About Dental Protection

With so much uncertainty in the global economic picture and with consumer confidence extremely fragile, it is gratifying to report that our claims and cases experience in Singapore has been reassuringly stable during 2008. We are still up at the levels that we first reached in 2004, after the sharp upward trend from about 2000 onwards, but we do appear to have stabilised at around that level without further deterioration.

The overall picture is somewhat mixed – and while negligence claims have eased back to the 2005 - 2006 levels after a brief upward ‘spike’ in 2007, complaints of other kinds have continued to increase and now sit at an all-time high. This should not give us any immediate cause for concern, however, because while these complaints are being mediated by the Ethics Committee of the Singapore Dental Association, history tells us that they are very likely to be resolved without solicitors being involved. This is a testament to the very effective and responsive way in which the Ethics Committee is managing these cases under the chairmanship of Dr Raymond Ang. Dental Protection would like to thank Dr Ang, Dr Lim Lii and their colleagues for the excellent work they have been doing on behalf of all members in Singapore.

However we also sound one note of caution, in that we are starting to see the emergence of some of the same characteristics that we have seen so often in other jurisdictions, resulting in a sharp upturn of case-related expenditure and as a result, in the subscriptions we have needed to charge in these countries. One such feature is the steady increase in implant-related claims. When these result in negligence claims, or complaints to the Dental Council, (and we have experienced both), they tend to incur much greater costs than the average claim involving other kinds of dentistry.

Subscriptions

The currently stable claims experience and the financial strength of Dental Protection and MPS, means that we have been able to hold our subscriptions at the same level as 2008; which means that Dental Protection’s subscriptions in Singapore will have remained remarkably stable for three consecutive years.

We all have a responsibility to play our own part in maintaining this stability, by continuing to work hard on developing our skills, by working within our training and competence, and by taking a proactive approach to risk management. Hopefully the present stability can be maintained.

Current issues

One of the hot topics in Singapore at the present time is the establishment of specialist lists by the Singapore Dental Council. As Dental Protection knows from its experience in many other countries, this impacts upon our work in many different ways.

Firstly, members who are not accepted for specialist registration may somtimes believe that they have been treated unfairly. It is not the proper role of Dental Protection to interfere with the process itself, or how high the ‘bar’ is set by those who are deemed to be the competent body for this purpose in Singapore. But ensuring fairness in the treatment of our members is very much part of what we do, and members who believe that they are being treated unfairly or in a discriminatory fashion, are welcome to seek guidance and advice from us.

We are often asked if the establishment of specialist registers means that general practitioners should then refer all their more complex cases on to the specialists in question. Clearly this would be nonsense, and would not be in the best interests of the patients, the specialists, or the practitioners themselves. All clinicians should treat patients only within the limits of their training, skills and competence, and it is an important part of a general practitioner’s function to act as a responsible ‘gatekeeper’ of primary dental care – recognising when to delegate tasks to other team members, and when it is necessary to call in the specialist expertise or experience of others. This could mean a specialist, or simply a more experienced colleague.

A practitioner has a duty of care to the patient, to satisfy himself/herself that the person to whom the patient is being referred, has the necessary skills for the task in hand. The existence of specialist lists makes this task easier, but it does not rule out the possibility of a referral to someone who may not be a formally recognised specialist, but who is known by the practitioner in question to be able to carry out treatment of a particular type, safely, successfully and to an appropriate standard.

Online CDE

Our Risk Management Modules are an invaluable resource at your disposal, and they can be freely downloaded from the Dental Protection website's online risk management library

Each covers a specific topic (for example, ‘cosmetic dentistry', ‘implants', ‘endodontics') and summarises the key areas where problems arise, the records that need to be kept, and the consent issues that need to be covered.  As an additional bonus, an online CDE facility and on completing the necessary exercises, a certificate of continuing education is provided. The Singapore Dental Council has approved DPL as an accredited provider of CDE.