Risk management: The importance of staff disclaimers

The morning paper was uneventful except for one small, front page item above the fold, what newspaper editors term a “hot” story.

For more on this topic, go to www.dentaleconomics.com and search using the following key words: sexual harassment, risk management, Civil Rights Commission, OSHA, informed consent, staff disclaimers, Dr. Duane A. Schmidt.

The morning paper was uneventful except for one small, front page item above the fold, what newspaper editors term a “hot” story. The headline read, “Local dentist charged with sexual harassment.” It held serious implications for only one person: the involved dentist ... and I read in stunned silence that it was me!

This story could have happened in any dental office in America. It revolved around a chairside assistant who had been in my employ for eight months. Despite her demonstrated great chairside skills, Melinda could not work well with her teammates. I learned that one bad apple can indeed spoil the barrel, and Melinda had to go.

Wanting to save her the ignominy of being fired in front of her peers, I called her into my private office and closed the door. In my naivete, closing the door was a serious breach of management ethics, inviting everything that was to follow.

I told Melinda her tardiness and unwillingness to arrive early to help the staff set up for the day, and her ease with slipping out early at the end of the day, had caused staff antagonism. I then wished her well in her next job.

I handed her a severance check, she gathered her things, and the situation was closed ... or so I thought. That proved not to be the case, and the morning newspaper told me how terribly wrong I had been.

A few days after Melinda left, I received a letter from a local attorney asking for $15,000 to quell Melinda's story. Melinda claimed that she had been told to either have sex with me or be fired. Refusing my purported advances, she quit my employ. The attorney's letter said if I refused to pay, I would be reported to the Civil Rights Commission.

Few moments in a dental practice carry greater terror. My attorney told me that sexual harassment is not covered by professional liability insurance and, therefore, my options were to negotiate a lesser amount, pay up, or face the consequences.

In my anger, I chose to ignore what I considered to be blatant blackmail and take my chances. The morning paper now revealed how foolish my decision had been.

No dentist is immune

That this scenario plays out in dental offices everywhere testifies to the fact that we dentists have a serious breach in our ability to manage risk. An assistant, even though fired for good reason, may vent her spleen by seeking revenge in any of several forms. She may make a false report — as Melinda did — to the Civil Rights Commission. She might also report imagined violations of the Dental Practice Acts to the State Board of Dental Examiners or report noncompliance to OSHA. Dentists are also frequently accused of falsely elevating insurance codes or of illegal drug or prescription practices. Charges such as these almost always make the news, but if they are proven to be false, that rarely is deemed worthy of similar news coverage.

Forestalling disaster

While there is no foolproof way to bar the potential of these incidents, I discovered a strategy that has saved our office several times. We designed what we call a “staff disclaimer,” which all staff members must sign monthly. The text states that the staff member has seen no illegal billing, drug use, staff functions, or sexual harassment. And, if the staff member knows of any illegal office activity, she is invited to report it directly to the proper authorities, with contact information completely disclosed. Our disclaimer form can be viewed at http://downloads.pennnet.com/web_dl/2161.pdf .

The importance of risk management

Superb risk management allows the doctor to focus on serving people, not fighting off former staff, or even dissident patients. And with these efforts comes the realization that sturdy risk management barriers are the epitome of sound practice management. Melinda, by the way, left town before any action by the Civil Rights Commission. I was thus denied even the opportunity to prove her claim was false.

To view demos of informed consent video barriers, visit www.PreOpEd.com. Free downloads of documents that support this and other barrier techniques, including a staff disclaimer, can be found on the Web site.

Dr. Duane Schmidt is a Fellow in the American Academy of Pediatric Dentistry, an adjunct professor at the University of Iowa College of Dentistry, and a published author. With a staff of 55, he led the creation of a 34–chair dental practice in Cedar Rapids, Iowa. His e–mail is DuaneASchmidt@aol.com.

More in Practice Management Software