Complaints against Dental Workers at the HPCSA: Dental Curriculum Implications

Objectives: This study was conducted to investigate the nature and outcome of complaints laid against different categories of oral health care workers charged with misconduct at the HPCSA in order to inform dental curriculum content. Methods: Data were extracted from the HPCSA records (2004-2009) and complaints were categorized according to the general ethical rules. An open-ended category was added for cases when a complaint could not be directly linked to a specific rule whereupon the categorization was based on the commonality of the content of the complaints. The outcomes (guilty, not guilty, and not finalized) and the penalties (reprimand, suspension, removal from the register, fines, restitution, and further training) were also recorded. The number of registered oral health care workers was obtained from the HPCSA in order to calculate the prevalence of complaints. Descriptive statistics and Chi-square analyses were employed to analyze the data. Results: The prevalence of complaints against dental therapists (5.5%) was significantly higher (P<0.001) compared to dentists (2%) – even when accounting for those who are employed abroad. Fraud (46%), followed by unacceptable treatment quality (19%), unethical advertising (15%), poor infection control (8%), and the creation of expectations that could not be met (8%) were the most common complaints laid against dental therapists. Unacceptable treatment quality (52%), fraud (29%) accounted for the most common complaints against dentists. Ninety percent of finalised fraud cases and 74% of finalized complaints pertaining to unacceptable treatment quality resulted in “guilty” outcomes. Penalties varied appreciably. Conclusions: The implications for dental curriculum content will be to focus on knowledge, skills, attitudes and behaviours that could improve treatment management and administrative integrity, as well as risk management strategies to prevent complaints in general. As a potential deterrent, the methods of policing fraud and the consequences of fraud should also be addressed.