Gerald S. Fine, D.D.S.
Oral and Maxillofacial Surgery
It is not uncommon as an oral and maxillofacial surgeon to receive a letter from an attorney's office requesting medical records. These records are most often associated with an accident or other injury which is the result of trauma. Unfortunately, sometimes our office is contacted by an attorney requesting medical records because of a potential medical malpractice case against another dentist. In these situations, the alleged charge by the attorney is Contributory Negligence.
Having patients fail to follow through with recommended treatments, not seek consultations, or miss scheduled appointments are part of the reality of dental practice. Contributory negligence is the term applied to the conduct that falls below the standard required for the patient to protect himself or herself from suffering physical harm. Most patients are cooperative and follow instructions. Should they fail to do so, any resulting negative effects usually are not clinically significant. However, some patients do suffer harm while under a dentist`s care because of their own poor compliance. It is important to ensure prudent risk management has been practiced.
The first step in protecting yourself from the charge of professional negligence is to record in the patient's record ALL acts of contributory negligence as well as to document that the patient was informed of and understood the negative consequences that could occur because of noncompliance. It is also important to advise other dental or medical caregivers about the patient's noncompliance and potential consequences. The dentist must at some point determine whether it is wise to continue treatment of the patient despite his/her uncooperative behavior. You are under no obligation to treat noncompliant patients who exhibit self-destructive behavior.
It is impossible to ensure that patients will comply with instructions or even keep appointments all the time. All of these instances should be noted in the patient's record. Should a patient be truly noncompliant and suffer clinically significant negative results, the dentist has a record of the contributory negligence. He or she should also consider whether it is wise to continue to care for a patient who does not follow instructions and is bringing about negative effects on dental health as well as a potential Medical Malpractice suit.
Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery