ADVICE


OUT OF SCOPE


BACKGROUND A dental hygienist – Ms B – is an associate member at MDDUS and contacts the dental advice line in regard to a prescription from a dentist to provide additional treatment out with her scope of practice. She has been asked to drill out composite covering implant screws in order to remove a superstructure of dentures and then carry out scaling of the restoration and the implants. She would then have to re-fit the appliance.


ANALYSIS/OUTCOME A dental adviser responds to Ms B advising her that this procedure (beyond the scaling) would not be considered within the scope of practice of a dental hygienist. He warns her that the potential pitfalls in such a treatment plan are not insignificant and could lead to a claim of negligence and likely GDC proceedings.


KEY POINTS ●Do not give into pressure to act beyond your competence. ● To do so could lead to a negligence claim and GDC involvement.


COMPLAINT HE SAID, SHE SAID


BACKGROUND A letter of complaint is sent to a hospital ward by a patient – Mr K – in regard to a recent in-patient stay for assessment of a suspected neurological condition. In the letter he claims that an ST in the department – Dr D – had in an out-patient appointment stated on several occasions that he would receive an MRI scan, EMG (electromyography) and blood tests, with an appointment two weeks later to discuss the results and a referral for genetic counselling. In the event the patient did not have the


MRI and was still waiting months later for a follow-up discussion of his results (which were negative) and for the genetic counselling. The hospital contacts Dr D to ask for a response to the complaint.


ANALYSIS/OUTCOME Dr D contacts MDDUS for advice in regard to her draft response. In the letter she states that, although considered, she did not offer an MRI and her notes from the various consultations confirm this. This was also supported by admission documents and a letter to the patient's GP. In regard to a follow-up appointment to


discuss results, Dr D was advised by the consultant neurologist that this was not necessary, and she regretted if this had not been clearly communicated to Mr K. Her notes also indicate that she informed the patient that genetic counselling would only be necessary if the test results were positive. MDDUS reviews the complaint response


which is forwarded to Mr K via the hospital. The patient replies to say he is satisfied


with the response but still feels there was a lack of communication – and the ST is encouraged to reflect on this.


KEY POINTS ●Ensure patients are provided with clear, accurate information about proposed investigations/treatments, presented in a way they can understand. ● Ask patients to confirm their understanding of what is being proposed to ensure they know what to expect. ●Record what has been discussed with patients regarding treatment plans.


MDDUS INSIGHT / 19


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