Tom Hester: I’ve been working with Densura since the beginning, so 10 years this year. We set up originally with the Oasis Dental Group and the call-to-action for us was that dental indemnity had seen huge increases. When I started in the industry, dentists were paying around £900 pounds for indemnity, and at this point, it was getting towards £2,500-£3,000 for indemnity.
The idea was a sustainable alternative to the major medical defence organisations who had been the providers to date. But also we wanted to offer something which was a little bit different. We wanted to offer cover that was contractual, giving you not just that guarantee of cover, but also offer a claim service, which is, we believe, pretty unique in that it’s instant access to dentists.
You know, nobody likes to receive any letter or message of complaint. A lot of the time, the key is just for someone to say that you’re not the only one; this happens to everybody and this is how we’re going to deal with it. A lot of the time, it’s just “Thank you for your letter and very sorry to hear that you weren’t happy with the treatment.”
As humans, we just want to be heard sometimes. And again, that’s something that we do. We also understand that time is essential; we do it quickly, efficiently and at a time that works for you.
Dental claims industry over the last 10 years
I’ve been involved in looking after practitioners now for nearly 16 years. And that’s everything from dentistry obviously, but also osteopaths, homeopaths, opticians etc. Actually, one thing that you see across the board, which is really frustrating is when consent lets somebody down. The reality of it is that it’s often that the practitioner is not at fault but can’t prove it. We say all the time if it isn’t written down, it didn’t happen, which is so true.
Insurance is there for those days when unfortunately you just have a bad day, but actually, you could have a perfectly good day, perform a brilliant treatment, then a patient criticises you. But you can’t prove it. It’s the biggest frustration for us because it ends up potentially being a substantial payout and a claim where nobody was in the wrong. Consent has got to be the most important thing that you do, bar the treatment.
The reason for the increasing number of claims
Unfortunately, we sort of shadow the US in that respect. Litigation grew and grew out of there. You’ve only got to go to the US and on the side of every bus, there’s an advert for claims. We also have more access to information. We have law firms, people like the Dental Partnership, who have a lot clearer access to patients. It’s much easier for them to reach out. Fifteen years ago, we just weren’t really aware of the potential of making a claim. There wasn’t the ‘no win, no fee options’ that there are now.
We’ve now ended up in a situation where actually people are prepared to claim more and it’s so easy to do. It’s not the old days of having to sit down with a lawyer for many many hours. It’s a matter of logging on to an app and filling out some basic information and you know, that just unfortunately means that we see more.
One of the things that we see quite often is when a dentist retires: another dentist will come into that practice and will potentially criticise the work of their predecessor. That gets picked up by a law firm and then before you know it, there’s an advert in the second page of the local chronicle saying, “Did you see this doctor in the last 10 years? If you did get in touch.” People see that. They put big figures on these adverts saying “You could receive £10,000+ in compensation” etc.
Unfortunately, especially at the moment when people are feeling the pinch financially, the opportunity to get a bit of tax-free cash means they’ll jump at the opportunity. Unfortunately, it’s just the way the world is at the moment. The thing that we stress all to all of our clients is make sure you do everything you can so that you’re always as water tight as possible.
I don’t want to sit here and scare people because you know there’s many many dentists that will go through their careers and will have no complaints or claims – maybe just the odd notification. But if it does come across your desk, especially when you’re not at fault, you want to make sure you can defend yourself.
Why are the traditional forms of medical consent flawed?
It’s just missing things. One of the cases that always sticks in my mind was when a dentist had done a perfectly good consent with the patient. The patient turned out to be a nine-year old girl; he’d gone through the consent with the parent and the child in question. It said at the bottom that both parents and child were present. He explains the procedure to the nine-year old in very basic terms. He’d used a digital app for the consent, and basically all of the answers were preselected. You’d have to actually manually say no to certain things.
One of the questions asked about smoking and he’d forgotten to say, no, he hadn’t talked about smoking to this child. When the particular case went to court, the prosecutor came and said, “Why would you talk to a child about smoking? You clearly didn’t.” Which then actually meant that the rest of the consent form was written off. So, you know, even when you’ve done consent, it’s got to be right. The reality there is being able to prove, to anybody, that’s reading it that you went through it lawfully and it wasn’t just the tick-box exercise.
iConsentu fills in the gaps of obtaining medical consent
When I first was shown iConsentu, what I really liked about it was the simplicity of it. In the event that you are having a procedure of some description done, I want to know the ins and outs upfront. I want to know what the potential outcomes are that are negative. So to have a digital way that someone can watch that information, that you as a practitioner can monitor –
I mean, you can’t force somebody but the reality is that they are given every opportunity to sit there and watch it, which is recorded. It’s really, really detailed, but done in a way which is very, very simple.
It really takes away so much of the potential risk that a practitioner finds themselves in, which, to me, is so important. It’s also very easy to use from the point of view of the individual, and from the practitioner’s point of view. So it’s a win-win for everybody in my mind. It just moves the game forward and I genuinely believe that it will take out a huge amounts of the claims that should never get as far as anybody’s desk, and certainly not bothering a dentist who’s busy enough as it is.
The effect of claims on your dental insurance premiums
Unfortunately there’s a common myth amongst practitioners – and this is certainly not just the dental market – but across the healthcare space too, that if I ring my insurers my price will go up, which is is definitely not the case. It’s one of the things that here at Densura we strongly encourage people to call.
But if there is a formal notification and it’s likely that it’s going to be a claim, just one notification will see your price with some insurance companies. We’re certainly not like that, but the reality is that you pay £2500-£3000 a year, say, for your insurance. If that insurer has to pay out £50,000-£100,000 then it’s going to increase in your premium.
Avoiding claims is key to keeping your price down. That’s a standard whatever the form of insurance. Again, as I said at the beginning, that’s one of the big things that we’ve been trying to do over the last 10 years, to offer a sustainable option. Of course we can’t help inflation and other things that are going to naturally increase premium slightly, but we want to avoid premiums rising based on big losses.
Why Densura are pleased to partner with iConsentu
iConsentu are a great organisation and at Densura, we really, really like what what the product has to offer. One of the things that has been key for me when developing dental insurance products over the last 10 years is giving something back, and offering value for money. What I don’t want is for potential clients just to see it as a begrudging payment.
Hopefully insurance is something that you don’t need, but we try to add some value on top of that and offer things that are going to hopefully benefit your practice and ultimately make you a better dentist. We want a really sustainable profitable book that’s going to survive for the next 20-60 years. Our retention ratio is very high, in the 90s, and we’ve just had our first dentist that has been with us for our whole 10 years. I like to think a lot of that is to do with the fact that we’ve constantly evolved and improved our products.
So iConsentu is the evolution of what we have to offer and it’s really exciting because as I say I think it’s an incredibly useful tool, and to be fair every dentist that I’ve spoken to about it has been really excited about it. Offering iConsentu to our clients means there’s something that can add value and help with the day-to-day because as I say, being a dentist is hard enough without horrible claims that are ultimately not your fault.