Risk management in the dental office

Owing to a massive increase in malpractice suits directed against dentists and an escalation in the amount of settlements and court ordered awards, professional liability premiums are increasing at an alarming rate. Perhaps more important to the dentist is the anguish caused by the legal process that exposes him or her to allegations made in the public arena of the courts and the press regarding the delivery of substandard care. In addition, the dentist may suffer considerable loss of money as a result of findings of negligence by the courts. The license to practice also is at risk. In today's environment, the practice of a health profession does not appear to be emotionally, professionally, or financially secure. Despite these disadvantages in the practice of dentistry, there is much the practitioner can do to reduce or eliminate legal vulnerability. In addition to maintaining a level of care that meets the standards of other dentists in the community through the process of quality assurance, legally sound office practices and practice management procedures may contribute significantly to minimizing legal risks. A process known as risk management is currently available to assist the practicing dentist in achieving these goals. The principles of risk management was borrowed from industry by the health care industry following the crisis in medical malpractice of the early 1970s. Its primary focus is the protection of resources from losses due to legal action. The activities associated with risk management are easily adapted to dental practice. The focus of these activities is directed at identifying areas of legal vulnerability, taking steps directed at reducing or eliminating them, and purchasing insurance to offset potential financial losses. The current areas of legal vulnerability center around issues of (1) absence of consent to care, (2) negligence, and (3) breach of contract. Consent to care, to be valid, must be informed and granted voluntarily. To meet the test of "informed," the information given to the patient must be in understandable language and contain the risks, benefits, and alternatives to the recommended treatment. In addition, the patient must be given an opportunity to have his or her questions answered. Obtaining consent from one having legal capacity to grant consent is another essential requirement. The treatment of minors and those that are emancipated, raises many problems with consent.(ABSTRACT TRUNCATED AT 400 WORDS)