A potential malpractice suit is an ever-present reality for dentists, but you can avoid some legal actions with preventative action. Malpractice lawyer, John Barry, offers these 8 steps to help defend your practice and your reputation. Mr. Barry, who is a Queen’s Counsel, has represented many dentists and others in the health care community.
- Know Your Patient
Update a patient’s medical history at each appointment. Has their general health changed? Any new medications? Could this impact medications you may use or prescribe? Be sure to record and date this information.
- Obtain Informed Consent
Verbal consent on simple procedures is alright as long as you chart it, but signed consent is recommended for most treatments. The form should clearly indicate that the patient understands and acknowledges:
- the purposes of the treatment;
- possible alternatives (including no treatment);
- the risks involved;
- possible complications.
Record recommendations for treatments to be performed by specialists and include copies of referral documents. Note post-treatment compliance requirements for the best possible outcome. If possible, review this with the patient before, rather than on, the day of a procedure.
- Know Your Skill Limits
There are several reasons to refer a patient to a specialist including your experience and comfort level, the complexity of the case, the patient’s medical status, or their wishes. Don’t take on more than you can confidently handle. Legally, a general dentist is held to the same standard of care as a specialist, so it’s not in your best interest to take on unnecessary liability.
- Screen for Oral Cancer
The CDA and most provincial and territorial dental associations recommend annual screening for oral cancer. Litigation is now more prevalent when possible cases of oral cancer are not investigated.
- Chart, Chart and Chart
A complainant’s lawyers will try to use poorly kept records as evidence that you didn’t provide the required standard of care. The more thorough your records, the better your chance of success.
Avoid these common issues:
- not noting prior dental work in the chart’s dentition diagram;
- lack of regular updating to show the current status of dentition;
- lack of detailed observations, including non-compliance when it occurs;
- improper notation of test results;
- treatment plans that aren’t updated.
- Put Dates on Everything
Add clear dates to:
- all notes and patient communications;
- X-rays (particularly for non-digital images) and other diagnostic results;
- models of a patient’s teeth at various stages before, during and after a procedure.
- Be Legible
Your charts and other notes must be clearly legible. Avoid abbreviations, acronyms or other jargon that may not be generally understood. Even with computerized charting and records, you need to make sure entries are easy to comprehend.
- Don’t Make Promises
Be reassuring and optimistic with your patients, but be honest, too. They can have long memories, and sometimes, unreasonable expectations. Anything approaching a guarantee is never a good idea.
Do You Have Enough Coverage?
The amount of malpractice insurance you require may vary according to your patient demographics, your specialty, if any, and the types of procedures you typically perform.
CDSPI offers up to $25 million in malpractice coverage for dentists. In Ontario, CDSPI Excess Malpractice Insurance* is available in excess of the $2 million primary malpractice coverage mandated by the Royal College of Dental Surgeons of Ontario (RCDSO)*. For details about available coverage, refer to our plan sheet.
Please contact an Insurance Advisor from CDSPI Advisory Services Inc. if you would like to discuss your options.
CDSPI offers many insurance plans to help you protect your prosperity. We can also help you grow it with a team of outstanding financial advisors. Find out how to evaluate a financial advisor, then contact us to see how well we measure up.
CDSPI Malpractice Insurance and Excess Malpractice Insurance in Ontario are underwritten by Aviva Insurance Company of Canada. CDSPI Malpractice Insurance is not available in Quebec.
* You must be a dentist licensed to practise in Ontario and a member of the Ontario Dental Association to be eligible to apply. CDSPI Advisory Services Inc. is not affiliated with the RCDSO.