Challenges Involved in the Dentistry Field - Page 9 - 11 - proof read

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Major Challenges or Issues Involved

Based on the statistics from the previous section, “Allegations Involved in Paid Claims”, the two major challenges or issues that could be noted were poor recordkeeping and poor communication. The most important aspect of recordkeeping is that of maintaining an up-to-date patient records, copies, or summaries and to safeguard the patient’s right to privacy. Communication on the other hand involves educating the patient on the treatments that will be performed and knowing when to refer the patient to or consult another medical professional.

Recordkeeping Issues

With reference to table 2.1 a total of over 30% of allegations involved in paid claims involved failure to diagnose, failure to obtain informed consent, treatment of wrong tooth, failure to appropriately treat medically compromised patients, no x-ray or incomplete x-ray, and alteration of treatment records that could be linked with poor recordkeeping. The result of poor recordkeeping would ultimately lead to complications in the treatment of the patient and in sever cases the possibility of death or major injuries. According to Dr. Jack Daniels* poor recordkeeping could be due to lack of funds to adapt to modern technologies, not having back-up copies of patients record, misplacing or misrepresenting copies, and mostly because the records are not kept-up-to-date.

Communication Issues

According to the ADA’s Principle of Ethics and Code of Professional Conduct, communication deals with educating the patient about the procedures of the treatment and the risk involved, “knowing one’s own limitation and when to refer to a specialist or other professional, and knowing when and under what circumstances delegation of patient care to auxiliaries is appropriate”. Over 9% of the allegations involved in paid claims are due to poor communications with patient’s specialist, failure to refer, and incorrect prescriptions. Communication is disrupted when there are frequent interruptions when talking, thinking the patient/ dentist understands what has been said, acting like they are in a hurry, talking down to each other, and mostly because the dentist/patient is not listening. Therefore it is vital that the dentist keep their knowledge and skills current.

Recommendations

Patient recordkeeping and communication are essential components to increasing the standard of care. Failing to meet these standards often results to lawsuits and if sued for negligence it will in turn increase the insurance deductible. Misrepresenting or omitting of information such as medical conditions, recording inaccurate measurements, or failing to record specific treatments can cause serious complications in the treatment of the patient. It is a good practice as well as inexpensive to maintain an accurate dental records and communicate with the patient.

Communication is the key to “patient involvement”. This involves informing the patient of the procedures and risk involved in a treatment, and any reasonable alternatives, in such a manner that it allows the patient to be involved in treatment decision. This process also helps in increasing the standard of care. According to Dr. Jack Daniels, studies have shown that a dentist who spent an average 18 minutes with patients were less likely to be sued than those who spent 10-15 minutes. Those who were not sued were also likely to use humor, to tell patients what to expect and to give patients a chance to ask questions.

Body language is also an important form of communication. It s necessary to show attentiveness, keep eye contact when talking with the patient, nodding of head to show understanding, making use open gestures, referring to the medical record by keeping it open at all time, asking questions in an open-ended manner, and making sure the tone is in a positive voice. Suggestions for more open communication with patients include:

• Pay attention to non-verbal behaviors
• Avoid medical jargon
• Do not criticize other's performance
• NEVER guarantee an outcome
• Treat all patients courteously and with respect
• Be considerate of their time, comfort and privacy
• Return calls as soon as possible
• Present a professional image and provide patients with a positive environment
• Address complaints and concerns

Apart from safeguarding the confidentiality of patient records it is equally important that the entries be clear, concise, complete, and legible. In addition, colleges should teach potential dentist's on patient management as it applies to clinical protocol, procedures, and record keeping. Dental records serve many purposes, for example, communication with team members, healthcare providers, consultants, insurance companies, and most importantly the patient. An accurate and complete medical and dental history is important for treatment planning and identifying “at risk” patients. Dentists should maintain dental records on each patient. The key components being:

• Personal data.
• Patient’s reason for visit.
• Dental and medical history.
• Clinical examination.
• Diagnosis.
• Treatment plan.
•  Informed consent.
•  Progress notes or any referral letters.