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Introduction to Managing Professional Risks

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Managing Professional Risks
Introduction
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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. You’re managing risk even when you’re:

  • Communicating with patients
  • Managing the financial aspects of the business
  • Hiring and supervising staff
  • Conducting or overseeing marketing activities
  • Ensuring that everything done on-site complies with all of the federal, state and local regulations whether it relates to actually doing dentistry or not.

Many dentists go through their entire careers without experiencing any situation that has the potential to do severe professional, reputational or financial harm. Yet, things can happen that have nothing to do with the appropriate and professional care that you provided to a patient.

Each year, the American Dental Association (ADA) receives hundreds of calls from dentists asking how to find a lawyer and guidance on getting the right type of legal advice. While the ADA’s national headquarters can’t provide individual members with legal advice or local referrals, they do encourage dentists to have the right attorney and the right liability carrier to help them navigate challenging situations. 

Identifying the risks that exist in a dental practice is the first step to effectively managing them. Once you know what the risks are, you can develop plans, systems and protocols to reduce the likelihood that one of those possible risks will become a reality that has the potential to significantly damage your ability to practice, your professional reputation and your financial stability.

Risk management systems, sometimes called assessments, can be triggered in many ways: they can result from an audit, or from an awareness that something can be improved, such as a suggestion gleaned from a colleague or a continuing education program. Regardless of what prompted the assessment, the important thing is that you have an effective system in place before you need it. 

While risk assessments that are prompted by specific incidents that happen in the dental practice may be troubling, it’s helpful to view them as teachable moments. Look at these situations as an opportunity to improve your processes going forward.

Many risk assessments start with a review of the dental record, or patient chart. When properly managed, this official record can be an invaluable defense if you’re ever accused of malpractice or receive a complaint from your state dental board or insurance audit. The thing to remember is that every entry for every patient matters every time.

Knowing how to communicate with patients also matters. Having a personable and approachable, yet professional, chairside manner can make the difference between a happy patient and an angry patient. Happy patients who like their dentists are less likely to file complaints with the state dental board or civil lawsuits. Listen willingly and attentively anytime a patient expresses dissatisfaction with some aspect of treatment; sometimes, a listening ear and some empathy are all it takes to resolve a situation that could otherwise escalate. Your office staff can be an invaluable resource alerting you to a patient’s complaint or dissatisfaction that otherwise may be overlooked.

This ADA Guidelines for Practice Success™ (GPS™) module on Managing Professional Risks discusses some of the preventive steps you can take to protect yourself and your practice.

The content contained in the Managing Professional Risks module of the ADA Guidelines for Practice Success™ (GPS™) provides general information about some of the preventive steps dentists can take to lessen many of the risks associated with working in, operating and/or owning a dental practice. The module also includes original resources, such as checklists, tip sheets and FAQs, that were created specifically for this project and designed to make it easier for ADA members to mitigate their potential liability.

As this resource was produced in 2018, it’s important to recognize that that the liability and risk management landscape continues to evolve. Therefore, while we believe this information will be a valuable tool to dentists at all stages of their careers and in all types of practice, we urge you to continue to pay attention as laws, rules, regulations and requirements may change at any time.

Best Practices

Clinical Practice Risk Management 

Patient Records, Charting, and Documentation Protocols

The Consent Process

Audits

Securing Legal Support and Advice

Managing Risks with the Dental Team

Patient Prescriptions

Practice Transitions and Other Changes

Peer Review Options and Considerations 

Dental Board Complaints

Managing Cyber Liability Risks 

Allegations of Discrimination/Hostile Work Environment/Sexual Harassment 

Americans with Disabilities Act (AwDA)

Managing Employment Practice Liability Risks 

The American Dental Association thanks the following individuals for their contributions to this module:

  • Dr. Craig Ratner, Council on Dental Practice 2014-2018, chair 2017-2018
  • Dr. Scott L. Theurer, Council on Dental Practice 2014-2018
  • Dr. Christopher Liang, Council on Dental Practice 2017-2021
  • Dr. Julia K. Mikell, Council on Dental Practice 2015-2019
  • Dr. Paul S. Casamassimo, M.S., Council on Advocacy for Access and Prevention 2016-2020
  • Dr. Peter Hehli, Council on Members Insurance and Retirement Programs (2014-2018), chair (2017-2018)
  • Dr. Naomi Ellison, Council on Members Insurance and Retirement Programs (2014-2019), vice chair (2017-2018)
  • Dr. Richard C. Engar, FAGD, FADI, FICD, FACD
  • Dr. Richard S. Harold, B.S. (Pharmacy), J.D.
  • Mr. Michael D. Peterman, CPCU, RPLU, ARM, AU, AIC, ARe, AMIM, AINS
  • Mr. William P. Prescott, Esq., M.B.A.-Executive Program
  • Dr. Michael R. Ragan, J.D., L.L.M.
  • Dr. Paul Sauchelli, J.D.
  • Dr. Dean Stratman
  • Dr. Frederick W. Wetzel
  • Dr. Ronald R. Zentz, R.Ph., CPHRM, FAGD, FACD

In addition to the individuals cited above, principal contributors to this publication include Dr. Pamela M. Porembski, director, Council on Dental Practice, Rita Tiernan, senior manager, Council on Members Insurance and Retirement Programs, Dr. Jane Grover, director, Council on Advocacy for Access and Prevention, Cynthia Kluck-Nygren, manager, Dental Team, Advocacy & Content Development, and Dr. Diane Metrick, senior manager, Special Projects and Emerging Issues. Special thanks to the ADA’s Council on Dental Practice, Council on Members Insurance and Retirement Programs, Council on Advocacy for Access and Prevention, and Council on Ethics, Bylaws, and Judicial Affairs for their review of and contributions to this module.

Disclaimer

The American Dental Association created the ADA Guidelines for Practice Success™ (GPS™) module on Managing Professional Risks as a resource to help dentists be aware of – and comply with – some of the many issues they need to consider in order to protect their practices, their patients and themselves. In making these materials available, the ADA does not, nor does it intend to, provide either legal or professional advice. None of the content in this module represents ADA’s legal or professional advice as to any particular situation you might face or any decisions you may need to make regarding practice liability. Guidance of that nature is most appropriately provided by a properly qualified professional, such as an attorney and/or consultant or underwriter who specializes in professional liability matters, in your jurisdiction.

While some content within the ADA Guidelines for Practice Success™ (GPS™) module on Managing Professional Risks may discuss certain federal and state laws in very general terms, it does not and cannot address every federal and state law, rule or regulation that could apply to how your practice manages risk. This resource refers to various federal statutes and regulations, including those adopted by agencies such as the Department of Labor (DOL); the Department of Justice (DOJ); Center for Disease Control (CDC); Federal Drug Administration (FDA); and Health and Human Services (HHS). None of the information in this module has been reviewed or approved by representatives of those or any other federal agencies. 

We have made every effort to make these materials useful and informative. As a consumer of this information, however, you must understand that laws vary between jurisdictions and that changes to those rulings may occur more frequently than this resource is updated. For that reason, we make no representations or warranties of any kind about the completeness, accuracy, or any other quality of these materials or any updates, and expressly disclaim all warranties, including without limitation all implied warranties (including any warranty as to merchantability and fitness for a particular use).

To the extent that we have included links to any websites, we intend no endorsement of their content and imply no affiliation with the organizations that provide their content. Nor do we make any representations or warranties about the information provided on those sites, which we do not control in any way.

We welcome your comments and suggestions regarding the ADA Guidelines for Practice Success™ (GPS™) module on Managing Professional Risks.