If an employer changes the bonus plan to reward patient referrals, what action should a hygienist take?

• A. Continue participating
• B. Inform Dr. Smith that they cannot participate because it violates the Dental Practice Act
• C. File a complaint with the board
• D. Seek a new job

Answer: (B)

Financial incentives tied to patient referrals raise conflicts of interest and are restricted by the Dental Practice Act. A hygienist must not participate in or help implement a plan that rewards referrals, because it can influence clinical judgment and amounts to improper compensation for patient selection. The proper step is to inform the supervising dentist that the new referral bonus would violate the Act and cannot be participated in. This protects patient care, upholds professional and legal obligations, and signals a need to address the issue directly. If the dentist ignores the concern or insists on continuing the plan, escalation to the state dental board may be appropriate. Continuing to participate would perpetuate illegal conduct, while seeking a new job is an option only if the employer remains committed to the illegal practice.