Patient Education

Highlight the positive aspects of using the technology.  In the scenario proposed by our dentist with CBCT, these benefits include more detailed films and assist with greater treatment/procedural accuracy. Take care to educate the patient fully.  Coupled with these benefits are complementing issues to consider: films will capture more of the anatomy than just the oral cavity and this expanded view holds the potential to include – unintentionally – additional information on the film… information for which you may have little familiarity or knowledge.

An additional aspect of patient education requires informing your patient about your area(s) of expertise and training. Be candid with your patient about the possibility for conditions to be visible on the film that may exceed your capabilities and training to identify, understand and interpret.

Patient Options

Give the patient options. If you are suspicious about something that appears on a film you generated in an area exceeding the purview of your specialty, talk to the patient without causing undue concern.  Tell the patient that, because of the ability of the technology to capture areas of the body that go beyond, in this case, the oral cavity, it is prudent to have the entire film reviewed by someone with relevant expertise. 

Offer the patient a copy of the film to submit to his/her primary care physician. Or refer the film for a radiologist’s review to be further assured that nothing is overlooked that may suggest additional study or intervention.

Patient Consent/Understanding

To supplement the informed consent discussion, consider developing and implementing an informed consent document that explicitly outlines the capabilities of CBCT (or whatever diagnostic technology you utilize) and the extent of your abilities to interpret the films you take with this equipment.  As suggested previously, provide the patient with options for obtaining a review of those areas captured on film that fall outside the scope of your expertise.  Such a document also provides an area for the patient to acknowledge his/her understanding of the information provided and allows the patient to attest to having an opportunity to ask questions.  If questions were raised, these should be documented and include a brief note indicating that the question(s) was answered to the patient’s satisfaction.

Patient Record Documentation

Like communication, thorough documentation is a great risk-reduction strategy.  Written notes memorialize not only the treatment rendered, but also the recommendations you make to the patient for additional review or follow-up. Documenting your and your staff’s efforts to verify the patient’s adherence (or lack thereof) to your recommendation is an important component of the treatment process.

In addition to the steps outlined above which are patient-driven and patient-centered, arm yourself with:

Professional Education

Avail yourself of the educational opportunities that keep pace with evolving issues related to CBCT (or any diagnostic) technology.  When purchasing the equipment, be sure to take advantage of all the training provided by the manufacturer, including its use, maintenance, precautions to protect your patients and staff, and so forth.

Whether you are a dentist, specialist or general practitioner in the medical arena, understanding the full scope of the diagnostic technology you use and its far-reaching implications will assist you in developing a strategy to heighten patient safety while mitigating your professional exposure to an allegation regarding a missed diagnosis.