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Specialist referrals and reports from a dentolegal perspective

03 June 2020

Practitioners correspond with their specialist network frequently, to ensure the best care for our patients. But what about situations where we think we have already provided the best care but the patient doesn’t? Dr Annalene Weston, dentolegal consultant at Dental Protection, considers the valuable role of specialist reports

Case study

Dr L performs a root canal treatment on a 16 with all appropriate assessment and a valid consent in place. The treatment proceeds well and Dr L is happy with the result. However, after completion of the treatment, the patient states the tooth does not feel quite right. Radiographically it is sound, and Dr L remains confident that the root filling is adequate. A crown is placed as planned in the hope that this resolves the situation. Despite this, the tooth still feels not right to the patient. A series of repeated consults take place and both parties become anxious and frustrated, as Dr L cannot see what else they can do. The patient loses confidence in Dr L as they believe that the treatment is at fault.

This is when a specialist assessment of the treatment can be incredibly valuable: if there is an issue with the treatment, the practitioner can move forwards and assist the patient in getting this remedied. If there is no issue with the treatment, then the specialist can reassure the patient that all is well.

Further, if the patient remains unhappy, and moves to make a formal complaint to AHPRA or perhaps even a legal claim, then the specialist report can assist you in your defence, both in the standard of treatment you provided, and also to demonstrate that you fully dispatched your duty of care to the patient.

Patient referrals are essential when you are unsure of or concerned about a diagnosis, for example a red patch or non-healing ulcer. It is also prudent to take the step of offering a specialist referral to a patient prior to undertaking complex, elective or expensive treatments. If there is a complication with the treatment, then the circumstance of a patient choosing, for example, to have orthodontic treatment with you on consideration of all options, is viewed very differently from a patient who was denied the opportunity to consult with a specialist, if the treatment fails.

DO

Develop a strong network of specialists so you can seek assistance when needed

Consider offering a specialist referral to patients for whom elective, complex or expensive treatment are planned

Document that this offer was made to the patient, and their response to this, in your clinical records.

DON’T

Fail to consider a specialist referral if the patient is unhappy with their treatment outcome

Forget to contact Dental Protection to discuss the case. We’re here to help.

You can also listen to our podcast series for further guidance and advice. 

© 2019 The Medical Protection Society Limited

DPL Australia Pty Ltd (“DPLA”) is registered in Australia with ABN 24 092 695 933. Dental Protection Limited (“DPL”) is registered in England (No. 2374160) and along with DPLA is part of the Medical Protection Society Limited (“MPS”) group of companies. MPS is registered in England (No. 00036142). Both DPL and MPS have their registered office at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. DPL serves and supports the dental members of MPS. All the benefits of MPS membership are discretionary, as set out in MPS’s Memorandum and Articles of Association. “Dental Protection member” in Australia means a non-indemnity dental member of MPS. Dental Protection members may hold membership independently or in conjunction with membership of the Australian Dental Association (W.A. Branch) Inc. (“ADA WA”).

Dental Protection members who hold membership independently need to apply for, and where applicable maintain, an individual Dental Indemnity Policy underwritten by MDA National Insurance Pty Ltd (“MDA”), ABN 56 058 271 417, AFS Licence No. 238073. DPLA is a Corporate Authorised Representative of MDA with CAR No. 326134. For such Dental Protection members, by agreement with MDA, DPLA provides point-of-contact member services, case management and colleague-to-colleague support.

Dental Protection members who are also ADA WA members need to apply for, and where applicable maintain, an individual Dental Indemnity Policy underwritten by MDA, which is available in accordance with the provisions of ADA WA membership.

None of ADA WA, DPL, DPLA and MPS are insurance companies. Dental Protection® is a registered trademark of MPS.