Dentistry

Jul 28, 2022
Defensible Medical and Dental Records
Richard F. Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Patient records, which serve a critical function in healthcare delivery and routine clinical operations, can provide key evidence in the event of a professional liability action.

Jun 22, 2022
Patient Safety in Dentistry: Communication
Sue Boisvert, BSN, MHSA, DFASHRM, Senior Patient Safety Risk Manager, The Doctors Company
Effective communication improves teamwork and creates a safer environment for patients. It can also enhance patient engagement and satisfaction and reduce the risk of professional liability claims, even if an adverse event occurs.

Jun 22, 2022
Patient Safety in Dentistry Series
The articles in this three-part series provide strategies to help dental professionals enhance communication and documentation skills and manage adverse events in a practice setting.

Jun 22, 2022
Patient Safety in Dentistry: Documentation
Sue Boisvert, BSN, MHSA, DFASHRM, Senior Patient Safety Risk Manager, The Doctors Company
The primary purpose of documentation is to create an orderly chronological record of the clinical decision-making process, treatment provided, and patient responses. Records that are incomplete or inaccurate may lead to inappropriate treatment and patient harm.

Jun 22, 2022
Patient Safety in Dentistry: Managing Adverse Events in the Practice Setting
Sue Boisvert, BSN, MHSA, DFASHRM, Senior Patient Safety Risk Manager, The Doctors Company, and Jon Pellett, Attorney, Pennington, PA
When an adverse event occurs in a dental practice, providers and staff must be prepared to respond appropriately. A well-managed response includes caring for the patient, investigating the event, taking necessary action, and reporting the event appropriately as required.

Professional Education
Understanding and Preventing Adverse Events (HRA)
This enduring activity will explore patient safety and quality through multiple lenses. The initial session addresses the value of understanding adverse events, the second session focuses on engaging the C-suite, and the third covers teaching these topics to students, residents, attending, and other healthcare professionals.
1.3 credits

Professional Education
HIPAA Fundamentals 2022–2023 Edition
This on-demand program provides an orientation to the basic requirements of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA gives patients many rights with respect to their health information. This program provides details on the HIPAA Privacy, Security, and Breach Notification Rules, such as the type of information that is protected, who must comply with the rules, and how patient information can be used and disclosed. This on-demand program includes many resources useful to staff training.
1.5 credits

Mar 03, 2022
Challenges of Cultural Diversity in Healthcare: Protect Your Patients and Yourself
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education, The Doctors Company
A clinician’s cultural competence is critically important in helping to eliminate health disparities and social disadvantages for all patients, regardless of their ethnicity or race.

Professional Education
Burnout: Spotlight on System Changes
There is a national movement to address the systemic causes of clinician burnout. Read the article "Clinician Burnout: From a Crisis to a Movement" to learn ways that clinicians can create system change in their own work environments.
0.5 credit

Jan 10, 2022
Management of Treatment Complications in Dentistry
When treatment complications occur, it is often how the situation is handled that determines the outcome for both the patient and the healthcare provider. These strategies can help dental professionals enhance safety and mitigate risk.

Jan 05, 2022
Referral and Negligent Referral in a Dental Practice
We outline actionable strategies to help dental professionals keep patients safe and avoid potential liability when referring patients to specialty providers.

Professional Education
Safe Opioid Prescribing for Physicians and Dentists
Opioids play an important role in pain management—both in the acute and the chronic setting, but a variety of causes have contributed to an opioid-related epidemic leading to addiction and death. There has also been substantial misuse of opioids by prescription and by diversion.
2.5 credits

Dec 02, 2021
Dental Case Studies
The case studies presented here provide insights into closed claim scenarios that can help dental professionals enhance their practices as they mitigate risks.

Nov 19, 2021
Medical Emergencies in the Dental Setting
We present a compelling case example and outline risk management strategies that can help practices prepare for medical emergencies.

Nov 19, 2021
Unethical Treatment Leads to Lawsuit and Dental Board Action
Our analysis and risk management discussion of a case involving allegations of unethical treatment includes strategies to help dental professionals avoid becoming the focus of an investigation or claim.

Nov 19, 2021
Responding to Requests for Dental Records and the Consequences of Refusing
This risk management discussion can help dental professionals avoid complaints, investigations, and sanctions when they respond to dental record requests.

Nov 19, 2021
Process Failures Lead to Patient Harm in Dentistry
We outline important strategies for documenting the clinical justification for any alternative treatment plan, obtaining informed consent, and providing follow-up care.

Nov 19, 2021
Poor Response to Patient Concerns Contributes to Dental Claim
We offer actionable strategies that can help dental professionals enhance communication and documentation skills.

Nov 19, 2021
Oversedation and Failure to Resuscitate in Dentistry
This case discussion covers risk management issues involving sedation and provides strategies to help practices keep patients safe.

Nov 19, 2021
Inappropriate Dental Care and Delegation During Use of Conscious Sedation Lead to Patient Death
Our discussion of a tragic case includes strategies to help dental professionals avoid patient injury when performing a treatment or procedure involving sedation or anesthesia.

Nov 19, 2021
Failure to Diagnose and Refer Results in Court and Dental Board Action
This case explores the issues surrounding a misdiagnosis claim and outlines steps to help dental professionals avoid these types of allegations.

Nov 19, 2021
Documentation and Scope of Practice Issues in Dentistry
We analyze a case resulting in patient injuries and provide strategies that address documentation and staff protocols.

Professional Education
Prevention of Dental Errors for Dental Practices
Few dental errors are attributed to faulty judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors: wrong-site surgery, improper performance of dental procedure, wrong or unnecessary treatment or procedure, retention of foreign body during treatment, and diagnosis related. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis (RCA) to reduce system failures, respond to sentinel events, prevent dental errors, and improve patient safety. The purpose of this continuing dental education activity is to provide dentists with the most current information regarding the prevention of common performance and diagnostic errors. The course covers: • Identification of the most common quality-of-care violations. • Illustrative case studies detailing prevalent diagnostic and performance errors. • The necessary elements of an RCA. • Safety systems in healthcare organizations. • Risk management measures designed to prevent dental errors and increase patient safety.
2.0 credits

Professional Education
Prevention of Dental Errors for Florida Dental Practices
The purpose of this continuing dental education activity is to provide dentists with the most current information regarding the prevention of common performance and diagnostic errors. The course covers: • Identification of the most common quality-of-care violations. • Illustrative case studies detailing prevalent diagnostic and performance errors. • The necessary elements of an RCA. • Safety systems in healthcare organizations. • Risk management measures designed to prevent dental errors and increase patient safety. This course is specific to Florida statutes and reflects regulations effective in February 2018 for dentists licensed by the Florida Board of Dentistry.
2.0 credits

Sep 08, 2021
Terminating Patient Relationships
Julie Brightwell, JD, RN, Director, Healthcare Systems Patient Safety, and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
If it becomes necessary to end a patient relationship that is no longer therapeutic or appropriate based on patient behaviors, it is critical to end the relationship in a manner that will not lead to claims of discrimination or abandonment.

Sep 07, 2021
Interstate Licensure for Telehealth Can Fuel Practice Growth
Chad Anguilm, Vice President, In-Practice Technology, Medical Advantage, David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group, and Remi Stone, JD, Regional Director, Government Relations, The Doctors Company
Licensing restrictions have been eased to facilitate care during the COVID-19 pandemic, and the new normal of greater state-to-state cooperation for access to care may persist after the pandemic. Understanding the many restrictions that still apply, however, can help you reduce risk.

Professional Education
Patient Relations: Spotlight on Challenging Situations
The Doctors Company’s dedicated patient safety risk managers deliver a wide range of expert services and resources to our members—including personal telephone consultations to help guide members through challenging situations. A recent review of our call data shows that “patient relations” and “patient termination” consistently appear as the top reasons that members request assistance. The following strategies can help prevent challenging patient situations and provide guidance if one occurs.
0.5 credit

Aug 30, 2021
Telehealth: Frequently Asked Questions
Sue Boisvert, BSN, MHSA, Patient Safety Risk Manager II, The Doctors Company
As the evolution of telehealth continues, we address questions asked by medical and dental practices.

Aug 05, 2021
Top Seven Tips for Telehealth
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group
Now that practitioners and patients are more comfortable with and able to resume in-person visits, virtual visits have declined—although not to the same level as prior to the pandemic. Many believe there will continue to be a desire on the part of patients and practitioners to use telemedicine for healthcare delivery going forward.

Jul 21, 2021
Medical and Dental Record Retention
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Having access to well-maintained patient records helps medical and dental professionals ensure continuity of care. It can also protect them against any future professional liability claims, licensing board complaints, and peer review inquiries.

Jul 16, 2021
Medical and Dental Record Issues: Frequently Asked Questions
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
We answer questions frequently asked by members about medical and dental records, such as length of retention, how to destroy hard copy paper records, and creating backups of electronic health records.

Jul 09, 2021
Requests to Amend a Medical or Dental Record
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Patients have the right to request amendments to their medical or dental records, but providers have the right to determine if the changes will be made. Following the guidelines presented here can help ensure clear communication and documentation.

Jun 29, 2021
Pediatrics: Consider Car Window Hammers for Your Office Emergency Response Kit
Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
Seconds count if an infant, toddler, or young child is accidentally locked inside a hot vehicle. A car window hammer can be a lifesaving tool to include in an emergency response cart or kit.

Professional Education
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
1.3 credits

Jun 14, 2021
Should You Offer Your Services as a Paid Medical or Dental Expert?
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Consider these key questions before deciding to accept the role of paid expert witness. Functioning as an expert witness is not a role to be entered into lightly.

Professional Education
Telehealth: Review Your Service Components
Many practices implemented telehealth overnight in response to pandemic restrictions on elective care. Practices already using telehealth saw huge increases in volume. This program presents a roadmap for practices to evaluate their telehealth implementation using the best practice tips identified herein and their own lessons learned.
0.8 credit

May 25, 2021
Reduce the Risk of Wrong-Tooth Dental Procedures
Sue Boisvert, BSN, MHSA, Patient Safety Risk Manager II, The Doctors Company
Wrong-site procedures are a common problem in dentistry. A wrong tooth extraction can be prevented with the use of proper protocols, including confirmed communication with referring dentists and documentation of verbal discussions with patients.

Apr 02, 2021
Pre-Procedural Screening and Testing During COVID-19
Throughout the pandemic, surgeons have faced many challenges in adapting to new situations. Now that facilities have resumed elective surgeries, surgeons are facing additional challenges in evaluating and scheduling patients who have recovered from COVID-19. The strategies highlighted here can help ensure a consistent approach in keeping both patients and providers safe.

Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.

Mar 24, 2021
Patient Selection for Elective Cosmetic Procedures
James E. Vogel, MD, FACS, Associate Professor of Plastic Surgery, The Johns Hopkins Hospital and School of Medicine, and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education, The Doctors Company
The patient selection process is a valuable tool that can help you reduce risks when you assess prospective patients for elective cosmetic procedures.

Feb 26, 2021
Resources for Elective Procedures During COVID-19
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Julie Ritzman, MBA, CPHRM, Vice President, Department of Patient Safety and Risk Management
Your patients most likely want to know about the safety of surgery during the pandemic and what occurs if they contract COVID-19 post-procedure. You may have questions about keeping your staff and patients safe, informing patients about new risks the pandemic has created, and potential liability risks you may be facing.

Feb 23, 2021
Safe Handling of Medical Gas Cylinders
Ernest E. Allen, ARM, CHFM, Senior Patient Safety Risk Manager, The Doctors Company
When incorrectly used, handled, or stored, medical gas cylinders can create dangerous physical and chemical hazards for patients and staff. This review of safety standards can help healthcare facilities and physician and dental offices stay in compliance.

Professional Education
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
1.5 credits

Professional Education
HIPAA for Managers: The High-Level View
The program explores and defines HIPAA policies and procedures, business associate agreements, security assessment and analysis, training requirements, HIPAA compliance requirements, breach events, and informed consent.
1.0 credit

Professional Education
It's the Little Things: An Introduction to Enhancing Patient Relations and Reducing Risks
It's the Little Things is designed to assist medical practices with improvements in patient interactions by looking at how incorporating hospitality as a focus makes a difference. It has been developed to improve multiple facets of patient interaction.
1.3 credits

Professional Education
Safe and Effective Opioid Prescribing – Florida Edition
The Doctors Company recognizes the opioid epidemic in this country. This course provides insights into the risks of opioid usage, as shown by malpractice claims, and how to reduce those risks both for your patient and for your practice. Approved by the Florida Board of Medicine—Controlled Substance Prescribing.
2.0 credits

Professional Education
Prevention of Medical Errors: CME Risk Management Course for Florida Practices
This activity is specific to Florida statutes and reflects regulations effective February 2020. Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors that reflect on the most common issues identified by Florida—wrong site surgery, surgery complications, cancer, Ob/Gyn related conditions, gastroenterology conditions, cardiology issues, neurological issues, and adverse drug events—that will serve as the focal point of this patient safety and risk management course.
2.0 credits

Sep 22, 2020
Should Dentists in One Office Have One Malpractice Insurer?
Laura Archer, Vice President of Underwriting for The Doctors Company
One often-overlooked strategy for a group practice is having all dental professionals covered by the same malpractice insurer: With a group policy, a practice can keep up with changes, avoid damaging conflicts, maximize chances for desirable outcomes when claims arise—and even potentially realize a positive impact on premium.

Professional Education
Telemedicine to Telehealth: Trends and Emerging Risks
This course explores challenges and risks such as privacy and security, licensure, and technology concerns that might instigate a malpractice claim. The risks overlay the inherent challenge of replicating the interaction of a traditional, in-person encounter between a provider and a patient, without compromising the standard of care. It also provides resources for clinicians and practice managers to consider when making decisions about deploying telehealth services or to improve existing services.
1.3 credits

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Leaders
This activity is designed for healthcare professionals in leadership positions. It covers the principles of informed consent, crafting and disseminating an informed consent policy, and building systems to improve the informed consent process.
2.0 credits

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
2.3 credits

Jun 18, 2020
Moderate or Conscious Sedation in the Office Setting
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.

Jun 03, 2020
Job Shadowing: Observers and Volunteers in Medical and Dental Practices
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, Department of Patient Safety and Risk Management
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.

May 28, 2020
Reopening Your Dental Practice During COVID-19
Mariel Kagan, JD, MSN, Patient Safety Risk Manager
Dental offices across the nation are beginning to reopen as part of the federal government’s approach to reopening the economy. Because The Doctors Company is committed to supporting your practice and sharing important information during this unprecedented time, we researched guidelines and recommendations to provide resources for dentists and dental professionals around the country.

Professional Education
Physician-Patient Relationship: When Does it Begin and When Does it End?
This enduring program will assist the participant in understanding the principles which form the establishment of a physician-patient relationship, as well as the concerns which may result in the need for the physician to consider terminating the physician-patient relationship. Additionally, the concepts of providing patient centered care will be presented for the learner’s consideration.
1.0 credit

May 23, 2020
Providing Dental Services in the Hospital Setting
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II, Department of Patient Safety and Risk Management
Because of the infrequency of providing dental care in the hospital setting, many dentists are unfamiliar with hospital and medical staff requirements that apply to the providers who examine and treat inpatients.

May 01, 2020
Informed Consent for COVID-19 Risks: Frequently Asked Questions
To support our members and the entire medical profession during this unprecedented time, the following are answers to some frequently asked questions regarding informed consent for COVID-19 risks.

Apr 22, 2020
Minor Consent: Challenges for Pediatric Dentistry
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Consultant, Department of Patient Safety and Risk Management
Identifying legal guardianship and the rights of parents can reduce risk prior to treating a minor.

Professional Education
Internal Medicine: When Personal Relationships Interfere with the Standard of Care
Physicians and dentists are often faced with the decision whether to treat friends and families without realizing the inherent risks in doing so. A review of one case will highlight some common circumstances and risks associated with the treatment of friends and family members.
0.8 credit

Professional Education
Safe and Effective Opioid Prescribing - Georgia Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management, as delineated in Georgia Rule 360-15-.01. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Professional Education
Prescribing Opioids Safely
Faced with an opioid-related epidemic that continues to bring addiction and deaths, it is important to define the role of opioids for both acute and chronic pain management. This activity spotlights the epidemic and presents the Centers for Disease Control and Prevention (CDC) guidelines, regulations, studies, and emerging solutions to address the epidemic and allow for effective and appropriate use of these drugs.
2.5 credits

Professional Education
Safe and Effective Opioid Prescribing - Michigan Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and requirements delineated in Michigan’s law. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Nov 05, 2019
When Treating Kids, Learn from the Emergency Department
Phyllis L. Hendry, MD, FAAP, FACEP
To prevent communication gaps when treating kids, all specialties can benefit from lessons learned in the Emergency Department, where conversations are rushed, stakes are high, teams are assembled ad hoc, and physicians seldom have relationships with the patient.

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

Aug 28, 2017
The Search for Mary Smith
David B. Troxel, MD, Medical Director, Board of Governors
A case study illustrating the importance of researching healthcare technologies thoroughly before implementing them.
From The Doctor’s Advocate

Mar 16, 2017
San Diego Death Diaries
Roneet Lev, MD
Dr. Roneet Lev provides insights into the prescription opioid abuse epidemic.
From The Doctor’s Advocate

Mar 16, 2017
Analysis of Medication-Related Claims from The Doctors Company
David B. Troxel, MD, Medical Director, Board of Governors
Dr. David Troxel reviews 1,770 closed by The Doctors Company in which patient harm involved medication factors.
From The Doctor’s Advocate

Feb 18, 2017
Up for Review: Five Keys to Managing Online Criticism
Kevin Pho, MD, Founder and Editor, KevinMD.com
No matter how professional and caring a doctor you may be, eventually you will face criticism on the web. Here are five keys to managing that criticism.

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