Managing professional risks: The doctor/patient relationship

One of the most effective ways to mitigate many of the risks inherent in practicing dentistry is to create and nurture a positive relationship with every patient, according to the ADA Center for Professional Success. The way you and your team manage the patient experience can go a long way towards developing a partnership based on mutual respect and supported by open and clear communication.

Doctor/patient relationships don’t always start in the operatory, or even at the office. A patient may get to know you or a member of your staff at an event or function at any time. A doctor/patient relationship may develop when an individual relies on advice from, or an opinion of, a dentist even outside of the office environment. This is important to understand because once a doctor/patient relationship is established, the dentist has assumed responsibility for the patient’s dental care.

How you manage that initial contact will set the parameters for a doctor/patient relationship that, when properly managed, can be a rewarding experience for each of you for a very long time.

Dental care has been driven by preventive and restorative treatment, and the foundation of every clinical procedure you recommend and perform is built on the relationship you’ve established with each patient.

Every communication you have with every patient will reinforce their opinion of you and the care they receive from you and your staff. Positive experiences establish – and strengthen – positive relationships, which may reduce the likelihood of a dissatisfied patient filing a lawsuit, formal complaint with the state dental board, peer review, or dental insurance carrier.

Strong doctor/patient relationships require trust from both parties:

Patients must be able to trust that they can be completely open and forthright when communicating with you about their overall health status, any prescribed or recreational drug use, compliance with home care instructions, etc.
It’s important for them to know that you and your staff need this information in order to accurately assess their oral health needs and design an appropriate treatment plan.
Providers must be able to trust that patients have provided comprehensive pictures of their current medical conditions.
Recognize that some patients may not understand why their dentist is asking for information about their personal medical histories, drug use or even their personal behaviors.
Let your patients know that the information they provide will help you accurately assess their dental health and allow you recommend treatment that should yield a positive outcome.
Reassure them that their information is confidential and that your staff is a team of professionals who respect and honor the trust your patients have placed in you.
Use as little technical language as possible when discussing diagnostic tests and findings from oral exams, radiographs, photographs or during treatment such as surgery.

Problems can occur even in the best dentist-patient relationship and patient complaints can be prompted by a number of issues, including misunderstandings about treatments plans, the goals and possible risks of treatments, fees, etc. Always be open and willing to discuss the patient’s complaints or concerns. That genuine dialogue is often all it takes to clear up the matter.

Remember that a patient complaint does not indicate that you’re a bad dentist or that your ability to care for patients is lacking. What it likely signifies is that there was some type of miscommunication or a breakdown in the communications process.
Patients with complaints usually want the opportunity to be heard, to let off steam, or to get an explanation for why something happened. Maybe they just want an apology, or some type of remedial action and redress that seems appropriate to them. Sometimes they just want to be acknowledged and taken seriously, to be given enough time to fully explain their concern, and to feel as though they’re being dealt with honestly and with complete attention.
Research has found that dentists with the fewest complaints spend more time with each patient at each visit, get to know their patients well, listen actively, maintain a warm and friendly atmosphere, and are humorous, with a warm personality.
On any given day, the best dentist can make an error or omission. If so, take remedial action to correct the mistake. Remedial action may require a referral to a specialist. If prompt action is required, your office should arrange and schedule immediate referral rather than requesting the patient to appoint with the specialist. Include in the referral slip the reason for the referral and the area to be examined and/or treated. As an added precaution, also securely fax and email the referral slip. Follow the maxim “If you mess up, fess up.” Dentists who conceal their errors or misrepresent the cause or nature of the patient’s injury may betray their fiduciary duty of honesty and fair dealing with patients. Such betrayal can precipitate the genesis of a malpractice claim that otherwise might have been avoided with candor. Saying you are sorry for the injury is not necessarily an admission of wrong doing but rather an expression of compassion for the patient’s injury.

In some states, certain statements of apology may not be used against the dentist in a malpractice action.

Resources

The ADA Guidelines for Practice Success™ (GPS™) module on Managing Patients offers numerous articles and resources that can help you build strong relationships with patients. Key articles in that module include:

The Patient Experience: What it is and Why it Matters
The Patient’s First Visit
Informed Consent/Refusal
Specialty Referrals
Documentation/Patient Records
Noncompliance
Complaints
Refunds and Discounts
Patient Dismissal

Read more: newdentistblog.ada.org

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