Common complaints and how to avoid them

Originally published in the May/June 2015 issue of Dispatch

The College processed more than 600 complaints and inquiries last year, many of which have common themes. Communications issues are some of the most frequent matters that come before panels of the Inquiries, Complaints and Reports Committee.

The College understands that a dentist never wants to be the subject of a complaint. Improved communication is one step that can go a long way to help resolve patient concerns and potentially avoid a complaint ever being filed. Here are some tips on how to avoid four of the most common concerns we see in the complaints arena regarding communications issues.

Remember, though, that even if you do find yourself the subject of a complaint, the College complaint process is designed to be transparent, impartial, and fair to both parties throughout. And always remember to notify the Professional Liability Program of any circumstances that may result in a claim against you.

#1 “The dentist never warned me this could happen!”

One of the most common complaints arises when complications occur during a procedure or when a dental treatment subsequently fails. An endodontic instrument separates and can’t be removed. A tooth develops irreversible pulpitis following a deep restoration. A crown fractures at the gum line.

The College understands that negative treatment outcomes can occur even when the treatment rendered was appropriate and in keeping with the standards of practice. However, it is important to inform patients of such possible negative outcomes in advance as part of your informed consent discussions.

The chance of a negative treatment outcome should never be a surprise for a patient. A patient is far less likely to complain when treatment fails if they have been forewarned that this could be a possibility. The less of a surprise, the less likely a patient is to file a complaint. Of course, if a negative outcome does occur, the patient should be advised immediately and that discussion should be documented.

It is important, therefore, to take the time in advance of treatment to clearly explain the possible negative outcomes and their consequences, and to clearly and comprehensively document such conversations as part of the clinical record.

#2 “The treatment was far too expensive!”

Patients can often be surprised by the cost of dental treatment, even where such costs are reasonable and reflect the profession’s prevailing rates. A patient may be shocked to learn that what they thought was “just a few fillings” can add up to hundreds or even thousands of dollars worth of dental bills. Taking the time to explain costs to a patient in advance of treatment can help to prevent sticker shock and a potential complaint after the fact.

Though dentists may not always enjoy discussing the financial side of their practice, explaining the cost of proposed treatment is an integral part of obtaining a patient’s informed consent. Providing a formal quotation for expected costs or sending out a predetermination to an insurance provider is always a good idea when treatment is extensive or expensive. Even providing a rough estimate for more routine treatment, with appropriate provisos, can help a patient understand how much they are likely to be charged.

It is also good practice to explain clearly to patients what factors may have an impact on costs. For example, the presence of decay under a crown can lead to the need for further treatment and increase the potential cost.

#3 “The dentist didn’t even listen when I had a problem…”

Sometimes all a patient wants is for someone to listen to their concerns. Being a sympathetic ear to a patient’s concerns and setting out steps for how to address them can sometimes alleviate those concerns entirely. Practise active listening skills to help patients understand that you have heard and understand their concerns, even if you may disagree with them. Taking the time to listen before speaking will often save you much more time and trouble in the long run.

#4 “The dentist was so rude to me!”

Maintaining professionalism in stressful circumstances, such as dealing with a dissatisfied or even angry patient, can be difficult, but it is one of the hallmarks of professional practice. Speaking in an even and respectful tone, not showing signs of irritation or frustration, and not responding in kind to rude behaviour from a patient are absolutely key to good professional communication. It is also good practice to document any challenging discussions with a patient in a detailed, contemporaneous notation. Having any other staff members who witnessed or overheard any such patient interactions document their own observations, is also a good idea.

In addition, when responding to a formal complaint filed with the College, it is equally important to maintain a professional and respectful tone. Your response is being read by a panel made up of dentists and appointed members of the public who are tasked with regulating the profession in the public interest. Keep your audience in mind when writing your response, and never write when you are angry or upset – it will come across in your response.

Not only will improved communication with patients and a little common sense help you avoid being the subject of a formal complaint to the College, it will also help you establish and maintain long-lasting professional relationships with your patients.

COLLEGE CONTACT

Lori Long
Manager, Professional Conduct and Regulatory Affairs
416-934-5623
1-800-565-4591
llong@rcdso.org