Q One of our longest-attending patients, Miss C, has come into the practice with four bottles of champagne as gifts for the practice dentists. Each bottle is worth around £35. The patient said she simply wanted to show her appreciation after such a tough couple of years. Can we accept these gifts?
The General Dental Council (GDC) states in its Standards guidance that dentists “must refuse any gifts, payment or hospitality if accepting them could affect, or could appear to affect, your professional judgment”. The regulator also provides supplementary guidance in regard to potential conflicts of interest. This states that dentists must “ensure their professional judgement is not compromised by personal, financial or commercial interests, incentives, targets or similar measures". It adds that dentists are expected to: “Refuse all but the most trivial gifts, favours or hospitality if accepting them could be interpreted as an attempt to gain preferential treatment or would contravene your professional code of practice". Dentists should therefore proceed cautiously when considering accepting a gift. The practice should be satisfied that all actions taken are in accordance with such guidance and must be prepared to explain and justify any decisions made and actions taken. Consider keeping a voluntary register of gifts (e.g. name/details of donor alongside the type/value of gift), as this could be a useful reference should any concerns be raised down the line.
Q A patient, Mr G, has been coming in for regular treatment over the past few months, mostly with our dentist, Ms L. On his last visit he told the dentist he had developed romantic feelings for her and asked her personal questions. Ms L felt very uncomfortable and advised him she was not interested and that his behaviour was inappropriate. The practice is concerned about this behaviour – what should we do?
This is a difficult situation, however the practice has a duty to protect its staff and some action should be taken. One option would be to invite Mr G in for a meeting with the practice manager and practice principal to discuss the incident. During this meeting, it should be made clear to Mr G in a very gentle way that this type of behaviour is unacceptable and that he has put Ms L in a very difficult position. The patient should be advised that he is not to see Ms L and warned that if any behaviour of this type is repeated, you would have no option but to no longer see him at the practice. Make it clear to Mr G that you are prepared to continue treating him, but if he feels uncomfortable then he has the right to find another practice.
Private clinic ads
Q We have rented a room in the practice to a private provider of aesthetic treatments. They have asked if we could put up some posters in the waiting room and public areas highlighting their service. Is this allowed?
Putting up posters to advertise this service is not a conflict of interest per se, but you should approach this with caution. If it appears that the practice is in some way recommending the clinic’s treatments, and if the practice benefits financially from patients attending, then this could create difficulties. You should refer to the GDC's Guidance on advertising, which states that dentists must make sure that any advertising, promotional material or other information that you produce is accurate and not misleading. It also states that dentists “must not exploit the trust, vulnerability or relative lack of knowledge of your patients". It makes it clear that: “You should only recommend particular products if they are the best way to meet a patient’s needs. If you endorse products, you must ensure that you only provide factual information about the product which can be verified by evidence.”
Employee and patient?
Q We’re interviewing for a new receptionist and one of the candidates is also a patient. Should we discount her from the process for that reason, or does she have the right to be both a patient and a member of the practice staff?
If an employee is also a patient at the practice where they are employed, it can cause a myriad of problems. However, it would not be fair to simply reject her application for this reason. We would advise you to inform all prospective employees at the interview stage that the successful candidate would be required to register as a patient at another practice. The only exemption to this would be if your practice was in a remote setting and there were no viable alternatives available. As part of the conditions of employment, this information should be included as a policy in your employee handbook. There are potential conflicts of interest that can arise if an employee is a patient at the practice. The dentist-patient relationship should be kept separate and it is in the best interests of all patients to have access to independent and objective care.
Q Once government restrictions ease, the practice is looking to arrange a small party to thank staff for their hard work. I’ve never arranged anything like this before – are there any pitfalls I should look out for?
Before arranging any kind of social gathering, be sure to check this is compliant with the latest government Covid-19 advice in your part of the UK. Once it is safe to proceed, consider advising staff in advance about inappropriate behaviour. Remind them that, even though they are at a party, it is still work and every employee has the right to be in an environment free from bullying and harassment. It would be useful to highlight the practice’s bullying and harassment policy and the disciplinary sanctions that could be invoked if rules are breached. Some examples of inappropriate behaviour include excessive alcohol consumption, fighting, making discriminatory or inappropriate sexual comments and taking illegal substances. If you plan to provide alcohol, then it may be wise to limit the amount on offer, ensure there are plenty of alcohol-free drinks and be respectful of those who do not drink alcohol for religious or other reasons. Consider also transport home at the end of the night – it may be useful to note down some taxi numbers and basic information on public transport links.
Consent form template
Q Our practice is looking to create some information leaflets on consent for common procedures like root canal treatment, extractions and crowns. Do you have any examples of such forms that we can use as a reference?
Any consent form provided should be written specifically to suit each patient’s circumstances, rather than being generic. While consent forms can serve a purpose, bear in mind that the most important parts of the consent process are the discussions with your patient and the documentation of those exchanges within the records. The discussions should include the risks, benefits and alternatives to treatment. For these reasons, MDDUS does not provide generic consent form templates. Some useful points of reference for you would be the GDC's Standards guidance principle 3, “Obtain valid consent”. You will also find risk training resources in the MDDUS resource library on this topic (member login may be required).