Principle One

Put patient's interests first

 

Principle Two

Communicate effectively with patients

 

Principle Three

Obtain valid consent

 

Principle Four

Maintain and protect patients' information

 

Principle Five

Have a clear and effective complaints procedure

 

Principle Six

Work with colleagues in a way that is in patients' best interests

 

Principle Seven

Maintain, develop and work within your professional knowledge and skills

 

Principle Eight

Raise concerns if patients are at risk

 

Principle Nine

Make sure your personal behaviour maintains patients' confidence in you and the dental profession

 

Learning Material Case Study

Communicating effectively Communicating effectively

Miss Khan has not been to see a dentist for three years. She has had toothache for the past three days and books an appointment to see a local dentist, Ms Davies.

At the appointment Ms Davies gives Miss Khan a short examination and tells Miss Khan that she needs ‘RCT’ and a crown. Ms Davies talks about some of the processes involved, but does so in a technical way that Miss Khan finds difficult to understand. Ms Davies asks if Miss Khan understands but she does so in a brusque way while she is writing the notes. Miss Khan can see that Ms Davies is busy and doesn’t feel she can prolong the appointment by asking questions. She also doesn’t want to appear stupid so she says that she does understand and Ms Davies tells her she’ll need to book two hour-long appointments at reception. Miss Khan books the appointments, pays for the examination and then leaves.

The next day she decides to get a second opinion. The second dentist explains that there would be options for treatment but also recommends root canal treatment. However, this dentist spends time explaining why she needs the procedure and what it will involve. Miss Khan feels far more relaxed with this dentist and decides to book the appointments for the treatment. As soon as she leaves that practice, she rings the first practice to cancel her appointments. Miss Khan feels that the Ms Davies did not explain the process properly to her and decides to complain to the GDC as she does not feel comfortable complaining to the practice.

The fitness to practise caseworker considers that Ms Davies may have breached a number of the standards and guidance in Standards for the Dental Team including (but not limited to):

  • 2.2.1 You must listen to patients and communicate effectively with them at a level they can understand. Before treatment starts you must:
    • Explain the options (including those of delaying treatment or doing nothing) with the risks and benefits of each; and
    • Give full information on the treatment you propose and the possible costs.
  • 2.2.2 You should encourage patients to ask questions about their options or any aspect of their treatment.
  • 2.3.3 You should recognise patients’ communication difficulties and try to meet the patients’ particular communication needs by, for example:
    • Not using professional jargon and acronyms;
    • Using an interpreter for patients whose first language is not English;
    • Suggesting that patients bring someone with them who can use sign language; and
    • Providing an induction loop to help patients who wear hearing aids.
  • 2.3.4 You should satisfy yourself that patients have understood the information you have given them, for example by asking questions and summarising the main points of your discussion.

The case was referred to the Investigating Committee. The committee was concerned by Ms Davies’ failure to communicate effectively with Miss Khan and decided to issue her with a letter of advice reminding her of the importance of taking the time to communicate with patients and explain treatment options to them in language they can understand.

​​This complaint could have been easily avoided if Ms Davies had taken the time to explain the treatment options to Miss Khan in plain English. Ms Davies should also have explained the various treatment options open to Miss Khan together with the risks and benefits of each option. She should have encouraged Miss Khan to ask questions, and tried to make sure that she understood what had been explained to her.

Checking understanding can be difficult and it may sometimes be best to give patients a chance to go home and think over their options before having to commit to treatment.