Busting indemnity myths

There are many misconceptions about how indemnity works. MDDUS dental adviser Claire Renton sets the record straight

WITH the spookiness of Halloween behind us, we are rapidly on our way to Christmas – my favourite time of year. Even those who don’t observe it as a religious holiday will usually enjoy time off work with family, lots of good food, presents and maybe a silly pantomime for good measure.

This got me thinking that much of what we enjoy about this time of year stems not from evidence-based scientific fact but from myths and legends. Well-behaved boys and girls will be rewarded with gifts from Santa; a kiss is promised for those who pass under the mistletoe; and so long as Cinderella doesn’t break her curfew then all will be well. And of course everyone knows calories don’t count at Christmas... Fantasy is often more appealing than fact but the same should not apply to medical and dental indemnity.

No penalty for advice calls

When it comes to professional indemnity, there seem to be a few fairy tales currently doing the rounds. The first is the ludicrous suggestion that if you call MDDUS for advice then this will lead to higher subscription costs. Some doctors and dentists believe that if you call your indemnity provider for any kind of assistance then you will be penalised and your subscriptions will rise based on the number of times you call.

Well, sorry to disappoint but at MDDUS this is simply not true. We positively encourage members to call early for advice as we believe this will help them practise more safely and will help to resolve any issues before they escalate. Let’s take a closer look at how indemnity organisations work. In the simplest of terms, doctors and dentists club together to form a mutual organisation where shared funds are used to compensate patients who have suffered harm as a result of clinical treatment from our members. The mutual fund is also used to advise and support clinicians who are subject to scrutiny from their regulator or patient complaints/claims. At MDDUS we have no shareholders to pay (unlike most insurance providers) and all subscriptions are invested back into the mutual fund to help our members.

So, if you were running this fund which would you rather do? Suggest that members in need of advice call early, and as many times as they like, to prevent problems from escalating, or penalise them for seeking help and leave them to make a potentially costly error? Yup, me too - it’s not rocket science. We’d be mad to increase a member’s fees because of the number of times they call us. And we don’t. We never have. We want members to call at the first hint of anything going wrong. MDDUS has a team of experienced medical and dental advisers on duty from 8am to 6pm during the week plus a 24/7 out-of-hours advice line for emergencies.

Discretion is good

Another common myth scaring dentists just now, and it seems to be particularly aimed at newly qualified colleagues, focuses on the fact that MDDUS indemnity is "discretionary". The story going round is that our ability to operate discretion means that if we get out of bed on the wrong side and we don’t want to, then we don’t have to provide you with support or assist you when things go wrong.

Hmmm, that’s not true either. The fact is that at MDDUS we appreciate that we’re all clinicians and we embrace the ability to carry out our professional duties in our own unique way. We don’t want to put unnecessary constraints on our members providing care. Yes, it would be great if patients were always fully informed of every available treatment option and that this was clearly documented in the records and that every root treatment was done under rubber dam – but we know that in reality that’s simply not going to happen every time. We can and do use our discretion to help our members in these types of situations. The enormous benefit of being able to use our discretion is that we are not restricted to lists of treatment we can cover you for and are not forced to comply with inflexible terms and conditions such as those found in insurance policies. In many cases we have offered levels of support to our members that would not have been possible with a conventional insurance policy.

We can provide assistance and cover for patient care and what can be defined as the practice of medicine or dentistry. It really is very simple. The decision is made by healthcare professionals here at MDDUS who recognise that what we do for our patients can’t be fully listed in the small print of an insurance policy. We don’t ask you to complete an application form confirming how you treat your patients. We don’t look for ways to avoid paying out a claim like an insurance company might. For example, if a patient inhales an endo file and you’ve said in your insurance application form that you always use rubber dam for root treatments, what do you think the shareholderpaying company is going to do? Pay out or look for ways not to?

Discretionary indemnity really just means that we have the ability to be flexible. We can and do provide cover when the case doesn’t quite fit the norm. We don’t have to explain ourselves to an external insurance firm. Dental cases are handled by dentists – real, currently registered, proper dentists, who know what it’s like to be a dentist and who use their discretion to help and support you.

Unlimited indemnity

There is one final amazing fact that I want to share with you – one which may sound like something out of a fairy tale. If you find yourself called before the General Dental Council, and increasing numbers of good dentists do, we at MDDUS do not put a cap on the fees spent to defend your position. It’s hard to believe, I know, but what needs to be spent on your defence team gets spent. An MDDUS basic team for a GDC case consists of a dento-legal adviser (yes, one of those real dentists), an experienced clinical negligence solicitor (yes, a real registered practising solicitor) and a specialist barrister/advocate (yes, a real one). Once you add on others, including an expert witness, it can become very expensive indeed.

However, our job is to protect and defend your position at whatever cost is necessary. Believe me, if you are ever in that situation you would not want to be footing the bill yourself or have expenses capped. Finally, members should be aware that there are no limits on the amount that MDDUS can pay to patients who have been awarded compensation, unlike an insurance company.

So what’s the moral in all of this? (There’s always a moral). Certainly don’t believe the scaremongers and don’t be worried into making bad decisions. Please pick up the phone as often as you like and be confident in the flexibility of discretionary indemnity. Oh, one last thing, as this is all about truth and myths, I feel obliged to tell you that Christmas calories do count. Damn.

Claire Renton is a dental adviser at MDDUS