I had the opportunity last week to discuss standard of care and informed consent with a group of dental students at The Ohio State University College of Dentistry. I want to thank Dr. James Cottle, Assistant Professor of Clinical Dentistry, for the reoccurring opportunity to talk with young up-and-coming dentists about “doing it right” and taking the necessary steps to minimize risk and exposure in their practices. During the presentation, I touched on licensure, enforcement statistics, dental malpractice, and most importantly, the steps necessary to minimize disruption within their practices. I covered 10 important steps to minimize disruption:
- Develop systems that will alert you to problematic patients early to determine if patients are worth the long-term aggravation. In some instances, filling the chair is simply not worth it. And, sometimes, we do not realize it, until it is too late.
- Perform a risk-benefit analysis before each collection attempt. That is, just because the patient does not pay does not mean we collect. We need to carefully review the chart, understand who the patient is, and make a well-informed decision about collection.
- Document, document, document. Chart in a clear manner that can be deciphered by others. Your chart is your protection and your defense. If it is not written down, it did not happen.
- A good chairside manner by you and your staff matters. Do I need to say more?
- Designate a point person to oversee risk management and identify problems. As the dentist, you cannot do it all. Delegate, but stay involved and oversee.
- Criticisms should not be part of patients’ charts or communications. If you would not want to hear it about you, then do not say it.
- Follow-up with patients and document that follow-up was done. There are so many good reasons to do this.
- Formalize the discharge process, and document the steps taken. This cuts off the statute of limitations.
- Do not hesitate to refer when appropriate, and document the process. Be humble; sometimes it is better to get someone else involved. That is ok to do.
- Only use charting programs designed to allow and encourage narrative notes. But, be careful. Do not rely on these programs without reviewing them after the appointment for completeness and accuracy. They must be reviewed.
And finally, the number one way to minimize disruption within your practice is to simply be a good person. If you treat your team well, treat your patients well, and have a fantastic chairside manner, you will find that your team members will have your back and your patients will give you the benefit of the doubt.
Thank you again to Dr. Cottle. The Ohio State University College of Dentistry and their dedicated instructors, such as Dr. Cottle, continue to impress me. I look forward to facilitating another productive discussion with Dr. Cottle and his classes in the future.