Many dentists would have experienced situations where a patient has attended for an appointment and informed their dentist how they want to be treated.  These patients present a number of potential risks for the treating dentist.  Below is information dentists should consider when in this situation.

Patient expectations – when a patient has formed their own opinion about the treatment they require, they have possibly also formed an expectation regarding the outcome of that treatment.  It’s possible that this expectation isn’t realistic and may not be able to be met.  With all treatment provided, the dentist needs to have a conversation with the patient prior to treatment beginning to be sure their expectations regarding outcomes are realistic.

Clinical assessment – regardless of what a patient thinks they know about their condition or what treatment they’ve requested, it’s always the responsibility of the dentist to conduct a thorough clinical assessment to form their diagnosis.  This information is vital so the dentist can provide the patient with treatment which is clinically required and appropriate for their situation.  A request from a patient does not justify rushing this important process or making assumptions.

Informed consent – treatment requests from a paitent should not be considered informed consent for that treatment.  Informed consent requires the patient be informed, by the treating dentist, of their treatment options, the intended or expected treatment outcomes and the risks of treatment.  It should not be assumed that a patient who has requested treatment has this required information; there should always be a discussion to be sure the patient is fully informed.

Considering the patient’s wishes – when a patient presents with a request for particular treatment, the dentist may feel they’re in a challenging position from a communication and patient relationship perspective.  There may be cases where what the patient is asking for is completely inappropriate or not possible.  Yet if the patient feels their request has been simply ignored, they may not be happy with the level of service from the dentist.  The dentist therefore needs to be mindful how they approach the conversation about other treatment options and the reasons for these.

Clinically justified treatment – all dentists are responsible for any treatment they provide, and they need to be sure it is clinically justified based on that patient’s individual clinical situation; requests from patients don’t lessen this requirement.  If treatment provided is found to be inappropriate or harmful, stating that the patient requested it would not be considered a reasonable defence. 

Communication – all of the above information requires effective communication from the dentist.  It’s important that all health professionals never underestimate how important communication is to help patients understand their treatment options. And it’s also worth keeping in mind that patients don’t just complain about poor clinical outcomes, many also complain about how they’ve been communicated with or made to feel.  It’s therefore imperative that the conversation between the dentist and patient is had in a respectful way so the patient feels they’ve been listened to, even if the treatment they’ve requested is not what will be provided.

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Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791.  This article contains information of a general nature only, and is not intended to constitute the provision of legal advice.  Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them.