AAOIC eNews Summer 2020

AAOIC Serves Our Insureds as the Pandemic Situation Evolves
Through the COVID-19 pandemic, AAOIC^® The Orthodontists’ Malpractice Insurance^®, continues to be there for you, our insureds. Hopefully, you are aware that the informed consent documents available at aaoic.com, (click on the Informed Consent tab near the top of the page), have been updated.

New supplemental forms, “Orthodontic Treatment in the Era of Covid-19” and “Communicable Disease Questionnaire” in English, Spanish and French are available.

The “Comprehensive Informed Consent” document now includes a section on the transmission of communicable diseases and is also available in English, Spanish and French.  Be sure to use the most current version!  We recommend you use these forms or something similar as long as the pandemic continues. 

Also, as more state dental boards adopt rules on Teledentistry, there is a new supplemental consent form on that topic.  As there is a move to remove anonymity between doctors and patients, the form provides areas for the doctors and patients to disclose their identity and provides a notice, (required in some states), of the contact information for the state dental board.  If you are doing any Teledentistry, we recommend you use this supplemental form to help protect yourself. 

AAOIC would also like to remind you, when providing Teledentistry services - just as in-office services that in order to have coverage, you must have a Doctor-Patient Relationship.

The language of your policy reads as follows: “Coverage is provided ‘only if the insured has performed a comprehensive examination of the patient, has obtained and studied appropriate diagnostic records on which any resulting diagnosis, treatment plan or treatment recommendation is based, and has monitored the patient’s progress regularly or reasonably attempted to do so.”

In addition, most state jurisdictions will hold a practitioner to the same standard of care for Teledentistry as in-office treatment.

Requiring a Periodontal Referral from Each Adult Patient Reduces Your Exposure
A periodontal referral and subsequent clearance from the referral doctor could be the difference between a plaintiff or defense verdict in a lawsuit brought against you.

Pre-existing periodontal disease (as well as periodontal disease that develops or exacerbates during treatment) is a frequent basis for malpractice claims. Often the damages, as a result from periodontal infection, and/or bone loss may create a need for more frequent cleanings, periodontal surgery or even the loss of teeth. These claims are challenging to defend and can result in very high settlements or verdicts.

Many doctors say they make periodontal referrals for all adult patients prior to initiating orthodontic treatment. From a risk management point of view, clearance from a general dentist or periodontist provides excellent defense to claims.  Do not stop at the referral; obtain written clearance from the examining doctor before beginning treatment.

Do not simply take the patient’s word that their condition is “satisfactory.” Patients often fail to make an appointment for  an examination with the referral doctor, and then, after   a problem manifests itself during treatment, conveniently “forget” that they were referred.

THE MORE YOU KNOW….
Make a Transition Plan for Your Practice

What happens to a practice when the orthodontist becomes incapacitated?  Ortho treatment is a long-term process throughout which patients require continuing care.  Here at the AAOIC, the claims department staff has heard myriad after-the-fact problems that arose because of an orthodontist becoming incapacitated.  Here is an example of what can happen:

A doctor’s wife reported that her husband, the orthodontist, had died, and she was having difficulty arranging for continued care of the patients.  The office was in a remote location with few orthodontists nearby; no one else was close enough to assume care of the patients, and the patients were unwilling to travel. The wife was stressed due to the loss of her husband and doubly so at having to deal with practice transition problems about which she had no experience.  Who provides the treatment for the deceased doctor’s patients?  Who will assist the grieving spouse with transitioning the patients and dissolution of the practice?  This is a very serious and real situation.  Patients cannot be abandoned for any reason. 

If you do not want to leave a quagmire for your survivors, or face one yourself when the problem is too big to solve, it is wise to arrange for a transition plan before a problem develops.  Many of you belong to study clubs and from within, the member orthodontists have or can arrange for an agreement that most or all members may fill in for each other in the event of incapacitation.  If you are not in a study club, try to arrange for such an agreement with other local orthodontists.  It will be beneficial for all. 

If you do not currently have a practice continuation plan in place, the AAO and the AAOIC can help.
 

Our legal department has developed sample agreements for you and your colleagues to consider.  Just visit www.aaoic.com  and click on the ‘Informed Consent’ tab to download a copy of the sample agreements.  You may also contact the AAOIC Underwriting Department at 800-240-2650.

Patients who start orthodontic treatment deserve to have treatment; put a plan in place to ensure that occurs.  That is good plan for you, your survivors and for the profession. 

Can’t Find Your Current Policy Declaration?

Do not worry, you can access and print or save the declaration page of your current policy from your computer or smart device.  To access your current renewed policy online, visit:

https://www.aaoic.com  and click the ‘Renew’ button.

If you are not already logged in, you must enter your AAO member number to access your most recent policy.  Click the ‘Print Dec Page’ tab for access. 

Steps to Follow in the Event of a Patient Complaint or Claim
If you receive a patient complaint or claim, consider the following recommendations.

1.    Call your insurance representative. If you have a conversation with a patient or a family member who has expressed dissatisfaction with the treatment, give your insurance representative a call to discuss what happened and what to do.
2.    Have your information on hand. You will need to provide key information from the patient's record. Access to the file or computer record during the telephone call will save time.
3.    Anticipate a return call. Make sure you leave telephone and fax numbers so that your insurance representative can contact you. If you are insured with the AAO Insurance Company (a Risk Retention Group) (AAOIC) and have encountered an incident or claim, contact AAOIC Claims Representative Jessica Kaesberg, Shannon Hall, or AAOIC Claims Manager Elizabeth Franklin at 401 N. Lindbergh Blvd., St. Louis, MO 63141-7816. The AAOIC hot-line number is 800-240-2650. You can also report an incident or claim through the AAOIC website (aaoic.com). The AAOIC welcomes the opportunity to work with you.