'Tis the season to be jolly careful

How would you respond to these festive dilemmas?

Expensive gift

After carrying out a lengthy course of treatment, a dentist was surprised to receive an expensive watch as a gift from the grateful elderly patient, who explained it had belonged to her deceased husband.

The following week, the patient's daughter bumped into the dentist who was wearing the watch and remarked that her dad used to have a watch like that. The dentist was taken aback that the daughter wasn't aware of her mother gifting the item to him and rang the DDU for advice about whether he should return it.

The DDU adviser explained that the gift could be seen to be more than a simple token of appreciation and there was a danger that he could be vulnerable to an allegation that he was taking advantage of the patient.

GDC Standard 1.7.5 guidance states, "You must refuse any gifts, payment or hospitality if accepting them could affect, or could appear to affect, your professional judgment."

The dentist wrote to the patient explaining that having carefully reflected of the situation, he wasn't in a position to accept the generous gift and would like to return it. The patient accepted the explanation and bought the practice team a Christmas tree for the reception area instead. The practice also reviewed and updated its policy on staff accepting gifts.

Prescribing for a family member

A newly qualified dentist was visited by a family member on Boxing Day. The relative, who was visiting from another part of the country, pleaded to be prescribed a course of antibiotics to help with the gum infection she had developed on Christmas Day. The dentist felt it would be more convenient to do this than to ask the relative to contact their own dentist or call 111 but rang the DDU for advice.

The DDU adviser explained that although there is no absolute restriction on treating relatives GDC Standard 9.1.4 states that, 'You must maintain appropriate boundaries in the relationships you have with patients'.

The GDC has issued separate guidance on prescribing, stating that one aspect of responsible prescribing means doing so 'only where you are able to form an objective view of your patient's health and clinical needs'.

A lack of objectivity could potentially lead to issues that leave a dental professional open to criticism, such as missing another problem, inappropriate prescribing, or interfering with ongoing treatment that has been provided by other healthcare professionals. The GDC's guidance specifically states that, "Other than in emergencies, you should not prescribe medicines for anyone with whom you have a close personal relationship".

The dentist suggested the family member contact their own dentist who arranged for a prescription to be made available at a local chemist.

Festive emergency cover

A patient complained on social media that she couldn't get an emergency appointment over the festive period, which she needed after chewing on a toffee and losing a filling. The post was being shared and commented on. The practice manager saw it and asked the DDU for advice on whether to respond. She explained the practice had been short staffed over the holiday period because of staff sickness.

The DDU adviser explained that while it's never nice to receive negative feedback an ill thought out response could make the situation worse. Following the discussion, the practice manager decided to respond to the comment online, apologising for any inconvenience and asking the person to get in touch with them if they still wished to make an appointment.

The practice was careful not to respond in detail to any of the allegations because of their duty of confidentiality. The social media comments dwindled. The patient called later that day and although upset, the practice was able to resolve the patient's concerns and offer an emergency appointment.

The DDU advised the practice to check their arrangements for holiday periods to ensure patients still knew how to access treatment in an emergency.

This article first appeared in the December 2021 edition of The Probe.

This page was correct at publication on 16/12/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.