A local dentist who has been disciplined by the Royal College of Dental Surgeons says he's been penalized for treating his aboriginal patients the same as his non-aboriginal ones.
Dr. Brian DeMontmorency pleaded guilty to providing unnecessary dental services to 10 patients and was suspended from his practice for eight weeks during the winter.
His practice continues to be monitored by the college and he was assessed $18,000 in costs and fines according to the college.
But DeMontmorency said he feels unjustly punished for trying to provide the same level of dental care to all his patients, including his considerable native clientele who are paid for through a federal health program.
"I feel I did everything right. I provided appropriate treatment but this has been devastating.
"This makes me look like a bad person and a bad dentist and it's not true."
Instead, he says, there's a double standard when it comes to the care of native patients.
The Non-Insured Health Benefits (NIHB) program covers all aboriginal patients and that program has strict guidelines about what is and isn't covered.
X-rays can only be done once a year and there are strict guidelines about documenting work that is done.
"So, for example, aboriginal patients can't have smaller holes in their teeth restored (under the program.) Private insurance patients can make the choice but apparently my aboriginal patients can't make that decision."
DeMontmorency said the NIHB guidelines insist that a cavity on an x-ray has to be a certain size before it can be treated.
Likewise, he says that private patients can ask for silver fillings to be replaced but aboriginal patients have to have "significant recurrent decay" on the x-rays or significant clinical symptoms before the fillings can be replaced.
That, says DeMontmorency, constitutes a double standard.
His professional discipline hearing included no complaints from patients. Instead, the case revolved around a complaint from a NIHB auditor who looked into DeMontmorency's work because of his high number of native patients.
Once NIHB raised concerns about DeMontmorency's charting and "the frequency and necessity of replacing existing restorations" the dental college sent its own auditor in to gather evidence.
Poring over three years of charts, the auditor turned up cases involving 10 patients in which a total of 19 tooth surfaces were fixed without the full documentation and charting required by the insurance program and the college.
"These unnecessary procedures and the billings resulting there from benefited no one but the member," said the college's decision.
Faced with evidence of a lack of full documentation, DeMontmorency was given a choice of pleading guilty or fighting the charges.
"They told me the trial could take 15 days of my office time and if I was found guilty in any way I'd be back to Square One. My biggest error was back then, I didn't chart in detail. It wasn't that the work didn't need to be done or the patients didn't give permission to do it."
He pleaded guilty and hoped the situation would be resolved quietly.
These days, DeMontmorency charts much more extensively, as the dental college auditor found during a recent visit to check on his work.
But the situation frightened him enough that he thought about dropping his native patients from his roster.
"I considered not treating aboriginal patients any longer but the patients are good people who deserve good treatment. It's the government that's the problem."
Instead, the dentist now points out small cavities to patients and they either decide to observe and monitor the cavity or, if the patient prefers, the work is done and the patient fronts the cost, hoping to get repayment from NIHB.
The case has had some ripple effects in the community, says DeMontmorency.
"Because of this, a lot of dental offices now are not providing services to native patients or won't treat them unless they agree to pay up first.
"The ultimate scare is what happened to me -an honest dentist with a good reputation."