Avoid dental lawsuits: Peer Review through your Dental Society

Have you had a patient complain about their dental work lately? Is your patient angry and asking for their money back? Are you angry because you know you did the best possible work and this patient is being completely unreasonable?

May I introduce a wonderful solution?  Peer Review through your Dental Society.

If you try to go toe-to-toe with your patient, your patient explaining how awful your dental treatment is and how they’ve never even worn your denture, while you try to explain that you’re not a miracle-worker and dentures are a difficult adjustment (and by the way you’ve already adjusted them 3 times for no charge) – this disagreement can easily end up in an attorney’s office. As soon as your patient retains an attorney, now you have to be defensive and you’re naturally set up in an antagonistic situation.

What is Peer Review?

Instead, I recommend peer review. The Ohio Dental Association offers a fabulous program for all their dental societies to provide peer review services to their members. Peer review is a voluntary, informal mediation/arbitration process that allows patients to have their case reviewed by another dentist in the local dental society at no cost to the dentist or patient. Peer review has no formal ties to the state dental board and is not a legally-empowered entity and doesn’t take actions upon dentist’s licenses or issue fines. This is a safe alternative to fighting it out with your patient and hoping no lawsuits come out of it.

Here are the steps to the peer review process:

  1. Patients must start with the local dental society in which the dental treatment in question was completed – often referred by the original treating dentist.
  2. Patient fills out the “request for mediation” form and sends it to the dental society.
  3. The peer review committee chairman determines that the complaint fits the peer review process and assigns a mediator.
  4. The mediator interviews the patient and the dentist and the peer review committee will conduct a clinical exam and render findings and recommendations concerning the case.
  5. When monetary awards are recommended by the committee, they are limited to the fee charged by the dentist for the treatment in question as a refund or adjustment. Peer review does not award punitive damages or issue fines.
  6. If the dentist agrees to the refund, the patient signs a financial release first – agreeing they will not sue for any treatment completed by this dentist between specific dates. The dentist receives a copy of this financial release.
  7. The dentist refunds the money.

Benefits of the process

Some dentists do not encourage their seriously-upset patients to go through a peer review process. They may feel embarrassed that a patient is complaining about their dental work. They may feel that they don’t have to explain themselves to another dentist (or to the patient for that matter!).  They may feel that by referring the patient to this external process, they are failing to solve their own problems. While the emotional side of a seriously-upset patient is definitely rough, the benefits of this peer review process outweigh the downsides. By having a peer review committee evaluate the entire situation, you are working with your peers. Every dentist has a patient that is unhappy with the treatment from time to time, and across a dentist’s career, hopefully only a few will be upset enough to consider a legal solution. Your peer review dentists understand that upsets occur – and they know their job is to resolve every peer review complaint and not allow any upset to progress to an attorney.

Another benefit of working through the peer review process is that the monetary award is limited to refunding the fee for treatment. The worst thing that can happen is that the committee finds that the dentist should refund the entire treatment amount to the patient. Since the mediator’s job is to resolve this dispute and avoid the case going to court, the mediator will tell the dentist his/her opinion of the patient’s state of mind. This is priceless. The committee may find that the dentistry was done well and the dentist has provided the highest quality technical dentistry available.

However, the mediator can also tell the dentist that despite their excellent dentistry, the patient is still furious and intends to sue if they don’t get their money back. Although no one likes to refund money, it can be reassuring for a dentist to hear that their treatment was not at fault, it’s just that the patient is being unreasonable. Having another dentist honestly share their opinion about the patient’s intentions, helps the original dentist to recognize that they didn’t do anything wrong – and by refunding the money, they are guaranteed to avoid a lawsuit and they are also finished with this patient and all his/her drama.

Having this peer review process available through your dental society is reason enough to join and pay your dues to the local dental society. Think of this like insurance you hope you never need. Or, if you are willing to spend some time and learn vicariously, perhaps you could volunteer to serve on the peer review committee. Nothing like a good scary story to make sure you’re communicating well with your patients, gaining signed consent forms and setting clear expectations on those denture cases. Plus, at least in Ohio, the peer review chairman attends a one day seminar put on by the state dental association providing all the latest and greatest updates and form changes. Usually, he returns to his local dental society and shares his notes as well.

Most dentists communicate well with their patients and resolve disagreements easily. Very few over the course of an entire career will progress to a level where a lawsuit seems possible. If and when they do occur, referring patients to the local dental society for a peer review process just makes sense. For most patient complaints, a quick response and a logical process to work through their concern solves the problem. If you would like to handle patient complaints more smoothly in your practice – and even use the ideas gathered from these upset patients to improve your dental practice, then you may be interested in my report: Turn Upset Patients into a Practice Asset: How to take patients’ complaints & turn them into practice improvement ideas. Here’s to avoiding dental lawsuits and joining your local dental society!

For more ideas to improve the business-side of your dental practice:

AUTHOR: Jill Nesbitt
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