The newsLINK Group - Involving a Specialist Early on in the Treatment Plan

Editorial Library Category: General Business | Dental | Periodontist – Gum Disease Topics: Involving Specialists Title: Involving a Specialist Early on in the Treatment Plan Author: newsLINK Staff Synopsis: Deciding whether to treat a patient or refer the patient to a specialist is something that can only be determined on a case-by-case basis. Editorial: Involving a Specialist Early on in the Treatment Plan 4064 South Highland Drive, Millcreek, Utah 84124 │ │ (v) 801.676.9722 │ (tf) 855.747.4003 │ (f) 801.742.5803 Editorial Library | © The newsLINK Group LLC 1 Deciding whether to treat a patient or refer the patient to a specialist is something that can only be determined on a case- by-case basis. Although it can be tempting to treat a patient with a more difficult case than what you are usually faced with, you should also remember that if you do the treatment yourself, you will be held to the same standard of care that a specialist would have been held to if performing the same work. Don’t take a risk unless you are willing to be held to that standard. The best way to evaluate your case is to develop a treatment plan. Of course, the goal is always to cure disease and restore the patient to normal, pain-free functioning. However, you will have to determine what exactly needs to happen, in what sequence, and decide who should be responsible for each step of the plan. You will also need to decide how frequently you or a specialist will need to see the patient, how long visits will take, and how minor or major modifications to your plan should be decided. Plans do frequently change, so you may as well decide in advance how you wish to proceed. Simply put, you need to exercise particular care when you are deciding the likelihood of potential complications, and also when you are faced with the onset of any of those complications. If a problem does arise, and the case is a challenging one, it is important to involve a specialist as quickly as possible even if you originally thought you could handle the treatment on your own. Situations change. In addition to the basic decision of whether to treat someone or hand that patient off to a specialist from the very beginning, there are two other important habits that can affect your ability to defend yourself legally if a problem develops: Document the conversation between you and your patient that will allow your patient to give an informed consent to the treatment plan you have developed. You must have, and document, this conversation even if the patient is someone who has been in your practice for a long time, and who may have had the same treatment in the past. You still need informed consent from your patient again, even if the patient is already familiar with everything you have to say on the subject. When you talk with your patient about a condition that needs the intervention of a specialist, you have to talk about what the patient’s condition currently is, as well as the risks, the benefits, and probable outcomes for all of the possible alternatives to the treatment you have recommended. That includes telling the patient what will probably happen if the patient ignores your recommendation and receives no treatment whatsoever. Document the referral thoroughly. You will want to include information in the patient’s chart about the nature of the problem, the category of specialist you think best-suited to providing treatment, the reason you think a referral is justified, and whether your patient has agreed to see a specialist. The specialist will probably handle some aspects of the referral, and you will handle other aspects. In an ideal situation, you will have already created a treatment plan before you send your patient to the specialist so that when you communicate with the specialist, you can work together effectively as a team, with the ability of responding promptly and heading off or resolving complications as early as possible. It is your responsibility to make sure that the patient gives you a written response, indicating informed consent, that you then can place in the patient’s records for later reference. The informed consent should make it plain that you have explained the specifics of the case to the patient, that the patient understood what you said, and that you gave the patient an opportunity to ask additional questions. You are not done once you’ve had the informed consent conversation. You should also follow up with a written letter. Send one copy to the patient, and put another copy in the patient’s file. In the letter, go over the patient’s condition again, the reason for you giving the patient a referral, and a list of the potential risks that you explained earlier. Sometimes a patient will decide not to comply with your recommendation. You then have to decide whether to