Supervised Neglect is the third blog in this series dedicated to some of the confusing legal aspects of the dental profession.
Supervised neglect is when a doctor routinely examines a patient who exhibits symptoms of a disease or problem, but the patient is not aware of the situation and its progress. Sadly, supervised neglect occurs often by excellent and caring clinicians who mean no harm in treating patients. However, it can be very serious, and every attempt should be made to avoid this slippery slope.
There are many reasons supervised neglect occurs, and that’s why it’s important to keep the lines of communication open. Each patient should be apprised of their condition, treatment options, cost, time involved, risks, and benefits of proceeding with treatment versus doing nothing. Surprisingly, no treatment is a treatment option. Remember, the patient can only make an informed decision if they’ve been advised of and understand their oral status.
Why does supervised neglect happen?
- Fear- Doctors fear telling their patients bad news. They don’t want to upset them and dread their reaction.
- Responsibility- Often, doctors and team members feel responsible for the status of their patients. The patient’s oral health routine is a very important part of success or failure. If the patient has been informed of their condition, it’s their responsibility to maintain their oral health.
- Little to no support- Depending on the clinical setting, doctors and hygienists may not receive the support they need to treat patients properly or refer them to a specialist.
- Rejection- Some clinicians have difficulty discussing certain aspects of patient care because they fear that the patient will reject their recommendations.
- Betrayal- Seeing patients on a regular basis for many years often makes them friends and family. Some doctors presume that if given distressing news, the patient will feel that they’ve been betrayed.
- Assumptions- perhaps the biggest reason for supervised neglect is clinicians making assumptions. The most common assumptions are: the patient can’t afford the treatment, the patient is too old to care or spend the money, and guessing what the wants of the patient. Second guessing people is not ideal because you never truly know their thoughts and life status.
Supervised neglect can be avoided by being consistent with diagnosis, treatment, and patient education. Doing so will help in keeping legal ramifications away from your practice.