Tif Qureshi explores the issues surrounding effective patient communication.
Communication and patient consent are arguably some of the most crucial aspects within dentistry.
Poor communication can prevent your patients from providing fully-informed consent: good-quality, ongoing consent allows you to perform treatment confidently, knowing that your patient fully understands what the procedure entails. It also offers you medicolegal protection should your patient file a complaint further down the line.
A report from 2016, published by the charity Marie Curie, highlighted that poor communication within NHS hospitals impacts patient care, staff burnout and public funds. It was noted that some patients may require information that is more easily understandable, and it is the job of the healthcare professional to translate complex terminology into something comprehensible. By building a trusting and reliable relationship with your patients, you will enhance their experience and increase the likelihood of them understanding treatment, and ultimately being satisfied with their end results.
Various literature has noted the importance of a good patient-dentist relationship, with one study establishing it as the core of dentistry. The effects of poor communication on the patient are widely discussed, with research noting that dentist-patient relationships are key to a higher oral health-related quality of life. Good communication is also crucial for a patient to provide informed consent.
Communication and consent
Adequate communication is a crucial component to consent. Patients must demonstrate a thorough comprehension of the precise nature of treatment, any alternative pathways that could be taken, the material risks and any aftercare or precautions. The nature of certain treatments, such as those that are restorative or orthodontic, will require patients to be extra vigilant with maintaining good oral health and habits. Because oral hygiene must be properly maintained during and after orthodontic treatment, patients need to understand the role they play prior to the procedure for the best possible results.
Having established a strong dentist-patient relationship, detailing this information prior to treatment should be relatively straightforward. However, a study demonstrated that the fear of litigation was one of the most stressful aspects of being a dentist. A survey of over 1,100 dentists, conducted by Dental Protection, found that nine out of 10 were fearful of being sued by their patients. According to the Dental Deference Union (DDU), communication was one of the most common reasons for a patient to complain. When you’ve obtained sufficient, continuous consent from your patient, then you have a good defence against a complaint.
Thus, thorough communication is beneficial to both yourself and your patients throughout every stage of treatment. By ensuring both, you can have peace of mind that your patients can comprehend the treatment and, should a complaint arise, you have a solid defence.
Obtaining consent
Issues arise when certain patients, such as children, the disabled and the elderly, cannot give properly informed consent. Extra care must be taken to ensure they, and their guardians, can fully understand the nature of the treatment and consent accordingly.
Tailoring your approach to obtain consent is important when dealing with all patients, but especially those who may have difficulties providing this. Under the Mental Capacity Act 2005, there is a two-stage test for assessing a patient’s ability to give consent – firstly, you must be aware of any impairments that could affect capacity, such as dementia. Secondly, can the patient: “Understand the relevant information, retain that information, use or weigh up the relevant information as part of the decision-making process and communicate their decision to the dental practitioner?”
Similarly, a child who is under 16 and not competent enough to provide consent, then their parent or guardian may do so on their behalf. If they are deemed of sufficient intelligence and competence to understand the treatment, then they may consent.
Brush up on your communicative skills
Taking steps to analyse and improve how you communicate with your patients will further enhance their experience, and influence their ability to understand and ultimately consent to treatment.
There are many pathways available for you to brush up on your communicative skills – one route is the Complete GDP course, delivered by IAS Academy. It covers patient communication as a topic in one of its modules and teaches dentists how to successfully examine, diagnose, treatment plan and treat their patients with a range of resto-orthodontic techniques. Alongside improved patient communication, the course covers how to provide a comprehensive examination, a step-by-step process for predictable treatment planning and how to contour and polish restorations with a structured approach.
Communication between the dentist and the patient is a crucial foundation for ongoing consent and exceptional patient care. It will help patients feel confident and empowered when making decisions about their oral health.
For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1)
References available on request.