Risk Management “It Won’t Happen to Me” “

by Rollin M. Matsui, BSc., DDS, LLB

It won’t happen to me.” You know what I mean: I’m referring to the dreaded investigation of your dental practice by your provincial regulatory body arising from a complaint. After all, you are a good dentist and everyone knows “It” only happens to bad dentists, right?

In my law practice, I have acted for numerous “good” dentists who have had the misfortune of having a complaint filed against them with the Royal College of Dental Surgeons of Ontario (the regulatory body for dentists in Ontario) or being the subject of a College investigation. You may be surprised to know that many such complaints have taken the defendant dentist completely by surprise.

Let me discuss a few typical situations for you to consider.

1. A common situation is the suspicious or unhappy patient who simply doesn’t tell you her concerns. Instead, she intentionally or unintentionally seeks out a second opinion from another dentist. In my view, it is remarkable how often the patient’s complaint to the College, without any prior warning to the dentist, arises because of comments made by a subsequent dentist to the patient.

Some may believe it is proper for a second dentist to criticize another dentist’s treatment of the patient if it is inappropriate. Whether or not you agree, one thing should be certain: no comments should be made by the second dentist unless “all the facts” have first been obtained. In my experience, too often a second dentist makes disparaging remarks about a prior dentist’s treatment based on incorrect assumptions and inaccurate “facts”. In my view, such conduct is most unprofessional and the second dentist should be subject to College scrutiny for same. After obtaining and reviewing all the facts, then the second dentist can provide the patient with a valuable second opinion, the first dentist can be “judged” fairly and an unjustified complaint by the patient can be avoided. However, until all “second dentists” out there universally adopt this approach, any notion that “It won’t happen to me” should be banished from your mind.

2. Another situation arises when your patient fails to pay his account for your rendered services after repeated reminders and the dental office decides to send the account to a collection agency or perhaps sue the patient in Small Claims Court. You may genuinely believe that the patient simply doesn’t want to pay the monies owing and have no hesitation in taking such action against the patient. Unfortunately, you may well be surprised to find that as a result of such actions, a complaint has been filed against you by the patient with the College.

It would be prudent for you to anticipate that a patient will complain to the College in such situations and take this into consideration when deciding if it is appropriate in the circumstances to “go after” the account owing.

3. A situation that has arisen in recent years is the complaint filed by an Insurance Company who is unsatisfied with explanations provided by the dentist regarding claim forms submitted by such dentist over a certain period of time (eg. profiling results). In these cases, you may have thought your explanations to the Insurer were sufficient only to find that, to your surprise, a College investigation has now been initiated against you by your regulatory College. Even if you believe your completed claim forms are accurate and complete, this can be no assurance that “It won’t happen to me”.

4. Perhaps the most shocking situation can arise when a dentist colleague or disgruntled staff member decides to report you to the College giving rise to an investigation of your practice. Your partner or associate may have a civil dispute with you and decide to use a College investigation as a tool to further their position. Your employee or former employee may wish to retaliate against you by providing incriminating information, which you may not even be aware of, to the College.

In today’s environment, complaints and College investigations may well be an inevitable hazard of dental practice for all dentists, including “good” practitioners. For peace of mind, your best risk management strategy should be to obtain insurance to cover your legal costs to defend yourself in such College proceedings. (Remember, malpractice insurance usually does not cover College investigations; contact the Canadian Dental Protective Association at (416) 491-5932, toll-free 1-800-876-CDPA (2372) or Canadian Dental Service Plans Inc. at (416) 296-9401 for more information.)

Dr. Rollin Matsui is a dentist and a lawyer, maintaining a private law practice in Richmond Hill, ON. He primarily acts for dentists in professional misconduct related matters before the RCDSO and in commercial matters involving dentists.