Practitioner article: Getting it right before things go wrong
Patient complaints and notifications of concerns about practitioners are not common. But they can be very stressful when they occur.
In this article, the Dental Council professional advisor, Dexter Bambery provides practical advice to improve communication with your patients, and promptly address and resolve patient concerns that arise from time to time.
Why do patients complain?
Surprisingly, complaints rarely involve practitioner error, it is typically communication and relationship issues that prompt a patient to complain formally.
Patients who complain tell us they felt the practitioner communicated badly, did not listen to them, lacked empathy, or did not provide enough or accurate information. They often feel disempowered or devalued. Sometimes they feel they have not been understood or taken seriously.
Actively working on professional relationship skills can make a difference. Patients are often unsure about the quality of treatment provided but frequently judge our professional competence based on our communication skills rather than our clinical or technical expertise.
First impressions count
Even before meeting the practitioner, patients form an impression about you based on their initial contact with your practice.
Patients will also judge a clinician the first time they meet. If you have just finished a demanding treatment session with another patient, you may not be as welcoming as usual to your next patient. Running late, being hungry or tired, or still being angry from a previous encounter or argument may cause the patient to question your professionalism.
Take a moment to check and consider if you are ready to see the next patient each time you move from one appointment to the next.
Managing expectations
Patient disappointment with their dental care is usually due to unmet expectations. Identifying and addressing patient expectations is an important strategy to minimise the risk of complaints.
Sometimes our own advertising or promotional material can contribute to unreasonable patient expectations. Special care is required with unrealistic expectations associated with appearance dentistry or with advanced restorative dentistry.
If you are not sure that you can meet the patient’s demands, it may be wise to refer to another practitioner or a specialist colleague.
Be wary of patients that want you to decide on their treatment. If things go wrong, they may be less likely to share the responsibility.
When things go wrong
All should have a prepared strategy for dealing with adverse outcomes.
Some basic principles for your strategy include:
- Open disclosure – commit to clear and timely communication, and make sure you fully explain the situation to the patient honestly, using language they can understand.
- Meaningful apologies – depending on how you deliver it, an apology does not necessarily imply you have made an error or mistake but can defuse a situation.
- Collaborative communication – work together with your patient and colleagues to find a solution or remedy.
- Empathy and support – feeling deserted or abandoned often prompts patients to complain.
Avoid arguments
When things go wrong or expectations are not met, you may be faced with an upset angry patient. Avoiding arguments and adrenalin-based reactions is an important strategy in these cases.
As professionals, we need to resist the temptation to prove we are right and instead focus on finding a solution. Consider asking questions the patient can agree with and avoid reacting to incorrect or exaggerated words. We may win an argument but arguing may give rise to a complaint.
Teamwork
How your patients perceive you is affected by how they perceive all the other people working in your practice. Make sure your team understands the importance of making patients feel welcome.
A practice operating as a team with a philosophy of “checking each other and welcoming being checked” will mitigate risks of complaints. Those who challenge us should be thanked – even when they are wrong.
Dental assistants are in an ideal position to read a patient’s body language, or cues, when practitioners are focussed on their work.
Informed consent
Every patient has the right to be fully informed and consent to proposed treatment.
The Dental Council informed consent practice standard is a fundamental requirement under the Code of Health and Disability Services Consumers' Rights.
Whether verbal or written, there must be a record of the consent process. It is essential to check that the patient fully understands options, risks, benefits, and costs. Treatments which are elective, risky, or expensive need to be explained carefully.
Second opinions
Critical comments by dental professionals consulted for a second opinion is the most common communication issue leading to complaints.
We have an obligation to our patients to give accurate, professional and considered clinical opinions.
It is best to provide comments and opinions in writing and consider when and where such opinions will be used. Before making any comment to a patient who has suffered an adverse outcome while under another colleague’s care, it is wise to be sure of all the facts.
Communicating well with your colleagues is just as important as communicating well with your patients.