I attended the Dental Forum in the Algarve at the start of June and aside from the obvious benefits of being able to work in the Portuguese sun it was also a fantastic opportunity to listen to leading figures in dentistry.
One of the presentations was incredibly thought provoking and centred on Indemnity, not just for individual dental practitioners but also for the dental practice or dental group as a business. Indemnity for the practice or group is known as Entity Medical Indemnity or Vicarious Liability Insurance and protects the business against claims of dental negligence.
Of course under GDC regulations all individual dental practitioners must hold indemnity appropriate to their scope of practice, either through one of the Medical Defence Organisations such as the DDU, Dental Protection or MDDUS or through an insurance company. But who has the ultimate responsibility over patient care? Is it the individual dentist or is it the practice? After all, the patient is making payment to the practice and is being treated under the practice brand. The increasingly litigious nature of dentistry means the line between who holds the ultimate responsibility (liability) is becoming more blurred.
The industry has seen many cases of poor dental treatment being provided by dentists who have come from overseas to practise only to disappear when claims start to arise. And often, we have seen indemnity providers on behalf of the dentist refuse to provide indemnity for these patient complaints as they are unable to discuss the case with their member.
Another scenario we have seen on many occasions is where dentists have defaulted on their monthly payments to their indemnity provider and subsequently their indemnity has been terminated. Responsible dental practices will record on file copies of the dentist’s indemnity when joining the practice and at every subsequent renewal. But if their indemnity is terminated half-way through the year due to non-payment you may not become aware until a complaint is brought against that individual.
An area where there have been complaints in the industry involve Warranty. What is a warranty? Warranty is the length of time of which you guarantee the quality of a treatment. A treatment cannot have a life-time guarantee – nothing lasts forever! The life-span of a treatment depends on many variables such as how well the teeth are maintained and how regularly the patient attends the dentist. This must be clearly explained to the patient during the informed consent process. Do you give a warranty for certain treatments at the practice? How do you determine a warranty? Is it a written warranty? Does the patient know about the warranty? What happens when it runs out? And what happens if it is not understood? Is the practice responsible for the warranty given for a particular treatment or is the dentist?
In each of these scenarios legal liability falls on the practice to indemnify the patient in respect of any potential compensation and their legal costs and any other associated costs such as expert witness reports. The industry has seen costs for successful claims for dental negligence against an individual range anywhere from as low as a few hundred pounds up to around £1,000,000.
Unfortunately, it is commonplace that a dentist who is providing a poor standard of care to their patients will have multiple complaints waiting to come through. When you consider the wide scope of treatments now available in dentistry and the value of claims we see along with the increase in the volume of claims being brought against the profession, a substantial risk exists for the dental practice. If a Vicarious Liability policy is not in place then the practice will have to pay any claims costs from the gross revenue and profits of the business.
The larger the dental group the more significant the risk!
A Vicarious Liability policy is readily available from specialist dental indemnity providers. All that is required is the completion of an application form and a quote can usually be turned around within a couple of days.
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