Confidentiality breach
Aubrey Craig looks at what can be learned from a case involving a breach of confidentiality as well as complaints about the cost of treatment and consent
Mrs M attends her dentist, Mr A, complaining of pain in an upper tooth. They discuss treatment options and she agrees to undergo private treatment, including root filling and the fitting of a new crown. She signs a treatment plan which shows the cost of the work will amount to around £500.
The treatment is carried out without incident and Mrs M pays part of the bill before leaving that day. The practice sends out an account detailing the remaining total but, three months later, no further payments have been made. Mr A issues another written account to Mrs M but is then contacted by Mr M who says he is assuming responsibility, with his wife’s consent, for the bill. He asks why the cost is so high but Mr A explains the treatment given and that the price was agreed in advance.
Five months after the initial appointment, still no further payment has been made. Mr A phones Mr M at home to discuss the matter. There is no answer but the phone switches to an answering machine, identified as belonging to Mr and Mrs M. He leaves a message asking Mr M to contact the practice about the unpaid bill.
One week later, Mr A receives a cheque for £150 from Mr M along with a promise that more money will follow soon. It is also accompanied by a letter of complaint from Mr M who is angry that the dentist disclosed information about the unpaid bill in the answering machine message. His daughter had dropped by while he was out and heard it, causing him considerable embarrassment.
Mr A sends a written apology to Mr M and agrees to let him pay the bill off over the next two months.
A short time later, however, Mr A is notified by the General Dental Council that a complaint has been made against him alleging a breach of confidentiality and claiming the cost of treatment was unfair and had not been
clearly discussed.
Analysis/outcome
Mr A calls MDDUS for advice. It is recommended he writes a further letter of apology to Mr M. Mr A accepts that sensitive information about the unpaid bill should not have been disclosed in the phone message and that practice procedures have been changed to avoid a repeat of this error. It is also advised that Mr A waives the outstanding sum owed to the practice in recognition of the distress caused by the confidentiality breach.
Regarding the disputed fee, Mr A is confident that this was fully discussed with the patient in advance and he has the treatment plan signed by Mrs M to support this.
The GDC case is eventually closed with no action taken against Mr A.
Key points
- Never disclose sensitive patient information in telephone messages
- Be aware of the potential for third parties to intercept messages, even on personal mobile phones
- Always ensure costs are discussed and agreed upon, in writing, before treatment is carried out.
About the author
Aubrey Craig is head of dental division at MDDUS. For more information, go to www.mddus.com
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