflicting political views.Harvard Business Review. October 22, 2020; (October 22, 2020)https://hbr.org/2020/10/managing-a-team-with-conflicting-political-viewsDate accessed: April 1, 2022Google Scholar By being proactive in this way, you may be able to reduce disruptive behavior among your team. The advisory opinion 3.F.1. (Disruptive Behavior in the Workplace) states, “Dentists who engage in disruptive behavior in the workplace risk undermining professional relationships among team members, decreasing the quality of patient care provided, and undermining the public’s trust and confidence in the profession.”1American Dental Association American Dental Association principles of ethics and code of professional conduct, with official advisory opinions revised to November 2020.https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/ada_code_of_ethics.pdf?rev=86aeaa6fb0d0467f8a380a3de35e8301&hash=89BAA88FB9305B8F134414E337CAE55ADate: 2020Date accessed: April 1, 2022Google Scholar Different viewpoints may not always be disruptive and can, at times, enhance relationships and broaden one’s understanding, but when they are asserted in a way that criticize or belittle the views of those in opposition, this can detrimentally affect the function of the dental team. Therefore, developing constructive ground rules for political discourse is necessary for both the staff members and patients. Once the trust or confidence of the patient or the team member is shaken, other areas are likely to be affected. For example, doubts regarding other attributes of the dentist or team member may be called into question. If this does occur, looking to Section 4 of the ADA Code, the principle of Justice (“fairness”)1American Dental Association American Dental Association principles of ethics and code of professional conduct, with official advisory opinions revised to November 2020.https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/ada_code_of_ethics.pdf?rev=86aeaa6fb0d0467f8a380a3de35e8301&hash=89BAA88FB9305B8F134414E337CAE55ADate: 2020Date accessed: April 1, 2022Google Scholar may offer some direction. Although those with opposing views may not consciously treat their colleagues or patients differently, the risk of unconscious bias is real and should be kept in check via “…discovering your blind spots and then actively working to dismiss stereotypes and attitudes that affect your interactions.”4Edgoose J.Y.C. Quiogue M. Sidhar K. How to identify, understand, and unlearn implicit bias in patient care.Fam Pract Manag. 2019; 26: 29-33PubMed Google Scholar Although eliminating political conversations is likely not possible, we can surely establish boundaries and still be respectful of others’ views. So, in answering your question, the ADA Code can offer some resolution for the health of the practice by reminding the dentists of their obligation to ensure a collegial workplace and to be fair in dealings with staff members, patients, and colleagues. To accomplish this may be easier said than done, but this does present the opportunity for an inclusive team conversation and perhaps the collaborative development of a practice policy that can rebuild the trust and confidence that may have been eroded. Dr. Reavis is a dentist in Atchison, KS, and a member of the American Dental Association Council on Ethics, Bylaws and Judicial Affairs.