Fraud
Dentistry’s white-collar crime
In his second article on dental provider fraud, Dr Liam Lynch looks at the reasons dentists commit fraud and what can be done to counter it
I
n the previous article, the salient issues in Dental Provider Fraud (DPF) were described. In this article, the motivations for DPF are discussed. Some methods
of countering this type of fraud are also considered.
Why do dentists engage in DPF? Three factors are hypothesised by Ramosı
,
to influence whether an individual engages in fraud. These are rationalisation, opportunity and pressure. This hypothesis is described graphically in the well-known Fraud Triangle in Figure ı. Duffield and Grabosky2
discuss what
they term the “psychological factors in fraud”. They state that at first glance:
“A psychological explanation for fraud would appear simple – greed and dishonesty. Such an explanation is, however, overly simplistic. There are many in society who are aggressively acquisitive, but generally law abiding. Moreover, they are also associated with entirely legitimate forms of human endeavour. Technologies of prediction remain imperfect. Not all dishonest people commit fraud. To date, behavioural scientists have been unable to identify a psychological characteristic that serves as a valid and reliable marker of the propensity of an individual to commit fraud.” When discussing motivation Stotland3
points out that: “…sometimes individuals’ motivation for crime may have originally been relative deprivation, greed, threat to continued goal attainment and so forth. However, as they found themselves
26 Ireland’s Dental magazine Opportunity
Circumstances exist that provide the opportunity
successful at this crime, they began to gain some secondary delight in the knowledge that they are fooling the world, that they are showing their superiority to others.” There is also the gratification obtained
from the mastery of a situation. He terms this motivation “ego challenge”. In ı940, Edwin Sutherland4
coined the
phrase “white-collar crime”. Sutherland’s concept of white-collar crime had a ground- breaking polemical impact. Sutherland discredited widely held theories of his day that attributed criminal behaviours to poverty and its associated pathologies.
Rationalisation/ Attitude
Ability to rationalise a
fraudulent act as consistent with personal ethics
Sutherland described the white-collar
criminal as one who is “respected”, “socially accepted and approved” and “looked up to”. He later refined his definition of white-
collar crime to “crime committed by a person of respectability and high social status in the course of his occupation”5
.
Fraud committed by dentists in the course of their profession is a perfect example of white-collar crime. As well as positive motivations for
white-collar crimes such as fraud, there are also “weak restraints” that lessen the
The Fraud Triangle These conditions are
present when fraud occurs Figure 1
Incentive/Pressure Provides a motive to commit fraud
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