Informed Patient Selection and Dismissal

Lifeline Liability

You likely have invested considerable time and money in a marketing plan that attracts new patients to your office along with the energy and resources to ensure those patients are retained. Building a thriving practice and growing your patient base is even more rewarding when new patients are referred to you from satisfied existing patients or other trusted health care providers and peers.

As much as you want to welcome new patients, remember that barring the use of any discrimination, dentists are not obligated to accept all patients into their practice. Those within your patient base should be able to contribute to productive, healthy provider-patient relationships. In some cases, difficult personalities, unwillingness to follow treatment plans, rudeness toward staff and failure to keep appointments or pay for services can make a patient-provider relationship untenable. Approach both patient selection and dismissals with caution.

Case Study on Patient Dismissal

In one case reported to TDIC’s Risk Management Advice Line, a dentist called for advice on dismissing a patient. They described the patient as antagonistic, someone who had behaved rudely to everyone in the office and cried at every visit to their office.

The patient had a few provisional crowns in her mouth and had been undergoing specialty procedures by an endodontist and periodontist. However, it had been reported to the general dentist that the patient had not been keeping her appointments at the specialists’ offices. The patient had expressed her life-long fear of dentistry to the general dentist during her initial visit. The dentist told the Risk Management analyst that they did not wish to continue working with the patient due to her unwillingness to follow treatment plans and her difficult behaviors.

As much as you want to welcome new patients, remember that barring the use of any discrimination, dentists are not obligated to accept all patients into their practice.

In this case, TDIC’s Risk Management analyst reminded the dentist of her role as the general dentist and team leader overseeing this patient’s overall dental care. Due to the potential liability risks of patient abandonment, the dentist was cautioned against dismissing the patient while mid-treatment.

Understanding that the patient had communicated a previous history of dental anxiety, the analyst suggested