Dismissing Clients

Added to Handbook: Prior to June 2004
Last updated: January 2014

PURPOSE

To provide guidelines for dental hygienists dismissing clients.

BACKGROUND

As part of the CDHBC Practice Standards and Code of Ethics, dental hygienists have a responsibility to render competent, appropriate and safe dental hygiene care to clients. However, dental hygienists may encounter situations where their ability to meet practice standards and provide appropriate and competent care is compromised. It may be in the best interest of both parties for the dental hygienist to dismiss the client from their care and refer to another dental health professional. This may be related to the continued non-compliance of the client to recommended treatment, a conflict of personalities, or threatening or inappropriate behavior by a client. In situations like this, the collaborative relationship with the client may break down.

POLICY

If the dental hygienist determines that appropriate and competent care is not possible due to circumstances beyond their control, they have a duty to inform the client that treatment is not possible, and that alternative services can be arranged. Under the BC Human Rights Code, treatment of a client cannot be terminated on discriminatory grounds such as age, gender, sexual orientation, and religion, to name a few.

It is important for the dental hygienist to ensure that the client's oral health is not jeopardized in the dismissal process. When possible, and if the client is not refusing treatment, any dental hygiene procedures that are partially complete should be finished.

When a client is dismissed, the dental hygienist must provide the client with a letter outlining:

  • the importance of finding a new dental hygienist
  • a review of any outstanding treatment
  • a description of risks associated with not completing treatment

The dental hygienist should also record the dismissal and reason for it in the client chart and maintain a copy of the dismissal letter. It is optional to provide names of other dental hygiene professionals who may take over care.

It may not always be necessary to formally dismiss a client if it is possible to have another dental hygienist in the same practice assume care with the client's consent.

As guided through the CDHBC documentation practice standards, it is important to keep accurate and detailed records including any communication and correspondence with the client.

REFERENCES

  • CDSBC Manual for Dentists. Dismissing a patient - practical and ethical concerns. Vancouver: College of Dental Surgeons of BC; 2011. Available from:
    CDSBC Dimissing a Patient Information Sheet (2011 pdf)
  • College of Massage Therapists of British Columbia. Bylaws, Schedule "C", Code of ethical conduct. 2013. Available from:
    CMT BC Bylaws Schedule "C"
  • College of Registered Nurses of British Columbia. Duty to provide care [Internet]. 2012 [updated 2012 June; cited 2013 Aug 21]. Available from:
    CRNBC Duty to Provide Care
  • Government of British Columbia. Human rights code. Victoria: Queen's Printer Website; 2013.Available from:
    Human Rights Code [RSBC] Chapter 210
  • CDHBC Patient Relations Program. Victoria: College of Dental Hygienists of British Columbia; 2013.
  • CDHBC Code of Ethics. Victoria: College of Dental Hygienists of British Columbia; 2013.