Abusive patient

BACKGROUND: Mr W appears at the dental surgery with a lost screw-retained post crown in UL5 that had been previously re-cemented. Dr T advises the patient that it will probably not last and a new post should be fitted prior to providing a new crown. An appointment is arranged but on later reviewing the X-ray the dentist has concern over the condition of the existing root filling and decides to schedule a shorter consultation to discuss treatment options.

Mr W attends the appointment and is annoyed that the treatment plan has changed. Dr T tries to explain his view on the necessity to carry out root treatment before refitting the post – but the discussion grows fraught. Mr W begins to shout, using aggressive and abusive language. Dr T manages to calm the situation and agrees to re-cement the old crown that afternoon. An appointment is made for the root treatment but the practice and Dr T are left traumatised by the experience.

Dr T sends the patient a treatment plan and receives an angry letter of complaint, disputing the “extra” costs of the treatment made necessary by the dentist’s “indefensible clinical failure”. The dentist contacts an MDDUS dental adviser for advice on a draft letter of response.

ANALYSIS/OUTCOME: The dental adviser reviews the letter and makes a few suggestions, including the need to set out a clinical justification for reviewing treatment options rather than just re-cementing the old crown. The dentist is also advised to set out in the letter the practice policy toward aggressive and abusive behaviour and state how Mr W’s actions and language will not be tolerated in future.

Nothing more is heard on the matter and Mr W changes dental practice.

KEY POINTS

• Ensure you have a practice policy on dealing with abusive patients.
• Inform patients in advance of proposed changes to treatment plans.