Houston Dentistry Magazine Volume 1 Issue 1 - Page 17

Just a little bit of information about how the State Board works – any complaint made to the Texas State Board of Dental Examiners will be investigated to conclusion. It does not matter how ridiculous that complaint may be. Once made, the complaint cannot be withdrawn. Even if you and the patient who made the complaint have now become the very best of friends, the complaint can’t be retracted. When you receive notification of a State Board complaint, you’re asked for a complete copy of all records regarding the patient in question and a brief narrative. Initially, these two components make up your entire defense. From experience, I can tell you that this is where you will want the complaint to end and end in your favor. The investigation The investigation involves essentially two parts, the first part being to determine the validity of the patient’s complaint. In other words, did you actually make a clinical error with regard to treatment or diagnosis? I’ve read hundreds of these complaints over the last 20 years. To be kind, all I’ll say is that the average person on the street doesn’t really understand very much about clinical dentistry. Maybe that’s the reasoning behind the State Board’s decision beginning January 2014 to stop sending an actual copy of the patient complaint as part of the notification process. That is the only part of the State Board’s 2014 reorganization of the complaint process I didn’t really understand. Anyway, the clinical part of the complaint is often dismissed rather quickly. The second part of the complaint has to do with your records. In many cases, this is where things can get unpleasant for the dentist. The Texas Dental Practices Act identifies the components of a proper patient record. These elements are defined in detail and this requirement is the real reason a dentist should make certain their patient records are complete and in order. The State Board investigator will look for a complete and updated medical history form, procedure specific consent forms, treatment plan and clear, accurate and complete progress notes that chronologically detail the treatment performed. not minor at all) as failing to record the patient’s blood pressure in the progress notes. This doesn’t mean that a blood pressure reading wasn’t taken, only that it wasn’t recorded. If it’s not in the record, as far as the state board is concerned, it didn’t happen. Keep in mind, a permanent sanction is public record and permanent means forever. Anyone armed with a computer and a dentist’s name can go to the State Board website and easily find out if that dentist has been sanctioned. They can even read the details of the disciplinary action. My staff is instructed to check this website anytime a dentist makes application for professional liability coverage. Most credentialing processes include this step, too. It’s a big deal. So, if a patient makes the threat of a State Board complaint unless you give them whatever it is they want from you, the first thing you want to do is take a look at your records. That’s going to give you a really good idea of how you’re going to need to respond. I’ve seen far too many dentists backed into a corner over this issue in recent years and that’s a really uncomfortable place to be. Better yet, take a look at your patient record protocol now, before anything has happened. There are many simple little fixes you can implement that will produce the record that you want to have when the issue does arise. Changes now could save you a lot of heartache later. Kyle Wallace, CIC has been active in the insurance business since 1985 and started working exclusively with dentists in 1997. He is the owner of Wallace Specialty Insurance Group in Richardson, Texas serving dentists throughout the Southwest. For more information, send an email to: kyle@wallacesig.com or call (972) 663-5190. The outcome Missing or incomplete elements often lead to fines, requirements for additional hours of CE and even permanent sanctions against the dentist. Often the outcome is a combination of all three. I’ve never seen a fine less than $1,000 and I’ve never seen the requirement for additional CE to be less than six hours. The permanent sanction is of course the worst of the possible outcomes and I’ve seen permanent sanctions given for something as relatively minor (arguably www.houstondentistrymagazine.com | HOUSTON DENTISTRY 17