There are three key dento-legal risks for dental professionals to manage; complaints, regulatory issues and claims in negligence. These are, of course, interrelated and can happen sequentially or all at once. Good complaint handling that results in a fair and satisfactory resolution - something that we have discussed in previous journals and will no doubt re-visit in the future - can significantly reduce the risk of claims. However, there are some circumstances when a claim is unavoidable and we hope it is comforting for DDU members to know that they can confidently turn to us for our advice and support.
Dental cases are often more straightforward than medical cases, making them a prime target for solicitors targeting clinical negligence claims. This is especially true for small and medium-sized claims, as they can generate costs with limited risks.
As would be expected, the majority of claims relate to 'routine' dentistry such as fillings, extractions and root fillings, but as patterns of treatment change we are seeing an increase in the number of claims relating to orthodontics and implants. The most costly claims remain those concerning undiagnosed periodontal disease and implants.
Competent adults have three years in which to begin formal legal proceedings, starting from the date of the alleged incident or when they became aware that harm may have arisen from the incident. This means that the claim may come in many years after the incident; in fact, over 45% of dental claims are brought more than two years after the date the patient was treated and almost a quarter are brought more than five years later.
Because we provide indemnity on an occurrence basis, our members can look to us with confidence to request assistance with such cases, as indemnity remains in place indefinitely for claims arising in the future without the payment of further 'run-off' costs.
Our teams of dento-legal advisers, specialist claims handlers and solicitors understand the impact that a claim can have on an individual dental professional, and we do take this into account when handling claims. The DDU will never settle claims for expediency's sake or on economic grounds. Such an approach would be detrimental to members as it would set a damaging precedent.
In 2017 we successfully defended the majority of dental claims, despite the fact that very many claims are carefully selected by specialist claimant lawyers in advance based on what they expect to win. The length of the claims process depends on the complexity and value of the case.
In recent times it has been well documented that the legal costs in a negligence case can easily exceed those paid to the patient and so we comprehensively examine, and where appropriate, challenge and contest the expenses of claimant solicitors.
The DDU will never settle claims for expediency's sake or on economic grounds.
Whenever we possibly can we'll defend members all the way, as was illustrated in our recent Court of Appeal Ombudsman judgment. However, if there is clear evidence that a patient has suffered avoidable negligent harm, we will ask for the member's agreement to negotiate a reasonable settlement as quickly as possible. This is in everyone's interest, but you may be assured that we would never settle a claim without our members' agreement.
The DDU and MDU have been actively campaigning to make compensation fair, proportionate and affordable. This includes addressing excessive legal costs and radical reform of the civil litigation system. You can find out about our Fair Compensation Campaign and the other legal reforms we propose on our website, and we encourage dental professionals to get involved and make their voice heard.
Prevention is, of course, always better than cure and so you can look to us for risk management advice through our website, social media and other channels or speak to us via our telephone advice line. We know that your time is precious and on occasion you will need advice urgently, so we work hard to ensure that you have access to expert advice when you need it. Our records show that 98% of members who called were connected to one of our dento-legal advisers - who are all dentists themselves - straight away.
We recognise that it is impossible to completely eliminate risk from dental practice, but as a DDU member you can be assured that if difficulties do arise you can look to us for robust, professional yet empathetic support throughout the process - on your side and by your side.
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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