Nipping complaints in the bud is always the best approach, where possible – Dental Protection’s Dr Simrit Ryatt, Dentolegal Consultant, looks at how we can help manage complaints on your behalf.

There will always be patients who are dissatisfied with their treatment, or whose expectations are not met in some way. It is important to appreciate that some dissatisfied patients do not necessarily complain; many of them simply decide never to return to the practice, and some of these patients will tell the tale of their dissatisfaction to anyone who is prepared to listen – for weeks or months to come. 

Often, patients want to be heard and provided with an opportunity to let off steam, so they feel their concerns have been acknowledged. Others want an explanation or an apology and some form of appropriate remedial action, whether this involves financial recompense or not. Unless an opportunity is grasped to address the patient’s needs and resolve these complaints quickly and effectively at an early stage within the practice, there will always be a risk that the patient will take their complaint to another, perhaps higher, authority outside the practice.

The proactive approach 

When they happen, there is often a very small window of opportunity to nip complaints in the bud and Dental Protection has always urged members to be proactive when receiving a complaint. We know from our experience that some members go through a range of emotions when they receive a complaint. The emotion can be the catalyst for an initially defensive reaction and by the time we get involved it’s obvious that being proactive but with the wrong response can easily inflame the situation instead of calming things down. 

The strategy is always to find out why the complaint has been made and find a solution that is mutually acceptable. A well-managed complaint lowers the risk of the patient feeling they have to involve anyone else in the process, particularly the Dental Council. By making it difficult for the patient to receive an appropriate response we just make it much easier for them to follow the path of least resistance and vent their frustrations, not only about the cause of their complaint but the way it has been handled. Patients and professional regulators nowadays expect concerns or complaints to be acknowledged, listened to and dealt with promptly. Members should appreciate that complaints, if left unresolved, can proceed on two or more fronts simultaneously. 

How we can help

We are here to provide advice for a variety of situations and our dental members are encouraged to contact Dental Protection as soon as a complaint is received, or in the event you anticipate the situation with a patient is beginning to unravel. The earlier you contact us, the more help we can give you in the important early stages. We can also suggest approaches to and assist with suitable responses when speaking to patients or responding to patients via email. We can also help you to realistically manage patients’ expectations with respect to turnaround of responses.

We have an out of hours advice line for urgent situations that cannot wait until the next day and there is always a dentolegal consultant to provide reassurance and immediate general advice. If specific detailed written advice is required, additional details will be obtained before further considered advice is provided. When cases reach the Dental Council, they expect registrants to investigate and provide detailed and professional responses to the complaint. You may prefer to request assistance via email and we can swiftly start the process by seeing how we can best assist you.

Case study  

You’re not alone

Since normality had resumed after the various outbreaks of COVID-19, Dr W was glad to be back in clinic, although he been particularly busy recently and he had been working long hours. The outbreaks of COVID-19 had placed additional financial worries on the clinic and this had caused Dr W a considerable amount of anxiety. 

Dr W had not taken any significant worry-free time off work since the outbreak started. Tomorrow was Friday, with the weekend break nearly in sight; Dr W was looking forward to spending time with his family and attempting to unwind and de-stress. He was completing a straightforward procedure of a scale and polish for Mr F, a gentleman in his late 50s with a generally healthy mouth. There was minimal calculus to remove, but Dr W could see a fair amount of staining. 

Dr W diligently performed the scale and polish, and treatment was completed 15 minutes later. He was just about to leave when he could hear a commotion at reception. He was surprised to see Mr F shouting at his reception team and he was demanding a refund; Dr W immediately tried to defuse the situation. It transpired Mr F felt Dr W hadn’t removed all the staining from his teeth. He was angry he had been charged full price for this treatment as he felt it hadn’t been completed properly. 

Dr W was perplexed by this as he was certain all the stains had been removed, so he attempted to invite Mr F back into the surgery so he could review the patient and understand what the problem was. However, Mr F advised he had lost trust in Dr W and did not want to be seen by him. Before any other suggestions could be made Mr F hurried out of the clinic and as he left, he threatened to contact the Dental Council.

Dr W had a restless evening and he considered contacting Mr F to discuss the matter further, but he reflected that he attempted to resolve matters already and Mr F was adamant he had lost trust in him, so surely any further resolution attempts would be hopeless. Dr W had a sleepless night and struggled to work the next day. He was meant to be attending his daughter’s recital on Friday evening but as he was extremely anxious from Thursday's events, he didn’t attend and he stayed at home on his own. Dr W spent the rest of the weekend feeling worried about the events on Thursday with Mr F and the issue was on his mind for a number of weeks afterwards. 

Almost inevitably, and a bit like a self-fulfilling prophecy, Dr W received correspondence from the Dental Council as Mr F had lodged a formal complaint with them. Dr W contacted Dental Protection and he spoke to a dentolegal consultant, and he broke down. He advised he was already struggling at work due to the stress of COVID-19 and the complaint from Mr F had tipped him over the edge. Immediate reassurance was provided on the phone by the dentolegal consultant and Dr W was advised of the counselling service that is available to members for case related issues at no additional cost. 

This really reassured Dr W, and he immediately felt comforted, understood and supported. The dentolegal consultant also requested that Dr W send in all the information relating to the case, including the correspondence from the Dental Council and his treatment records.

The following day, the dentolegal consultant had reviewed the complaint to the Dental Council and the patient had submitted photographs of their teeth, which were supposed to demonstrate the residual staining that had not been removed. Having reviewed the photographs it was clear the patient was referring to the darker dentine that was visible at the incisal edge due to attrition, and Dr W had not left any staining present. Dr W explained to the dentolegal consultant that he felt frustrated he was not provided with an opportunity to explain this to the patient, and this was included in his explanation to the Dental Council that outlined the misunderstanding.

A few weeks later, the Dental Council accepted Dr W’s explanation and, although it was an agonising wait, Dr W was grateful for Dental Protection’s support and assistance. 

Learning points

• With hindsight, had Dr W contacted Dental Protection when the patient initially complained, we might have been able to prevent Mr F from progressing his concerns to the Dental Council. Dental Protection would have suggested Dr W take proactive action and assisted him in drafting a conciliatory well-written response, including an explanation about the difference between dentine and staining. 

• In our experience, calmly written responses can reduce the possibility of a patient raising their concerns elsewhere. Our team are here to provide all levels of support and there is no problem too trivial. It is often helpful to speak to a dentolegal consultant to introduce a level of objectivity to a situation where situations become all-consuming.