Who You Gonna Call?

The Texas heat forced Dr. Kuba and Bethany into their cozy closet to record today’s important episode. Dr. Kuba throws two completely different scenarios to Bethany and puts her on the spot for advice. Both with the question - Who you gonna call? A patient receives services in your practice and then three weeks later gets admitted to the hospital with facial swelling. Should you self-report to the Board? In another scenario, a practice owner has an incredibly valuable employee that is looking at jail time. Should you intervene to help? Regardless of the scenario, it is critical to have the right people lined up to call when really weird and yet substantial scenarios hit your door. 

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Transcript

Hey friends, before we kick off today's episode, I wanted to remind you that time is running out on that early bird

0:08
special for our September leadership summit. It is coming up on Friday,

0:13
September 18th in the Colony, Texas, so about 15 minutes from DFW airport. And

0:20
if you're a subscriber, you're getting almost 30% off the registration fee. And

0:26
then of course we've got our early bird special that ends at the end of this month. So check out the show notes

0:33
today. [music] Don't hesitate. Sign up for that leadership summit. It's going to be a great event. [music] And while

0:38
you're at it, why don't you also become a subscriber as well because then you can get your 30% off and get all the

0:45
benefits of being [music] a subscriber. Okay, that's enough for now. Tune in right now to me and Dr. Kuba talking

0:51
about who you going to call.

1:00
What's up, lady? Hey, what you doing? It is freaking hot here in Texas.

1:07
That What is it, though, Wizard? I'm melting. I I do feel like I'm melting. Yes, chronically.

1:13
Like, we are back in my closet where we've not been in a very long time because I was like, we cannot sit in a

1:18
parking lot. Like, it's We will heat stroke out in the car. Yes. So, we're back in my closet. Um,

1:25
I'm kind of crusty, salty today because you were in my office today. I love that I bring such lack of

1:34
sunshine and rainbows. Apparently, I hate when you're in my office. [laughter]

1:40
[gasps] Um, I'm going to delete that you said that. I don't ever edit, but I'm deleting that. It's a day of reckoning. I feel like

1:47
it's all the things that I, you know, have to unberry. I'm like, damn it, this is going on in the practice. Damn it, I

1:52
didn't know so and so was upset and about to leave. Damn it, I didn't realize that three parents had called

1:57
upset about whatever. I'm just like, would it have just been easier to bury my known?

2:03
Yes. Yes. Well, now you know. So, I guess you can always choose to

2:10
bury your head again. It's very tempting, [laughter]

2:15
especially cuz it's like summer. It's freaking hot. I'd rather be on vacay

2:21
and I don't know the endless staffing issues, the endless it's busy and it's

2:30
summertime but it's really not as busy as as it should be but it's our new normal cuz we're out of network and

2:36
we're still like you have to constantly remind me that the numbers still look good but I'm like it just feels weird that not I'm not running like a chicken

2:42
with my head cut off like I don't know. I'm just having all these crusty feelings today. It it maybe maybe it's just you're still

2:50
kind of in vacation mode. Let's let's chalk it up to that. Yeah. I'm going to be this damn hot. I

2:56
bet I I would have preferred to be on the beach like I was a weekish ago. You're right. Yes, I know. And then I come in and

3:03
crank up the heat even more. Yes. Yes. But not It's not me. I'm just bringing

3:09
things to you that we got to deal with. To the face. You're the one who just took the shovel

3:14
to my box and dug me out. [laughter]

3:20
Yeah. And kicked that dirt in my face. That That's how I feel. [laughter] So, is this a good time to remind our

3:27
listeners of our leadership summit? [laughter] Where can I sign up?

3:34
That you are co-leading with me. [clears throat]

3:40
Bring all your crust. There's plenty to go around. I'm sure Bethany will have shovels there for all of us. Just

3:46
sprinkle the dirt. Yeah. Yeah. We're It's going to be a crusty day where we talk about issues and you will de divulge as you are so

3:54
good at your own crusty issues. Yes. Yes. Okay. So, today I uh actually

4:03
I I have a theme for today. I have two small examples. Okay. You might have more. I've not told you

4:08
the examples. I've not told you the theme or the topic. You know, nothing. Um, but my question is like this is what

4:16
fell on my door these last couple of weeks. And so, luckily, they're not really my problem, but you know,

4:22
any colleague that's going through things that reaches out to me, I do feel like that's why you and I do. Yeah, we

4:28
do. And and I want to help and then I go, what if that happened to me? Well, what I do? And so, normally I bug

4:34
you with these, but I think I've just been my head in the sand still. You've voice memoed me a couple, but not

4:40
these situations. Not these two. Yeah. Um, okay. You ready? I think I am.

4:46
Should I go ahead and say the title or the theme? Say it. Yes. Cuz this is all you know. Who you going

4:51
to call? And now we all have the song in our head. Yes. Yes. Yes. Do you have it on Q? Can you queue

4:58
it up? Um, okay. So, who you going to call? Um, so this was a colleague a week ago and

5:06
colleagueu's manager reaches out to me. Okay. And I know her pretty well and and so

5:12
whatever. No, the manager or the both a colleague I'm very close to and I happen to know her manager too. And um

5:19
so she's like, "Well, I have an employee that um has some uh legal issues.

5:30
And um I guess is potentially um in in

5:35
um like her probation, okay, maybe not maybe she did something to

5:42
violate her probation." Okay. an employee doesn't think she has, but that's what the legal system is

5:50
saying. Well, you didn't meet these two criteria, so you're looking at jail time.

5:57
[sighs and gasps] And so manager's like, "What do what do I do with this?"

6:02
Yeah. Like we need this employee um smaller town and so, you know, she's really trying to protect employee and

6:09
all of that. And um so I [clears throat] you know I'm kind of

6:14
like what are the what what are we talking about here? What kind of legal whatever. So it's anyway I was like well

6:22
what is her attorney advice? Well she doesn't have an attorney. Oh gosh. Well why doesn't she have an attorney?

6:28
She must have had one at some point if she's figured out a probation agreement. Um well I guess she never she's not she

6:36
maybe didn't like the person. Didn't reach back out to the person. Okay. So employee is now

6:42
thinking like getting a lawyer is going to be too expensive. I'm already paycheck to paycheck. Maybe

6:48
I'll just go ahead and serve my time and move on. So it's not I don't what

6:54
little bit she told me. I I don't I don't think it's like a violent crime or anything like that, but it's still just

6:59
legal troubles and whatever. Um so

7:05
what what do what does manager do? Do you just let this employee go? Is that

7:11
But again, it's a small town. Employees been employed there for a while. Yeah.

7:16
Um if employee goes to jail, then they can't rehire her at any point because it's a felony on the record,

7:23
right? Um so I think that was my first inclination. It's like why why would you even deal with this? Just fire and move

7:29
on. Put a post for a new person. And she's like it's it's somebody that you know again everything I just said. She's

7:35
like, "We'd really rather not lose her." Yeah. Yeah.

7:40
So, who do I call? So, I guess she called me, but I'm just like, "Okay, well, what would I do if I was in this

7:47
situation? Who would I call? Am I washing my hands of it? Am I So then that, you know, when you go

7:55
down that rabbit hole, okay, am I just firing and saying, "Okay, well, I mean, obviously if you go to jail, then that's bye-bye and we're going to put up a post

8:01
now." So, [snorts] that's option one. Yeah. Option two, um would I help my

8:07
employee find a lawyer? Right. Um when I was asking my husband this, he

8:13
was like, you wouldn't like we were going back and forth over different parameters if it was, you know, happening to me or whatever. And it's

8:20
like, would you would you wouldn't pay for the lawyer, would you? And I'm like, I don't I don't know. Yeah.

8:26
Like I I don't know. Yeah. Um anyway, so

8:32
yeah. What are you going to call Bethany? What? I I I wasn't even really sure what to tell this lady. I know that's such a hard spot and my

8:40
mind goes in a lot of different directions because first of all, I always go towards

8:47
protecting my clients, the dentist, the teams, the practice. So, I tend to go to

8:53
risk adverse mode first and foremost. If I may interrupt, I think that's probably was part of her concern too because it's

9:00
a [clears throat] small town and if it comes out that she's no longer there and word in the community gets out

9:05
that she's in jail, like would it not be better to help her get a lawyer to avoid that but also protect the practice so

9:11
that the practice isn't going, "Oh, you had this person working in your office cuz then they can't share the details of

9:16
it wasn't a, you know, it's not like she harmed. It wasn't a violent

9:23
Yeah. situation. I don't know. Anyway, carry on. You were saying you always try to protect the

9:28
client. So, my mind is going there first. And then there's also this part of me that's

9:34
like I can't not think of the staff members. I I work with so many amazing team

9:41
members that really I just so appreciate them as people that I can't completely

9:47
ignore this person's situation that he or she's in. And so there's also the human side of it

9:53
that I feel like we have to kind of grapple with it as well. And this is where practice ownership is so hard

9:59
because you've got it's not black and white. Like I could I'm about to tell you some things that I would think about

10:05
as far as protecting the practice, but then there's also the human side of it that grays things up quite a bit. And we

10:11
could be, you know, super draw the line and this is what's going to be right to protect the practice. and that may not

10:17
be what's best for this employee that's been a part of your practice for quite some time. And so I it's there's a lot

10:25
of gray I feel like in this scenario. So number one, I I would say we have to

10:31
know some more information about what this person's offense is. I know your

10:39
colleague told you it's nonviolent and was probably not sharing all of the details of what she knows about it, but

10:45
I think we have to know what this person's offense is so that we can

10:51
navigate appropriately. So, what would be some things that could come up um

10:57
that would be concerning? You know, in all honesty, a recent drug

11:03
charge. I didn't Now, this is where again, it's all gray. So, I'm just going to give my opinion on it if I were

11:09
advising your friend on this DWI and DUI. Um, I tend to look on less

11:18
um strictly as I do like you were selling drugs, you were um you know on

11:26
some heavy meth and got caught with that. That to me is a different level of

11:31
severity primarily because of in the dental field we have drugs around us all

11:37
the time. Now, would that if I saw that she had been, you know, a high up in

11:44
the, you know, drug cartel and that's what's on her record, but that was 5

11:51
years ago and she's still serving pro parole for that and has been doing just fine on parole. Then again time also

11:59
becomes relevant here which I would imagine with your friend since she's been working at the practice this lady

12:06
person whoever employee has been working at the practice for several years my guess is this is an old offense so then

12:14
I would look even though drug is a higher offense in my mind for protection for the practice it would be lower

12:21
because it was obviously several years ago unless it's what happened now

12:26
like why Is this coming up now? Did you correct? So, I guess that's what they need to determine. Yeah. What was the original offense and

12:34
how did he or she break parole? Because if it was just oh, he or she missed two

12:40
meetings with the parole officer, even though that's not good. I'm not saying that that's a good thing, but or did we

12:48
have this major relapse where she was caught he was caught selling drugs? Okay, that answers our question right

12:55
there. we can't risk the protection of the practice because we think about you

13:00
know what if he or she actively was caught selling drugs again. Now we think about protection of our team, our

13:07
patients and our practice and the type of people that he or she may be interacting with to sell these drugs if

13:14
they know that he or she has a place of an employment at your practice. Well,

13:19
now I'm worried about the type of people that could be coming into the office,

13:25
could be doing drug deals out in the parking lot, could be, you know, coming into the

13:31
practice and and risking your patient safety. So, we've got to think about that side of things. Um, [clears throat]

13:39
I don't think there's any risk to the practice for wrongful termination. If somebody is has a record, has broken

13:48
their parole, then you are in most states, you're well within your right to go ahead and fire. So, we don't have to

13:54
think about that from a protection standpoint. Um, but we have to also think about the protection to the

14:00
practice in what it's going to do from a staffing standpoint. What if your

14:06
colleague, this person has been on her team, your colleague's a she,

14:12
so this um team member has been on your employ on your colleagues team for you

14:18
know years, three years, and she she or he is your colleagueu's

14:25
only employee, your only RDA, let's say,

14:30
that's a major risk to the practice to is that same day. Oh gosh, you broke

14:37
Pearl. You're gone. And now your colleague, she's trying to figure out how she's going to run her schedule with

14:43
no RDA in a small town where she can't find an RDA fast enough. That's a that's

14:50
a risk to the practice. So to me, that decision would be, okay, if if we're

14:57
going to terminate this employee, then it needs to fit in a timeline that still

15:02
gives your colleague time to find a replacement. So that's also a part of the risk. Let me pause there because

15:07
I've said a lot. You no, I that that's where I'm just like I I don't I think

15:13
with me not knowing too much about the offense. Yeah, that's that's a good point. I I didn't really ask I I really was just letting

15:19
her vent more than anything. Um, so but in my own thinking about this going,

15:25
well, what I do, what I think my temptation would be to just be like, bye-bye. I don't want to

15:31
deal with this. Yeah. Um, but like you said, the human side of it and trying to find a different

15:37
employee for the practice and all of that, it's, you know,

15:42
but if the employee themselves are like, you know what, I'm just done. I'm going to go ahead and do my time.

15:48
Yeah. I guess I just feel so bad for that per like I would I don't think I would ever I can't think of one thing

15:55
that would make me go I'd rather sit in jail than X. I know. You know what I mean? So I I guess I can't wrap my brain around that. Um so

16:02
for coming to that level of Yeah. you know, to to me that you're that's the human

16:10
side of it that I think you know what if this person did something as simple as missed a couple of parole meetings and

16:18
now he or she is looking at jail time simply because they don't have the money for a lawyer.

16:25
It still goes back to what's the original offense, how long since the original offense is truly the only

16:31
reason that he or she's not contacting a lawyer is financial. Is it financial or is there something else? Something that

16:38
they're not wanting to say that they did to broke to break parole. So, I think we'd have to dig in a little bit, but in

16:44
all honesty, you could be doing the practice a favor and this person a favor

16:50
if you were willing to contribute a set amount of money towards a lawyer

16:56
that could help this person get out of this situation. Now, here's the only downside to that is lawyers are

17:04
expensive. So, you could say, "Man, I'm going to be super generous to my employee, and I'm going to gift them.

17:11
I'm not even going to ask them to repay it. I'm going to gift them with $1,000. They've been a loyal employee. They make

17:18
my life great. I would hate to lose them. I'm going to just gift $1,000 um

17:23
towards le legal fees." uh if this person the the employee is going to have

17:29
to end up in front of a judge, which is highly likely for this scenario, $1,000

17:34
is not going to be near enough to get through that process. So then you're

17:40
like, "Okay, well then does that even help them enough? How much would I be looking at if I

17:46
truly wanted to help this situation go away?" I mean, you could be looking at $5 to $10,000,

17:53
which would be impossible if this person is living to pay, you know, paycheck to paycheck for them to pay that off in any

18:00
period of time. And then you're thinking, is am I gifting that? Which

18:05
there's nothing wrong with gifting that. I think there's plenty of generous people out there that have the means to

18:12
do that and would do that. And I think that's wonderful. I think some people aren't in the situation to be able to

18:18
gift that much to an individual. And so I think that's also got to be part of

18:23
it. If you knew the original offense and knew for sure why this person was not

18:29
fulfilling their parole requirements, then you could decide how much you're willing to invest. See, and I feel like

18:34
funny you say that because I think the old me, the me of, I don't know, eight, nine years ago, I would have been like,

18:41
[gasps] you know, you're a single mom. You've got whatever. You got yourself into this jam. And, you know, people with money

18:48
could have gotten themselves out cuz a lawyer would have found a loophole or whatever. But I think the jaded me, the crusty me

18:56
now is like even if you missed two parole meetings, you did that. Those

19:01
were choices you made. And so why am I shelling out 10 grand?

19:06
Yeah. Like it is what it is. I guess that to me though it was where I was like, man,

19:11
that sucks because there are people who can make it go away because they've got the money for the lawyer. Yep. Um and I guess my question was, but

19:18
shouldn't you even at least talk to a lawyer to know your options better, right? Um, which maybe it was the July

19:26
article that I wrote was fresh on my mind because uh I talk about, you know, if you if you needed a lawyer, how where

19:33
do you where do you start? What do you look at? And I think for me, I see in a

19:38
lot of times where dentists are having to defend their their work, the number of dentists that don't hire a lawyer is

19:44
just mindboggling to me because I'm like, you don't know the system and you don't know

19:50
you don't know what matters to people versus what's and you can in your own mind go, "Oh, well, this explains away

19:56
this." I I heard somebody at the last time I was consulting um an

20:01
orthodontist, young guy, been maybe practicing 8 years, 10 years, something like that,

20:06
really sharp guy, but in his rebuttal letter, it was like, I don't think that

20:12
this is, you know, this is this rule is kind of stupid and I don't think whatever. And I'm just like,

20:19
dude, who who nobody cares about your opinion. Yeah. Nobody the the

20:25
Nobody cares about your opinion. Yeah. Come with facts and and look at what's the law and the people lawy people

20:33
aren't going to care about what you think of the law, right? So, you've written this like I don't

20:39
know two-page thing about your opinion of why you think this is stupid. And I'm like, you're the one that's looking

20:44
stupid, buddy. Right. Hire a damn lawyer. Yes. Lawyer would have told you to put that in the trash.

20:50
Yeah. Um, so you don't know the system and and what you're arguing may be true. like we

20:55
could laugh about it over a beer, but know your audience. And you don't know your audience because you've never gone

21:02
through this before, which is a good thing, right? But hire a lawyer to guide you through that. And so this is what I was saying

21:07
to to the colleague uh to the office manager to tell the employee like if it really was missing two parole

21:15
meetings, I don't know. Is there something? Could you write a letter? Could you show proof

21:21
that you were at your kids's teacher meeting or what? I don't know if those things matter or don't matter, but a

21:27
lawyer would know that. So, could you at least know your But I'm guessing it's the money

21:33
between the lawyer and fighting it or doing whatever and she's

21:38
just kind of given up. And I just was like, that is heartbreaking. On the other hand, you made your bed. So, I I I

21:45
just didn't know what what would you recommend? Who would you call? Yeah. And so, yeah, I think that it really is a tough

21:51
scenario. I tend to be so um you know subjective in my opinions because I if

21:58
this employee is the only RDA on a team or or is super pivotal in daily

22:05
operations, I know the impact of losing a valuable team member like that. And so

22:10
I might be inclined, if this were my client, to say, "Hey, let's let's pay

22:17
for a 1-hour consultation for her to be able to talk to somebody and let's just

22:23
see where it goes from there." After we figure out original offense, time since the offense, what's the parole offense,

22:29
after we do that due diligence, then I would probably say if she's super pivotal and this is a small town and all

22:37
of that, I would probably be inclined to say let's see what we can do to help because it in turn helps the practice.

22:44
If it's a larger team, this is even if she's been there several years, but we

22:51
we're going to be fine. Um, then I would probably be more inclined to be like,

22:57
"Hey, he or she kind of made her bed, made his bed, like just got to let her

23:03
or him do his thing." And if that means going to jail, that's really sad, but it is what it is. And so I think it's so

23:10
practice dependent. It's obviously dependent upon the original offense with this person, but also I think it just

23:16
depends on the practice. So a comment and a question. So, back to who you going to call cuz that's where

23:23
office manager called me and I had nothing to say. Um, but thinking about myself in the situation, I was like, who

23:29
would I call? Well, I would call you. But I also thought about Tink, uh, the compliance Dwayne Tinker. And,

23:36
um, so I mentioned that to the office manager because they're also Tink clients. I was like, can you reach out

23:42
to Tink already? Yeah. And she's like, no, what what does compliance have to do with this? I said, I don't know. Tink knows a lot of people

23:47
and knows a lot of situations and he used to be a cop and just pick his brain anyway. And so um so

23:53
I guess in my mind that's like that's who I would call. My phone of friends would be I would call Bethany obviously

23:59
and I would call Tank just to say hey do you know any lawyers? Is this worth

24:04
trying to help or you know what do you do? So um those would be my phone of

24:10
friends. So that was my comment there. My question for you is, so you're talking about an offense like a I think

24:16
you said DUI, DWI, whatever. What would be some other offenses that you would be like, "Oh, hells no." Like cut ties and

24:23
that's that. Anything related to theft? I just don't play with that. I

24:32
What about an assault like a bar fight? And again, I think that's very situation

24:38
dependent because while I do not condone violence to me, I and this is where my

24:46
uh true crime crime self comes out because you if you do enough

24:53
research on scenarios um you know legal scenarios, you realize there are two,

24:59
three, four sides to every story and there is one situation that I read up on

25:06
that it was a bar fight and thankfully videos became evident and this this

25:12
person had been in my opinion wrongfully arrested. She had a right to defend herself. Um

25:20
and the videos ultimately showed that. Um but again the system is can be slated

25:26
to privilege the privileged and she was not privileged and I think um you know as I

25:34
watched her story unfold I was like it's just really unfair and so you think about something like a bar fight and

25:42
obviously that's not good but at the same time I I would be very careful to

25:47
immediately just assume that your employee was completely in the wrong um you

25:54
I look at things like intentionally injuring other people like assault

26:01
charges as far as um you know assaulting their kids and they

26:06
got arrested for that. Okay, that's a little bit of a different scenario, especially if you're a pediatric dentist

26:13
or you see kids in your practice, you've got to keep in mind patient safety. Um, and if somebody has a record of abusing

26:20
kids or I've had one um that we did a background check and um sexual assault

26:28
came up on theirs and it was an immediate no for for me because to me

26:34
that's something that even if you were wrongfully accused of that, the fact

26:41
that it had something sexual in nature, I'm like from a um patient protection

26:48
standpoint. That's just risky waters that I just don't think it's worth the risk. And so I think again,

26:53
see, and that's for me, I would still pause like did somebody just accuse you willy-nilly? Yeah.

26:58
Like I I would want to know more. Yes. Which again, I think anything that pops up either with a current employee

27:04
or somebody that you're looking to hire. We have to ask the questions and get the the scenario.

27:11
But keep in mind, everything comes with a risk. And so we've got to be I'm I'm much more inclined to just be like heck

27:17
no to a applicant. I feel like it's different when the

27:22
person's on your team incorporated and something comes up then there's they

27:29
they should get your consideration in that they've earned your consideration with their longevity on your team. So

27:37
those are some of the things that come to my mind as far as the record. Okay. drugs is a big one for me. Theft

27:44
is a big one. Um and then to me, sexual assault um is one that I think is worth

27:51
looking into. Doesn't mean that it's an immediate like heck no, but I think it's worth looking into.

27:58
Yeah, we need to see if we can get accurate details, and that's going to be the next part of the challenge is how do you get

28:03
Yeah. any accurate details. So, um Okay. Well, that was a fun Who you going to

28:09
call? Do you like that one? Like, gosh. [laughter] No. Okay. Um I got another one that's

28:15
completely a different topic. Um but uh I guess

28:21
um colleague. So it's my colleagueu's colleague and he was like, "Hey, could

28:27
she call you and talk to you?" Yeah. So, I guess um her she did a a

28:34
filling or whatever on a patient and the patient was fine and then a few weeks

28:39
later the uh tooth starts acting up. The kid

28:45
gets swollen. [snorts] Um they end up in the ER. The ER they

28:51
end up extracting the tooth and that's that. Well, the um apparently [clears throat]

28:59
the uh family has cut off contact with the dentist when she's tried to like

29:05
follow up. Follow up. And the dentist that did the filling is also the one that extracted the tooth. No, the one that extracted the tooth is

29:12
the one who was on call at the children's hospital. Okay, gotcha. So, when she heard that all of that had

29:18
happened, like she referred them to the children's hospital for IV antibiotics. The kid ends up getting admitted

29:25
for a couple of days and then the doctor on call comes in and extracts the tooth and perhaps did some other dentistry

29:30
while they were at it. So now she doesn't know is the parent upset because

29:36
she missed decay and this other provider had to do treatment. Is she worried that

29:42
the parent is like how could my kid's face blow up after filling? You must have done something wrong. Is she not

29:47
mad at the client at the the doc to begin with and she's just not calling

29:53
back because it's summer break? Like she just doesn't know. Yeah. But the question was, does she need to

29:59
self-report because the kid ended up in the hospital for 2 days? So, this is going to go back

30:06
to like state laws and what do you do? So, so some gaps that I wanted to make sure

30:12
I understand. So wh when did the dentist that did the filling become aware that

30:18
there was a problem? 3 weeks after the filling. 3 weeks after the filling parent calls

30:24
and says they're having sensitivity or parent calls and says their face blew up. Their face is swollen. Okay.

30:29
And they were Yeah. The face is swollen and so now dentist says, "Okay, then they need IV antibiotics. Proceed to the

30:36
children's hospital for IV antibiotics." Kid gets admitted for two days and then has surgery to remove the tooth. Mhm.

30:43
Um, so what do you do?

30:48
Who you going to call? Who you going to call? Go. Do you call anybody? Do you call anybody? Like, does does the

30:55
dentist go, "Okay, well, I'm glad the kid's okay." But if she's got this murky feeling of

31:00
going, I don't know if this mom's okay or not, or what? And did I do anything wrong? And and then along the way, somebody said

31:07
something about, "Do you self-report?" And so then that to me it's like then do

31:13
you go back to your state law? You have to you've got to go back and look at that. But my mind immediately

31:20
goes to again protection mode which is as weird as it sounds the first person

31:26
that I would want to talk to is malpractice. So apparently

31:32
she did call malpractice and they're like we can't give you legal advice.

31:37
And I will tell you the time I've called malpractice about a custody something like if the parents bringing this but

31:44
then that parent saying that like what do I do? And I got a same blanket. Well,

31:49
I'm not you know we can't give you legal advice but you should just follow whatever the law is in your state. What

31:54
am I paying my premiums for? Oh my gosh, that's so frustrating. So I don't know who her malpractice is.

32:01
I know who mine is. And I'm just like useless. Yeah, they're they're covering

32:07
themselves. Yeah. So, I was just like, "Okay, so she did. That's who she found." Okay, good. That's good.

32:14
That was useless. I would still say start there because you never know. They may have some good

32:19
advice and they at least need to be made aware of the situation in case a claim is filed. [gasps] Um I in this

32:27
particular case, I would start with a trusted colleague like you. You

32:33
obviously received this phone call. I think you've got to discuss this with another clinician first and foremost and

32:40
not just your good old buddy down the street that's going to tell you what you want to hear, but I think somebody that

32:46
is a thinker and somebody who's really going to take this situation to heart seriously and think through it. Um

32:53
because to me, just two minds together on this is better than one. Don't talk to your spouse about this if they're not

32:58
in the dental if they're not a clinician. you need to talk to a clinician. Um, I think immediately going

33:05
back and reviewing the X-ray, hopefully you've got a good pre-op prefilling

33:13
X-ray and you've got a good post op filling. This is why we do post op not

33:19
filling, post-op x-ray of the filling. Um, that would be very helpful to have

33:25
on file. And I know that's cumbersome. Every time I recommend posttop X-rays to team members, I literally get every

33:32
single person, including the doctor, roll their eyes. So, you say every treatment. Mhm.

33:39
Yeah. Which is I hate that I even have to say it, but these And then you can't build that out.

33:44
No, you don't build that out. Okay. That's a That's a free X-ray.

33:50
And I hate free, but I like practice protection more than anything else. And

33:55
this is you wouldn't think about it on a filling. You're like, "Really? I gotta do a posttop x-ray on a filling." Yes,

34:02
just do it. Just take the dang PA, take the bitewing, whatever you feel like going to give you the best. Okay. So, in in Pete's case, or even in

34:09
general, honestly, with all the people that like radiation,

34:15
what do we say there? We need to make sure. Yeah. We got to make sure there's no cement left behind. We've got to make

34:21
sure that we think margins look good. I can't tell you how many times somebody's taken a post op x-ray on a filling and

34:29
they see cement that they just missed. Um, or they'll come in, the patient will

34:36
come in, you know, two weeks later like, "My gums are still so sensitive." They'll take snap that X-ray and sure

34:41
enough, there's cement there that's been irritating. So, I get that with a crown because at least in Texas, like I I don't I don't

34:48
know if there's a state board rule for it or not, but it's it's what do you call it? what a reasonable and prudent dentist would do to make sure that that

34:54
margin is closed. Yeah. And that's gotten a lot of people in trouble because if if the margin is open and then the

35:02
dentist is like, "Oh yeah, this is my X-ray and it looks fine." And then the reviewers are like that you think that

35:08
that is fine. Um, but even ledges that we can see with fillings. I mean, think about the things

35:14
that can get trapped, you know, on on those ledges or if the patient is being

35:19
a good patient and flossing and then did they crack that margin open and now we've got a filling that blows up on us

35:26
to me, which which in that case too where you're like, "Oh, that's okay. I would just like have the patient come in. If

35:31
we took an X-ray and realized it, then I would fix it." And the problem with that is a lot of times if you're closed,

35:37
you're not there, or the patient's like, "Your appointment is the next day at 2:00 p.m., but they're like, "I got to

35:42
go to work. I found a dentist down the street that is open at 8:00 a.m." And that dentist tells them that there's a

35:47
ledge that you just filled a month ago. Y that's where a lot of these cases agreed

35:53
come to light. Yeah. So it she the colleague that reached out to you may or may not have

35:58
had that. But just in a general rule of thumb, I just don't think it hurts to take those posttop X-rays. And I think

36:05
this is exactly why. You would never think with a filling that you're going to need to rely back on the integrity of

36:11
that filling through the X-ray, but this is a perfect scenario where that would help to protect her in this case. So, go

36:18
back, look at the x-rays, go back, look at the notes. Um, call a f phone a

36:24
friend, a colleague, a clinician that you really trust. Um, and then I think

36:29
it does depend on the state on whether you self-report. Um, in Texas, I would

36:34
say don't self-report. Um, but again,

36:40
you know, why would you say that? Because technically this was not something that occurred within this is

36:47
weeks later after this filling. Yes, it was related to the original treatment,

36:54
but it didn't happen. It didn't happen right there in the moment she her face

36:59
blew up or the very night her gums are all swollen. So to me, it's been enough

37:04
of a length of a period of time that I don't feel like it relates. Obviously,

37:10
it's due to this tooth being bad, but it wasn't necessarily a bad filling in my

37:15
opinion. Apparently, the decay was already too far gone and the filling just didn't solve it. So, I think you

37:21
can create enough of a gap there. If this is a day or two later, even a week later, I would say, okay, yeah, maybe.

37:27
But so I'm going to read you what the Texas what I found online for this Texas rule

37:34
says uh for a self-report a patient hospitalization report within 30 days of a patient being admitted to a hospital

37:40
or emergency facility as a possible consequence of your dental services

37:46
possible consequence consequence of your dental services but your dental services was that filling. Yeah. So, this is saying you need to

37:54
self-report that possible. Yeah, it's a possible consequence of the

37:59
work you did. Possible is really gray. Okay. So, then

38:05
I'm looking at just looking and going um so I I just looked on like Reddit like

38:13
what are people right? And so somebody's like am I dumb here? Why are you tattling on yourself? Um

38:18
there's no need to self-report. Patients get infections all the time. Sounds like he identified the issue in a timely manner, referred the patient to the

38:24
appropriate department, whatever. Um, [snorts] the who self-reports to the board.

38:31
So, I know how dentists feel. I think for me,

38:37
I I agree with you that it's a gray area. Did you nick a ? Was your filling inadequate? If your filling was

38:43
inadequate, really, would it blow up that quickly? I don't know. And I have no idea that is this person putting in

38:50
crappy feelings? I don't know. Um, so it it you have all of those questions. I

38:56
think where I hesitate is if if the parent had called you back and

39:03
everything was great and you the kid was coming back for posttop and all of that, I think the inclination would be like,

39:08
well, why am I self-reporting? But according to I mean I guess that's the question in general is does anybody

39:15
ever self-report right like I don't is everybody

39:21
listening right now going who the hell self-reports that's the dumbest thing I've ever heard. So my question then

39:27
becomes okay well in this case that the thing that makes me a little anxious is

39:32
that she's telling me that she doesn't know patient is nonres our parent is nonresponsive to those

39:37
and she's wondering if the parent is upset at her. Mhm. And if the parents upset at her, then

39:44
are you going to complain to the board? Right. And if you complain to the board and now they investigate and they found that the

39:50
kid went to the ER, the board's always going to say you should self-report. Yeah. And so, can they add that to the list of

39:56
allegations? Yeah. So, I don't know. And I think that's

40:01
where I was because again, she's a colleague of a colleague. Yeah. So, I guess um somebody had said to her, "Who

40:09
the hell self-reports? This happens all the time." Same as whatever this person on Reddit said, "This happens all the time. You did the best you could and

40:16
whatever." But then another colleague was like, "No, you're supposed to self-report cuz it's gray, right?" And

40:21
so, she was trying to seek counsel, but she was getting two differing opinions. Yeah. And then the one friend that was like,

40:27
"I think you should self-report asked me because I help consult the things." And I was just like,

40:34
I mean, I see both sides of it. I know it state board would view it as.

40:40
So, but this is where it goes back to this is why you have a good attorney that's

40:45
familiar with the Texas State Board to help advise you on this because if they think this is going to be an extra quote

40:52
unquote charge, well, let me let me take it back even further. First of all, the patient could report the parent could

40:58
report to the state board. the state board if they look into this

41:03
situation and they look at that preop x-ray, they look at that posttop, they

41:08
look at all the documentation, they look at the attempts of the dentist to follow up after she realized that she had to

41:14
refer them to the hospital, the the reviewer could say, "I don't see that the dentist did anything wrong. Shut the

41:22
case. We're not going to think about it any any further." The lawyers who are familiar with your

41:28
state board are going to know whether it's a big enough deal because it is gray. It says as a possible

41:34
consequence to something that you did. And so a lawyer's going to know, can I argue that case or not? Or am I so

41:42
connected with my Texas state dental board that I know they're just eager to to slap anybody for any offense and no,

41:49
we're going to follow by the book and you need to self-report. So, I think this goes back to what you've said

41:55
earlier, have a good attorney. But, so I guess to me, who are you going to call? Because to me, in my mind, set

42:00
attorney would be malpractice. And they're like, well, we we can't give you legal advice. So, then now who's she going to call?

42:06
Does she ask malpractice for an attorney's phone number? Yeah, she can. Does she? But to me,

42:13
this is where this goes to your article that's out in our digest right now that

42:19
you've got to have an attorney ready to go before you need an attorney.

42:25
Figure out who that is. Get I mean, obviously in the state of Texas, you're familiar. I mean, I reach out to you all

42:31
the time like, remind me which attorney you recommend because you know you know who does a great job um in these

42:37
scenarios. And so you've got to ask around and figure out who but you need to have that attorney on file before a

42:44
situation like this pops up. Even if you've never had to call him or her, you need to know who you're going

42:50
to call in that scenario. Who you going to call? Mhm. Yeah.

42:56
For for everybody that's like, "Hell's no I'm not self-reporting. That's the dumbest thing I ever heard." But it

43:01
could still come back to bite you. Yeah. And know your state know your state laws.

43:07
But I would imagine most state laws are this gray. I hope that's not helpful. Like it's damned if you do, damned if you don't.

43:14
I know it creates but to me it creates choice. I would much rather have gray in

43:21
the law rather than it to be so ironclad that your back's going against a wall and you can't make a choice. True. But I

43:29
my heart went out to her because I talked to her and I was like, well, you know, here here's the way I see it. And

43:35
again, I don't know all the details. They have sands or buts. Like, is the mom truly mad or not? Or yeah, you know, how do you try to discern all

43:41
of that? But if you suspect that she is now, so that's one scenario. The other

43:47
scenario is again, if mom's super happy, but are you supposed to report?

43:54
Yeah. And so, you're kind of gambling with that. Like, what are the chances that this would get to this? I don't know.

44:00
Yeah. So, are you rolling the dice and playing dumb? Are you What? Now that you've asked,

44:06
are you going, "Uhoh, I've put it out in the universe. Like, maybe I shouldn't even ask. Just carry on my humrum way." I I don't I don't know. So, I was like,

44:12
"Well, this is what the rule in Texas says, so you need to look at your state rule, and this is what people are saying on Reddit. Good luck, friend."

44:19
Yeah, I This stinks. Yucky. I know it really does. There's nothing

44:26
fun about it, but I think it takes a lot of just judgment, getting your, you

44:32
know, getting a good colleague's advice, looking deeply at that X-ray, those X-rays, again, your charting, and just

44:40
making a judgment call, knowing your after you know your state law. And again, if you've already got your

44:46
attorney on speed dial and you knew who you were going to call, pay the money to

44:52
run past them and go, "Do you think I need to report this?" and lean in on their advice. That's all you can do.

45:00
So, I know we're probably out of time here, but the two scenarios I gave you about who you going to call, do you have, as you've been talking, do you

45:06
have your own scenario for who would you call or are you like there's so so many that I could bring up

45:12
that I it would be worth another episode. So, you can do a part two, but also I I just have to be really

45:19
careful. So, I don't know. There's there is a long list. Yes. Okay. I'm going to have to try to work

45:25
on you to [snorts] divulge more than I need to. Yes, we want some meat.

45:31
Drama, drama, drama. Oh, drama. Thanks for joining the conversation

45:36
today. We hope that you are comforted in knowing that you are not alone, [music] but we also hope that you're walking

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away with some really great tips and tricks to try in your practice.

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