TDIC’s Risk Management Advice Line offers guidance for complex practice challenges

October 3, 2023
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Dentistry presents its practitioners with a myriad of challenges that go beyond providing exceptional patient care. Running a dental practice involves intricate business management and navigating the dynamics of working with employees. As dental professionals strive to deliver top-tier services, they often encounter complex situations that require careful consideration of potential risks. Knowing when to seek specialized advice from risk management experts is essential for safeguarding both patients and the dental practice itself.

The Dentists Insurance Company’s Risk Management Advice Line is staffed by experienced analysts, and access to it is a benefit of CDA membership. When policyholders and dental association members are in doubt about how to handle an issue or have concerns about potential risks, TDIC Risk Management analysts are available with advice based on minimizing risk and reducing liability. Their guidance is not intended to be legal advice, but instead aims to help dentists navigate potential risks toward safe solutions.

Advice Line analysts have a wide array of experience and history within the dental profession. Responding to thousands of calls each year, they’ve steered dentists through a variety of challenges, including:

  • Maintaining employee records and following state law in hiring and firing processes.
  • Determining if patient dismissal is warranted and following the proper dismissal procedure.
  • HIPAA, employment and AwDA compliance and effective documentation.
  • Required regulatory reporting to state dental boards when adverse events
  • Conflict mitigation and communication with difficult patients and employees.

Across the board, risk management experts agree that it’s best to seek advice sooner, rather than later. So practice owners should always reach out to the Advice Line when facing practice challenges. Along with their own knowledge and expertise, analysts have a wide array of past calls to draw on when providing guidance. Callers benefit from the past experiences of their colleagues and the solutions that may or may not have been successful in similar situations.

Patient Care and Ethical Considerations

Patient care lies at the heart of dentistry. Dentists adhere to high ethical standards, but certain situations involving patient care may warrant guidance from risk management experts. Patient selection and dismissal are some of the issues commonly reported to the Advice Line. Analysts can provide guidance on the dismissal process, as well as letters and customized resources that can protect dentists before a separation is finalized.

Certain situations warrant the finesse of risk management experts in order for dentists to maintain positive relationships while protecting practice interests. For instance, one practice owner called the Advice Line after an associate asked for permission to provide free treatment to a young relative with special needs. The dentist felt uncomfortable with the request yet wanted to respect the associate’s desire to help a child in need. The analyst was able to help the practice owner verbalize his concerns about the child’s well-being considering the complexity of the needed treatment and the level of pediatric patient management potentially requiring sedation that the office was not equipped to provide. With the analyst’s help, the practice owner was able to offer alternative suggestions to support the associate’s compassionate efforts. Without seeking risk management guidance, this situation could have negatively impacted the working relationship of the owner and the associate or—far worse—resulted in avoidable injury to the patient and potentially a costly liability suit if the risks to the child had not been considered.

Another example of an Advice Line call was when a dentist felt pressured to perform a complex treatment plan because a patient refused to seek care from recommended specialists, stating that they “trusted” only the dentist. In patient dilemmas such as this, collaborating with risk management experts can help dentists decide whether they can safely provide treatment or need to firmly maintain that the patient should seek care from a specialist. By seeking advice, dental professionals can ensure they make informed decisions that prioritize patient safety and well-being.

Cases involving patient dissatisfaction or matters that could lead to potential malpractice claims demand a thorough understanding of risk management strategies. Consulting analysts can help dentists effectively address patient concerns through improved communication and mediation. Clear communication can often avert legal entanglements and maintain the reputation of the practice.

Practice Management

Risk management experts play a pivotal role in advising dentists on practice management challenges, including matters related to employment, documentation and regulatory compliance.

As their practices grow, dentists may consider expanding their business by hiring an associate, opening additional locations or introducing new services. When considering business expansion, dentists should consult with risk management experts to assess potential risks and develop strategies for successful implementation. During a recent call to the Advice Line, a dentist was in the process of hiring an associate to assist with increased patient demand. The analyst suggested that the caller create a contract with the associate to provide clear language about the associate’s role, the dentist’s expectations and what the associate could expect from the practice owner. The caller was also directed to the resource “Hiring or Becoming an Associate.” 

Risk management guidance is a valuable benefit that provides dentists with the tools, knowledge and resources to protect patients and staff, ensuring the financial and operational well-being of their practice.

Employee Relations and Workplace Culture

Maintaining a harmonious workplace culture and managing employee relations are vital components of a successful dental practice. However, conflicts and challenges can arise, requiring the input of risk management experts to ensure a fair and legally compliant resolution. In situations involving employee grievances, harassment allegations or disciplinary actions, consulting with risk management experts can help dentists navigate sensitive matters while adhering to legal and ethical guidelines. This ensures that both the employees' rights and the practice's interests are respected and protected.

One area where risk management experts are invaluable is collaborating with employment attorneys to develop employment policies and resources that can be customized for the dental practice. Advice Line analysts can help employers identify potential legal risks and take proactive measures to prevent them. Clear policies, ranging from infection control protocols to employee conduct guidelines, help prevent misunderstandings and potential legal disputes.

An important employment resource developed by TDIC’s Advice Line analysts is the Sample Employee Manual, which has been updated with relevant employment laws and regulations that protect both employees and employers. The resource also addresses workplace policies and cultures that are beneficial to dental practices. Recommendations from Advice Line analysts and their published resources can help dentists maintain compliance with employment laws and create a positive work environment.

Advice When It’s Needed Most

While dentists are well-equipped to provide exceptional patient care, seeking specialized advice from risk management experts is essential for addressing the complexities of running a dental practice and managing employee dynamics. Whether offering advice on making critical patient care decisions, managing the practice or fostering a positive workplace culture, Advice Line analysts offer valuable insights that safeguard the practice's reputation, financial well-being and overall success.

Along with providing one-on-one support to callers, TDIC’s Risk Management analysts have developed a robust set of resources specifically designed to support dentists. These include:

By recognizing scenarios that would benefit from risk management consultation, dental professionals can proactively manage potential challenges and minimize risks. Collaboration with Advice Line analysts not only enhances patient safety and satisfaction but also contributes to the long-term viability, success and prosperity of the dental practice. In a constantly evolving health care landscape, the guidance of risk management experts empowers dentists to navigate uncertainties and focus on delivering exceptional care to their patients.

Contact TDIC’s Risk Management Advice Line for assistance navigating complex situations encountered in the course of practice.

TDIC’s Risk Management Advice Line is a benefit of CDA membership. Schedule a consultation with an experienced risk management analyst or call1.877.269.8844. Reprinted with permission from the California Dental Association, copyright October 2023.

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