May 2, 2019
by Josh Koziebrocki, LLB, BA
Becoming a dentist can be a challenging process. Once licenced by the Royal College of Dental Surgeons of Ontario (“RCDSO”), any dentist, regardless of the quality of their work, may become the subject of a formal complaint. Implementing best practices as early as possible is often a prudent way for dentists to protect themselves. Based on our extensive experience providing legal advice to dentists and representing them in regulatory proceedings, we have prepared the below list on 10 important tips for new dentists at the RCDSO.
1. Always Obtain and Record Informed Consent
We often assist dentists who are alleged to have performed treatment without consent. Dentists should ensure that they only provide treatment with the informed consent of their patients, and should keep a record of this consent. Obtaining signed, written consent is ideal. Where treatment risks are significant, it is prudent to detail these risks in a document and have this signed by the patient.
2. Detailed Treatment Plans
Complaints to the RCDSO often allege that a dentist’s treatment plan was overly aggressive or incorporated unnecessary dental work. It is important to keep treatment plans accurate and specific, and distinguish between minor or suspected issues that are being monitored, and those that are being recommended for treatment. It is prudent for dentists to keep comprehensive and transparent treatment plans that limit miscommunication with patients or the Inquiries, Complaints and Reports Committee (“ICRC”).
3. Appropriate Treatment in Appropriate Time
In our practice, we often assist dentists who are alleged to have (1) spent insufficient time on dental procedures, and (2) performed substandard work as a result. Scheduling treatment for the appropriate amount of time required is an important first step. Beyond that, keeping a record of the amount of time estimated for each anticipated procedure creates evidence that can help in a dentist’s defence. If an event occurs during an appointment and impacts the amount of time required to conduct dental work, this should be included and explained in the patient’s chart.
4. Proper Recordkeeping
Frequently, complaints against dentists will result in inconclusive findings on the grounds that were specifically set out by complainants. However, the ICRC may nevertheless take action against dentists if their records are not kept in compliance with the Dentistry Act, 1991. Proper recordkeeping provides dentists with documentary evidence in case they become the subject of a complaint at the RCDSO. Dentists who make digital copies of original handwritten records must also retain the original versions. Keeping electronic records requires additional safeguards, and dentists who do so should use an Electronic Records Management System.
5. Professionalism with Staff and Patients
Formal complaints to the RCDSO often involve allegations that dentists or their staff were rude to each other or to a patient, or did or said something that was inappropriate. No matter how minor the alleged conduct, the RCDSO is generally required by the Regulated Health Professions Act to investigate all complaints. Dentists should always be respectful towards their patients, and should make best efforts to ensure that their staff are trained in the same manner.
6. Relationships with Patients
Allegations of any sexual contact between dentists and their patients, in the dental office or elsewhere, are extremely serious. Dentists are prohibited from engaging in sexual relationships of any kind with patients, and legislation dictates that certain kinds of behaviour will require mandatory revocation.
7. Professionalism in Advertising and Public Statements
The Supreme Court of Canada affirms that dentists should prioritize professionalism rather than commercialism in their promotional materials. When making any advertisement or public statement, dentists should be aware that they are representing the dental profession, and have a responsibility to uphold its reputation. Dentists should familiarize themselves with the RCDSO’s policies and Practice Advisories, and with the advertising laws under the Dentistry Act, 1991.
8. Seek Mentorship
New dentists can work to prevent complaints before they happen by seeking out advice from their senior colleagues. Receiving mentorship from experienced dentists will likely help new dentists expand their knowledge and skillset, and can demonstrate to the RCDSO a genuine desire to learn and follow best practices.
9. Refer Patients to Specialists When Appropriate
Dentists who perform specialized work outside of their formal designation may find themselves subject to allegations that the treatment they provided was improper and should have been conducted by a specialist. General practitioner dentists should familiarize themselves with specialists, and refer patients to them when appropriate. Even when general practitioners are comfortable providing more specialized services, they should not advertise or present themselves as specialists.
10. Review the Associate Employment Agreement
It is commonplace for new dentists to sign an associate employment agreement with a senior dentist at an established clinic. These contracts may include terms such as a non-compete clause that bars associate dentists from practicing a specific form of dentistry within a certain geographical radius of the employer dentist. New dentists may find it prudent to retain legal counsel to review these employment agreements.
About The Author
Josh Koziebrocki, LLB, BA (Hons), is the principal lawyer and founder of Koziebrocki Law. He represents numerous dentists and has extensive experience dealing with regulatory issues. He can be reached at 416-925-5445 firstname.lastname@example.org | www.koziebrockilaw.co