Top 5 lessons from claims

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dental claims

This article is sponsored content brought to you by Guild Insurance.

Owning and operating a practice comes with a range of challenges every day. And while there’s a lot for you to worry about, there are common scenarios many dentists believe will never happen to them or their practice. But, claims reported to Guild Insurance tell a different story. It may surprise you to know, thousands of dental claims reported to Guild Insurance highlight the same recurring themes year after year. Don’t fall into the trap of thinking it couldn’t happen to you or your practice with the top 5 claims we get for dental practices here at Guild Insurance. 

1. Poor communication tops the list.

Our claims clearly show that if dentists don’t manage patient expectations from the outset, they significantly increase their risk of serious complaints.

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Don’t assume that what’s clear or obvious to you is understood by your patients. You’ll often need to explain the same information more than once throughout the course of treatment.

2. Informed consent to treatment runs a close second.

What’s an acceptable risk to one person may be completely unacceptable to another. And it’s the dentist’s responsibility to ensure each patient has the right information to make an informed decision about their treatment and associated costs. Avoid the temptation to assume you know what the patient considers to be reasonable or acceptable. And don’t simply ask someone if they understand, as in many cases they’ll say yes even if they don’t! Ask them to tell you what they’ve understood from the discussion.

3. Claims reported to Guild Insurance make a compelling case for improving dental records. 

Hundreds of cases every year are extremely difficult to defend because the dentist’s records are so poor. The patient and the dentist often have different recollections of what happened, so in the absence of good records, the patient’s views tend to hold sway. No prizes for guessing this one… yes, dental records!

Yet our claims experience also shows that a dentist’s version of events is more likely to be accepted, if they can demonstrate that good record keeping is part of their usual practice. Not just for the patient in question, but for all patients.

4. Don’t perform procedures unless you can demonstrate the requisite training, skills and experience.

When sub-optimal outcomes occur, the quality and appropriateness of the treatment is frequently called into question. Importantly, you’ll be judged against what the dental profession considers appropriate standards of practice and training. 

Therefore, it’s imperative that you keep pace with changes in dentistry and seek supervision when needed. It’s surprising how many dentists we meet who are not fully aware of their professional obligations.

5. Resist the temptation to embark on overly ambitious treatment plans.

Take the time to think through the pros and cons of each possible treatment and your level of expertise in delivering what the patient expects. Many claims reported to Guild Insurance focus on allegations of poor quality treatment, where the patient seeks reimbursement of not only the initial treatment costs, but the cost of replacement or corrective treatment too.

Consider referring the patient to a specialist where appropriate, and carefully explain the difference between what you can offer and what a specialist can do. Likewise, weigh up the risks of adopting new techniques or equipment – don’t be blinded by commercial opportunities.

These scenarios do happen; often causing considerable distress to the dentists involved. For more information on how you can limit the likelihood of a claim for your practice, visit riskhq.guildinsurance.com.au


Disclaimer

Insurance issued by Guild Insurance Ltd, ABN 55 004 538 863, AFSL 233791 and subject to terms, conditions and exclusions. This article contains information of a general nature only, and is not intended to constitute the provision of legal or financial advice. It is important for you to read the Product Disclosure Statement (PDS) and policy before you make a decision about an insurance product. You can get a copy of the PDS by calling 1800 810 213. GLD4136 Dental Risk HQ It could happen to you – Bitemag 05/2019

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