The perks and perils of treating family and friends

Posted on 19th January 2021

An interview with ADAWA CEO, Dr David Hallett

Q: Do dentists often ask whether they should treat family and friends?

DH: They do; often they want to know what the ethical dimensions are around treating family and friends, and, in some cases, they actually don’t want to treat their own family.

Of course, the question is around whether the family member will be able to obtain a private health insurance rebate for the treatment that their father, husband, wife or daughter provides.

Q: What should a dentist consider before they treat a family member or friend?

DH: You have to realise that this relationship with this particular patient is more than a professional one; it is a personal relationship as well. As such, we run the risk of the standard of care being compromised because we are too familiar with the patient, which then perhaps influences our objectivity and our professional judgement.

Once we strike that professional relationship, then there are other issues that can arise where we might be forced into inappropriate prescribing. Also, incorrect documentation or not enough documentation, particularly around our record keeping and so on, and particularly around diagnoses.

The appointment can be too casual. We are talking almost non-professionally during the appointment, which is natural because we are friends and so on, but that flows on to other aspects of the care that we are providing, like writing up our notes.

Q: Where should dentists draw a line or a boundary?

DH: The various health funds and our indemnity insurers start to define what they believe to be immediate family and so on. So, if you wanted to draw a line in the sand, those various entities can do that for you. But ultimately, of course, it is going to be how you deem the relationship to be.

Q: How can you politely decline treating family and friends?

DH: I think you can selectively interpret the Dental Board of Australia’s Code of Conduct that talks about conflict of interest and personal relationships with patients.

Q: What are the health-fund rules around treating friends and family?

DH: For every health fund in Australia there is a different rule in relation to the payment of benefits for dentists or health practitioners treating their own family. It varies from immediate family, right through to extended family, as well as professional colleagues from the same practice and staff within the practice.

Q: If I’m working in the practice, and my colleague sees my family member, is that ok?

DH: With some funds, no. Other funds, yes. Of course, you can still treat family, but it is a matter of whether they are going to be able to claim a benefit or rebate as a result of you treating them.

Q:  What should a dentist consider if they are planning on treating family or friends?

DH: They need to consider the rules of the health fund and also what the Code of Conduct expects of us as well, such as maintaining good clinical records and ensuring high standards of confidentiality and privacy.

We also have issues around consent. With family and friends, you will tend to not seek consent in the same way.

Q: Any final thoughts?

Broad topics such as this always creates a lot of interest and discussion; if any member wants to discuss anything further with me, or wants to make further enquiries, ADAWA is always more than happy to assist. You can call 9211 5600 or email ceo@adawa.com.au

This article is an abridged version of a longer interview that was broadcast as a “Bonding with ADAWA” podcast episode. To hear the interview between Dr Amanda Phoon Nguyen and Dr David Hallett in full, visit https://anchor.fm/bondingwithadawa or download wherever you get your podcasts. You can also hear interviews with Dr Jenny Ball and psychologist Alex Hoff.