Thursday Troubleshooter: Handling dental patients who are under the influence

This dental team member dismissed a patient who was under the influence, but the dentist isn't supporting her decision.

May 9th, 2019
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Problems! Who doesn't have them? If you have a problem or concern in your dental office position, you might be too close to the situation to solve it yourself. Share your concerns with Team Troubleshooter. The experts will examine your issues and provide guidance. Send your questions tomegk@pennwell.com.

QUESTION: I had a patient come in who was under the influence. I felt that it was not right to treat the patient at the time, so I dismissed him and did not tell him why. I wanted the dentist to be the one to make the dismissal decision and come with me into the room to assess the situation. But when I told the dentist what was going on, he never entered the room or gave me a straight answer. Now the situation has become a big ordeal, and because I work for a corporate office it’s become an even bigger issue. Did I do something wrong? Does anyone know if there are any solid facts on how to handle this type of situation?

ANSWER FROM JAN KELLER,Jan Keller & Associates:
It is understandable you were concerned about treating a patient you believed was under the influence. I have several questions that would help give me a clearer picture of this situation. However, my experience and the opinions of other hygienists and team members is we trust that we have the support of our doctors if we’re faced with a similar situation.

Why did the doctor not give you a straight answer or come into the treatment room to assess the situation? You did not say where the conversation took place. The conversation should have taken place in a private area away from other patients to avoid any HIPAA violations.

You mentioned that corporate is involved in the situation. What are they upset about? Are they upset that the patient was dismissed without the permission of the doctor? You mentioned the environment you work in is corporate. Was the doctor uncomfortable making a decision? In many corporate settings, the office manager is the person to discuss this situation with. Did you address your concerns with the office manager before dismissing the patient? Are standards in place, and if so, did you follow them?

Regarding your concern for disciplinary actions, according to Rebecca Boartfield of Bent Ericksen & Associates: “From a human resources perspective, the employee could face any ramifications the doctor believes is appropriate. That can be any of the classic disciplinary methods, such as verbal counseling, written counseling, suspension from work without pay, or termination. If the employee handled this inappropriately, then she can be managed accordingly.”

The question is, were you aware of any expectations? Does the office have standards in place to deal with unruly patients?”

I recommend a team meeting to discuss this situation so that everyone understands the expectations. When everyone is on the same page, then proper protocol can be followed. A discussion regarding any liability issues for you, the doctor, and the practice should be discussed when dealing with patients with bad behavior, who are under the influence, or any other issues that may arise and put you in a similar situation. No team member should ever feel uncomfortable in the presence of patients, doctors, or other team members.

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Don't be shy! If YOU have a tough issue in your dental office that you would like addressed, send it tomegk@pennwell.com for the experts to answer. Remember, you'll be helping others who share the same issue. Responses will come from various dental consultants, as well as other experts in the areas of human resources, coding, front office management, and more. These folks will assist dental professionals with their various issues on DentistryIQ because they're very familiar with the tough challenges day-to-day practice can bring. All inquiries will be answered anonymously each Thursday here on DIQ.


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