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Dealing with unreasonable expectations

15 July 2014
Staff have opinions too and any concerns they may have about a patient are worth listening to...

A female patient arrived at the dental surgery requesting treatment. She was concerned about the appearance of her upper anterior crowns. The patient stated that although she had been happy with her previous dentist, she was not entirely happy with the crowns, which she felt were too dark and too large and she requested their replacement.

The dentist felt that although the existing crowns were in reasonable clinical condition, he would replace them as the patient was unhappy with their appearance. He did not foresee any problems with the treatment.

However, the dental nurse was concerned about the patient and her expectations. She noticed that although the patient appeared very reasonable and co-operative when in the surgery with the dentist, she was much more difficult in the reception area.

She was very insistent that she wanted her appointments late in the evening or on a Saturday morning, when the surgery was not normally open. She eventually agreed to the appointments offered, but stated that she hoped that everything would ‘now be perfect with the crowns’. She further stated that she knew that the crowns would make her look much younger.

No problem

The nurse informed the dentist that she felt the patient had unreasonably high expectations of the treatment. The dentist did not agree with this and insisted that he did not anticipate any problems.

When it came to fitting the crowns, the patient expressed her dissatisfaction with the colour and shape, saying that they should be lighter in colour and smaller. She was informed that the crowns were a good match to her other teeth as well as being an appropriate shape for her mouth.

The patient was informed that the crowns could be temporarily cemented; she stated that she did not have time to come back for any further appointments and that the crowns should be permanently cemented. Some months later the dentist received a letter from the patient requesting a refund of the money. She had been to see yet another dentist who was willing to replace the crowns.

Done his best

The dentist consulted Dental Protection. It was agreed that he had done his best and that no other course of action was sensible in the circumstances. However, the dentist did agree with hindsight that he should have discussed the size and colour of the crowns in more detail with the patient.

The dentist was advised that he could either refuse to refund any money to the patient or agree to a refund as a gesture of goodwill. The dentist felt that he did not wish to go through the time and stress involved should the patient take the complaint further and decided to refund the money.

Learning point:
This case demonstrates that other members of the dental team may ‘read’ a situation quite differently from the dentist in charge. Listen to any misgivings the staff may have about a patient. The lines of communication with the patient may need to be improved to avoid any potential areas of conflict.
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