What is a dentist’s liability if a patient opts for a treatment that is not the recommended treatment?

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What is a dentist’s liability if a patient opts for a treatment that is not the recommended treatment?

I work in a dental office. We are wondering if someone has periodontal disease in their mouth, and the standard of care is scaling and root planing which is a $1000 procedure, are we allowed to just do a regular prophylaxis cleaning if they refuse scaling and root planing. Most patients want to opt out of scaling and root planing due to cost, but a prophy does not treat their disease. Is this supervised neglect?

Asked on October 29, 2014 under Malpractice Law, Texas

Answers:

Thomas Reilly / Albert W Chianese & Associates

Answered 6 years ago | Contributor

It would appear to anyone looking at the case as if it were supervised neglect.  In order to make sure that an attorney or an expert witness looking at the file sees what is actually happening you must adequately document the file.  It would be a good idea to provide the patient with a written correspondence that they require further treatment and what the consequences of not receiveing the treatment are.  You can go as far as having the patient sign a document stating they know what is needed and the consequenses of not receiving the treatment along with any alternatives.  You should also document referalls to specialists and may even want to terminate the doctor patient relationship.    If you do not do this it will come down to your word against the patients.  The patient is going to testify that the doctor never said anything more needed to be done and that they were never told the alternative treatments, risks or benifits of those treatments.  My suggestion would be to end he patient doctor relationship based upon the patients refusal to undergo necessary treatment, a jury may look and say the doctor didnt do  enough and shouldnt have been providing simple cleanigs when more was required, because in teh end the doctor is teh one with a degree and should be controlling treatment. 

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 6 years ago | Contributor

It would be malpractice is either 1) the dentist did not fully explain the recommended treatment and the limits of the treatment the patient opted for; or 2) the opted-for treatment not only did not treat the disease, but in some way made things worse (a medical professional may not do anything to harm patients, even at the patient's behest). However, if the prophy is a reasonable procedure to do otherwise, eve3n if it doesn't address this problem, and if the patient made an informed decision, that is not malpractice. It would be a good idea to give the patient some written information sheet and also to get their understanding and consent in writing, to avoid future misunderstanding.


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