In the dynamic world of dentistry, practitioners often face challenges that extend beyond patient care. Complaints, claims, and legal matters can add significant pressure to already demanding roles. To shed light on how these issues are managed, we spoke with Shivani Patel, a Dental Legal Advisor at Densura. Shivani has been with Densura for six years, and her insights provide a comprehensive look into the vital support these advisors offer to dental professionals.
A Learning Curve and a Support System
Shivani began by reflecting on her journey: “It was all new to me when I started, but it’s been a really great learning process, both in terms of learning about a new industry and understanding some of the issues we face as clinicians. This role has also helped me in practice to understand that a claim or a complaint is not the end of the world and that indemnity services are here to support you. It’s been a valuable learning curve, and I’ve really enjoyed the process of working with a team.”
At Densura, Dental Legal Advisors work closely with the claims team, providing clinical advice to insurers to ensure claims are managed in the best way possible for policyholders. “For instance, if there is a clear breach of duty, there are occasions where we may suggest to the insurers that if a complaint were to escalate, it could lead to a significant claim. When there is a risk of a complaint escalating to a claim, insurers may sometimes consider paying a settlement to the patient in an effort to prevent escalation,” Shivani explains.
Communication and Collaboration
Communication is a cornerstone of the support provided by Densura. Shivani elaborates: “The policyholders’ first point of communication is with their Dental Legal Advisor. At Densura, we aim to keep policyholders informed about their ongoing cases. Our team is available to discuss the process, working closely with insurers to secure the best possible outcome.
We frequently request policyholders to provide comments on their cases, which we then relay to our insurers, RSA. These comments are discussed to determine the best way to proceed.
Empathy and Expertise
One of the unique aspects of Densura is that all Dental Legal Advisors are practising clinicians. “Being in practice keeps us up-to-date and helps us understand the difficulties and complications that can impact the quality of patient care. We can relate to the limitations and challenges that our policyholders face,” says Shivani.
This dual role allows advisors to empathise deeply with the challenges faced by their clients. “Another strength of Densura is that we all have our own areas of expertise. Some of us work privately, while others work within the NHS. This difference in approach can be crucial. We also have advisors with experience in orthodontics, implants, and other areas. When a case requires a second opinion or a different level of expertise, we collaborate with each other to ensure the best outcome for our clients,” Shivani explains.
Case in Point
Shivani shared a memorable case to illustrate the kind of support Densura provides. ” One case that comes to mind involved a policyholder who contacted us regarding a complaint that had escalated to the patient requesting a refund. Unfortunately, we were notified late, after several attempts by the client to resolve the matter internally. The patient had started aligner treatment and returned complaining of an ulcer in the buccal sulcus around the lower incisors. This was initially attributed to the aligner causing trauma. Unfortunately, the ulcer persisted and the patient was later diagnosed with a perio-endo lesion involving the lower 1’s.
After reviewing the records, it became apparent that the initial investigations were lacking, and that periodontal disease had not been identified. As there was a clear breach of duty due to inadequate initial investigations, it was recommended that the policyholder offer a full refund to prevent escalation. Open discussions with the policyholder were crucial in reaching this resolution, and it also served as a learning opportunity to prevent similar issues in the future.
Navigating NHS Pressures
Shivani acknowledges the pressures within the NHS and how they can lead to increased complaints. “NHS patients often have high expectations for their treatment, and time pressures can make it difficult for dentists to manage these expectations adequately. When dentists refer patients for treatments that might not be available on the NHS or have long waiting lists, it can lead to complaints. We understand these pressures and help our policyholders navigate them by providing detailed advice and support.”
The Densura Difference
So, what sets Densura apart from its competitors? Shivani highlights the quick response time and open communication. “Our policyholders’ first point of contact is a Dental Legal Advisor. Once a complaint is notified, the case is assigned to an advisor who contacts them within a couple of hours. This quick response and the open communication we maintain throughout the process set us apart.”
Additionally, Densura’s close collaboration with insurers ensures that clinical input is integrated into the management of claims. “We work closely with insurers to provide clinical input, which can help reduce the cost of claims and resolve issues more efficiently. This collaboration and our ability to provide specialised advice ensure that our policyholders receive the best possible support,” Shivani concludes.
In summary, the support offered by Dental Legal Advisors like Shivani is invaluable. Their ability to combine clinical expertise with legal insight ensures that dental professionals receive the comprehensive support they need to navigate complaints, claims, and other legal matters effectively.
