A patient accused a dentist of bait-and-switch tactics after he used the term “Invisalign” instead of the generic term “clear aligners” when discussing treatment options. This case study highlights the potential risks that can arise when branded and generic terminology are used interchangeably and a patient’s expectations are not clearly documented. TDIC’s risk management analysts share their advice for the dentist and what all practices should do to avoid ending up in the same situation.
In healthcare settings, clear and explicit language is critical to ensure patients understand the treatment plans and options and providers understand patients’ expectations. Miscommunication doesn’t just create patient dissatisfaction—it can sometimes escalate into complaints or other regulatory consequences.
In this case study, a dentist's casual wording led a patient to believe that the treatment she agreed to was downgraded to the treatment she ultimately received. The patient accused the dentist of employing a “bait-and-switch” tactic and threatened to file a complaint with the state dental board.
Learn what TDIC’s risk management experts advise to avoid similar situations and what steps to take if a miscommunication happens.
Case study: The impact of one word
People commonly use brand names in place of common household items. “Do you have a Band-Aid?” “Can you pass me a Kleenex?” and “Put the leftovers in the Tupperware” are phrases we’ve all likely said and that the people around us have understood without a second thought. These brand names are so well-known that they’ve become interchangeable with generic product terms.
While this practice may be harmless in our day-to-day lives, it can have unintended consequences when carried over into the medical field.
TDIC’s risk management team recently received a call from a dentist who had a patient interested in orthodontic treatment. As the patient prepared to begin treatment with clear aligners, she expressed interest in Invisalign, a brand of clear aligners. Upon reviewing the patient’s orthodontic insurance benefits, the office determined that treatment with Invisalign would cost the patient approximately $1,000 in additional out-of-pocket expenses compared with generic-brand clear aligners. The office informed the patient of the cost difference and offered to still do the treatment with generic clear aligners to reduce the cost to the patient.
Hearing the offer, the patient became angry and sent an email to the dentist accusing him of trying to provide lesser treatment to her with what she felt was an “off brand” orthodontic treatment compared to Invisalign. The patient then said that if the dentist didn’t provide her with Invisalign-brand aligners for the treatment, she’d file a complaint to the dental board.
Concerned by the patient’s response, the dentist reviewed past email correspondence between his team members and the patient and found that they had used the term Invisalign to refer generically to clear aligners. The dentist realized that the patient may have been referencing this correspondence when she claimed the office made false representations about the aligners that would be used.
The dentist reached out to TDIC’s risk management team for guidance on how to respond to the patient’s concerns and to determine the appropriate next steps.
Analysts’ advice: Discuss with patient and prioritize trust
With the patient threatening to file a report to the dental board, TDIC’s analyst advised that the dentist address the situation at the patient’s next appointment and explain in person the office’s use and intended meaning of the word Invisalign. However, the dentist should be prepared to provide treatment without holding the patient responsible for the increased cost of using Invisalign.
The analyst expressed concern with the patient’s quick escalation to threaten to file a dental board complaint and reminded the dentist that a climate of trust is critical in a dentist-patient relationship. If this relationship no longer exists or the patient continues to be combative and accusatory, the dentist should consider telling the patient he is uncomfortable moving forward with care.
To avoid a similar situation of miscommunication and mistrust, dental practices should establish clear and consistent terminology for how all members of the team discuss treatment options, fees, products and procedures with patients. Use of the same language across the practice helps lower the risk that a patient will feel misled or deceived about their treatment. In this scenario, the analyst suggested that the dentist remind his team to use the generic term “clear aligners” when referring to aligner treatment and only use Invisalign when referring to that particular brand.
This case study demonstrates how the use of one word can escalate a situation and lead to patient conflict. Clear communication and outlining of expectations can help mitigate risk and maintain patient satisfaction.
TDIC’s Risk Management Advice Line is a benefit to TDIC policyholders. To schedule a consultation with an experienced risk management analyst, visit tdicinsurance.com/RMconsult or call 877.269.8844.