Using appropriate guidelines can prevent a malpractice claim.
The American Dental Association’s Code of Professional Conduct states:
“Once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient's oral health is not jeopardized in the process”.
The health and well-being of a patient is always a primary concern. However, when it’s necessary to end the relationship, dentists should follow acceptable protocols to withdraw from the dentist-patient relationship. If appropriate protocols are followed, the dentist decreases the probability that a patient’s charge of abandonment will be successful.
Under some circumstances, dissolving the dentist-patient relationship is appropriate. These include, but are not limited to:
In other circumstances, additional steps or a delay in withdrawing from the dentist-patient relationship may be necessary. These circumstances include, but are not limited to:
When appropriate circumstances exist to withdraw from the relationship, dissolution should be completed formally. The dentist should notify the patient of his/her decision to withdraw from the relationship in writing. The written notice should be mailed to the patient by regular and certified mail, return receipt requested. Maintain copies of the letter, the original certified mail receipt, and the original certified mail return receipt, regardless of whether the patient signs for the certified letter. Maintain all forms of written communication in the patient’s dental record.
The written notice should include these components:
Although there are situations in which it is acceptable to withdraw from the dentist-patient relationship, a dentist should exercise caution to recognize acceptable circumstances before any action is taken. The dentist should ensure that appropriate steps are followed to reinforce that a patient receives ongoing dental care. Also, if established protocol to withdraw from the dentist-patient relationship is followed, it could reduce the probability that a patient will pursue an abandonment claim.
Under all circumstances, it is recommended that dentists exercise caution and request assistance from a Patient Safety Risk Manager or the Department of Patient Safety and Risk Management to address specific dentist-patient relationship scenarios.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.