Failure to communicate – nothing to complain about?

The recent Dental Complaints Resolution Service Annual Report outlines some common reasons for complaints to dental practices.

We are a profession well used to interacting with patients. After all, we spend considerable time in other people’s personal space in the course of our day-to-day work. The nature of dentistry is such that we communicate with our patients not only before and after treatment, but also during. We communicate a lot. Mostly this goes well. Sometimes it does not.
The most recent Annual Report from the Dental Complaints Resolution Service shows that a significant proportion of complaints arose from poor communication. This may seem surprising, given the central importance of good communication in providing treatment successfully. On the other hand, when you consider how much communicating the profession must do every day, it is perhaps to be expected that we will not always get it right.
There are clear strands in the communication failures, which the DCRS report picks up on. The difficulties appear to arise in relation to poor explanation of treatment costs and failing to address complaints. It is worth considering why these two areas might feature.

Treatment costs

Firstly, treatment costs may not always be predictable; they may change as treatment progresses. It may not always be possible to foresee the exact amount of the possible increase, but has the patient been warned that the cost may be more than initially indicated? For example, the root canal treatment cost may go up if a specialist referral is required half way through treatment. It is better to make sure that the patient is prepared for this possibility.
There is sometimes a lack of clarity about what the fee covers (e.g., does the quotation for that root canal or implant treatment include restoration with a crown? Does the orthodontic fee cover replacement retainers? If so, how many?)
Other factors that can potentially lead to communication breakdowns include simple oversights, such as not providing details of treatment costs in advance, or being vague about what these will be. Patients can also have a selective memory of the information given, or may have unrealistic expectations of what the cost should be.
The best way to prevent treatment cost complaints is to make sure that the patient understands the details of the treatment that they will get for their money and knows what they can expect to pay in advance. Written treatment plans with detailed explanations and costings can be well worth the effort.

Managing complaints

Nobody likes complaints. Receiving one can trigger a whole range of simultaneous, unhelpful emotions, which can create stress just at the point when you need a calm and objective view of the situation. This can clearly influence our communication skills.
Another factor can be unfamiliarity with what to do with a complaint. You may simply not be used to this and may unwittingly respond in a way that aggravates the situation. Sometimes it might seem easier to not engage and hope that it just goes away.
The best way to manage a complaint is to attend to it promptly and in accordance with a process with which you are familiar. Check your current practice complaints procedure and make sure it is up to date, particularly given the unique challenges dental professionals are facing due to the Covid-19 pandemic.
A prompt and process-driven response to a complaint helps to keep things objective and unemotional, as well as avoiding the hazards of delay, which can stem from a lack of confidence when figuring out the next steps. It’s always a good idea to remind yourself of the practice complaints procedure, even if you don’t need it at present. One day you will be glad you did, as an effective, early response to a complaint can stop a small spark becoming a big fire.

Dr Martin Foster
BDS MPH DipHSM
Martin is Dentolegal Consultant at Dental Protection