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Early complaint

in Risk Management

Early complaint

I'm Olutusen Ariyo Onafowokan, I often get cut down to Riyo or Olu. I am "quite" sarcastic, I love a good beer, play football twice a week, I've started reading again (not that I ever forgot how to read, I'd just stopped) and I'm trying to learn a new language.

I also used to play rugby for England, but no one believes me (it is true).

I grew up in Leeds (God's Country and the capital of the North), before doing dentistry which "I've wanted to do since I was five". I graduated from Manchester (a suburb of Leeds) in 2013 and I am now living in London, I miss the North, they don't say barrrrth or carrstle, the water tastes better and I don't have to use all my shampoo before I get any lather and it's a lot cheaper. But it's not too bad, it makes coming home all the sweeter.

The article is about my first week in practice and my first complaint. I wrote it because I felt pretty low and there was no one in the same position as me who had, had this experience. So this is intended for, everyone hoping this won't happen to them and if it does how I coped with it happening in my first week!! Hopefully it could help you too.

As soon as I saw it on the computer screen, "PT (patient) doesn't want to see OO (me) for treatment, it made my heart sink. It might as well have said "Olu is the worst dentist ever".

I ran through the situation over in my mind, trying to find a reason why he didn't want to see me. This is what had happened:

  • Patient comes into the practice in pain
  • English is not his first language (brings child into the surgery to translate)
  • Two lower wisdom teeth are un-restorable, teeth erupted fully, full arch
  • Poor oral health, irregular attendee
  • Treatment decided XLA of wisdom teeth
  • Discussed procedure, patient happy
  • Next visit XLA

All I could think about was had I done something to upset the patient? Was my communication that bad? Am I not an effective communicator? Am I a bad dentist? Didn't I get appropriate consent? Have I harmed him? Was I that intimidating or unapproachable that the patient felt they couldn't speak their mind?

A million other questions race through my mind, usually ending in the affirmative.

When I graduated, I said to myself (yes literally):

"Olu I want you to be the best dentist you can be. I know there will be temptations but I don't want you to cut corners. You are confident, remain so.

If all else fails be approachable, take your time and be a good communicator.

And of course keep your clinical work to a high standard. Oh and try to not get any complaints, that'd be nice".

And if you can do all that and keep your head, when all about you are losing theirs, you'll be a man my son.

Okay I never said that last sentence. But the rest were my ideals, which had crumbled like a grossly carious tooth being extracted.

So my feelings were hurt, my usually undamaged ego smashed. Confidence was way down. I felt I had let the practice down, my nurse down, my school down, my family and especially myself.

After speaking to my trainer he was very pragmatic, he said not every patient will agree with your treatment plan. You will not get on with every patient that you have. This is not a slight on you at all.

Kind words indeed.

But the fact of the matter is; I had spent over an hour in two sessions with the patient, explaining the treatment options. I had asked him if he understood the prognosis of his teeth and why we couldn't do a RCT, he said yes. I asked him to repeat the options back, he did. I asked him if he could bring someone with him to translate. He said he would bring his child. Was he happy to undergo treatment, he said yes.

I received a second opinion from another associate who had agreed with my treatment plan. From a clinical point of view, the treatment proposed was fine.

I thought I had done everything to accommodate my patient and for him to complain against me was painful.

However, it's not all doom and gloom, Keane songs, black and white stills and other depressing things. I needed this lesson and the earlier I acquired it the better.

Leaving dental school, I was on a fluffy cloud and under the impression that nothing could go wrong, and I would keep sailing this naïve cloud forever.

At dental school I'd had a good relationship with all of my patients even if some of my dentures were slack or I may have fractured a root on extraction.

But I hadn't perforated or taken out the wrong tooth.

Dental school was a nice bubble, I didn't see patients as patients; I saw them as Tony 58 has three daughters, works in sales, "hates the dentist" (of course). Each had their own story. And they knew me too.

What I have realised is the difference between work and university. You could see patients as "friends or relatives in terms of familiarity at university. But in practice you can be friends on the surface but in your mind you have to see patients as patients, or better still… clients.

The honeymoon period was over, off went the rose tinted specs and I started writing my own risk management forms and communication forms. I ensure that I now go through all of these with all patients as standard.

I also found in similar patients; that Google translate is invaluable in conveying your message across, but writing in the notes on what you have discussed is time consuming! But worth it!

EPDP – the bane (not the Bain of Batman) of every foundation dentist's first few months actually really helped me. The self-analysis actually made me feel better. I reflected what went well and what went wrong. It helped me set goals that 'fingers crossed' will enable this not to happen again.

This may not happen to anyone in their foundation training but if it does, it is important to see the positive aspects of a complaint. Rather than focus on the negative, think about the other 99.999999% of patients that love/like you.

As for my patient he is booked back in, in three weeks' time. Wish me luck!

Top tips:

  1. Risk management of the procedure and the patient (know when to refer)
  2. You are treating a patient not just their mouth
  3. Google translate!
  4. Use your trainer!!! Invaluable for a second opinion
  5. You cannot communicate enough, make sure the patient is happy
  6. Remember patients may not always want the "ideal" treatment
  7. Reflect on it see the positives!! For every negative experience there is a positive. It can happen to anyone.

Olu Onafowokan

Dental Protection has more than 50 dento-legal advisers to support you if you receive a complaint.
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