Medical consultation versus clearance: A critical distinction for dentists

CDA Practice Support and The Dentists Insurance Company are receiving an increasing number of calls from members on the subject of obtaining medical clearance for patients who have certain chronic conditions such as diabetes or are undergoing certain therapies.

Historically, dentists have utilized a “medical clearance” form to inform the patient’s physician of upcoming dental treatment and to verify patient allergies, medications and other health conditions that should be considered before proceeding with the proposed dental treatment plan. Carla Christensen, senior risk management analyst with TDIC, warns dentists that the medical clearance process is misleading because it implies that the patient is “cleared” for treatment.

“No patient is free of risk when undergoing any medical or dental procedure,” Christensen says, adding that the decision to proceed with treatment or surgery belongs with the dentist and patient. “Requesting a medical clearance does not shift any liability from the dentist to the physician, as dentists are ultimately responsible for the decisions and treatment they provide their patients.”

CDA Practice Support resource to assist members

The increased calls from members are largely stemming from the significant changes taking place in the health care landscape. These changes demand better alignment between dentists, physicians and other health care professionals — all with the goal of providing optimal patient care. Such alignment requires consultation and collaboration to address any potential concerns about a patient’s medical condition prior to treatment. “This may also help mitigate possible liability issues for the dentist,” Christensen says.

To assist member dentists in collaborating with physicians to achieve ideal patient outcomes, CDA Practice Support in collaboration with TDIC Risk Management has published a new resource titled “Request a Medical Consultation, not Medical Clearance.” In it, dentists can find guidance on how to propose a peer-to-peer discussion with physicians, including those who are part of large provider groups. Large groups may have specific protocols in place that make it more challenging for dentists seeking a response.

The resource also offers suggestions for initiating the collaborative discussion or sharing patient records with the physician.

Find the new resource “Request a Medical Consultation, not Medical Clearance” in the Practice Support section of CDA’s website.

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