How To Respond To A Patient Complaint Against A Dentist - Page 5

By Matthew Wilton

The key is effective written advocacy

Most patient complaints are dealt with solely on the basis of the patient’s written complaint, and the dentist’s written response. It is therefore critical that the dentist’s communications with the regulator be effective, and to the point. Litigation lawyers quickly learn that any trier of fact, whether it is a Judge or a Discipline Committee or a Complaints Committee, has a limited attention span. It is essential that written responses to complaints contain only the information necessary to advance the dentist’s position. One of the biggest failings of dentists who act on their own behalf in responding to complaints is that the complaints letters are long and rambling, and contain irrelevant content. The following are the types of comments that appear regularly in complaint letters written by dentists, that are simply not relevant at the Complaints Committee level:

1. I have always been nice to Mrs. Jones and her son, and have always treated them kindly.

2. I have worked in this Community for 35 years without a complaint.

3. I have bent over backwards to help this patient and her family, and I cannot believe that she is now complaining about me.

4. Mr. Jones has poor personal hygiene and is very unpleasant and aggressive to all my staff.

5. I have done much good work in my Community, and I have 15 patients who will attest what a wonderful person I am.

6. When I received Ms. Chin’s complaint, I was emotional and very upset, and I have not been sleeping well for the past several weeks. The complaint has also caused my wife migraine headaches.

7. I have a bad back and I am on medication for this, and I am also currently suffering from depression.

8. I cannot believe that Mrs. Jones has betrayed my trust in her and her family. I am devastated by her complaint, and can’t believe that she would double cross me in this way.

9. I reported this incident to my liability insurer and the liability insurer has told me that they have no concerns with respect to the dentistry that I did.

10. I have been doing restorations in this fashion for the last 20 years and nobody else has complained about the way I do them.

11. The patient is very stupid.

12. The patient is cheap and does not wish to pay for any dentistry.

13. Even if I had offered to do a crown on that tooth the patient would have been too cheap to pay for it.

The problem with all of the above comments are that they are not typically relevant to what a Complaints Committee must consider with respect to a standards of practice complaint against a dentist. Throwing yourself on the mercy of the Complaints Committee, because you consider yourself compassionate or kind (while an understandable impulse), is not a submission that would be given any weight by a Complaints Committee. The Complaints Committee has a job to do: to look at dentistry issues and the dentist’s dealings with the patient. The regulator will typically not be swayed by any emotional appeals, or by any attacks on the patient’s integrity. The complaint response letter has to put forward all of the important information that the dentist wishes the Committee to rely upon, in reaching a decision that the dentist has acted properly. Too much verbiage detracts from the dentist’s core message, and may cause the Complaints Committee to conclude that the dentist doesn’t really have a proper and effective response to the Complaint. Put forward only the relevant and helpful facts. Focus on the core risks identified by the complaint. Further, the complainant will see your response, and as a result, it should not be offensive to the patient.

I have yet to read a Complaints Committee decision where the Complaints Committee is insulting to the patient. Therefore, any dentist’s complaint response letter that insults the patient is not serving any useful purpose. I have read hundreds of Complaints Committee decisions in the last 24 years. While issues about a patient’s oral health and dentition are entirely appropriate, personal invective is not.

Is there insurance for dental complaints?

I am currently associated with the Canadian Dental Protective Association, which is not an insurer, but which renders assistance to dentist members in respect of most complaint matters. The CDPA was established by Ontario dentists, and to this day is run by dentists. The CDPA uses a roster of lawyers who are all very experienced in dental legal issues. The CDPA also provides continuing education to dentists with respect to risk management issues. Perhaps the most valuable aspect of the CDPA program is that the CDPA offers risk management advice, initially not from lawyers but from trained dental advisors. The CDPA utilizes dental advisors who have a great deal of experience in dealing with patient complaint issues. This is a useful resource for dentists who may not wish to contact a lawyer, or who may not need to contact a lawyer. You would be amazed at the level of knowledge that a skilled dental advisor can bring to a complaint issue, in spotting issues relating to patient and business concerns that dentists have. The CDPA dental advisors receive regular training and input with respect to developments in the area of professional regulation. The dental advisors also regularly meet with the RCDS and other officials who impart their wisdom with respect to the complaints process. From acting for other dentist clients, I am also aware that the CDSPI offers insurance coverage that may cover dentist complaints. You need to make sure that the particular coverage you have through CDSPI covers RCDS dentists’ complaints. Typically there is a $1,000.00 deductible, and a $100,000.00 limit for legal fees. Even though lawyers may be expensive, this is usually far more than enough money to cover legal fees!

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