I’m the sort of person that cares too much and becomes emotionally committed to my patients. While kind and caring patients appreciate this, when a patient sets out to destroy you it takes over your own life instead.
I generally had excellent feedback at dental school, but supervisors would point out that I became deeply invested in how my patients fared and struggled to let go. Little did I know what was to come; that I would have to learn how to prevent my work overwhelming my life.
A tricky procedure
The patient seemed to numb up well but the tooth was too difficult to grab. I then proceeded to section the roots. I wasn’t too worried at this point as I had successfully performed two surgeries earlier that week. The three sections were separated and mobile but just as I obtained sufficient purchase and was about to do the final movement, the patient began to experience pain.
Despite topping up LA intraligamentally and waiting a good while, the patient still felt pain from that final movement. There was no other dentist in town that day and the nearest specialist was 200km away. The patient simply wouldn’t numb fully and I was reluctant to cause more pain to finish the extraction. I called the principal dentist in the state who advised antibiotics and painkillers, and that I bring the patient back for review in a few days and attempt the extraction again. I discussed the situation with the patient fully and apologized for the situation.
The dreaded call
During a follow up call the next day, however, the patient was understandably unhappy, and later that same day I received the type of call every dentist dreads. The patient had spoken to their dentist friend who rang me, telling me that the patient was threatening to sue me. This dentist demanded I pay for the patient’s extraction. If I did not, the patient would definitely lodge a complaint against me.
I called Dental Protection straight away, spoke to a dentolegal advisor and submitted my notes and X-ray. The advisor reviewed my clinical notes and my actions and reassured me that I had done nothing wrong, had followed the path of duty of care, and that Dental Protection would assist in payment of the extraction with another dentist. My advisor also helped me draft a letter to the patient, stating the payment was an act of goodwill and my wishes that the follow up treatment would be satisfactory.
The patient’s regular dentist took out the tooth successfully once the acute infection had a few days to settle down and the practice manager handed my letter to the patient. I was still on edge but grateful that the tooth was out. However a few days later, things took a turn for the worse.
The patient sent a threatening email to the practice which basically stated that since I had paid for the extraction, I had admitted liability. The patient wanted me to name a sum to be paid to him to avoid litigation, also questioning my competency and integrity.
I was not in a good state and immediately got on the phone to a dentolegal advisor, who was very patient and kind in a moment of great distress for me. The team at Dental Protection engaged a top law firm on my behalf and took over all correspondence with the patient. My dentolegal advisor had recommended the phone counselling service available to all Dental Protection members and I took advantage of this and engaged with a supportive psychologist.
This sort of event destroys your confidence and makes you question all your choices. Your sleep, diet, routines, relationships and even concentration when driving are all affected. Even though, under scrutiny, I was found to have done nothing wrong, having a patient out to get you makes you an overly-cautious practitioner, and it takes a huge amount of energy from your support network to move on.
My true recovery only began when a similar surgery occurred again at a remote satellite clinic in my subsequent job. What appeared to be a simple upper 3 extraction became difficult as the patient was a chronic bruxer with tough bone, and the tooth had a curve not visible on the PA. The threatening emails and calls were at the back of my mind during the extraction but I stayed calm and asked the patient to attend surgery at the main clinic the next day, and prescribed antibiotics and painkillers.
The patient drove several hours to see me the next day where I removed the tooth surgically. This patient acknowledged that he had trouble with his teeth, and was so grateful that I was willing to take it out that he gave me a massive hug at the end and couldn’t thank me enough.
It was only my experience with this second patient that restored my faith in humanity. I understood that I had an unfortunate horrible experience very early on in my career and the majority of patients are generally quite grateful and understanding. I can’t say that I am completely recovered – I have a heightened sense of suspicion and tend to assume patients will attempt the worst – but without Dental Protection by my side there is no chance I would be where I am today. I can honestly say that indemnity insurance is worth every cent towards your future. Never neglect it, because you simply cannot predict how a patient will react in a complicated situation.
The Dentolegal adviser's perspective
Dr George Lazaridis, Melbourne Office
As professionals we all care for our patients and work within our scope and our “competency”. Complications and adverse reactions do take place and this young dentist was unfortunate to come across a very angry, disgruntled and opportunistic patient when carrying out this procedure. A difficult situation not only for a young graduate to deal with, but also for many experienced practitioners.
This practitioner behaved ethically and professionally by halting the procedure, contacting both a colleague for advice and an adviser from Dental Protection. The patient was managed and the matter was dismissed. A harsh learning experience and I am pleased to read that the practitioner’s confidence is back to where it should be. Dental Protection will always be there to guide one through such an unfortunate experience.
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