GPS Managing Professional Risks
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Dentists do a lot more than dentistry. Everything you do in your role as the dentist requires you to be aware of – and manage – some type of risk.
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Resources for the Guidelines for Practice Success, Managing Professional Risks module to make it easier for you to locate the additional information, samples, and resources discussed throughout.
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A doctor/patient relationship may develop when an individual relies on advice from, or an opinion of, a dentist even outside of the office environment.
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Many states have regulatory and oversight agencies whose responsibilities may be similar to those at the federal level. Sometimes there are differences in requirements issued at different levels.
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While there is no single definition for standard of care, it can be influenced by the legal definition of negligence that are alleged in professional liability lawsuits filed in your community.
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The ADA has various policies and recommendations to help dentists ensure that patients’ radiation exposure is as low as reasonably achievable and in compliance with as low as diagnostically acceptable principles of good radiation hygiene.
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One possible step to ensuring that the person who shows up for treatment is the person you think they are – and the person they claim to be – is to request some type of personally identifiable information, such as a photo identification or an individual’s Social Security Number.
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The dentist owns the physical record of the patient and is the legal guardian of the chart and its complete contents, including radiographs.
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Dental practices are considered covered entities if they transmit electronic “covered transactions,” such as electronic claims, to dental plans.
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HIPAA considers dental practices covered entities if they transmit electronic “covered transactions,” such as electronic claims, to dental plans. A dental practice can also become a covered entity by contracting with an outside service, such as a clearinghouse, to submit electronic covered transactions on behalf of the dental practice.
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While attorneys and dentists might debate who should make the entries in the dental record, typically it’s up to state law to determine who’s authorized to make notes in the record. No matter what the laws are in your state, the dentist is always ultimately responsible for every entry in the dental record.
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The recording of accurate patient information and treatment in the dental record, sometimes referred to as the patient chart, is essential for good risk management. As a result, the value of maintaining thorough and accurate dental records cannot be overstated.
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While the dentist may designate a staff member to assist in the process of having patients complete and/or update their medical/dental health history forms, remember that you, as the dentist, are fully responsible for obtaining, maintaining and reviewing patients’ up-to-date health histories.
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While every patient’s record, and the notes it contains, must be specific to the patient undergoing examination and treatment, much of what is written in the chart can be seen as common to almost every patient.
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Beyond implied consent, the two types of consent most common within the practice of dentistry are general consent and informed consent. Both of them require a doctor/patient discussion and each should be the sole topic of discussion.
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The process of securing a patient’s informed consent for treatment can require several doctor-patient conversations and the consideration of many complex issues, some of which the patient may or may not be willing to share with you, especially when they relate to personal matters such as being able to afford treatment.
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Dentists need to be aware of when they can properly defer to an adolescent patient for information instead of requiring the parents to provide it. Dentists also need to be familiar with how to proceed in cases involving children of divorced parents and who has the authority to grant consent, as well as who has financial responsibility for the treatment provided.
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Dentists need to be familiar with how to proceed in cases involving children of divorced parents. Key issues involve who has the authority to grant consent and who has financial responsibility for the treatment provided.
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Dental practices covered by HIPAA must comply with that regulation and with any applicable state law that is not contrary to HIPAA. You must also comply with any state laws that are more stringent than HIPAA.
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It’s imperative that you have the required permissions to release any or all of a patient’s dental record before duplicating and transferring records. This is critical to ensuring the confidentiality of the protected health information (PHI) that the document contains.