The impact of communication on claims

It would be understandable for dental prosthetists, and any other health professionals for that matter, to assume that the majority of patient complaints stem from poor or unexpected clinical outcomes. And while clinical outcomes

do feature heavily in complaints, there’s something else that also plays a significant part – communication.

Analysis of claims reported to Guild Insurance shows that poor communication, or communication breakdowns, feature in most patient complaints. In some of these cases, the patient will complain about the way the professional communicated to them. In other cases, the patient might only mention the clinical outcome in their complaint, however when the matter is investigated further, it’s found that communication has contributed to the patient’s dissatisfaction.

Why do we sometimes get communication wrong?

There can be many reasons why a dental prosthetist’s communication might not always be at the most ideal

standard, such as: 

> They may be particularly focused on their clinical and technical skills and not giving the necessary focus to how they’re communicating.

> When people are stressed, busy or under pressure, the clarity and detail in their communication can drop away.

> They may at times forget that the knowledge they hold is highly specialised and not understood as easily by patients. 

Patient expectations

It’s not uncommon for a patient’s expectations to not be met when receiving services from a dental prosthetist, particularly dentures. This is often because the expectations the patient had weren’t realistic for their clinical situation.

It’s the responsibility of the treating dental prosthetist to have a conversation with the patient about likely and realistic treatment outcomes. It can’t be assumed that patient’s will know what’s realistic, especially given the reliance on social media for information. It also can’t be assumed that, if a patient has been referred by another dental practitioner, this

conversation has already been had.

Informed consent

It’s a requirement that dental prosthetists obtain informed consent from their patients before treatment. To do this, they need to have a conversation with their patients about their treatment options, the likely outcomes of these options as well as the associated risks. This information needs to be shared with the patient in a way they’ll understand. To do this, dental prosthetists should avoid overly clinical terms and acronyms. They should also consider using non‑verbal communication to support the conversation, such as diagrams and models. And it’s important to be sure there’s a note made about the informed consent conversation in the patient record, detailing what was discussed.

Record keeping

Many people wouldn’t consider clinical records a part of professional communication for dental prosthetists. However, they serve an important role in communicating vital clinical information.

Dental prosthetists can’t rely on their memory to recall all aspects of how each patient has been treated. Therefore, the information contained in the record is a way for the practitioner to communicate back to themselves, or other practitioners, regarding previous consultations and work undertaken.

The information in clinical records is also used to communicate information to a range of people in the event there’s
been an allegation of a poor outcome. If something isn’t noted in the record, it’s easy to assume it didn’t happen or

wasn’t done.

The level and quality of detail required in clinical records isn’t always achieved. And unfortunately, this can impact the quality and appropriateness of treatment provided as well as the ability to defend the actions of the dental prosthetist. Dental prosthetists should refer to the information provided by the Dental Board of Australia to better understand what they need to do to meet their record keeping requirements. Communicating about colleagues On occasions, patients will seek treatment from different dental prosthetists. There are a few reasons why this could happen, such as because they were on holiday when their denture broke or because they haven’t been happy with the clinical outcome received and wanted another opinion. Whatever the reason, it’s important that dental prosthetists maintain professional communication when treating someone who’s received treatment elsewhere first.

Unfortunately, Guild sees cases where a patient claims that a treating practitioner has informed them that 

the treatment provided by someone else wasn’t up to the standard which would be expected. And it’s evident that this information contributes to their decision to lodge a complaint and seek compensation.

It’s thought that in many of these cases, the practitioner hasn’t deliberately criticised the work of another. It could have just been a casual comment made during an assessment, and not intended to sound critical. However, there are cases where the comments have been intentionally critical.

Dental prosthetists need to remember that when they’re seeing a patient who’s received treatment elsewhere, they don’t understand the full clinical decision making behind the previous treatment. Therefore, they should be mindful of not opening judging past treatment and just focusing on the clinical situation they’re dealing with at the time.

Appropriate and professional communication

Dental prosthetists should never underestimate the importance patients place on being spoken to in a manner which is respectful and honest. In what may come as a surprise, Guild manages patient complaints where the core focus of dissatisfaction is how they’ve been spoken to and made to feel.

If patients are unhappy with how their treatment is progressing and they don’t feel their concerns are being heard, they may escalate the matter to a complaint to Ahpra. Patients may also complain if they feel the communication has been inappropriate, too friendly and made them feel uncomfortable.

It’s important to build a professional relationship with patients where they feel they’re included in the decision making for their treatment. However, all health professionals need to be sure this communication doesn’t blur their professional boundaries. 

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