Chapter 4. Clinical Operations

Liability Protection

Why is malpractice insurance important to the clinic?

Any individual who believes he/she has suffered a personal injury resulting from dental treatment can file a malpractice claim against the provider of that treatment and the organization for which the provider works. The claim must be filed within the statute of limitations of the date of the alleged incident or from the patient's knowledge of the alleged injury (frequently two years). The insurance carrier of the provider and/or the health care organization will investigate the claim to determine its merit. If the claim is considered meritorious, settlement negotiations will usually be initiated. If the insurance provider believes there is no liability on the part of the provider, the claimant will be notified. At that time the claim may be taken to court for a legal decision.

Necessary Conditions for Malpractice to Have Occurred

  • There was a duty of the provider to the patient to conform to standard conduct or a standard of care established by the profession or by law.
  • There was a breach of that duty by the provider, whereby the provider failed to conform to the accepted standard of conduct or care.
  • There were actual damages to the patient in the form of bodily harm, either permanent or temporary.
  • Causation can be established; that is the damage must have resulted from the breach of duty, either in fact or by proximate cause. Proximate cause is a legal concept based on foreseeability of harm when a duty is breached. (e.g., one can foresee that failure to use a rubber dam when performing endodontics can result in the aspiration of a dropped file.)

Tips to Reduce Malpractice Risk

  • Provide conscientious dental care.
  • Encourage and support continuing dental education for employees.
  • Make clear and legible entries in the health record.
  • Bring the patient into the decision making process through informed consent.
  • Have peer review and analysis of adverse events that occur in the clinic.
  • Discipline repeat offenders by reducing their privileges or by dismissal.
  • Place an emphasis on establishing a good rapport with patients.
  • Use a Patient’s Bill of Rights and Responsibilities, written in lay language the patient can understand and provided in pamphlet form and as a poster prominently displayed in the health care facility.



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