Dentolegal challenges, from dental school to days of leisure
Leo Briggs looks at how you can meet expectations throughout your career, with help from your dental defence organisation.
Dental school gives you time to get to grips with the fact that you have professional responsibilities to your colleagues, patients, and the public.
Even as a trainee, your conduct will be under scrutiny to ensure you have the skills, knowledge, character and health to practice safely and effectively. The General Dental Council’s Student professionalism and fitness to practise (General Dental Council, 2016) sets out the standards expected, explains how students can demonstrate good practice and gives examples of behaviour that would cause concern.
You may be surprised to find that your personal life can come under examination as much as your knowledge and technical skills. However, any behaviour that suggests you may be unfit to practise, from abusive social media posts to an undeclared police caution, is likely to concern your dental school. In addition, the GDC warns that ‘unprofessional behaviour, criminal convictions and cautions or serious health problems that have not been appropriately managed during your training can affect your ability to register’ following graduation.
If you do have a problem, seek support as soon as possible and contact your defence organisation if you are subject to a fitness to practise investigation.
When you join your first practice, one of the most daunting things to adjust to is being fully accountable for the planning, delivery and management of patients’ treatment. All the skills you have learnt in training will be put to the test, including your ability to communicate effectively with a patient so they understand their options and the associated risks.
Perhaps the most frequent pitfall for newly qualified dentists lies in advising a patient about treatment or performing procedures with only limited experience. The GDC says ‘you must only carry out a task if you are appropriately trained, competent, confident and indemnified’ (General Dental Council, 2013).
It’s important to know your limits and be prepared to ask for help or refer patients to an appropriately trained colleague if a treatment is beyond your expertise. Make sure you develop all your skills during the first few years after qualification so that you are competent and confident to tackle all the clinical tasks expected of you. Ensure you familiarise yourself with the procedures and policies at any new practice, especially with regard to areas like referrals, infection control and complaints. When you move on, ensure the practice is still able to contact you in the event of a complaint or claim to avoid any delay in responding.
Taking on a practice means taking on additional dentolegal responsibilities as an employer and provider of regulated services. Notably practice owners are financially liable for the acts and omissions of staff during the course of their employment under a principle known as ‘vicarious liability’. It’s therefore important to ensure you have adequate and appropriate indemnity, as well as someone to turn to for expert legal advice.
The GDC has higher expectations of dental professionals in a leadership role, which are reflected in its standards. For example, it requires you to provide a hygienic and safe working environment; ensure team members are registered with the GDC if appropriate; have an effective procedure for raising concerns; and train all staff in complaints handling. You must also keep up to date with relevant laws and regulations, including areas such as radiography, data protection, and child protection.
Finally, you need to be mindful of the requirements of other regulators such as the Care Quality Commission, the Information Commissioner’s Office and even the Advertising Standards Authority (when marketing your practice). Failure to meet your obligations could result in them referring you to the GDC.
After you have removed your brass plaque from the door, you might think that you no longer have to concern yourself with dentolegal matters, but you’d be wrong. Unfortunately, the DDU is aware of retired dentists who have received a clinical negligence claim many years after treating their last patient. Periodontal claims can have a particularly long ‘tail’ as the full effects of a delayed diagnosis may not be apparent for some time.
The possibility of allegations being made after such a long time highlights the value of making sure that the clinical records are retained for as long as possible, ensuring they are stored securely and protected from damage.
It also shows why it is essential to check your indemnity position to ensure you and your former patients will not be disadvantaged if a letter of claim arrives.
General Dental Council (2016) Student professionalism and fitness to practise
General Dental Council (2013) Standards for the dental team
If you have a dentolegal concern at any stage in your career, contact your dental defence organisation for advice and assistance.