Dentists have Discretion to Implement Cancellation and Late Arrival Policies

A patient complained about the conduct of his dentist, stating that the dentist’s cancellation policy and possible refusal to provide treatment violated the patient’s human rights. The patient also stated that the dentist’s receptionist was abusive and uncooperative. The receptionist allegedly interrupted him, refused to transfer him to another staff member and refused to provide him with a copy of his records.

The Health Professions Appeal and Review Board (the “Board”) confirmed the decision of the Inquiries, Complaints and Reports Committee (the “Committee”) of the Royal College of Dental Surgeons of Ontario to take no action.

Background

The patient was advised in a December 2013 email that he would not be charged a cancellation fee for future appointments. The email stated that if he is within 10-15 minutes late, the office is happy to take him for the appointment. However, if he is later than this window, they will have to reschedule the appointment. In December 2015, the patient arranged for appointments for that month and was advised by email that appointments need to be cancelled within 48 hours to avoid cancellation fees. The patient complained that these policies violated his human rights.

The Committee

The Committee stated that dentists have the discretion to implement cancellation and late arrival policies. The patient’s position was that the dentist’s policy violated his human rights because he has health conditions that may cause him to be unable to provide the requested notice. The Committee determined that the patient was never charged a cancellation fee and that there were no circumstances where his health conditions were unaccommodated.

The Committee stated that it was unable to make determinations on the issue of the receptionist’s conduct and the alleged failure to provide medical records.

The Board

The Board proceeded via written submissions and their mandate, to consider either the adequacy of the Committee’s investigation, the reasonableness of its decision, or both. The investigation does not need to be exhaustive to be adequate. The Committee must seek the necessary information to make an informed decision.

The patient stated that the Committee did not provide him with materials in a manner that accommodated his medical issues. The Board found that the Committee made efforts to accommodate the patient and that there was no indication that any failure to provide materials impacted the investigation. In addition, the Board stated that neither party argued that additional information should have been assessed. The Board concluded that there is no indication that additional materials would have impacted the Committee’s decision and the investigation was adequate.

The Board also stated that the Committee’s decision not to take action on the patient’s complaint was reasonable. The Committee noted that dentists have discretion to implement cancellation and late-arrival policies in their offices, and many dentists generally require notice of an impending cancellation. Further, in this case, the record supports the Committee’s conclusion that the patient was not charged a cancellation fee.

In addition, with respect to the allegations regarding the receptionist, the Board noted that when a complaint involves an exchange between two people, there is often no recording or documentation of the exchange. In these instances, there is no basis to favor one side over the other and it is generally inappropriate for the Committee to act on one version of events. In this case, there was no basis upon which to favor the patient’s version of his interaction with the receptionist over the receptionist’s version.

Takeaway

Based on this decision, it is reasonable to conclude that health professionals may charge cancellation fees and implement late arrival policies if these policies are administered fairly.  If you have any questions about this decision or regulatory proceedings in general, please contact us.