An open and shut case
One of the many cases that have been handled by Dental Protection, in order to demonstrate an important learning point
The registration of DCPs has created many benefits, not the least being the formal recognition for the different members of the dental team. Dental Protection has advocated the benefits of team working for many years and is a large enough organisation to ensure that the interests of every member of the dental team can be independently represented by a different dento-legal adviser (there are now 70) should there be a dispute about clinical matters.
Fortunately, disputes between colleagues are infrequent but if they should ever arise it is important that independent advice is available for everyone concerned. But let’s think positively and consider the advantages of teams when they communicate well and work in harmony.
Consider the case of a patient who recently had a large filling placed in a molar tooth. He rang the practice three hours after returning home to say that the tooth was starting to hurt him. The receptionist reassured him over the phone and advised him to take analgesics. She also logged the telephone conversation in the patient’s notes on the computer.
The patient refused to pay for the endodontic treatment on the grounds that he thought he should be compensated for the earlier three days of pain
The following morning the patient telephoned again, saying that the pain was getting worse. An appointment was offered later that morning, but when the patient was examined, there was no indication of anything more than the normal post-operative sensitivity from a large filling. A periapical radiograph that was taken at the time revealed nothing abnormal.
A day later, the patient was waiting in the practice car park as the staff opened up. He had been unable to sleep all night because of the intensity of the pain. He was most angry when the receptionist told him that the dentist was away for the day on a postgraduate course. He demanded that some attempt should be made to reach the dentist and recall him to the practice, or alternatively arrangements should be made for him to be seen by another local dentist. The receptionist suggested that, if all else failed, she might be able to arrange for his local doctor to see him, but in the meanwhile she undertook to try to contact the dentist on his course.
As it happened, the dentist telephoned during the lunch break, and offered to see the patient that evening on his way home. He opened up the surgery specially to accommodate the patient. As he had already anticipated, it was necessary to remove the pulp of the tooth and start endodontic treatment. The patient’s pain disappeared immediately.
Some weeks later, the patient refused to pay for the endodontic treatment on the grounds that he thought he should be compensated for the earlier three days of pain, made worse by the dentist’s unavailability and the lack of emergency arrangements. The situation escalated even further when the patient’s complaint became the subject of a formal hearing before the GDC.
The committee completely exonerated the dentist. He had provided emergency treatment very promptly and appropriately on two occasions, and on the third occasion he had made himself available in a situation where many other dentists might not have done. The dentist elected not to pursue the patient for the unpaid endodontic fee, offering this as a goodwill gesture.
Both the dentist and the team had learned a valuable lesson from the experience, about the importance of establishing effective emergency arrangements at times when the dentist is away from the surgery, and of good record keeping by himself and his staff. Without the documented episodes of this patient’s phone calls and appointments that were offered in response, it would have made the defence of the complaint so much more difficult.