BILL ANALYSIS                                                                                                                                                                                                    







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          |Hearing Date:April 8, 2002     |Bill No:AB                |
          |                               |1026                      |
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                    SENATE COMMITTEE ON BUSINESS AND PROFESSIONS
                             Senator Liz Figueroa, Chair

                        Bill No:        AB 1026Author:Oropeza
                       As Amended:April 1, 2002 Fiscal:   Yes

          
          SUBJECT:  Healing Arts: dentists - advertising 
          
          SUMMARY:  This bill restricts the conditions under which a  
          licensed dentist may advertise himself or herself as a  
          "specialist," or advertise an area of practice  
          specialization.

          Existing law:

          1)Makes it unlawful for healing arts licensees, including  
            dentists, to provide or advertise false or misleading  
            statements, photographs, etc., in order to induce the  
            rendering of professional services or the rendering of  
            products from the licensee's professional practice or  
            business.

          2)Specifies various types of advertisements that are  
            restricted pursuant to the false/misleading advertising  
            prohibition and various types of advertising that are  
            permissible, including a provision permitting advertising  
            to include a statement that the practitioner is certified  
            by a private or public board, or agency, or a statement  
            that the practitioner limits his or her practice to  
            specific fields.

          3)Provides for the licensing and regulation of dentists by  
            the Dental Board of California (DBC), and restricts a  
            licensed dentist, who limits his or her practice to a  
            specific field or fields, to only include a statement  
            that he or she is certified by a board or association if  
            the board or association is recognized by the DBC.






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          4)Restricts a licensed physician from advertising that he  
            or she is certified or eligible for certification by a  
            board or parent association unless the board or  
            association is: (a) an American Board of Medical  
            Specialties member board, (b) a board or association with  
            equivalent requirements that is approved by the licensed  
            physician's licensing board, or (c) has an Accreditation  
            Council for Graduate Medical Education approved  
            postgraduate training program that provides complete  
            training in the specialty or subspecialty.

          5)Prohibits a licensed physician from using the term "board  
            certified" unless the certifying organization is a board  
            or organization that meets the requirements specified in  
            #4 above.

          This bill:

          1)Prohibits a licensed dentist from advertising that he or  
            she is a "specialist," or "specializes" in an area of  
            practice, unless he or she is certified or eligible for  
            certification by a dental specialty board recognized by  
            the American Dental Association (ADA), in the area of  
            practice in which specialization is advertised, or by a  
            dental specialty board with equivalent requirements  
            approved by the DBC.

          2)Requires a licensed dentist who is not certified or  
            eligible for certification by a board recognized by the  
            ADA or a dental specialty board with equivalent  
            requirements approved by the DBC to state that he or she  
            is a general dentist in any advertisement that describes  
            his or her practice as limited to a specific field of  
            dentistry.

          3)Specifies that a dental specialty board approved by the  
            DBC must provide both a didactic and clinical curriculum  
            to practitioners who seek certification by that Board.  

          FISCAL EFFECT:  Unknown.  This bill is keyed to go to  
          fiscal committee.  Violations of the bill's expanded  
          advertising prohibitions would be misdemeanors - and the  
          bill contains a crimes and infractions disclaimer of local  
          law enforcement costs.
           
          COMMENTS:





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          1.Purpose.  This bill is intended to protect the public  
            from being misled by specialty advertising that implies  
            that there is an established dental specialty field where  
            none exists, and that an advertising dentist has  
            expertise derived from some education and training in a  
            particular area of practice when that is not necessarily  
            true.  The bill provides a specific statutory prohibition  
            against a dentist's advertising that he or she  
            "specializes" in a field of dentistry for which there is  
            no ADA-recognized specialty and related ADA-recognized  
            specialty certification board, or their equivalent  
            recognized by California's state dental licensing board -  
            the Dental Board of California.

          2.Background.  This bill is sponsored by the California  
            Dental Association (CDA).  According to the author and  
            the CDA, currently there are dentists who hold themselves  
            out to the public through advertisements as "implant  
            specialists" or specialists in "cosmetic dentistry,"  
            where there is no bona fide area of specialization that  
            is recognized by either the ADA or the Dental Board.  The  
            CDA notes that currently there are eight (8) specialties  
            recognized by the ADA - endodontics, periodontics,  
            prosthodontics, orthodontics, pediatric dentistry, oral  
            surgery, oral radiology, and oral pathology.  In order to  
            be eligible for ADA-recognition, a dental specialty must,  
            among other things, "be a distinct and well-defined field  
            which requires unique knowledge and skills beyond those  
            commonly possessed by dental school graduates?."

          Existing law states that a licensed dentist who limits his  
            or her practice to a specific field or fields, shall only  
            include a statement that he or she is certified or  
            eligible for certification by a private or public board  
            or parent association recognized by the dentist's  
            licensing board (the DBC). Historically, the DBC has only  
            recognized those boards or associations officially  
            recognized by the ADA.  The DBC sought to propose  
            regulations that would provide criteria for when a board  
            or association could be recognized by the DBC, and  
            thereby allowing dentists certified by those boards or  
            associations to advertise that certification.  However, a  
            lawsuit filed by the American Academy of Implant  
            Dentistry (AAID), which is not recognized by the ADA,  
            resulted in the DBC's proposed regulations being declared  





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            unconstitutional.  Consequently the sponsor states that,  
            due to this court decision, the DBC's current statutory  
            authority to set minimum consumer protection standards  
            for "specialty" advertising has been called into  
            question.   

          3.Arguments in Support.  The CDA argues that certification  
            in the current eight ADA-recognized dental specialties  
            requires a dentist to have successfully completed both  
            didactic and clinical curriculum in that specialty,  
            assuring that he or she will have expertise in that  
            specialty.  The CDA states that it believes that minimum  
            standards for the advertisement of non-ADA-recognized  
            dental disciplines, such as implant dentistry, laser  
            dentistry, and cosmetic dentistry, provide legitimate and  
            important consumer protections against potential  
            incompetence.

          According to the CDA there are many weekend or  
            correspondence (e.g. via the Internet) courses that  
            provide a participant with a piece of paper (credential),  
            but which do not offer any real or sufficient training.   
            CDA also argues, that it is inappropriate and misleading  
            to imply expertise or specialty in an area of dentistry  
            that is routinely provided by a general dentist such as  
            cosmetic dentistry (e.g. applying tooth veneers or  
            whitening teeth).

          4.The CDA states, that this bill follows the model that has  
            worked successfully for physicians and the Medical Board  
            of California, and thus will clarify the authority and  
            role of the DBC to specify minimum standards for  
            specialty advertising.  SB 2036 (McCorquodale - 1990)  
            established a procedure for the Medical Board to regulate  
            the advertising of board certification by physicians that  
            authorizes such advertising if the physician is certified  
            by a board approved by a recognized national medical  
            specialty certifying organization or a board with  
            equivalent requirements that is approved by the Medical  
            Board. 


          SUPPORT AND OPPOSITION:
          
          Support:California Dental Association  ( CDA - sponsor)






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           Opposition:None received.


          Consultant:Jay J. DeFuria