Dentists are not immune to health conditions
What happens when dentists focus on their patients’ oral healthcare at the expense of their own health? When dentists experience their own physical or mental health issues, they need to consider whether their ability to practise safely and ethically is impacted.
Why is a dentist’s health relevant to RCDSO?
The College’s Code of Ethics specifies that dentists must recognize their limitations.
Most health conditions do not impair patient care. For example, if a condition is temporary and/or does not affect a dentist’s dexterity or executive functioning. Many dentists step away from patient care or self-limit their practice while undergoing treatment. They return to work only when recovered or medically cleared to return.
Unfortunately, some health conditions may impact a dentist’s ability to assess their own capacity to practice accurately. Some dentists attempt to maintain their usual practice unaware of, or despite, the impact of their health condition. Occasionally, dentists return to practice before they are recovered or medically cleared to return.
What is a mandatory report?
The Regulated Health Professions Act (RHPA) requires regulated health professionals to file a mandatory report if a dentist’s “incapacity” may impact their practice (s.85 and s.57-63 of the Health Professions Procedural Code). The legislation defines “incapacitated” as follows:
“a member is suffering from a physical or mental condition or disorder that makes it desirable in the interest of the public that the member’s certificate of registration be subject to terms, conditions or limitations.”
What happens if I or someone else contacts the College about my health?
Knowing that regulated health professionals may have a mandatory duty to report, some dentists opt to self-report. Dentists may notify the College of changes to their health status or practice and seek information about the College’s expectations for their practice management during periods of illness.
College staff manage health inquiries with sensitivity. They will contact a dentist if information is received about their health status. Though they may ask questions about a dentist’s condition, answers to these questions are not mandatory.
A dentist’s health information is confidential, yet dentists may be willing to share information about their circumstances so that the College and the Registrar can determine whether further health inquiries are needed.
The College reminds dentists about resources that are tailored to dentists (i.e., those offered by the Ontario Dental Association or the Canadian Dental Protective Association to their members).
What happens during the health inquiry process?
Dentists are involved in the health inquiry process. If health inquiries proceed, the Inquiries, Complaints and Reports Committee (ICRC) may:
- request more information from the dentist
- request the dentist’s expressed consent to access their confidential health information
- require the dentist to undergo an independent medical examination (IME).
Regulated health professionals retained by the College to conduct the IME are objective and separate from the therapeutic relationships that dentists have with their healthcare providers. An IME will offer an opinion on whether the dentist has a physical or mental health condition that impacts patient safety. They do not direct the dentist’s care, but they may recommend how the dentist can safely practise while receiving treatment.
Will I lose my license to practise?
Most often, dentists are willing to sign an agreement with the College to have their health monitored by a regulated health professional or a workplace support person. Dentists can request the ICRC to vary their agreements if/as their health condition changes over time.
Some dentists offer to limit their practice or to cease practising until their health condition is resolved. In some circumstances, with information from the dentist, their healthcare providers or an IME, the health inquiry concludes.
Very rarely does the ICRC refer a health inquiry to a hearing before the Fitness to Practise Committee (FTP). If a matter is referred to the FTP, the fact of the referral and any restrictions are posted on the public register. There have not been any FTP hearings at the College for more than five years.
The College and its committees have an abiding interest in seeing dentists practicing ethically, safely and, where needed, with appropriate support to ensure patient health and safety.