August 1, 2003
by Blake Nicolucci, BSc, DDS
When I was much younger, I remember thinking that ‘once something happened in the States, it was only a matter of time before it came to pass in Canada’.
Take for example — Sunday shopping. When there was no Sunday shopping in Canada, people often headed to the U.S. for entertainment and shopping. There were numerous occasions when I heard people saying, “it’s sacrilegious to shop on Sunday,” and I heard people talking about boycotting stores that stayed open. It wasn’t long before the ‘hoopla’ died and now, nearly all stores are open on Sunday. And by the look of the over-filled parking lots, there was obviously a ‘Silent Majority’ around that ‘Vocal Minority’.
This brings me to another significant finding in my ‘Point of View.’ I’ve talked to a number of colleagues who have had the unenviable luck of dealing with a legal matter related to their practice. Not too long ago, frivolous ‘lawsuits’ with huge settlements were heard of more frequently in the United States. However, in this day and age of high-speed Internet, e-mail and electronic communications, the world has become a much smaller place. We must protect our system and prevent the atrocious level of insurance premiums from migrating north, to ensure that our lower premiums persist.
In talking to colleagues, the frequency of litigation seems to have increased over the past decade. This is not a trend we are used to in Canada. It was something we usually heard associated with our neighbors to the south. This is not always the result of ‘malpractice’, but it is increasingly the result of clients looking for some ‘easy money’ at our expense. The thought out there is that, if a plaintiff commences a lawsuit, they will gain financially, no matter what the circumstances are. This course of action is starting to be taken too frequently. This is usually because the insurance company does not want to pay out huge legal fees. An ‘out of court’ settlement seems the cheaper route. The whole process can be quite disturbing and psychologically unsettling for the dentist. Some of these cases can last for five to seven years before they are finalized. It disturbs me to think that a patient we have been treating like a ‘member of our family’ could arbitrarily commence court proceedings on a whim.
When dealing with implants, there is a greater risk for complications and we should be constantly aware of some facts. Remember, ‘if it wasn’t written in your chart, it didn’t happen’. Records are a major factor in protecting ourselves from litigation. One way to help avoid this travesty is to be amicable and pleasant to your patients. Don’t allow accounts to become delinquent. Record everything — from treatment plan to fee estimate. Cross your ‘T’s’ and dot your ‘I’s’. Discuss the limitations of your implant treatment plan, and the possible complications that could be encountered. Make sure you have provided your patients with all of the possible alternative treatment plans, and the ‘pros’ and ‘cons’ of each. Make sure the patient signs after you have discussed each of these items. I believe that if the patient is required to sign for something, the likelihood of litigation is reduced somewhat. Discussing any options with the patient before administering sedation is a definite ‘plus’ in my books.
Finally, know what the Protocol and Requirements of the College are, before you start with any implant treatment. Adequate training for any of the procedures you perform is an absolute ‘must’. These requirements are minimal, and not hard to obtain. FOREWARNED IS FORARMED! Let’s try to help reduce the number of complaints by not only being great dentists, but by being well prepared.