Dr Joe Ingham, dentolegal consultant at Dental Protection, looks at the role of probity in a healthy dentist-patient relationship

The professional relationship that exists between a patient and a dentist is built on mutual trust and understanding. The fundamental partnership is further based on honesty, confidentiality, mutual respect, responsibility and accountability.

Dentists must be honest and open in any conversations they have with their patients and guardians of children. They must also be honest when completing and signing forms, applications, reports, claims for payment and any other documents. This means that dentists should take reasonable steps to make sure that they verify the information in any documents they present, sign or submit electronically. They must not deliberately leave out anything relevant or include false or misleading information.

Survival tips

• Probity means being honest and trustworthy and acting with integrity.
• Be honest about your experiences, qualifications and position.
• Be honest in all your written and spoken statements not only within your day to day professional obligations but also in your life outside work.
• You must be open and honest with any financial arrangements with patients, commissioners of services, insurers, suppliers and other organisations or individuals.
• Never sign a form or submit a form electronically unless you have read it and you are absolutely sure that what you are committing to is true.
• If you are uncertain, double check with a senior colleague.
• Assume that all patient records will be seen by the patient and others.

Scenario

Dr S qualified three years previously and worked in a busy dental practice with other more experienced dentists. The last patient on Friday afternoon presented with very poor periodontal health and several chronically infected areas of pocketing and bone loss. After a conversation with the patient about this, Dr S offered to make an urgent referral for the patient to a periodontal specialist. The patient agreed to this and left the practice having made a review appointment with Dr S for four weeks hence. Unfortunately, Dr S forgot to write and process the referral before he left the practice that evening.

After a month, the patient attended again and told both Dr S and the dental nurse in the surgery that he was concerned because he had not yet received an appointment from the specialist. Dr S realised straight away what had happened. He reassured the patient and said he had sent the referral immediately after the last appointment and he would follow it up. He added a note in the records to the effect that the referral must have got lost.

The dental nurse was uneasy because it appeared that Dr S had just misled the patient about the referral. She mentioned it to the practice principal, Dr P. Dr P confronted Dr S who admitted his error and asked Dr P not to say anything. The patient had suffered no significant harm from the delay in referral and Dr P called Dental Protection to ask for advice. A dentolegal consultant suggested that Dr P discussed the breach of professional behaviour further with Dr S with a warning that, if he became aware of any further similar issues, he would have no choice but to raise his concern with the regulator.