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Many patients pay into schemes which cover the cost of dental care. The details of the schemes vary. Some cover only a certain type of treatment whereas others have a qualifying period during which no treatment can be claimed. Generally the patient pays the cost up front to the dentist at the time of the treatment and reclaims it by submitting receipts to the scheme Each scheme will commission its own probity checks to ensure the veracity of the claims being made. Of course the onus is on the patient to make an appropriate claim. Whilst most patients claim truthfully, there have been occasions when a patient has asked a dentist to provide an inappropriate receipt – perhaps in someone else’s name, or for a different treatment, or for treatment not provided, or for treatment provided at a different time.
As healthcare professionals we may be sympathetic to a patient who cannot afford their dental care. However, every dentist also has a professional duty to act ethically and responsibly. Whilst a patient can be quite persuasive in making such a request, the dentist needs to be quite clear to the patient that their request will not be entertained. It is not uncommon for probity checks to be performed with records being requested, sometimes along with verification from the patient. Patients may see things more simply and may not understand the implications for the dentist and the fact that they are wrong to make such a request.
Falsification of the details on the patient’s receipt for their treatment can put your registration at risk
Any dentist who provides an inappropriate receipt (eg. falsifying either treatment details, dates or names) is putting not only his or her professional reputation at risk, but also, potentially, his or her registration. The dentist may also be at risk of a criminal prosecution and such a prosecution could then lead to action from the Dental Council. Unfair though it may seem, the dentist can actually find himself or herself in much more trouble than the patient.
Scenario
A patient, who had not been to the dentist for a number of years, attends for a check-up. She had neglected her teeth and needed a large number of fillings. On reviewing her treatment plan and the associated fees she advised the dentist that she could not afford the proposed treatment - a not uncommon situation.
The dental nurse suggested that the patient might join a scheme then return for her fillings after that scheme’s three month qualifying period. The patient thought this was a good idea, but wanted to have her dental treatment completed within a short period of time before her holiday. She applied pressure to have her treatment completed during a two-week period in January, but wanted a receipt indicating that the treatment was carried out in April. She implied that friends had claimed for dental treatment in this way and it was “common practice”.
Although sympathetic to the patient’s dilemma, the dentist was unequivocal in his response. He explained that he had a professional duty to act ethically and provide a receipt which was factually correct. He could not support the patient’s intention to deceive the scheme. The dentist stood his ground in the face of the patient’s insistence that she would only be able to have her treatment at the practice if a post-dated receipt was provided.
Once she realised that the dentist would not act inappropriately, the patient left to seek dental care elsewhere. If she adopted a similar tactic at your practice - what would your response be?
Based on an article featured in Riskwise Ireland 26