Stats:

• Number of GDC hearing that are currently open = 1000.
• We will be sued, on average, 5 times during our career.
• 45 full time dentolegal advisors working for Dental Protection (DP).
• Calls have reached up to 102 in a morning the DP office.
• Average case load per advisor per day is 400!
• By the end of 2014, the UK will be the riskiest (highest chance of being sued) place in the world to be a dentist.

Background:

• Trust – a business that doe not invest in building trust will over time be rejected by its customers.
• Commercial marketplace (Anderson and Philipsen 1998) – we are part of the credence characteristics – build on this.
• Dentistry has been sucked into consumerism. It’s important to realise that the patient is buying the benefit that the treatment gives them rather than the product itself.
• An information asymmetry exists between the seller and buyer and therefore there is a scope for dishonesty and breach of trust.
• Studies have found that patients go to a particular practice for the dentist, not the décor! People buy people!
• Ethics – framework for human conduct that related to moral and legal principles and attempts to distinguish what is right and wrong.
• Professional misconduct and going to the GDC is more of a threat than being sued.
• Often the dentolegal companies will say that a case is difficult to defend and therefore end up paying up rather than fighting the case. This does not mean that the dentist is in the wrong.

 Artistotle’s core ethical principles still valid 2000 years on:

• Respect autonomy
• Do no harm
• Benefit others
• Be just
• Be faithful

Ethical decision-making (American College of Dentists):

• Assess – is it true, is it fair, is it quality?
• Communicate – have you listened, have you informed the patient, have you explained the outcomes, have you presented the alternatives?
• Decide – is now the best time, is it within your ability, is it in the patient’s best interest, is it what you would want yourself?

If you can answer yes to the above 11 questions and have recorded the evidence of the above, you are most definitely safe.

Tips for consent:

• For large treatment plans especially involving cosmetic work that is elective and expensive, consent is critical.
• Break down the consent to three elements that each need to be signed by the patient:

1. The risks as well as the benefits have been explained and I understand them.
2. In relation to (1), I have been given the opportunity to consider the options and ask questions.
3. In relation to (1) and (2), on the basis of the information received, I am prepared to go ahead with the proposed treatment.

 What’s the cause of the increase in litigation and how can we address this?

• We need to look at our self and the system we are currently working in.
• We are hard-wired for motivational bias (Book to read – Max Bazerman – Blind spots).
• Saying sorry does not admit negligence. This might be all the patient needs to hear.
• The patient has a right to say what they expect due to the information asymmetry that exists.
• Use the new Standards (GDC) booklet to lift text from there to use on your templates as this is what you will be judged against.
• Conflict of not working beyond competency but also onus is on the GDP to upskill.
• The GDC will judge you against what they expect a GDP’s competency level to be at.
• Whilst it is easy to assume that patients will complain or sue whenever anything goes wrong, the reality is that the vast majority of patients will not. Although patients who have been seriously harmed may take the matter forward, it is often the negative factors in the relationship, between the dental team and the patient that results in the patient deciding to do so.
• Be nice to your patients and build rapport – this is the secret to risk management.

General Dental