Just because everyone does it does not mean it complies with the rules: dual licensing in dentistry as an example

“Everyone does it this way.”

“I have worked in this field for twenty years and I have never had a problem.”

And, in activities regulated through official platforms, a third phrase may appear:

“The system lets me do it.”

All three may be true. None proves, by itself, that a practice complies with the applicable rules.

Experience makes it possible to understand how an industry actually works. That knowledge is indispensable: a lawyer who does not understand the operation of the business may end up proposing solutions that are impeccable on paper and useless in practice.

The problem appears when one takes an additional step and turns a widespread practice into a legal conclusion.

“This is how it is done” and “this is how the law allows it to be done” do not mean the same thing.

Dentistry offers a particularly clear example.

The problem can go unnoticed for years

In practice, it is understandable that several dentists may want to use the same infrastructure on different days. A fully equipped dental unit represents a significant investment. If one professional uses it on Monday and another could make use of it on Tuesday, leaving it idle may seem economically inefficient.

That arrangement can be repeated for years until it becomes entirely normal within the sector.

When the possible existence of dual licensing is raised, responses such as these then appear:

“That only applies to healthcare institutions.”

“It does not apply to independent professionals.”

“We have always shared consulting rooms that way.”

Or even:

“The REPS application—the official information platform—lets me ‘disable’ one professional and enable the other.”

That is precisely where practical experience must be separated from the legal structure.

The first mistake: assuming that “provider” means only a healthcare institution

Much of the confusion begins with the concept of a healthcare service provider.

In everyday language, the term may immediately be associated with a clinic, a hospital or an IPS. Decree 780 of 2016 uses a broader category.

Article 2.5.1.1.3 expressly includes among healthcare service providers both Healthcare Service Provider Institutions and Independent Health Professionals. The latter are natural persons in the health field who are authorized to act autonomously in providing the service.

The consequence is simple:

a dentist acting as an independent professional is also a healthcare service provider.

The dentist is not an IPS.

But the dentist is a provider.

That is why a rule addressed to “healthcare service providers” cannot be assumed to apply exclusively to IPSs.

What is licensed is the service

The second piece is equally important.

Licensing is not simply a matter of proving that a person holds a dentistry degree and may practice the profession.

An independent professional registers in REPS and declares the healthcare services the professional intends to offer. To do so, the professional must identify, among other elements, the site, the service, the modality and the installed capacity, and make the corresponding self-assessment declaration.

The licensed service is not reduced to the label “general dentistry” or to the physical presence of the dentist. Its operation involves infrastructure, equipment, human talent, processes and the other resources necessary to meet the licensing standards.

That is why the legally relevant question is not simply:

“Who is using the consulting room today?”

One must ask:

who is the responsible provider, what service has that provider licensed, and with what infrastructure and resources is that license being supported?

That is where dual licensing appears.

Dual licensing exists and is not exclusive to IPSs

Article 9 of Resolution 3100 of 2019 provides that the provider that licenses a service is responsible for compliance with and maintenance of all its standards, even when other persons, organizations or contractual arrangements participate in its operation.

The provision ends with an express rule:

“The service must be licensed only by the healthcare service provider responsible for it. Dual licensing of a service is not permitted.”

The legal connection is direct:

Independent professional → is a provider.

Provider → licenses a service.

Service → must have a single responsible provider.

That is why saying that dual licensing exists only between IPSs starts from an incorrect premise.

Two dentists may have the same type of service

This does not mean that two independent dentists cannot have the same type of service licensed.

They can.

Dentist A may have dentistry licensed and dentist B may as well.

The problem appears when two different providers attempt to support their licenses on the same service, under the same conditions and using the same infrastructure and resources.

That issue was analyzed by the Ministry of Health in Opinion No. 2025231000075991 of January 18, 2025.

In interpreting what should be understood as the “same service,” the Ministry considered infrastructure, resources, and technical and human capacities. It stated that when different providers offer similar services, each must have an individual license based on its own infrastructure, without overlap.

The opinion does not create the prohibition. The prohibition already exists in Article 9.

Its importance lies in showing how the Ministry itself interprets the prohibition when different providers seek to use the same resources to support their licenses.

“One works today and the other tomorrow”

Suppose there is a consulting room with a dental unit and the necessary equipment.

Dentist A works there on Mondays.

Dentist B works there on Tuesdays.

They are never physically present at the same time.

The intuitive response may be:

“If they never use the consulting room at the same time, there is no dual licensing.”

But that response confuses time of use with the continuing validity of the license.

If A is a licensed independent professional, A is a provider.

If B is as well, B is another provider.

And if both maintain their respective licenses in force supported by the same consulting room, the same dental unit and the same resources, A's license does not disappear when A finishes work on Monday.

Nor does B's license come into existence only when B arrives on Tuesday.

Schedules may alternate. The licenses remain in force.

The correct question, then, is not whether both dentists are sitting in the same chair at the same time.

It is this:

are there two providers whose licenses are supported by the same infrastructure and resources?

Under the criterion expressed by the Ministry of Health in January 2025, that is precisely where the overlap problem appears.

The REPS application can contribute to the confusion

A particularly interesting phenomenon appears here.

A person who regularly uses the platform may say:

“But the REPS application lets me do it.”

That circumstance can create a false sense of security: if an official platform accepts the entry of information, it may seem reasonable to assume that what is being done is permitted.

Legally, however, it does not work that way.

REPS is a tool for entering, declaring and processing information. It is not a system that, merely because it allows a form to be completed, certifies that the underlying operation complies with every licensing rule.

Resolution 3100 itself requires the interested party to determine the services, installed capacity and other data, complete the form and make a self-assessment declaration. The form and supporting documents must then be filed with the corresponding Health Secretariat. The Secretariat verifies the documentation and, once the procedure has been completed, records the registration and issues the licensing certificate.

In Bogotá, the Secretariat expressly warns that receipt of the documents does not imply a favorable decision on the procedure; the documents are subject to verification and validation.

Even more revealing is the REPS portal for reporting changes:

until the form and its supporting documents have been filed with the territorial authority, the change is not considered filed and is not reflected in REPS.

This requires distinguishing three things:

what the software allows a person to enter;

the legal change that is intended to be reported;

and the material reality of the service that must correspond to that change.

They are not equivalent.

“Disabling” oneself on the platform is not a legal category

In practice, expressions such as these may be used:

“I disable myself,” “I remove my license,” “I take one person out and put the other in.”

But that computer or colloquial terminology does not replace the categories of Resolution 3100.

Article 12 expressly distinguishes, among service changes:

• temporary closure;
• reactivation;
• permanent closure;
• change in the service delivery schedule.

And, among changes in installed capacity, it separately distinguishes the opening and closure of consulting rooms.

That distinction is legally important.

Changing the schedule is not closing the service.

Closing a consulting room is not necessarily closing the service.

And ending the workday is not equivalent to a temporary closure either.

Temporary closure is not a switch for managing shifts

Article 13 of Resolution 3100 allows the provider to report the temporary closure of a service and later its reactivation. The rule does not establish an exhaustive list of reasons that must cause such closure.

But it does not follow that temporary closure may be used as a day-to-day switch for alternating providers over the same infrastructure.

If the reality is:

A works Monday and Wednesday; B works Tuesday and Thursday,

that describes an ordinary distribution of schedules.

It does not naturally describe four closures and four successive reopenings of the service every week.

Therefore, if the temporary-closure change is used solely to make a provider disappear from the register for a few hours and allow another provider to occupy the same infrastructure, the question is no longer a software question but a legal one:

did the service actually close, or is the closure mechanism being used to represent as a succession of closures what is materially a permanent rotation of schedules?

Not every incorrect use of the platform can automatically be characterized as simulation. That will depend on what occurred and what was actually declared.

But if there is materially no closure and one is reported solely to create a registry appearance different from the real operation, the mismatch between what was declared and reality becomes legally relevant.

REPS must reflect the situation of the service.

It must not create that situation artificially.

“The platform accepted it” also does not mean “the law authorized it”

This may be the most important point.

An official platform may accept the entry because the system operates on information declared by the provider.

That does not mean that each piece of information entered has already been checked by the software against every applicable health rule.

The platform allows the procedure to be processed.

The law determines what is permitted.

The territorial authority verifies and administers the registry within its powers.

Confusing those levels can create precisely the false sense of security that accompanies some sector practices for years.

“The system let me do it” proves that the system allowed an operation to be performed.

It does not yet prove that the operation was legally permitted.

That difference is as important as the difference between:

“I have never been sanctioned”

and

“the law authorizes me.”

A contract does not cure a structure that conflicts with licensing rules

The same logic applies when an attempt is made to solve the problem through mandate agreements, leases, service agreements or consulting-room use arrangements.

All of them may be valid legal transactions.

A lease may explain why a professional has access to certain infrastructure. A mandate may justify a third party administering the professional's schedule or carrying out certain formalities.

But Article 9 expressly provides that responsibility for the service remains with the provider regardless of the organizations, persons and contractual arrangements participating in its operation.

The contract may organize the operation.

It cannot rewrite the health rule.

The same is true of the software.

Twenty years may demonstrate experience, not legality

A professional may state, with complete sincerity:

“I have been doing it this way for twenty years and I have never had a problem.”

The professional may be right.

The practice may have been learned from other professionals, used for decades and even carried out repeatedly through an official platform.

But those twenty years prove one thing only:

that it has been done that way for twenty years.

They do not prove that Article 9 does not exist.

They do not turn an independent professional into someone other than a provider.

They do not turn a schedule into a temporary closure.

And they do not turn a REPS functionality into legal authorization.

Practices are passed on. Mistaken interpretations are passed on as well.

That is why experience should be the starting point of the analysis, not its conclusion.

The useful question is not only:

“How is this normally done?”

Another must follow:

“Why can it legally be done this way?”

If there is a legal basis, the practice can be preserved.

If it requires adjustments, they will have to be made.

And if the only explanation remains “because everyone does it,” an essential part of the analysis is still missing.

Just because everyone does it does not mean it complies with the rules.

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