Frequently Asked Questions

Have a question about a pressing risk management issue? Our experienced Risk Management analysts have answers. From treating minors to retaining patient records to employee leaves of absence, chances are, your question has been asked before. The following is a list of frequently asked questions, along with practical solutions, that can help you avoid liability within your practice.

A patient posted a negative review on Yelp about my practice. Can I respond to the review? What if the poster isn’t a patient of record and it is just a bogus review?

Patient Care

We recommend not responding. If you feel compelled to respond, write something like this: “By responding to this post, I am neither confirming nor denying that you are a patient of my practice. If you would like to discuss the issue, please call my office at _______________.”

If patients come in and mention the negative review, we recommend addressing it as follows: “Yes, I am aware of the review. Unfortunately, anyone can write a review about the practice online – whether they are a patient of mine or not. Being a healthcare provider, I cannot respond. But you are here today, so let’s get started.”

Following TDIC’s recommendation, I’m getting ready to dispose of the records of adult patients who have not been seen in my practice for more than 10 years. What is the proper way to dispose of those records?

Record Keeping

Dispose of old patient charts by burning or shredding them. Do not simply throw them in the trash, as they include confidential information that you have a duty to protect. Hiring records disposal companies that specialize in destroying records by burning or shredding is preferable. Because the Environmental Protection Agency does not permit the burning of radiographs, we recommend shredding them. Whether you destroy them yourself or hire a company, keep a log of which records are destroyed, and when. This practice will assist you in identifying which records are unavailable in the event they are requested later.

When searching for a company to dispose of records, look for companies listed as specializing in legal or law records disposal. This may yield a wider range of options than simply looking under dental or medical records disposal.

How do I discharge a patient from care?

Patient Care

A patient must be notified in writing. TDIC does not recommend dismissing a patient who is mid-treatment, i.e. in a provisional or temporary. You have the option of giving the patient a reason for the dismissal, such as non-compliance if they are not complying with active treatment requirements or necessary appointments. Alternatively, you may choose to dismiss with no reason, if the doctor-patient relationship has a loss of trust. Give the patient a reasonable amount of time to seek a new dentist. Often, 30 days from the date the letter was mailed is sufficient, during which time you agree to see them for emergencies only. You should provide valid referrals for the patient to find a new dentist, such as the local dental society, or refer them back to their insurance carrier, but do not provide specific names of other dentists. TDIC has sample dismissal letters that can be customized by your practice for withdrawing from care for your patients. Please contact a risk management analyst directly for sample letters or if you are unsure about your liability in relation to the dismissal.

I am closing down my practice, not selling it to another dentist. How do I let my patients know in a way that it is not considered abandonment? Do I need to keep their records?

Patient Care

Check with your local dental board for state specifics regarding closing a practice. With that said, you should notify your patients of record with a letter advising them of the closure of the practice. The letter should indicate your actual termination date, where they can locate their records after that date, and the importance of continued dental care. In some instances, you may also place an ad in a local newspaper. Comply with your state’s requirements for retention of records timelines, and, if placing them in charge of a custodian, be sure to have it spelled out who will pay for storage and reproduction costs of records.

I am considering requiring my patients to sign an arbitration agreement. I have heard that arbitration is inexpensive and is a quick method to resolving disputes. What should I do?

Patient Care

On the surface, arbitration appears to be a perfect solution for the dentist as well as the patient. It can be less expensive than litigation and typically moves expeditiously. However, arbitration does have its drawbacks. First, having a patient sign an arbitration agreement binds you and the patient to abide by that agreement, even if the problem could be resolved in another manner. There is no option of appealing the decision. Second, in arbitration only two to three arbitrators, as opposed to a 12-member jury panel of your peers, hear your case. Additionally, arbitrators who often hear similar cases may have preconceived notions regarding dentistry, which may affect how they evaluate your case. Finally, consider the impact of asking your patients to sign such an agreement. Often patients view signing an agreement prior to treatment as a pre-admission of substandard care. Some will perceive it as your attempt to strip them of their legal rights, should something go wrong with treatment.

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The suggestions provided represent experience and opinions of TDIC. There are no guarantees that any particular idea or suggestion will work in every situation. The ideas and suggestions contained in this document are not legal opinion and should not be relied upon as a substitute for legal advice. For legal advice specific to your practice, you must consult an attorney. 
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