This is a new section of the newsletter which will focus on case studies of competence, conduct and health cases dealt with by the Council in the hope practitioners can learn from the experiences of others.
All identifying details will be removed from the case studies and practitioners involved will be notified before articles are published.
Scenario
Dr A is a general dentist practising in a private practice.
The Dental Council received a notification[1] from Dr B, also a general dentist. The notification related to a patient (X).
Dr B said pre-approval from ACC was given for patient X to have a pulp extirpation/obturation under sedation. Dr A had provided treatment where, according to clinical notes, a pulp capping was performed under nitrous oxide sedation. Subsequent radiographs showed no evidence of obturation. Dr B queried whether open apex endodontics was appropriate for a general dental practitioner. Patient X’s parents had paid an ACC co-payment for treatment that seemed not to have been provided.
When offered the opportunity to provide his comments to the Dental Council, Dr A said Dr B’s concerns appeared to be based on misinterpretation of documents and assumptions of what had happened, and that Dr B had provided incorrect documentation not related to the tooth in question.
Dr A said he had not carried out open apex endodontics, or claimed any such treatment from ACC.
The Council directed its professional advisor to make inquiries into the notification. The professional advisor’s review of the clinical records showed Dr A’s management of the case was appropriate and a review of practice standards showed a high level of compliance. His report noted the concerns raised by Dr B were genuine but may have been based on a complaint by a dissatisfied patient. Dr A acknowledged that patient X’s mother had been unhappy with some aspects of how things were managed and there were missed opportunities to handle the situation better.
Outcome
Council’s view was that the concerns raised in the referral were not clinically founded but related to relationship management and communication issues. It appeared patient X’s mother’s interaction with Dr A’s receptionist may have contributed to her dissatisfaction and provided the basis for the notification from Dr B.
Council noted its disappointment that Dr B had not first contacted Dr A directly to address his concerns.
Council notified both practitioners to advise no further action would be taken.
Key lessons
When approached by a patient with a complaint about another practitioner, it is important to acknowledge that you may not have all of the information. Direct and professional communication between practitioners can often resolve the situation quickly without involving a notification to Council. (See the Council’s standards framework, professional standards 17 and 18, which provide guidance on how practitioners should engage with colleagues and other health professionals in order to achieve the ethical principle of communicating effectively.)
In this case, opportunities to address the patient’s parents’ concerns were missed. Oral health professionals and dental practice managers should ensure all staff, including non-clinical staff members, understand the importance of treating patients with professionalism and respect throughout their entire visit to the dental practice.
If as a practitioner you do have genuine concerns about a colleague’s standard of practice, and particularly if you believe there is a risk of harm to the public, it is important to seek advice. The Council’s registration team can provide advice without a formal notification, while other colleagues or your professional association could also help in deciding what action to take.
[1] under section 34(1) of the Health Practitioners Competence Assurance Act 2003
