A positive and professional relationship between a patient and their dentist is critical to the success of diagnosis and treatment. We have produced a Practice Advisory on Maintaining a Professional Patient-Dentist Relationship which offers guidance to dentists.
Dentists have an obligation to develop, maintain and foster a successful relationship with their patient. This can be achieved with good communication skills, making efforts to understand the patient’s point of view and providing accessibility accommodations. When best practices are followed, patients are more likely to collaborate with their dentist and follow instructions.
Ideally, the patient and the dentist respect each the other; mutual respect and excellent communication will always provide the best results, including timely access to care and continuity of care.
There is a power imbalance between a patient and dentist: the dentist has knowledge, experience and expertise that the patient does not. Dentists have a responsibility to provide their best advice, in a clear manner that is easily understood by the patient and enables patients to make decisions about their dental care that best meet their needs.
From time to time, challenges may arise in the patient-dentist relationship. We expect dentists to make a concerted effort to solve problems and rebuild relationships. If those efforts fail, a formal and respectful process must be followed to end the relationship must be followed.
Dismissing a Patient
If the dentist-patient relationship is no longer co-operative and trusting, or if it becomes antagonistic, it may be best for the parties to go their separate ways.
If a dentist feels that dismissal is the best option, the patient should be notified formally, preferably in writing. Any discussion with the patient about dismissal should be handled personally by the dentist. Letters should be sent by the dentist or in the dentist’s name.
Sample Dismissal Letter
Dear [PATIENT NAME],
It has become clear that our patient-dentist relationship has broken down. I am writing today to tell you that I am no longer able to be your dentist.
We have had several discussions about your concerns about your existing amalgam (silver) restorations (fillings). You have asked me to remove them and replace them with composite (white) restorations. I have explained to you that your existing restorations do not need to be replaced at this time: there is no decay under the restorations and the restorations are in good condition. I have also explained to you that there are no health risks associated with amalgam restorations, that any symptoms you have reported are unrelated to your existing restorations, and that replacing these restorations would increase the risk of sensitivity and need for further treatment in the future.
Despite these discussions, you continue to insist that I replace your amalgam restorations, and you have expressed doubts about my clinical knowledge. Our discussions have led me to believe that you have lost trust in me as your dentist. As a result I have concluded that it time for us to go our separate ways.
I recommend that you continue to attend for dental hygiene (cleaning) appointments every six months, Dental conditions do change and issues that arise tend to worsen over time if they are not addressed. I would be happy to discuss your case with your new dentist and will provide copies of your records at your written request.
If you need help finding a new dentist, you can seek recommendations from friends, family members or your physician.
Until you find a new dentist, I will be available to you on an emergency basis. If you prefer, I will help you make emergency arrangements at another dental office.
I appreciate the opportunity to have been your dentist.
With all best wishes for the future,