While the word “notification” commands instant anxiety, practitioners can take positive steps to ensure they are well placed to deal with any that arise. Daniel Spencer, Senior Associate in the Health Law team at Panetta McGrath, and Dr Annalene Weston, Dentolegal Consultant at Dental Protection, set out 10 simple steps.
While the receipt of a notification is not within your control, what you do in caring for your patients – from an initial consult through to discharge – certainly is. And while it is the quality of the care that is critically important, the documentation of such care is equally so.
We believe that there are also a number of ‘controllables’ for practitioners in seeking to mitigate any adverse finding by the Dental Board, should a notification or complaint about you arise. We recommend that you take these ten simple steps to safeguard your risk, as while they may seem onerous at the time, your future self will thank you for going the extra distance.
Maintain complete, accurate and contemporaneous clinical records
This is a challenge with the busy-ness of everyday practice. It is critical for you to record the process of taking informed consent, so the conversation of consent including the actual risks discussed (rather than simply stating “risks and warnings given”), making a note of any documentation you have provided the patient. Templates can assist in this regard, provided they are thorough, personalised and up to date.
Communicate clearly with patients and colleagues
This cannot be overstated. Try to document all conversations with patients, and with colleagues if about a patient’s care. It is also good practice to follow up important conversations with a patient by email, particularly where there is the potential for dispute or confusion about what was said or agreed.
Be open and honest and apologise if something goes wrong
It is important that our patients know what has happened, and what we are going to do about it. It is also important that they understand what is going to happen next and that they do not feel abandoned by us when they have suffered harm. This is very much a conversation that Dental Protection are here to help guide you through.
Inform yourself of Health Fund and Medicare requirements
Be aware of requirements regarding the billing of items, remembering each third-party payer may have different rules and regulations. Regularly review Health Fund and Medicare updates and engage in open discussion with colleagues about what they mean. Don’t assume your billing is fine “because everyone else is doing it”. This defence won’t fly in an audit.
Don’t self-prescribe and don’t prescribe for your friends and family
Various guidelines stipulate that this should be avoided wherever possible. If you have to do so, be prepared to justify your decision, make a clear record of what you have done, and advise the patient’s GP in writing, including your clinical reasoning where appropriate. Remember, you are limited to prescribe medications related to the practice of dentistry ONLY.
Seek the advice of colleagues or mentors when unsure
This may help you clarify your decision-making and assists in developing a collegiate profession. It also assists in better outcomes for our patients.
Respect professional boundaries – yours, your patients and your staff
Be aware of professional boundaries with patients and colleagues. Seek to terminate a therapeutic relationship at the first sign of a relationship evolving into something personal.
Use a chaperone where appropriate
Chaperones are there to protect you as well as the patient. Their presence can be critical when defending allegations of sexual misconduct. It can also be the difference in being out of practice for 12 months or more.
Use social media with caution
Be very careful when using social media (even on your personal pages), when authoring papers or when appearing in interviews. Health practitioners are obliged to ensure their views are consistent with public health messaging. This is particularly relevant in current times. Views expressed that may be consistent with evidence-based material may not necessarily be consistent with public health messaging.
Talk about it
As well as maintaining good mental health, asking for help whether through formal channels (such as your GP) or informally, by talking through complaints or clinical concerns with colleagues, friends and family can prevent a situation escalating out of control. It can not only help you, but it can also help others as it acts to reassure that mistakes can and will happen to everyone. We can even learn from the mistakes of others, which is a valuable gift to share with a colleague.