B. CASEY CRAFTON & STEPHEN KAUFMAN
Tips to help you avoid being hauled in front of your disciplinary board thanks to aggrieved patients or former employees.
FOLLOWING A HIATUS, our legal columnists have returned to our pages to answer your questions and offer advice about dentistry and the law.
NO ONE WANTS to be involved in a dental-board disciplinary action. At best, it’s emotionally taxing and time-consuming; at worst, you’ll be fined or reprimanded, or lose your license. How best to avoid a board hearing, though?
Everyone knows that sex, drugs and dishonesty will lead to board action, as will malpractice or failing to renew your medical license. Unfortunately, though, you need not do something grievously wrong to end up with a complaint filed against you. Many such complaints are frivolous; among those we’ve seen are “the office was cold,” “the staff was rude to me” and “my tooth still hurts.”
Anyone — including the board itself — can get a board action started, but the primary sources of complaints are employees (especially former staffers) and patients. With employees, the three most common problem categories are the chronically unhappy, the office moralist and the angry ex-employee. The constant complainer is a type familiar to anyone who has ever had a job, and the best defense is preemptive: Don’t hire such a person in the first place. Fortunately, these sorts of people often have checkered work histories and can be ferreted out with some basic sleuthing. Assiduously check references and look at the potential hire’s social-media accounts, particularly Facebook, for warning signs.
“My tooth still HURTS.”
The moralist is the staffer who thinks he’s been demeaned or made to do something inappropriate or outright unethical. The solution: sound practice management. Treat all your employees professionally and insist that they reciprocate, with you and one another. Hold non-judgmental team meetings, give everyone a regular performance review and encourage feedback. Genuinely listen to your staff and address their concerns.
The final category is the one most likely to file a board complaint: the employee you fired. To protect yourself, try to minimize his anger and defend yourself proactively. Have a reasonable, written disciplinary process in place, and follow it to the letter. Make sure every employee understands what’s expected and what merits termination.
Don’t unnecessarily blindside a staffer with sudden job loss, though. If you suspect that someone you intend to fire poses a heightened risk, you could offer him a release — a document in which the employee waives his right to sue you in exchange for a payment up front. Releases can also include promises not to badmouth you to anyone, including your board. Be sure your lawyer approves any release, as state laws vary greatly.
“The staff was RUDE to me.”
In this regard, at least, patients are a lot like employees. They file complaints when they feel disrespected or put down in some way — and sometimes they file complaints because they’re just bad apples. Try to identify this last type as early as you can — are they rude to your staff? Do they relentlessly argue about their bill? — and discharge them before problems escalate. If you’re lucky enough to spot one of these bad apples before he becomes a patient, don’t agree to take him in the first place.
The playbook is otherwise the same as with employees: Treat all patients with respect — don’t keep them waiting a long time without explanation, for example — and train your staff to provide friendly customer service. Your front-desk corps should smile and greet patients by name, not just brusquely request an insurance card. Patients who have personal relationships with doctors and their staff are far less likely to complain, even if something legitimately goes wrong.
Finally, there are three other easy things you can do to reduce your complaint risk. First, be circumspect when collecting bills. Seeming aggression on the part of the provider can drive people to file board actions defensively in an attempt to avoid paying up. Second, refer to others patients who have clinical issues outside your comfort zone; failed procedures lead to upset patients. And because unrealistic expectations often cause the mistrust and anger that lead to complaints, don’t just get informed consent from patients — aim for truly informed patients in possession of a realistic outlook. Instead of rattling off your rote consent speech or presenting a consent form that might go unread, much less understood, engage in two-way conversation with all your patients to ensure that they fully understand.
“The office was COLD.”
Ultimately, nothing can guarantee that you won’t at some point be called before your disciplinary board, but following principles of good management and patient relations will improve your odds and make for a better workplace for you, your patients and staff.
Next issue: The do’s and don’ts you need to be aware of if, despite your best efforts, you receive a board complaint.
STEPHEN KAUFMAN, Esq., is chair of the Health Care Group at the Wright, Constable & Skeen law firm, serving doctors throughout the country. B. CASEY CRAFTON, DDS, Esq., is a practicing dentist and a lawyer. Submit queries to firstname.lastname@example.org.