Perks of being a dentist

[Utdarsenal]

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I can see why people really dislike this profession. I try really, really hard to like this profession. I take a lot of CE, try performing everything to the best of my ability, treating patients the best I can -- but there are factors out of your control that just come and give you a nice slap whether you like it or not.

I've been a dentist for barely 3 years and have already had 3 or 4 patients threaten to sue me. This is a good feeling barely being new, and all. (just kidding). These have been the scenario's that presented themselves.

1) A new patient showed up with gross-decay, every tooth grinded down almost to the gum. One tooth was hurting and I told him he needed antibiotic and pain meds (active infection). He had drug seeking behavior, he said "I can't take that" to every pain med I offered and said "vicodin works". I told him I'm not prescribing you that. He got up, yelled in my face, left the clinic and left a message over the phone saying he was going to sue all of us and that he's in extreme pain thanks to us. He didn't want to accept any other prescription we were going to give him.

2) A patient showed up for a "third opinion" on a tooth he was told needed a root canal at the previous clinics. Bunch of red flags right off the bat on him. I referred him for the root canal (keep in mind, he was not in pain and he had a chronic PA abscess on the tooth. Not active). Anyways, time passed... never saw him again and about three months later, he called us yelling "why didn't you guys give me antibiotic at that appointment?? I had an infection and you guys didn't do anything about it" and said we would be hearing from his lawyer soon..

3) Had a 93 year old patient who was only chewing on 6 teeth for 5+ years we recently made full dentures on. At the tooth try-in appointment, we even brought his son in to look at the dentures with him and give us the green light for going to finish. Patient signed the denture try-in acceptance form (accepting esthetics/form, etc.) with his son in the room. The guy has been super nice all along the way. Saw him for an adjustment last week where he mentioned he felt the buccal flange was too thick. I made it a little thinner and he said it felt much better. Today, his wife and sons called on the phone saying they all hate his denture and that he hates it, wants us to re-make him a new one or they will move towards legal action. In person, he's always said everything is good while apparently over the phone, everything is not. Probably need to really sit down and talk with him about how dentures work and how he's never had these in his life.. but, you see how easy people can jump towards wanting to raise havoc..

None of these cases progressed to anything and they'd all likely lose in court. The last case is new but.. It's just really annoying when people try accusing you of things. There are seriously some crazy, crazy people out there.. I think I'm starting to becoming immune to these accusations but it's still is an unsettling feeling.

People have a really, really hard time accepting their circumstances and love trying to bring others down with them (YOU). To me, these scenario's are the ones that get the most stressful.. Just wanted to shine a light on other things that go on in Dentistry that you might not hear of too often.

If anyone has any more stories or advice to share, please chime in.

 

[Saddleshoes]

Your stories are VERY common for those of us that have been around awhile.
As long as you know you are providing excellent dentistry don't worry about keeping people happy. You can never keep 100% of the patients happy so don't even try.
The door is your best friend. Encourage problem patients to use the door and go elsewhere.

 

[Unwind]

I can see why people really dislike this profession. I try really, really hard to like this profession. I take a lot of CE, try performing everything to the best of my ability, treating patients the best I can -- but there are factors out of your control that just come and give you a nice slap whether you like it or not.

I've been a dentist for barely 3 years and have already had 3 or 4 patients threaten to sue me. This is a good feeling barely being new, and all. (just kidding). These have been the scenario's that presented themselves.

1) A new patient showed up with gross-decay, every tooth grinded down almost to the gum. One tooth was hurting and I told him he needed antibiotic and pain meds (active infection). He had drug seeking behavior, he said "I can't take that" to every pain med I offered and said "vicodin works". I told him I'm not prescribing you that. He got up, yelled in my face, left the clinic and left a message over the phone saying he was going to sue all of us and that he's in extreme pain thanks to us. He didn't want to accept any other prescription we were going to give him.

2) A patient showed up for a "third opinion" on a tooth he was told needed a root canal at the previous clinics. Bunch of red flags right off the bat on him. I referred him for the root canal (keep in mind, he was not in pain and he had a chronic PA abscess on the tooth. Not active). Anyways, time passed... never saw him again and about three months later, he called us yelling "why didn't you guys give me antibiotic at that appointment?? I had an infection and you guys didn't do anything about it" and said we would be hearing from his lawyer soon..

3) Had a 93 year old patient who was only chewing on 6 teeth for 5+ years we recently made full dentures on. At the tooth try-in appointment, we even brought his son in to look at the dentures with him and give us the green light for going to finish. Patient signed the denture try-in acceptance form (accepting esthetics/form, etc.) with his son in the room. The guy has been super nice all along the way. Saw him for an adjustment last week where he mentioned he felt the buccal flange was too thick. I made it a little thinner and he said it felt much better. Today, his wife and sons called on the phone saying they all hate his denture and that he hates it, wants us to re-make him a new one or they will move towards legal action. In person, he's always said everything is good while apparently over the phone, everything is not. Probably need to really sit down and talk with him about how dentures work and how he's never had these in his life.. but, you see how easy people can jump towards wanting to raise havoc..

None of these cases progressed to anything and they'd all likely lose in court. The last case is new but.. It's just really annoying when people try accusing you of things. There are seriously some crazy, crazy people out there.. I think I'm starting to becoming immune to these accusations but it's still is an unsettling feeling.

People have a really, really hard time accepting their circumstances and love trying to bring others down with them (YOU). To me, these scenario's are the ones that get the most stressful.. Just wanted to shine a light on other things that go on in Dentistry that you might not hear of too often.

If anyone has any more stories or advice to share, please chime in.

Well misery loves company, and these bad folks are acting like craps in a bucket trying to bring others down with them. People are irrational, but it's usually a very small percentage that are actually bad. Every profession has them.

Hang in there and just focus on your patients that actually like your services. I'm sure there are plenty that do, and they tend to be the patients that stay with you the longest.

 

[FunnyGirl1116]

You're just talking about the patient side.

I would imagine a lot of owner dentists are stressing out right now, especially during covid times, managing the employee side. The stress of managing hygienists, assistants.. My friend's dad's office was sued by a front desk receptionist once.. She was caught stealing from the register, but made up some false accusations.. Her accusations were so unbelievable that my friend's dad didn't even bother to hire a lawyer. He went to court himself and won.

 

[Molar Whisperer]

I can see why people really dislike this profession. I try really, really hard to like this profession. I take a lot of CE, try performing everything to the best of my ability, treating patients the best I can -- but there are factors out of your control that just come and give you a nice slap whether you like it or not.

I've been a dentist for barely 3 years and have already had 3 or 4 patients threaten to sue me. This is a good feeling barely being new, and all. (just kidding). These have been the scenario's that presented themselves.

1) A new patient showed up with gross-decay, every tooth grinded down almost to the gum. One tooth was hurting and I told him he needed antibiotic and pain meds (active infection). He had drug seeking behavior, he said "I can't take that" to every pain med I offered and said "vicodin works". I told him I'm not prescribing you that. He got up, yelled in my face, left the clinic and left a message over the phone saying he was going to sue all of us and that he's in extreme pain thanks to us. He didn't want to accept any other prescription we were going to give him.

2) A patient showed up for a "third opinion" on a tooth he was told needed a root canal at the previous clinics. Bunch of red flags right off the bat on him. I referred him for the root canal (keep in mind, he was not in pain and he had a chronic PA abscess on the tooth. Not active). Anyways, time passed... never saw him again and about three months later, he called us yelling "why didn't you guys give me antibiotic at that appointment?? I had an infection and you guys didn't do anything about it" and said we would be hearing from his lawyer soon..

3) Had a 93 year old patient who was only chewing on 6 teeth for 5+ years we recently made full dentures on. At the tooth try-in appointment, we even brought his son in to look at the dentures with him and give us the green light for going to finish. Patient signed the denture try-in acceptance form (accepting esthetics/form, etc.) with his son in the room. The guy has been super nice all along the way. Saw him for an adjustment last week where he mentioned he felt the buccal flange was too thick. I made it a little thinner and he said it felt much better. Today, his wife and sons called on the phone saying they all hate his denture and that he hates it, wants us to re-make him a new one or they will move towards legal action. In person, he's always said everything is good while apparently over the phone, everything is not. Probably need to really sit down and talk with him about how dentures work and how he's never had these in his life.. but, you see how easy people can jump towards wanting to raise havoc..

None of these cases progressed to anything and they'd all likely lose in court. The last case is new but.. It's just really annoying when people try accusing you of things. There are seriously some crazy, crazy people out there.. I think I'm starting to becoming immune to these accusations but it's still is an unsettling feeling.

People have a really, really hard time accepting their circumstances and love trying to bring others down with them (YOU). To me, these scenario's are the ones that get the most stressful.. Just wanted to shine a light on other things that go on in Dentistry that you might not hear of too often.

If anyone has any more stories or advice to share, please chime in.

I believe I'm one of the few dentists here that had been sued. Just a brief recap of my post dedicated to malpractice lawsuit. Practice reasonable standard of care, take risk mgt courses seriously, and chart so that the non-dental literate jury will believe you.
For case #1) No merit for lawsuit. My dialogue with drug seekers is this: "The state Board audits all the narcotics I prescribe." That usually prompts them to seek drugs from elsewhere.
2) I document on the chart under exam of the tooth: "No vestibular or facial swelling, no acute infections detected." Under RX given: "No oral antibiotics indicated at this time." Remember, the jury has no dental and medical knowledge and will believe what's documented first and any "infection" will be after the fact of noncompliance.
3) Continuation of #2. Document the patient was pleased with fit, retention, midline, esthetics, shade, bite, and function at delivery and followup appts. Document the compliance and followup details as well.

There was a free on-line Risk Mgt course on "Treating the Noncompliant Patient." The course discussed a noncompliant perio pt. The dentist did everything he could...perio probe, discussed tx plan, referral to periodontist. The pt no-showed all his appts and referral to a specialist and later sued the dentist. The jury still found in favor of the pt because accordingly, "the dentist did not adequately prove to the pt his deteriorating periodontal condition." Because of this case, I have included this documentation of: "Patient was advised of his/her deteriorating gums and bone conditions (and or teeth due to uncontrolled caries) and the need to comply with recommended treatment and home care. If these recommendations were not in compliance, and further teeth, gums, and bone deteriorates, then teeth loss may occur." At each subsequent visit, document the lack of compliance and discussions of your recommendations clearly.

 

[OMSDoc]

It sounds like you are a great dentist.

Three percent of your patients will cause 97 percent of your headaches.

This comes with the territory and you cannot stop it, but you can manage it.

Be sure to document these contentious conversations, and put in quotes the goofy things they say, and in particular, any threats of legal action (e.g., “I am going to sue you” or “You will hear from my attorney”, etc.).

Threat of legal action is a trump card that gives you the option of dismissing the patient without abandoning them. When this has happened to me, and I want to do that, I tell them (with afore knowledge of my malpractice carrier...I never do anything without talking to my attorney), “Mr. Smith, it would be inappropriate for me to continue treating you after you have threatened legal action.” I say it in a calm, kind, and empathic voice. I never get into verbal sparring after a threat.

Then, I never talk to their attorneys if they call me. I tell them who my attorney is and tell them not to contact me again.

If their attorney calls mine, they are informed that there is no claim, and that if they pursue legal action, we will vigorously defend it, and they will lose. Then, we will pursue their attorney for a malicious prosecution. If you lose sleep over their threats/actions, document that.

Finally, juries like the nice doctor. If patients are unhappy for a legitimate reason, I am happy to give them a refund.

 

[allDAT]

Patient’s who say they’re going to sue are just venting. No need to lose any sleep until you receive a letter of intent to sue from the patients attorney. Before that, they’re just barking. Even when you get a letter of intent to sue (I’ve received one) as long as you’ve documented well and done the right thing, you’ll be fine.

 

[allantois]

We need tort reform.

 

[2TH MVR]

Approx 15-20 years ago I was sued and it settled out of court. I was innocent, but the system is geared towards plaintiffs and settling. My case settled for approx 30K which is nothing in the "Lets sue a Dr. and get an easy payday" world we live in.
1st off. You should be worried if a patient threatens to sue. I would do ANYTHING to appease this patient to prevent further escalation. Believe me. The process of getting sued will ruin at least a year of your life. Ruin. In most states .... if you are sued ... the dental board is mandated to do an investigation into the incident. So even if you are cleared or the case settles .... you will need to prove once again to the dental board that you were innocent.

Malpractice coverage has different levels and also states if the ins co can settle with or without YOUR approval. I had good insurance and it was MY decision to go to court and be judged by my peers (lol) or settle. But you have to think about the consequences of "If you go to court and LOSE". If the payout is over a certain amount ..... your ins can decide not to insure you at renewal. Then you are looking for replacement insurance after being sued. Goodluck. If you settle ..... no issues. Still listed on the Practioner Data Bank, but life goes on.

So maybe you want to settle after a few months of evidence discovery and all the legal BS. It doesn't happen that fast. It gets drawn out for months, maybe years. During all this time .... you are trying to run a practice while being dragged through the mud by expert witnesses, plaintiff's attorney, request for documents, etc. etc. Trust me. It RUINED an entire year for me.

btw. The plaintiff's case was weak. She also had a history of suiing her drs along with anyone she could get her greedy hands on. Previous to myself ... she had sued her hairdresser for allegedly burning her scalp with a curling iron. After suiing me ... she went on to sue her next ortho and an OMFS.

Sometimes ... it doesn't matter what you do to appease a patient. I currently practice defensive treatment with EVERYONE. I document EVERYTHING. The days of writing a simple extraction referral form to have #C and #H extracted without FULL DIAGNOSTIC records is over. Not a patient of mine and you want a replacement ret? FULL DIAGNOSTIC records will be taken 1st. The liability of handing out a $300 replacement ret to a non-patient is not worth it. Records are everything. The plaintiff's attorney will review EVERY detail of your chart entries.

So. Take this stuff seriously. If you have a situation brewing with a patient. Do everything you can to diffuse it. Do not let your EGO get in your way.

 

[Molar Whisperer]

Patient’s who say they’re going to sue are just venting. No need to lose any sleep until you receive a letter of intent to sue from the patients attorney. Before that, they’re just barking. Even when you get a letter of intent to sue (I’ve received one) as long as you’ve documented well and done the right thing, you’ll be fine.

I'm going to provide a valuable link. Anyone can register for free. There is a free on-line risk mgt class called "Treating Challenging Patients" where the dentist can do & chart everything right and still lose. Keep in mind that the plaintiff attorney will do anything to convince the non dentally educated jury his/her client deserves the maximum award. It doesn't matter if the dentist is right. A lot of my colleagues blew this off because they think they will never get sued. It's the most valuable 1 hr commitment to your practice. The site also has "Anatomy of a Malpractice Suit" class that can be valuable.

Fortress

www.dds4dds.com

 

[Molar Whisperer]

Approx 15-20 years ago I was sued and it settled out of court. I was innocent, but the system is geared towards plaintiffs and settling. My case settled for approx 30K which is nothing in the "Lets sue a Dr. and get an easy payday" world we live in.
1st off. You should be worried if a patient threatens to sue. I would do ANYTHING to appease this patient to prevent further escalation. Believe me. The process of getting sued will ruin at least a year of your life. Ruin. In most states .... if you are sued ... the dental board is mandated to do an investigation into the incident. So even if you are cleared or the case settles .... you will need to prove once again to the dental board that you were innocent.

Malpractice coverage has different levels and also states if the ins co can settle with or without YOUR approval. I had good insurance and it was MY decision to go to court and be judged by my peers (lol) or settle. But you have to think about the consequences of "If you go to court and LOSE". If the payout is over a certain amount ..... your ins can decide not to insure you at renewal. Then you are looking for replacement insurance after being sued. Goodluck. If you settle ..... no issues. Still listed on the Practioner Data Bank, but life goes on.

So maybe you want to settle after a few months of evidence discovery and all the legal BS. It doesn't happen that fast. It gets drawn out for months, maybe years. During all this time .... you are trying to run a practice while being dragged through the mud by expert witnesses, plaintiff's attorney, request for documents, etc. etc. Trust me. It RUINED an entire year for me.

btw. The plaintiff's case was weak. She also had a history of suiing her drs along with anyone she could get her greedy hands on. Previous to myself ... she had sued her hairdresser for allegedly burning her scalp with a curling iron. After suiing me ... she went on to sue her next ortho and an OMFS.

Sometimes ... it doesn't matter what you do to appease a patient. I currently practice defensive treatment with EVERYONE. I document EVERYTHING. The days of writing a simple extraction referral form to have #C and #H extracted without FULL DIAGNOSTIC records is over. Not a patient of mine and you want a replacement ret? FULL DIAGNOSTIC records will be taken 1st. The liability of handing out a $300 replacement ret to a non-patient is not worth it. Records are everything. The plaintiff's attorney will review EVERY detail of your chart entries.

So. Take this stuff seriously. If you have a situation brewing with a patient. Do everything you can to diffuse it. Do not let your EGO get in your way.

From my observations, there are an overabundance of injury plaintiff attorneys and they are all hungry. The defense attorney really has no incentive to bend over backwards for you. He/she may have numerous other cases going on that may be more pressing. My attorney even told me there is not much money defending dentists. I had to dig into the plaintiff's background and fortunately found 2 meth related arrests, one of them during my time of treatment. This action on my part brought the suit from $995k down to settlement of $35k. The plaintiff attorney will get about 40% of the settlement which I believe is more than my attorney will get since he is on retainer. I wanted to paint the plaintiff as a low-life criminal, but my attorney says the jury may sympathize with her if we get too rough.