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Risk Management Protects You and Your Patients By Elizabeth Kincaid, Esq.

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The success of your practice depends a great deal on your risk-management abilities. You may be the most competent dentist in the world–but whether you end up facing a malpractice lawsuit often depends very little on your culpability. You can be 100 percent innocent and still be sued. That’s why it’s crucial to do everything you can to consistently protect your practice and professional reputation.

Here are some ways to ensure you’re doing all you can to manage risk in your practice.
  		• Attend seminars on risk management. Not only will they help you determine the strategies that will work for you, but they’ll give you a chance to network with other professionals to find out how they’re managing similar issues.
  		• Create a professional office atmosphere. Maintain friendly and courteous personnel, and cultivate and maintain a good rapport with patients.
  		• Provide consistent, high-quality care. Allow adequate time for diagnostics. Make sure X-rays are of the best possible quality; if not, determine the problem and retake them. Analyze the findings carefully before you formulate a treatment plan.
  		• Refer patients whose conditions do not improve with treatment over a reasonable time, and be sure to record the referral.
    Take the following precautions:
  		• Don’t make extravagant claims or promise a patient anything you can’t deliver.
  		• Don’t allow patients to dictate treatment.
  		• Don’t persist in treating troublesome patients; refer them instead.
  		• Don’t practice beyond the scope of your license or ability.
  		• Don’t admit liability if a patient claims you are responsible for an injury.
  		• Don’t release X-rays or other records without a signed authorization from the patient. Never give original X-ray film or any treatment records to the patient; provide copies instead.
    Manage record keeping in a professional way. Record all patient contact, and be specific with regard to the following:
  		• Avoid ambiguous words. Qualify all subjective terms, such as “good,” “promising,” “uncooperative,” and so on.
  		• Properly identify the record and the record-keeper.
  		• Identify kinds of treatments and rooms in which the treatments took place.
  		• Document any unusual events.
  		• Avoid or explain contradictions in patient records.
  		• Maintain a legend for any codes used in your records.
  		• Document patient noncompliance.
  		• Never write anything disparaging about a patient. Try your best to be objective.
  		• Never criticize other providers or make frivolous remarks.
  		• Never enter data prematurely.
    Make additions and changes to patient records appropriately, keeping in mind the following:
  		• Never, ever alter records.
  		• Draw a single line through and initial changes. Do not scratch out the entire record.
  		• Do not skip lines or leave spaces. Draw a line through blank spaces.
  		• Do not “squeeze in” notes. Make a new entry.
  		• Do not use computer-generated notes unless they can be individualized.
  		• Write legibly in blue or black ink. Do not erase or use correction fluid.
  		• Do not use more than one pen to record a single day’s entry.
    Also:
  		• Review files periodically, and archive them after a period you deem reasonable.
  		• Maintain records according to state requirements, usually five to seven years.
  		• Proofread correspondence and reports for errors or omissions.
  		• Initial reports (X-rays, lab reports, consultations) before filing.
  		• Separate financial records from clinical records, and file them independently of one another.

    Elizabeth Kincaid, Esq., is the chief operating officer of NCMIC Insurance Company, which offers professional liability insurance to dentists through NCMIC Dental Solutions.sm Kincaid joined the organization in 1992 as the company’s first in-house staff counsel, and has also held the title of vice president of claims and underwriting. She earned a Juris Doctorate (J.D.) with distinction from the University of Iowa Law School. NCMIC Insurance Company is a subsidiary of NCMIC Group, Inc., which offers professional liability insurance to health-care providers as well as a variety of insurance and financial products and services. Kincaid may be reached at (800) 769-2000 ext. 342.

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    September 2025
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