Unresolved disagreements between dental professionals over financial or contractual matters can make working life uncomfortable, and may have wider repercussions. If friction between colleagues is allowed to spiral out of control, the fallout can affect patient care, damage the reputation of the practice, affect team morale and may even bring one or both practitioners to the attention of the GDC.
Matters of a purely contractual, business or financial nature do not lie directly within the benefits of membership and expertise of the DDU but members regularly call on us to advise on the ethical and patient care aspects of disputes, and the potential risks involved. Disagreements originating from business matters may escalate to involve third parties, including patients, Primary Care Organisations or the GDC. Involving the regulator can sometimes end in tears for both parties - the law of unintended consequences may apply should additional matters involving the complainant come to their attention during their investigations.
Common sense measures
You might have known your prospective practice partner since dental school and trust them implicitly but a casual ‘back-of-an-envelope’ agreement is naïve when you consider the amount of money that your practice might generate in the long term.
Every partnership or business agreement between dental professionals should be underpinned by common sense measures to pre-empt misunderstandings including, for example, an appropriate comprehensive business agreement drawn up by a suitably experienced solicitor, and perhaps based on a BDA model.
If a dispute does arise between members of the practice, a dental professional’s ethical duty to maintain public confidence must trump business rivalry
Fee retention agreements between practices and their associates should also be carefully considered. If an associate leaves the practice, setting aside money to pay for patients' remedial treatment offers advantages to both the practice (who won't lose out if they need to replace a lost crown) and the associate (funding remedial treatment is better than a complaint or negligence claim).
However, the agreement must be fair and there must be goodwill on both sides for it to work. Again, it is important to set out every aspect of a fee retention agreement in writing, including the amount, the exact length of the retention period and the arrangements whereby the cost of any major remedial treatment will be agreed between the parties, before the associate departs for pastures new.
If a dispute does arise between members of the practice, a dental professional's ethical duty to maintain public confidence must trump business rivalry. Publicly disparaging a colleague or using the GDC as a tactical weapon could easily come back to haunt you, but a calm and constructive approach to resolving conflict at an early stage usually pays dividends.
Five tips for avoiding collateral damage
Always seek appropriate professional advice when drawing up business contracts.
- Consider external mediation to resolve business disputes before they escalate.
- Don't involve patients in disputes with colleagues, for example by encouraging them to complain about their care.
- Business disputes should not be settled via the GDC. To guard against any suggestion of malicious intent, contact your defence organisation for advice if you believe there are legitimate concerns to be raised.
- Both parties must be clear about the terms of any fee retention arrangements to cover remedial treatment.
Head of the DDU
John Makin BDS PgDL PgCDE FHEA is head of the DDU. He qualified in Manchester in 1983 and has worked as a general dental practitioner in Lancashire and Devon before joining the DDU as a dento-legal adviser. He was involved with foundation training for many years as both a trainer and VT adviser/training programme director with the Manchester and Exeter DFT schemes.
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