SDDSNY Bulletin January February 2021

One Fine Morning… Dr. A walked into his operatory to greet an emergency patient. This first-time patient, Mrs. P was in her fifties and referred by a friend. With a non-contributory medical history, the patient complained of slight sensitivity to cold and pres- sure upon chewing on her lower left side. Her last dental exam had been a year ago and her previous dentist had retired. Radiographs revealed a large DO amalgam with underlying recurrent decay close to the pulp on tooth #18. Dr. A examined the patient and confirmed that #18 was the likely cause of discomfort. Since a second molar root canal was well within the scope of treat- ments he routinely performed, Dr. A proceeded to explain the various treatment options and financial responsibilities. Mrs. P agreed and accepted the treatment plan, consisting root canal therapy followed by a build-up and crown. After the patient signed an informed consent form, Dr. A completed the endodontic therapy. At the second appointment, Mrs. P complained that the tooth was still sore. The dentist explained that some transient postoperative soreness was quite normal and expected and pro- ceeded with the buildup and crown preparation. Two weeks later, Mrs. P again complained that “the tooth still doesn’t feel right.” Dr. A took a new X-ray. He determined that the endodontic result looked perfect, as did the gingiva, crown fit, and occlusion. He thought to himself, “Every- thing looks great; maybe the patient is just a little overly sensi- tive.” He reassured the patient and completed the crown. The Follow-up Two months later, still suffering from pain, an unhappy Mrs. P called and reported that she now felt much worse than before treat- ment. Agitated and annoyed, she showed up for a re-evaluation. When a new X-ray showed no sign of pathology, Dr. A reassured her and explained that the residual pains would resolve in time. After another two months, in the middle of a busy day, the den- tist’s assistant interrupted an oper- atory procedure to inform Dr. A that Mrs. P was on the phone and that he should take the call. Mrs. P was quite angry, stating that she believed that “the work obviously was not done right,” and that she planned to file complaints against the doctor to the Office of Profes- sional Discipline and sue for all the money she had paid and aggravation. Dr. A paused. “What should I do,” he thought to him- self. “I did the proper treatment and standard of care but really don’t want to go through the scru- tiny of defending myself on the legal front...” A Disgruntled Patient’s Options When patients are dissatisfied with their dental treatment, they have three options: 1.They can file a malpractice claim but these lawsuits take years to resolve and are stressful for both the patient and the dentist. Fur- thermore, the decisions are deter- mined by non-dentist laymen and are dependent upon the eloquence of competing lawyers and “expert” witnesses. 2.They can file a complaint with New York State Education Department’s Office of Profes- sional Discipline (OPD). This could endanger the license of the dentist who is the subject of the complaint. However, even though patients might feel sat- isfaction by getting “revenge” against the dentist, the patient does not get reimbursed for the fees they paid the dentist. 3.They can file a complaint with the component’s Peer Review Committee. This is usually a win-win option for both patients and dentists. Complaints are resolved quickly, usually within 90 days, sometimes via media- tion and sometimes via a formal hearing with a panel of dental peers. If there was a deficiency in either the appropriateness of treatment or quality of care, the dentist is directed to immedi- ately return the patient’s fees. At no time do patients receive any remuneration above the fees they paid to the dentist. A written report detailing the final hearing decision is sent to the New York State Dental Association (NYSDA). The outcome is “all or none,” either for the dentist or the patient. Peer Review is an impartial, binding, confidential and timely way to resolve com- plaints about the appropriateness of treatment and quality of care performed by aNYSDAmember dentist. And, regardless of the outcome, the incident is never reported to the National Practi- tioner Data Bank or OPD. Who is Eligible? Resolving disputes through the peer review process is a highly desirable option that is only avail- able to members of the dental association. It is a very important benefit of membership. Treatment is eligible for peer review only if it was performed within the 2½ years of the statute of limitations and only if it involves complaints regarding the appropriateness of treatment and quality of care. For example, fee disputes cannot be resolved through peer review. Tales from the Files of the Peer Review Committee by Man Sing Cheung, D.D.S., M.S. Continued on Page 6 » WWW.SDDSNY.ORG 5