Treating family and friends presents challenges for dentists

PRESS RELEASE

For immediate release: Tuesday, 2 December 2014

Dentists are urged to follow the same procedures when treating family and friends as they do with all other patients, says UK-wide dental defence organisation MDDUS.

Treating those close to you can have implications on a dentist’s clinical judgement and result in poor consenting. MDDUS dental adviser Doug Hamilton believes that potential risks can be avoided by applying the correct rules uniformly, including such things as a treatment plan and cost estimate.

“With the exception of drug prescribing, the GDC does not impose stringent restriction on the treatment by registrants of family and close friends,” says Hamilton. “However, a less formal dentist-patient relationship does present challenges for dentists.

“Firstly, there is the issue of consent. Ordinarily, before treatment can commence patients will be advised of factors such as the risks, benefits, costs and alternatives.

“However, familiarity with a patient can make adherence to standard procedure seem unnecessary and even a little awkward. Particularly embarrassing is the issue of money with dentists often feeling obligated to discount fees or ‘just charge the lab bill’ as a gesture of goodwill.

“While this act of generosity is usually appreciated, it often remains undocumented, an aberration which can, unfortunately, lead to problems.

“It’s not unknown for even the most generous price reduction to be subsequently challenged or even misrepresented as a tacit admission of substandard treatment. With no record of what was agreed and on what basis, the practitioner is left in a vulnerable position.”

Over-eagerness to help our friends may not only result in poor consenting, but may also skew clinical judgement. “It is quite understandable that, when treating those close to us, we may adopt practices that would not be routinely countenanced,” says Hamilton. “A restorative plan, which would normally be regarded as over-ambitious, might just be attempted.

“Usually, treatment will proceed as planned and any such aberrations will have no relevance. Even when problems do arise, good friends or immediate family members will accept the outcome and be appreciative of the dentist’s efforts.

“However, it’s not hard to imagine circumstances where, for example, a more distant, estranged relative or a relative of a staff member takes a less indulgent view. These patients who may have been quite happy to benefit from your kindness when all was going well, can prove to be especially ungrateful if the finished treatment does not meet expectations.

“If the investigation of a subsequent complaint reveals inadequate consenting or questionable treatment planning, the fact that these faults were a product of kindness will get little sympathy.”

Possibly, the best means of pre-empting such problems and avoiding causing offence is to apply the correct rules uniformly.

“If the practice policy is to provide everyone with a written treatment plan and cost estimate prior to treatment of any complexity then no one should feel affronted,” says Hamilton. “Equally, no one can subsequently attempt to take advantage of your good nature by ‘misremembering’ the agreed charges.

“Regardless of an appointment’s informality, records must include all of the usual observations, such as examination results and details of the treatment provided. Where there are any doubts, don’t feel abashed about requiring a signature on the consenting document. After all, this is the standard procedure.

“Dentists who stretch the rules for friends will usually do so out of compassion. However, previous instances have shown that, where these actions conflict with GDC Standards, NHS regulations or accepted clinical practice, such mitigating arguments are of limited value.”

Ends

For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.