Taking over from another dentist can lead to conflict – but protecting the interests of the patients remains paramount...
A middle-aged dentist signed up his practice to a national capitation scheme and encouraged all his patients to join the scheme. He set his fees with the help of the scheme’s advisers and for many years carried out all the treatments the patients required and for which the scheme covered them.
On approaching retirement, however, the member stopped sending recalls to many of the patients. Those who did come in received minimal treatment and even less by way of x-rays and diagnostic tests. Although this resulted in a few patients with toothache, these were dealt with promptly. Shortly after that, the practice was sold.
Although the dentist who bought the practice agreed to accept all the capitation patients, he was somewhat shocked by their dental condition and insisted that any outstanding treatment due to the minimal care provided by the previous dentist was not his responsibility. He provided estimates for all the outstanding work to each of the patients, which in fact were extremely high.
On examining a sample of the patients, it was very clear that the retiring dentist had been negligent by not maintaining their oral health. He had been receiving capitation payments while neglecting the contracted level of care for the patients.
The new dentist, however, had over-estimated the cost of treatment to establish an acceptable level of oral health for the patients, and would not agree to provide any treatment under the capitation scheme until the remainder of the old treatment had been cleared up.
With the help of the capitation scheme organisers, an independent expert was invited to look at the retired and new dentists’ x-rays and records and to classify all the treatment according to whether it was the responsibility of the retired dentist or of more recent origin and the responsibility of the new dentist.
The expert also established what a fair fee would be in that area for the necessary treatment. These reports and the calculations based on them were then offered to the patients, together with an explanation. Some of the patients continued with the new dentist, but many more decided not to return on seeing just how much he had increased his charges, over and beyond those of the previous dentist.
Whenever a new dentist sees a patient, there is a risk that existing treatment will be assessed in a new light. It is essential that a dialogue between the two dentists should resolve the matter to protect the patient – often an independent third party can assist in negotiating the matter.