COMPLAINT HEALTHY EATING


BACKGROUND Eve W is eight years old and attends the dental surgery accompanied by her mother. She complains of a sore tooth and the dentist – Dr N – identifies two carious teeth and a loose filling in another deeply cavitated tooth. Checking the patient records he notes several other visits for the treatment of carious teeth in the past. Dr N temporises the teeth


with restorative material and asks reception to arrange a later appointment. He then asks Mrs W about Eve’s daily diet in order to identify factors that might be causing the tooth decay. He tries to explain the importance of reducing the amount and frequency of sugary foods and that these should only be offered at mealtimes. He also tells her that fruit juice and/or smoothies should be limited to one portion in total per day and again only at mealtimes. Mrs W becomes tearful and the dentist is


unclear whether she has taken in all that has been said. An appointment is made for the next week. Two days later the practice receives an


angry letter from Mr W. He accuses Dr N of bullying his wife and suggesting that they are bad parents. He states that Eve eats lots of fruit as the advice from school is to provide your child at least five portions of fruit and vegetables a day.


ANALYSIS/ OUTCOME The dentist contacts MDDUS for guidance in replying to the complaint. He drafts a response letter offering an apology for the distress caused by the


consultation and the misunderstanding as regards his intentions


in discussing Eve’s diet. The letter states that he in no way intended to cause offence or insinuate anything regarding parenting skills and was offering only general advice in


regard to diet as would be expected of any registered dental professional. Dr N offers his full endorsement of the


“five-a-day” campaign and states he only wished to suggest that juice should be incorporated with meals to reduce the frequency of consumption as fruits have natural sugars. He suggests that perhaps his language was unclear and apologises again if he seemed “blunt”. A face-to-face meeting is offered to


discuss the matter further but Mr W does not respond and the family remains registered with the practice.


KEY POINTS ●Be conscious of language used in consultations – be clear, comprehensible, neutral and non- judgemental. ●Be aware that in responding to complaints a sincere expression of regret can often diffuse conflict.


ADVICE PATIENT ABROAD


BACKGROUND A practice manager contacts the MDDUS advisory line with a query in regard to their video consultation service. A patient has telephoned seeking advice about a rash on her leg which she wants to show a GP using her smartphone. It transpires that the patient is on holiday in Spain. The practice manager has phoned to ask


whether it is appropriate for a GP from the surgery to advise the patient on her condition.


ANALYSIS/OUTCOME The MDDUS adviser urges caution in handling this request for a number of reasons. Doctors are professionally obliged to make an appropriate assessment of patient symptoms, and with video consultations this is very much dependent on the quality of the system being used. A poor quality video connection could mean


that images lack detail, and in any case it is essential to have the option to arrange a face-to-face consultation where appropriate. This is obviously not possible if the patient is abroad. A second issue is one of legal jurisdiction. MDDUS generally recommends that doctors do not consult with patients abroad as this may be deemed to be outside the UK jurisdiction. This means that a patient may bring a claim in the local jurisdiction which MDDUS cannot likely indemnify. The GP may also be practising in contravention of local law in not being registered with the relevant regulatory body. Conceivably the GP could even be liable to criminal charges in that jurisdiction. The practice is advised to urge the


patient to seek treatment from a local doctor or hospital and attend the surgery on her return with any remaining concerns.


KEY POINTS ●Online/video consultation services should always allow the option of requesting the patient attend for a face-to-face examination. ●Video consultations abroad may be subject to legal/professional liability within that jurisdiction. ● Legal indemnity will likely not apply when treating a patient abroad.


MDDUS INSIGHT / 17


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24