What would YOU DO?!

Patient was referred to an office by a dentist in regard to tooth #2.5 treated by an associate.  The patient was advised that the palatal canal was not detected and a PFM was placed about 6 months ago. Patient now presents on referral with a chronic apical periodontitis evident and the request is to surgically resolve the lesion of endodontic origin. The canal was never treated, surgical correction is not the first choice for resolution. It’s imperative that the canal be identified and debrided, disinfected and sealed. There is a risk to the integrity of the crown and in the worst case scenario it may have to be remade should the porcelain fracture or something untoward occur.  The discussion with the patient focuses solely on the reason for not doing surgery, the need to retreat the entire canal space and the risk concerns going through a crown.  The dentist of record contacts the office, upset that “blame has been designated”.  The dentist who is to do the work, records all conversations and that is definitely not the case. The husband of the patient is sophisticated enough to put two and two together and determine that placing the crown when the endodontic procedure was potentially incomplete establishes risk and liability and he feels that he should not pay if the crown has to be redone.

This type of scenario goes on daily in every dental office in this country. He said, she said in the absence of digital recordings becomes the sine qua non of claims to the colleges.  I’d like to see if we can stimulate some comments on this BLOG for a change. How would you deal with this situation if you were the original treating dentist, the dentist to whom the work was referred, do you digitally record your consultations and treatment appointments or do you simply transcribe notes. How do you defend yourself from being perceived “guilty” from the get-go when the call comes through about “what did you say to the patient”. This is dental ethics 101 and very much worth the trouble to discuss in bad or good economic times…………..viewers, speak up…………..