The Irreplaceable Dental Team by DAME · 2026-08-07 · 46 min
Key moments - from our scoring
Substance score
64 / 100
Five dimensions, 20 points each
Andrei Bennett brings a legal framework to one of dentistry's thorniest operational challenges: managing patient expectations around aesthetic outcomes while protecting practitioners from liability. He explains that every patient contact constitutes legal trespass unless covered by informed consent, and that liability flows through two streams - contract law (broken promises about results) and tort law (unauthorized treatment). For cosmetic cases, Bennett advocates moving beyond the outdated "standard of care" test (what colleagues think is acceptable) to what a reasonable patient would expect based on disclosed information. This means using mock-ups, quantifying success rates ("60% of cases achieve results matching the mock-up"), and documenting patient behaviors that affect outcomes (oral hygiene, smoking, diet). When third-party labs fabricate crowns or implants, the dentist remains liable to the patient contractually, making vendor due diligence critical. Bennett counsels dentists to avoid warranties in writing and instead use language like "statistically speaking" while expressly disclaiming responsibility for unpredictable outcomes. He also addresses mid-procedure pivots when treatment plans must change - advocating for stopping, explaining, and obtaining new consent rather than proceeding beyond the original consent scope, except in genuine emergencies where necessity overrides.
Informed consent is permission that covers the legal trespass that occurs whenever a dentist touches a patient; it protects practitioners from liability only if the patient understands and agrees to what will happen based on words shared between dentist and patient.
Use quantified language (e.g., 60% achieve results matching mock-up, 40% deviate), show mock-ups or computer-generated previews before starting, disclose statistical risks in writing, avoid warranties, and explicitly disclaim responsibility for unpredictable outcomes in signed agreements.
Stop the treatment if possible, explain the change to the patient, and obtain new informed consent before proceeding - unless it is an emergency where not proceeding would harm the patient, in which case clinical judgment about necessity takes precedence.
The dentist remains liable to the patient contractually because the patient contracted with the dentist, not the lab; the dentist should have explicit contracts with labs defining where liability falls and conduct thorough vendor due diligence.
Yes; surface behaviors that affect outcomes (smoking, diet, flossing, brushing) during the consent discussion and document that the patient understands how non-compliance may reduce treatment efficacy, though this does not eliminate the dentist's duty to meet the standard of care.
Our reviewer’s read on each dimension, with quotes from the episode.
The episode covers substantive legal concepts relevant to dental practice - informed consent, tort vs. contract liability, and risk disclosure - with concrete guidance on documentation and patient communication. However, the density is moderate rather than exceptional; much of the advice is relatively predictable (get written consent, document thoroughly, disclose risks), and there's considerable throat-clearing and repetition of core principles across multiple scenario variations. A practitioner would learn actionable ideas, but not at a rate that suggests rare or unexpected depth.
Every single time a person touches you, they commit a trespass to your person. That's the starting point.
the law asks, uh, the practitioner to. To consider whether a particular patient may have particular sensitivities. So if you know that it's a patient who is very fickle, it may mean that you need to go an extra step
The discussion of shifting legal standards from 'what colleagues would do' to 'what a reasonable patient would expect' is useful and somewhat contrarian to traditional medical practice norms, and the emphasis on patient-centric consent frameworks is forward-looking. However, the core frameworks (informed consent, risk disclosure, written documentation) are well-established in medical-legal practice and not novel. The guest does not introduce surprising frameworks or first-principles rethinking; rather, he applies standard legal doctrine to dental scenarios.
The best way I can say it. Recently however, in terms of the legal tests, that judgment has shifted and it's no longer what the colleagues think, but it's what a patient reasonably expects or thinks should happen.
it probably requires under this new dispensation to be practical. It requires maybe a mock up. Yes. Prior to the commencement of the procedure.
Andrei Bennett is a practicing attorney in Jamaica with stated specialization in commercial law, contracts, and some medical-legal matters. He has credibility as a practitioner and has spoken at professional conferences on informed consent. However, he is not a major figure in healthcare law, has not published widely cited work, and appears to operate in a relatively small jurisdiction. He is competent and relevant but not a top-tier authority that would justify significant premium on this dimension.
I am an attorney at law here in Jamaica... I specialize in commercial law, and so my focus is on contracts... I do have special interest in how people relate to each other and the law that governs those relationships.
I spoke at the Jamaica Dental Association Conference on the topic of consent, and in particular, informed consent generally.
The guest provides concrete scenarios (cosmetic crowns, implants, crown lengthening, associate using substandard materials) and some illustrative statistics (e.g., '60% of cases' for cosmetic outcomes, '70% of cases' for whitening longevity). However, examples are largely hypothetical rather than drawn from actual litigation or specific case studies. He references 'Mrs. Duchenne' and a personal anecdote about a difficult client, but does not provide named court decisions, specific damages awards, or documented precedent. The evidence is scenario-based rather than data-rich.
in 60% of the cases we are able to get you a result that looks very similar to the mockup. But in 40% of cases maybe it doesn't look that way.
in 70% of the cases, uh, we expect it to last for about two years, provided that you don't smoke
The host asks sharp, contextual follow-up questions that probe real pain points (e.g., managing patient expectations in cosmetics, third-party lab liability, scope creep during treatment, associate responsibility). The host challenges the guest respectfully and adds own professional judgment ('I'm a little radical. I'm not going to be able to do it'). However, the guest is rarely pushed hard on contradictions or limits of his position; the tone is largely deferential and confirmatory rather than adversarial. There are missed opportunities to probe edge cases or stress-test the legal frameworks offered.
So when we're looking at a situation where there's a, uh, third entity, a, ah, lab, who is responsible. Now, if something goes south, is it primarily the dentist? Is it the lab? Is it both?
But I yield to your expertise.
Computed from the transcript - who did the talking, and the words that came up most.
Welcome to the Irreplaceable Dental Team podcast brought to you by DAME - Dental Assisting Made Easy. A safe space to be mentored, empowered, and equipped. We are here to discuss "Getting Informed Consent with Andrei Bennett." Let's learn and stay on the grow! Please remember to subscribe, rate, and share. DAME - Dental Assisting Made Easy. We are better together! A big thank you to local Jamaican artist, Owen Pinnock, for the original music on our podcast.
Transcribed and scored by The B2B Podcast Index.
Speaker A: Every single time a person touches you, they commit a trespass to your person. That's the starting point. So if a dentist touches a patient, if a doctor touches a patient, they commit a trespass to that person. Now, that trespass is something that can be covered by consent. If the expectation is one thing because of the words that were shared between the dentist and the patient, and then the dentist goes beyond, touches the patient, and does things beyond what the patient expects, then there could also be liability because informed consent was not received.
Speaker B: M M. Welcome to another episode of the Irreplaceable Dental Team. And as usual, I got another good one for you today, but I'm not going to share. I'm going to let this gentleman tell us who he is, why he's here, and at the end of the day, I'm sure you're going to say, oh, my goodness, I'm so glad that she brought this guest on. Um, welcome, Andre. How are you?
Speaker A: I'm well, Doc.
Speaker B: Thanks.
Speaker A: Um, thanks for having me. It's my pleasure to be with you. And I hope that whatever I'll say today will be of value to those who listen.
Speaker B: I have no doubt. So I know who you are, but will you share with your guests a little bit about you and your journey and, um, why you think you're going to bring some gems to us today?
Speaker A: Okay, sure. So, I am an attorney at law here in Jamaica. Uh, we met recently, even though I knew you from well before, as I disclosed afterwards when I spoke at the Jamaica Dental Association Conference on the topic of consent, and in particular, informed consent generally. I specialize in commercial law, and so my focus is on contracts and how people negotiate those contracts, with a particular focus on government, commercial and government procurement law. But I practice in other areas as well, in real estate, conveyancing, in broad commercial matters. In corporate, I do a little bit of M and A, as well as some probate and administration and all other humdrum, boring stuff. But I do have special interest in how people relate to each other and the law that governs those relationships.
Speaker B: Yes, yes, yes. Well, in those few sentences, you have confirmed that you're the man. So, Andre, I have a quick question for you. Um, we are doing so many things now in terms of implant dentistry and crown and bridge and cosmetics and all the things that make people go to the dentist, a place traditionally where they would not necessarily have wanted to go. But with that new zest to come and have changes, there comes a certain amount of expectations. And I'm not sure where we fall between what we should allow them to expect versus what the guaranteed results are. Can you speak to that at all?
Speaker A: Sure thing. Okay, so I guess the first thing to, to reckon, to deal with is that in that kind of interaction, where we're dealing with people's expectations, liability may attach to a dentist from two primary streams of law. One is in relation to law of contract. And so where an enforceable promise arises based on the words that you use, then you could be found to be in breach of, um, that expectation, which, which is legitimately raised. And we can deal with that in a little bit more detail afterwards. The second no is in relation to this, this topic of consent. And that really rests primarily in the body of law we call law of torts. And what consent tries to do, it tries to dilute the very severe consequences of people touching other people. So let's be clear. Every single time a person touches you, um, they commit a trespass to your person. That's the starting point. So if a dentist touches a patient, if a doctor touches a patient, they commit a trespass to that person. Now, that trespass is something that can be covered by consent. So let's go back to the original question. If the expectation is one thing because of the words that were shared between the dentist and the patient, and then the dentist goes beyond, touches the patient, and does things beyond what the patient expects, then there could also be liability because informed consent was not received. Okay, so two possible streams, one in contract and one in torts. And I guess we can go into a bit more detail as you inquire.
Speaker B: So I guess what I would think as a, uh, challenge that could come up when we're looking at aesthetics.
Speaker A: Yes, it's.
Speaker B: It's very personal as to what I like versus what I don't like. And my colleagues in the past have used things like before and after photos to give people an idea as to what the end result might look like. And, um, at the end of the day, it might look perfect to me, but still not quite meet the expectations of the client who wanted these cosmetic crowns placed. Um, I don't know how. What do you consent to when you are signing up to change your smile or to enhance or improve how your teeth look? Great.
Speaker A: Great question. So let me. Since you frame the question in terms of consent, let me answer it on. On that basis. So in the past, um, the. The way that a practitioner, in particular a medical practitioner, was judged was on the basis of what his or her colleagues would say was. Okay.
Speaker B: Right.
Speaker A: And so let me be clear. The amount of Information that a practitioner ah, had to disclose about a particular outcome or particular risk in a procedure was judged by what all of those colleagues would say was okay.
Speaker B: Mhm.
Speaker A: The best way I can say it. Recently however, in terms of the legal tests, that judgment has shifted and it's no longer what the colleagues think, but it's what a patient reasonably expects or thinks should happen. So the question about something like a cosmetic procedure.
Speaker B: Mhm.
Speaker A: It probably requires under this new dispensation to be practical. It requires maybe a mock up. Yes. Prior to the commencement of the procedure. So the practitioner and the patient, they sit and they may look at a uh, computer generated graphic as uh, to how the thing is expected to look. But also the practitioner should at all times mention to the patient where there is probably a statistical deviation from the mock up, uh, and reality. So the practitioner may say something like in 60% of cases we are able to get you a result that looks very similar to the mockup. But in 40% of cases maybe it doesn't look that way. And so the patient is now aware of the risks that they are undertaking. And um, to that extent I think you could dilute some of the liability in relation to treating on the patients expectations. Now that's answering in relation to the, the consent bit. So the patient's consent allows you now to go and do the work with the expectation that they will look similar to how that mock up would look or to some other photograph or image of what you are sort of aiming at. Does that, does that make sense?
Speaker B: It does make absolute sense. Um, I think where I find myself in the little spider web is um, the 60, 40 meaning that the patient you're seeing, oh my gosh, this looks Great. This is 80% or better than what I expected. You've already said to the patient 6 to 40 and now they're seeing 30, 70 because of the um, fact that it's no longer looking at something that you can judge, but now you're looking at somebody's interpretation of what you've done. And I do know that going from looking at what the patient wants to, to even putting them in long term temporaries to see if it feels and works well before you go to the final steps are ah, all things that are good to have in place. But there's just this one set of folks that you and them looking at the same thing and you would not believe it based on the discussion that they're having with you. So I guess nothing is 100% proof. And I guess what I hear you saying is that do your due diligence, put everything in writing, make sure that the informed consent covers as much as it can. And, um, I guess what we are really saying is when it comes back, if it should come back to splitting hairs, your informed consent and your notes, copious notes, should be able to, um. To back you up.
Speaker A: That's right. So, yeah, you're. You're completely correct on. On. On how. How the law is likely to work in that respect. And taking those contemporaneous notes, noting what was told to the patient and the detail and extent that it was discussed so that the patient is able to, uh, appreciate the risks. And that is. Comes down to. In relation to this consent thing, what's the risk that the thing won't look the way I expect? Or what's the risk of a, uh, negative consequence? Because even with the best of technique, sometimes things go wrong.
Speaker B: Yep.
Speaker A: And what. What I want you to think about, though, just to give you a little bit of comfort, is that if this motto, if these matters were ever litigated before a court, the court will itself, uh, try to apply as objective a standard as possible. So even though, yes, it is really what the patient expects. But the court doesn't simply ask, what does any old patient expect? The court asks, uh, what does a reasonable patient could expect based on what you have disclosed to that patient? Now, the interesting thing about the way that the law has shifted, though, is that the law asks, uh, the practitioner to. To consider whether a particular patient may have particular sensitivities. So if you know that it's a patient who is very fickle, it may mean that you need to go an extra step in. In having that patient come to an understanding of whatever risks may be inherent in this aesthetic procedure or any other procedure for that matter. So m. One set of considerations. The other thing, though, I like what you said about putting things down in writing. And so this is where the contract comes in. Yes, Doc, as far as possible, when it comes to these results that you cannot predict what. What I try to advise practitioners to do is to not give warranties.
Speaker B: Right.
Speaker A: Yeah. Because. Because warranties are really important, uh, contractual terms. Right. The. The kind of guarantee that says, oh, yes, man, this thing will definitely happen, or this. Stay away from those things. Always coach that kind of discussion in the language of, uh, well, Statistically speaking, in 10 cases, six turn out this way or seven turn out that way. And in the documents that you have the patient sign, whether it be your invoices or so on, whatever communications between yourself and the patient, you expressly disclaim any responsibility for a particular outcome. M. Now that doesn't obviate you from I will allow you to know, simply go and breach things and ah, to perform at a standard below the contractually expected standard. But it says to the patient that, yes, the doctor is human, that there are some elements of this procedure that are unknown, and that to the extent that there is a contract, those unknown things cannot be pleaded to create liability for the practitioner. Very important. And, and I think too, just to, you know, wrap this up, uh, dental and medical practitioners generally should probably have a best friend lawyer somewhere in that room who can help to look at the forms and to draft some of these things. Especially as this era is so dynamic.
Speaker B: Yes, things change frequently, you know. And then let me add another layer to what you've said. Okay. We've, we've presented this case, it looks fabulous. The patient comes back maybe a month later, they're highly disappointed in how it looks. And you're looking at it and you're saying to yourself, this person's oral hygiene is absolutely the worst. Things are looking puffy and swollen, not because of the appliance, but because of the lack of appropriate care. So, you know, how do we balance that in the beginning, the wording or how should we protect ourselves to ensure that when we provide a product, um, do they need to sign something to say that they're committed to brushing and flossing? I mean, I'm just being a little crazy, but you understand what I'm saying to ensure that we realize that it's, uh, a win win. It's not just all about me, but it's me committing to give you something that is sturdy and aesthetic and you committing to take care of it on a daily basis.
Speaker A: Yeah, excellent question. And I'm glad that you raised it because I was actually going to go onto it to say that when you're having that discussion with your patient or your client about all the things that could go wrong in relation to a particular outcome, you also need to surface in that discussion their behaviors that may affect, uh, the long term outcome. Right. Especially in relation to this is this era of aesthetic dentistry. Okay. So when you're, when you're explaining that, okay, um, the patient says to you, okay, this whitening will last for two years, you say, well, in 70% of the cases, uh, we expect it to last for about two years, provided that you don't smoke, that you, you are not, um, chewing agents that will, you know, mess up your teeth. The one that my dentist cusses me about all the time is I drink too much coffee. Every time I go, she says, andre, why are you drinking so much coffee? It's staining your teeth, right? So all those practices and, um, that you would maintain your teeth by ensuring that you're, you're paying attention to regular, good oral hygiene, that you floss and you brush appropriately. So all of these things, all of these behaviors, if you do them, that's likely to take away from the efficacy of the treatment. And so you let them know that this is a part of the puzzle. Now, it still doesn't sort of, uh, completely allow you now as a practitioner to be negligent or irresponsible. Because at best, if a patient is not paying attention to their own oral hygiene, maybe that is just a contributory factor. If something goes wrong, the judge, a tribunal, may still very well find that your standard of care fell below what was expected.
Speaker B: Right. So what I hear you saying, though, is it needs to be clear beforehand what we are willing to do and what we're expecting the patient to do to ensure that this works. And at the end of the day, if we have done what we should and they have done that what they should, if there's an issue, then it's totally different than if we are holding up our end of the bargain and they are not. So all of that should be in writing up front. What we expect of them to ensure the longevity of this appliance, is that. Okay, let me put on another layer of it now, because when we're looking at implants and crown and bridge, we don't fabricate that in the office. Not everybody does. There are some scenarios where you can have crowns made now, immediately in the office. It wouldn't be an aesthetic case because, you know, crowns that are cranked out in a dental office in an hour are not going to be as aesthetically pleasing as those that you would have sent to a master lab technician who would match the colors perfectly. So when we're looking at a situation where there's a, uh, third entity, a, ah, lab, who is responsible. Now, if something goes south, is it primarily the dentist? Is it the lab? Is it both? Because I may put in an appliance. I've checked the bite, it looks great. Patient is compliant, saying they're doing what they should do and this thing, the porcelain chips off or it breaks. What do I do as a dentist? Do I now need to approach the lab and if so, you know, give us some guidelines around that?
Speaker A: All right, so I Would say that again. You see those two streams that were surfaced at the beginning, Liability in torts and liability in contract. Let's analyze this along those two.
Speaker B: Okay.
Speaker A: When the patient engages you for this, um, particular appliance that is fabricated elsewhere, the thing is the patient is in contract with you.
Speaker B: Right.
Speaker A: And so to the extent that the patient is in contract with you, the patient can and, and is not in contract with the third party fabricator, uh, then the patient would seek to sort of attach liability to you in contract.
Speaker B: Mhm.
Speaker A: Um, what that means therefore is that you have to ensure that your due diligence on these third parties is top tier and that your contract documents between yourself and them, ah, appropriately identify where liability falls in the event of an appliance failure. Now ordinarily these, uh, contracts as uh, between the dentist and the third party fabricator.
Speaker B: Yes.
Speaker A: Would even if it's not expressed in the written form of the contract, there would be some warranties because the dentist has nothing to do with the, the manufacturing. Right. So whenever that latent defect becomes patent.
Speaker B: Right.
Speaker A: Then they, even if there's no written, uh, agreement, you could imply those terms into the contract. But let me tell you something, that if you are in the territory where you are trying to imply terms into a contract, the amount of money you will spend and the amount of years you go wait to get an outcome, it's, it's, it's better you just have it properly expressed upfront so that when an event incepts you can be clear on that.
Speaker B: Okay.
Speaker A: Now the second component of that though is now what happens as between the dentist and the patient. So I sort of dealt with that. So there's an issuing contract to the extent that, you know, a particular warranty was given around the performance of the appliance.
Speaker B: Right.
Speaker A: And so to that extent, I would say once you recognize that the implant failed or the appliance failed, then you need to start to think about some kind of compensatory mechanism. And by that I mean you want to restore the patient to where they would have been had the thing not failed. Right. So that might mean use another device or you remove the appliance for a while and doing something temporary. I don't know, all of the dentistry things. Right. So, so you, you, you must in good faith try to make good on, on what has gone wrong in that relationship. In relation to the tortious issues, I would say that it's very important, especially if a third party fabricator is involved, very important that you get from the patient a list of uh, sensitivities, because maybe patients are sensitive, maybe they are allergic to particular materials that are being used by the fabricator. And so you'd want to know that upfront in order to ensure that you can discuss those risks with, with the patient.
Speaker B: Makes absolute sense. All right, so now I'm gonna pick your brain again. There's sometimes, you see, when you start a procedure, maybe it's a surgical procedure and you have treatment plan for A. Ah. But once you get in there, because despite all the imaging and so you still never know exactly what you're dealing with until you're in there. So, so let's say that you started along the course of treatment plan A, and something happens or something unforeseen, or some element looks different than how it looked on the X rays. You now need to veer to treatment plan B. Now the original consent was for A, but now for the health of the patient, or to ensure that the procedure goes well, you need to do a variation and move to B. But the original consent was for A. What do you do?
Speaker A: Stop if you can. Right. So if it's sensible, stop the treatment, explain to the patient what has happened, and obtain, uh, new consent for treatment plan B.
Speaker B: So can that be a verbal or what if the patient is under.
Speaker A: Yeah, great question. Okay, so I don't presume to know too much about anesthetics or anesthesia, but Doc, if it is something that you calculate. I'm going to leave this now to the practitioner's judgment.
Speaker B: Mhm.
Speaker A: This is something that you calculate where you calculate that the risk of not stopping.
Speaker B: Yes.
Speaker A: Um, outweigh the risk of stopping.
Speaker B: Yes.
Speaker A: Right. You weigh those and you make a determination as to what best serves the patient, recognizing. Cuz we're in the tort one now. Recognizing that the patient consents to the touch that was discussed in plan A.
Speaker B: Yes.
Speaker A: A touch that goes out of that scope is trespass to their person and therefore it's very problematic. No. You know, this is why the law is kind of crazy, because I would say that there has to be some kind of limited ground of necessity.
Speaker B: Right.
Speaker A: Because you're as a dentist and medical practitioner, your first job is to do no harm.
Speaker B: Right?
Speaker A: Right. So if you identify that this thing that is necessary.
Speaker B: Mhm.
Speaker A: Or saving the patient's life or for, you know, alleviating pain or what have you, that it is necessary to do it, then I think you're on better ground if you proceed. So if it's absolutely necessary. And again, that's going to be in your Judgment, phone a friend, especially if you're a young dentist, if you can go seek a quick consultation with a senior. Right. Us as attorneys, we do that all the time. I mean, because we're all on different parts of the spectrum of practice. Right. So young attorneys call me because I'm somewhere in the middle and I call the older attorneys because you want to be make sure that the decision you're about to take is the one, it is the most risk free.
Speaker B: Right.
Speaker A: So yes, there are times when in the middle of the treatment that you may need to proceed. But I would say the basic principle is that the consent for treatment plan A only covers the consent for, um, only covers plan A treatment. Any other treatment requires new consent.
Speaker B: Okay, so you know what that means. Enough prayers before you start anything?
Speaker A: Yes. No prayers. Um, you ask a good question about, about if, if the consent for plan B can be verbal. Yeah, I would say yes. You know, it is possible. But I would calibrate that on the basis of, uh, who is in the chair. So if you know that is somebody who is fickle, who is likely to come back and try, Try a thing.
Speaker B: Yes.
Speaker A: No, you're going, you're going to sign that right away?
Speaker B: Yes.
Speaker A: Yeah. But if you know it's somebody who you have a reasonably good professional relationship with, then, you know, in the company of your hygienist or whomever is assisting you, you can attest to what they, ah, have said. Then you could probably deal with the verbal consent in the moment and then maybe write it down afterwards.
Speaker B: Okay, that makes sense. So here's another scenario. Uh, I'm loaded with scenarios, right. Sometimes, right. A procedure requires multiple layers and in your best judgment, you're going to get the best result by doing it in multiple layers. But you'll get someone who says, no, I don't want to do that. Let's go straight to the end. Um, case in question, this person has short teeth. They want crowns. In order to have the length for retention and aesthetic value, they really need to have a crown lengthening. You know, create a little more space. Space so that when you put in the final crown, the dimensions don't look weird. The retention is more likely to be stronger. Um, in the event that that patient wants to skip the middle part and go straight to the end. How would you, how would you advise us, uh, to approach it? Let me tell you about me, right? I'm a little radical. I'm going to say I'm not going to be able to do it because I think people have selective memories yes. No matter how much you tell them. And, you know, when the end result is not what they would like, or it's not staying or whatever, they're going to come back and point to you. Even the best of friends.
Speaker A: Right.
Speaker B: But I yield to your expertise.
Speaker A: Yes. Yeah. You know, you're very similar to me, Doc. Um, just this morning, I attempted to fire a client because they, they have come to me for a particular service. This scenario is not exactly on point, but I'm just giving you an example of sometimes when your gut tells you to just exit from a relationship, it's probably better. Right? So, yeah, this client has come to me, is not a client who is unknown. Repeat business. And. But they're trying to rush me to do a particular thing which requires a lot of care. I mean, I meant to read a 78 page document in two days. I. I cannot do that. And they keep pushing, pushing, pushing. So I said to them this morning, you know, you may need to seek alternate counsel because I'm just unable to give you the result at the speed that you now want. Okay. Um, they were not too happy with that. No, no, no, we're gonna stay with you. We'll do whatever you say. All right. But more important to the question, um, I think your obligation as a practitioner is to explain fully to the patient all of the dependencies and contingencies. So you say, look, we need this treatment is composed of these two or three parts, and one depends on the other.
Speaker B: Right.
Speaker A: You may say now, to the extent possible, one is several. So you could maybe do step A and leave it there, but it's just not going to be as effective as, uh, doing step B and step A. Lay it out clearly to the client. When the patient gives you an answer, you repeat the answer to the patient. You say, are you sure that this is what you want to do? And you write it down and you allow the patient to sign to say that this is what was in. Because you will have some patients that will come back and say that you attempted to upsell them a particular treatment. All right? But it's in your clinical judgment that, uh, this is how the thing should go.
Speaker B: Right?
Speaker A: So just explain. Be as full, fully transparent as possible. Explain to them all of the parts, all of the contingencies. Give them the decision and allow them to sign to it. Maybe they need to go away and think about it. Allow them to do that. Because sometimes when people sign on the duress, they come and they say, no, this vitiates the decision that was made. Yes, that's how I would say approach it. Um, lay it all out, give them some time to think about it, record the, the response.
Speaker B: So what about a scenario where you have an associate dentist working in another dentist office? That associate is not necessarily feeling that these materials are best to be used on, um, the clients, but this is what is provided in this office. How responsible is that associate because of the materials that he's required to use? Um, especially if he knows that there are others out there that m may be better? Uh, how does you know? What level of risk do you have being an associate having to operate using the materials and equipment that are provided for you, even if you don't agree 100% with what is being offered for you to use?
Speaker A: Wow. Interesting. Okay, so I think there are two, I think there are two important prongs to that question at least maybe there are more. One is, is there any duty to raise this matter with the senior dentist with whom you work? And I would say an ah, unqualified. Yes. Do it in a manner that's respectful.
Speaker B: Right.
Speaker A: Because there may very well be a good reason that those particular materials have been chosen and given to you for use. You know, um, so, so you may, you know, request a meeting with the senior dentist and, and raise your concerns. Um, I would also recommend that you find a way to put it neatly in writing without coming over as very threatening. And so that preserves the relationship but also raises, um, the issue for the consideration of the senior dentist. Now, in relation to that same associate and his patients. Yes, now or her patients. I believe that the associate has always has a duty, if the associate is aware of particular risks in relation to the use of these materials, that those things must be discussed with the patient prior to the treatment. Now again, there are some relationship issues that are going to come into play because you don't want to do it in a way now that the patient goes back to senior dentist and say, hey, if you ever know what such and such is saying, right. You really do have to manage it well. But yes, if you are aware as an associate dentist, because again, the obligation you have to your patient is not something that senior dentists can step in and take necessarily, maybe some portion of liability will attach there. But your duty to warn and uh, to discuss the risk that you are aware of is probably paramount. Is going to over supersede any liability that will attach to senior. So yes, if you have concerns about particular materials, and I would, I would imagine that, that those concerns are not, are not sort of capricious, there must be Some m. Clinically relevant concerns that in 10 out of 15, uh, cases there was a negative reaction. Those are things that need to be discussed with the patient and as I say, discussed in an appropriate way with the senior dentist.
Speaker B: Let me tell you something. I think this is an episode that my listeners and viewers are going to have to listen to a couple of times because it's so rich with information, um, things that we need to know on a daily basis. Because sometimes your decision has to be made like that. And if you haven't thought it through, it's like you do the best that you can, but it may not be the right decision. So having the opportunity to process these things in advance is really, um, really something that we can hold on to and keep in our back pockets sometimes might have to pull it to the front pocket. But before we go, I want to ask you, is there any one thing that you wish every dentist understood and would be do consistently?
Speaker A: Okay. Yes. And if I could just say to all the dentists under the sound of my voice, all the dentists in radio land. Professional practice as a dentist, as an engineer, as an attorney, has become increasingly more difficult over the years as persons have become more aware of rights. Yes. Willing to take every step to vindicate those rights. In relation to that core of the dentist patient, uh, relationship. Your patient allows you to touch them only in relation, only with that limited scope that was agreed. That is all you are entitled to do. And it is no longer the case that you can say, this is what all the other dentists would have done. It is now for you to analyze from the patient's perspective, the extent to which they appreciate the risks of what you are going to do or what you intend to do. And so you have to be multiple times aware.
Speaker B: Yes.
Speaker A: All of the risks related to the procedures that you undertake, frequently, no matter how basic they may be. And you have to discuss them with your patient and you have to record them properly and, uh, ensure that you only work in accordance with the scope of the permission given to you for those purposes. And, you know, one of the things we discussed at that conference, Doc, was, was a particular, ah, um, situation with this patient, Mrs. Duchenne. Oh, I forget the particular issue she had now because, you know, medical issues have, um, these long names, but we raised it earlier. She went in for an aesthetic procedure and the dentist, with all the best intention in the world, he did a little extra thing so that all of the geometry would line up in accordance with what he knows is supposed to happen. But that did not Satisfy her because he went outside of what she consented to.
Speaker B: Yes.
Speaker A: So just remember these rights, they are arising like, you know, quickly. So just be mindful of that scope of consent and only operate within that. That will help you to be a, uh, bit more risk hardy and, ah, resilient in your practice as you proceed. That would be my, my, my word. There are many other things I would say, like make sure you have one lawyer, But that is secondary to, to making sure that, you know, you understand the shifting perspective in relation to this consent issue. Yes.
Speaker B: I think that you have really given us, uh, quite a bit of information and things that we can listen and put into place immediately. And it's so important, once you've had a conversation and gotten information, to be able to understand it in such a way that you can make a difference tomorrow. And I think you've done that for us. And, oh, my goodness. Now I want to see why I wanted him to be on the podcast. I told you he was gonna drop some gems. And he did. And then some. Um, I have one more question for you.
Speaker A: Sure.
Speaker B: Mr. Bennett, would you ever consider coming back to be a guest in the future? There's so much more I have to pick your brain about, but I'm mindful of the time.
Speaker A: Of course not. You can call me anytime. You might have to call me more than once.
Speaker B: I'm good at that.
Speaker A: Yeah.
Speaker B: Yeah. Anytime. I'm always, you know, good people are always very busy. When you're good at what you do, you don't have downtime. So. I get it. I get it. All right. Thank you so much.
Speaker A: You're most welcome.
Speaker B: M m. Well, we have been schooled. The information that we got today reminds us that informed consent is very specific. And if you're going to veer to the right or to the left, then, you know, need to recognize that that doesn't necessarily cover anything beyond what you agree to. We also have to make sure that our patients not just hear but fully understand and agree to what we are providing as treatment. And it's always good to have a, uh, legal air on hand just in case you need to clarify something or you just need to make sure that you're on the right path. Associates, associates, associates. It's your responsibility. So if there are things that you're being asked to use that you think are subpar, then you need to speak out. Right. Or make a decision as to whether this place is the right place for you or not. And finally recognize that the law no longer looks on what your colleagues would do, but they're looking at the patient what a reasonable patient would accept. Big difference. Anyway, the more we know, the more we can be informed. And, um, the more we will stay in control of a situation. Listen, if you haven't already, subscribe. Life is good when we live, learn and grow together.
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