Who decides?

A 15-year-old patient attended my practice with his mother; he had had some hot and cold sensitivity, and bitewings revealed that he had 11 cavities.

I went through all the relevant dietary and oral hygiene advice with the patient (Patient F) and his mother, and at the end of the appointment issued them an estimate for the treatment. According to my receptionist, upon seeing this estimate, the patient’s mum laughed and said to not worry about it as she would not be paying for the treatment – Patient F’s father would. She proceeded to leave the estimate on the counter; I did not find out about this until after Patient F and his mother had left – if I had, I would have asked more questions at the time.

Treatment proceeded and after three restorative appointments, it came to my attention that the family had an outstanding account. It appeared that only health fund contributions had been made and the balance had not been paid. This news corresponded with a seemingly panicked phone call to the front office from the patient’s mother, who requested that we did not speak to Patient F’s father about any treatment, but simply send him the bill. My receptionist advised that this was not the usual protocol, but the mother explained that she and her husband had separated and were going through a difficult divorce. She said again that the father was not to be told anything about the health of their son, as he would use it against her in his counterclaim to get custody.

Naturally, this was quickly followed by an angry phone call from Patient F’s father, demanding to speak to me about his son’s treatment. I did not know how to respond. On the one hand, we had been given express instructions not to speak to him by Patient F’s mother. But on the other hand, he was a parent wanting to know about the treatment of his son. More to the point, Patient F’s father was expected to pay the bill while knowing nothing about the treatment he was paying for or providing his consent. What about the son’s views? At age 15, could he decide who knew about his health?

I did not know what to do. I explained to the father that I was unable to speak to him at that moment in time, and that I would get back to him with some meaningful advice. I immediately called Dental Protection to seek said advice, and to help me resolve things amicably with the family.