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ePaper created 2015-11-12, 17:51:56 | version 1.38.0
feature _ interview I if nothing is done. Only then should the patient be asked to sign a declaration of consent. Unfortunately, the reality is often quite differ- ent.Patientsareoftenaskedtosigndeclarationsof consent on their way into surgery or while already onthedentalchair.Eveniftheyhadquestionsthen, there would be no time to answer them properly. Although it should be of major concern for every dentist to thoroughly inform the patient of the risks, as well as alternative treatment methods, before he or she is asked to sign a consent form, I am constantly confronted with the opposite. _So, you are saying that consultation should be of similar importance to treatment? Absolutely. In my opinion, building mutual trust between doctor and patient is key for avoid- ing malpractice and consequential charges. If pa- tients feel that their condition is being properly treated, and that money is not the dentist’s first concern, this alone can prevent litigation in many cases. Of course, if a nerve is damaged, there needs to be a settlement of some kind, but if a bridge fails, for example, instead of filing charges the patient will return for further treatment if there is a solid, trust-based relationship. _Time, communication, trust—what else is important when it comes to preventing mal- practice? One more basic rule every dentist should follow is adhering to evidence-based dentistry. This means not performing a certain treatment just because in the dentist’s experience it is con- sidered to be right. External scientific evidence should be implemented. Also, every single finding should be taken into account in determining how to treat the individual patient: diagnosis, radi- ographs, periodontal analyses, age, health status, literature and so on. Neglecting these related aspects can very likely lead to misconduct. _Do you see basic problems in dentistry that need to change? Nowadays, we face the problem of “cheap” dentistry. Owing to the amount of competition with the large number of dentists in the market, there are many cases of overtreatment. Cheap dentistry needs to be fast, yet I have documented cases in which patients have returned for retreat- ment of a simple problem up to 70 times in two years. If you add up the time those patients invest only to have a poor outcome, it is striking. How- ever, it is not possible for there to be elite dental practices solely. For legal purposes, dental treat- ment does not need to be exquisite, but it has to be reasonable. _Maybe it is a problem of today that patients have increasing expectations regarding the service or technologies their dentist should be using. That is certainly part of the same problem. Ad- vertising that promises people a new Hollywood smilein2hoursformsthebasisofpatients’beliefs or expectations regarding treatment. Dentists should not be tempted to involve themselves in this kind of misguided pressure. Honest com- munication is key when aiming to avoid dis- appointing patients. _Measures to prevent malpractice should begin as early as possible, but where should prevention start? Personally, I think legal regulation should be extended, such as specific laws or by-laws con- cerning the amount of experience and training, for example, required in order to perform certain procedures. Basically, it is just what common sense calls for and everybody will agree with if theythinkaboutit:shouldonebeallowedtoplace an implant after attending a speakers’ corner talk or looking over a colleague’s shoulder? No, yet this is often what happens. A second measure could focus on undergrad- uate education. Dental schools should devote more time to prevention of lawsuits. This aspect is neglected in the curriculum, although it is an essential part of dentistry. General awareness of the subject needs to be raised and this alone would help prevent mistakes. As I said earlier, mistakes are not always avoidable, but they should at least not arise out of negligence, hubris or greed. Apart from that, there will always be cases of medical malpractice. Dentists are hu- mans too; only he who does nothing makes no mistakes at all. _Thank you very much for the interview._ I 11CAD/CAM 4_2015 “I am confronted with many instances of damaged nerves caused while placing an implant, during tooth extractions or through an injection.” CAD0415_06-11_Wolff 06.11.15 11:56 Seite 4 CAD0415_06-11_Wolff 06.11.1511:56 Seite 4