By Dan Selner, D.D.S., CDA Council on Peer Review, Ethics and Professional Conduct
Chair, From the Summer 2024 Journal of the Colorado Dental Association
Every one of us has had a situation where a relationship with a patient is either on its way sideways or has gone completely off the rails, despite our best efforts. When this happens, if the patient and/or the dentist digs their heels in, there is typically only one way that it’s going to go … BADLY! This is where peer mediation can try to help lower the blood pressure of the situation and open the lines of communication. CDA mediation is a member benefit that provides a forum to help resolve disagreements related to dental treatment between a patient and a CDA member dentist.
When I joined my current practice, my senior partners, Dr. John Bassett and Dr. Gerry Wallace, taught me a valuable lesson I have never forgotten: If you were the dentist who had treated the patient first would you appreciate a call from the dentist giving a second opinion asking for specific details about your treatment and sharing their comments with you? I feel the obvious answer is, “OF COURSE YOU!”
It is amazing what you can learn when you are inquisitive and ask questions. When you make that phone call to the dentist you are giving them a heads-up about a problem they may have no idea exists. It may also give you valuable information that could prevent you from getting involved in a problematic case. If that phone call does not help to resolve the issue that is brewing between the patient and the original dentist, you can always encourage the patient to contact the CDA and ask for information about the Mediation Program. This is arguably the most common scenario by which we receive cases and is an excellent use of this member benefit.
CDA Mediation can give the patient and the CDA dentist an avenue to be heard to try to bring resolution without the issue becoming a lawsuit or Colorado Dental Board complaint (or both).
For a case to be accepted for CDA mediation, the nature of the complaint must be about quality of care and/or appropriateness of treatment. The CDA can only mediate cases involving CDA member dentists. Complaints received that involve a non-member dentist are denied and the patient is referred to the Colorado Dental Board for next steps, if appropriate.
There are several types of complaints that are inappropriate for the CDA Mediation Program. Complaints regarding the following topics are denied:
- Insurance Coverage – Patients with insurance coverage disputes, etc., are referred to their employer who provides the insurance or the Colorado Division of Insurance.
- Fee Disputes – If a patient feels the fees charged by a dentist are too high, this is a private matter between the patient and the dentist as a business owner.
- Misconduct that violates the Colorado Dental Practice Act or Colorado law. If a complaint raises issues that are apparent violations of the practice act or the law, the patient is encouraged to file a complaint with the Colorado Dental Board.
- Issues Already Involving the Colorado Dental Board – A complaint can’t be accepted if it has already been filed with the Colorado Dental Board.
- Issues Already Involving Legal Counsel – A complaint can’t be accepted if legal counsel has been engaged.
What most member dentists and their patients do not understand is that the CDA mediation process is not designed like a courtroom, where the peer mediator is serving as judge and/or jury, establishing who is right or wrong. CDA mediators work to understand what it would take to make the patient satisfied and then communicate that to the member dentist. Before mediation begins, the CDA explains to the patient and the member dentist that the most the patient can receive through CDA mediation is a 100% return of the fees that were paid to the dentist for the treatment in question. The member dentist has three choices regarding a refund request:
- Refund the full amount the patient paid.
- Offer to refund a portion of the amount paid and see if the patient is willing to compromise.
- Refuse to refund any of the amount paid.
It is important to note that if, and when there is an agreement reached on a refund to the patient, the patient and dentist must sign a General Release form that releases the member dentist from further refund or future liability regarding the dental services in question.
Every one of us has patients who end up being unhappy with their dental care for various reasons. We have all experienced seeing a patient for a second opinion when they are upset with their former dentist. We are here and happy to try to help with situations that are on their way to becoming more contentious.
