For immediate release: Wednesday, 18 December 2013
Dentists are urged to beware of patients bearing gifts this Christmas says UK-wide dental defence organisation MDDUS.
MDDUS dental adviser Doug Hamilton warns there are ethical dilemmas for dentists to consider before a patient’s kind gesture should be accepted.
“Positive feedback from our patients, perhaps in the form of a compliment or expression of gratitude, is always welcome,” says Hamilton. “It makes us feel valued, reassures us that we are ‘getting it right’ and helps cement the mutually respectful patient-dentist relationship.
“As Christmas approaches, it may be that certain patients will wish to convey their gratitude in the form of a gift. Normally, this would comprise of nothing more than a box of biscuits or a bottle of wine. All things being equal, it seems unlikely that a gesture of this nature would ever be regarded as anything more than an act of kindness.”
However, MDDUS members have enquired as to whether accepting even the most mundane gift could breach the following guidance in the new GDC Standards: “You must refuse any gifts, payment or hospitality if accepting them could affect, or could appear to affect, your professional judgement.”
“This advice is notable for two principle reasons,” adds Hamilton. “Firstly, it fails to define any limit below which a gift would be so innocuous that its acceptance would never be in breach.
“Secondly, it provides for highly subjective analysis by a third party. You may be completely satisfied that a gift from your patient will have no influence over your clinical or personal decisions. Yet, others may think differently.
“Potentially, this is a little minefield, and it should be made clear to any gift-giver that their gesture will not impact the care you provide. The problem could most obviously be circumvented by a practice policy which states that gifts cannot be accepted.
“While this, at least, cannot leave any patient feeling upset because their particular gift has been declined, it does entail the refusal of, for example, a box of chocolates, which may itself cause offence.
“Therefore, refusal of very low value items would, in most cases, probably be excessively cautious and may create as many problems as it solves.
“At the other end of the scale, the acceptance of high value items or monetary gifts of any amount would be considered inappropriate by the GDC. It might even attract interest from HMRC.”
This leaves the vexed issue of those items which are neither lavish nor cheap. Certainly, the vast majority of these gifts will be a completely genuine and innocent expression of appreciation.
“Even so, they might inadvertently create a sense of obligation,” says Hamilton. “The recipient dentist might, in future, find it harder to refuse this patient’s request for an early appointment or, more seriously, certain treatments which would normally be contrary to best practice.
“Other gifts, possibly of a more personal nature, might be made with the expectation that the relationship will develop beyond the clinical setting.
“Therefore, if there are any concerns regarding a gift, it should be politely declined, perhaps referencing the GDC guidelines as the reason. It would be advisable to ensure that a separate record of this conversation is made and that it is discreetly witnessed.”
Any information or correspondence relating to gifts from patients or their relatives should be kept in some form of gift register, including a note of the reason for accepting.
“If members of MDDUS are in any doubt as to how best to proceed, they should not hesitate to consult with a dental adviser,” concludes Hamilton.
For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email firstname.lastname@example.org.
Note to editors
MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.