MLMIC publishes Risk Management Checklists to assist insured dentists with the creation of policies and protocols in critical areas, including dentist-patient relationships. These checklists focus on specific risk management issues policyholders are likely to encounter in the healthcare setting, like properly discontinuing dentist-patient relationships, treating patients with whom you have a close relationship, managing patient noncompliance and managing negative online reviews.

We encourage you to review these checklists on a regular basis to promote patient safety and reduce potential liability exposure:

Properly Discontinuing The Dentist-Patient Relationship

Once the dentist-patient relationship is established, dentists have a legal and ethical obligation to provide patients with care. However, there may be circumstances when it is no longer appropriate to continue the professional relationship. A dentist may choose to discharge a patient for a variety of reasons such as non-compliance with treatment, failing to keep appointments or inappropriate behavior. Properly discharging a patient from care can be a complex issue. In order to avoid allegations of abandonment, providers should consider establishing a formal process for discharge.

View or download the checklist here: Properly Discontinuing The Dentist-Patient Relationship.

Treating Patients With Whom You Have A Close Relationship

Dentists are often asked by close friends, relatives or colleagues for dental advice, treatment or prescriptions both inside and outside of the office. At times, these individuals may be seen by you as a courtesy and/or at no charge. Although the American Dental Association does not specifically prohibit the treatment of relatives or close friends, it is not without potential risk.

Over the years, we have seen a number of lawsuits filed against dentists by close friends, colleagues and even their own family members because of care provided by our insureds. The defense of these suits is frequently hampered by the fact that there are often sparse or entirely non-existent records for the patient. The failure to maintain a record for every patient is defined as professional misconduct by 8 NYCRR 29.2. Providing care under these circumstances poses unique risks.

View or download the checklist here: Treating Patients With Whom You Have A Close Relationship.  

Management of Patient Noncompliance

Patient noncompliance may be a difficult challenge for dentists. Noncompliance may include missed appointments, failure to follow the plan of care, take medications as prescribed or obtain recommended tests or consultations. The reasons given by patients for noncompliance vary from the denial that there is a dental problem to the cost of treatment, the fear of the procedure or diagnosis or not understanding the need for care. Dentists need to identify the reasons for noncompliance and document their efforts to resolve the underlying issues. Documenting noncompliance helps to protect dentists in the event of an untoward outcome and allegations of negligence in treating the patient.

View or download the checklist here: Management of Patient Noncompliance.

Management of Negative Online Reviews

Dentists recognize that along with their practice websites, public websites such as Yelp, Healthgrades and Rate MDs, and social media sites like Facebook and Twitter, can be used as marketing tools to inform the public of their services. The online community, however, is afforded an opportunity to respond, rate and, at times, complain about those services. These statements and reviews are readily accessible to anyone with an internet-ready device.

While there is a basic instinct to immediately respond to negative online reviews, dentists must remember that privacy rules make a complete response via social media inappropriate, and responding directly to an online post puts the provider at risk of disclosing (PHI) protected health information. Your response may not contain any identifying statements, but the mere recognition of a patient-provider relationship is a potential HIPAA violation.

View or download the checklist here: Management of Negative Online Reviews.

MLMIC’s Risk Management Consultants are available to assist insured dentists in their ongoing efforts to identify and address areas of concern related to dentist-patient relationships. For guidance regarding a specific situation, please contact MLMIC’s Risk Management Department at (800) 275-6564.

In addition, policyholders can stay up to date on the latest risk management guidance and alerts by monitoring the MLMIC Dental blogThe Scope: Dental Edition, Dental Impressions and other MLMIC communications.