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Radiograph refusal

I am having a difficult time with patients refusing radiographs. I started working in this office in December and it seems that a majority of the patients refuse radiographs. I try to explain why they are necessary but it often does not help. Does anyone have any suggestions on how to handle these patients?



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9 Answers

Standard of care in my state is every two years, unless caries active or at risk. I asked the board how to handle refusals, they told me that you insist on two years, if they refuse, you don’t treat. Our licences are at risk if we do not provide standard of care.

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I have this issue as well. It seems that no matter what you say they will refuse it and give an answer usually involving radiation. In reality, I’m sure it has more to do with money. It takes some getting used to, but try asking what their fear is or hesitation with it first. If it is radiation discuss how it’s the same as spending an hour out in the sun. If it is money, try explaining that they are paying for an exam as well which cannot be thorough without the x-rays. Decay found sooner is always easier on the patient and has a better prognosis.

I’m sure you may be doing this already, but I hope it helps!

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I have the same problem. Honestly there is so much literature online about bitewings and cancer that a lot of pts have become resistant. My office recommends and then have the pt sign a refusal of dry form. That being said if its been past a certain amount of time e.g. 3 years and NO X-rays my dentist will consider dismissal of the pt

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In my state a signed refusal does not work. There have been cases of dentists being sued for ‘supervised neglect’ even with them. We insist on 2 years and if the patient still refuses we will not treat them.

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If I have given all the information about benefits vs. risks of xrays and they still decline then there is not much we can do. We have the patient sign the chart stating the dr cannot do full exam without xrays and we are not liable for decay present that can only be seen on xrays. Dr. hasn’t dismissed any patients yet that I know of for declining but he makes sure they understand the need for them every time they come in. We can’t force them.

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Signing a refusal form does not clear the doctor from neglect. Sometimes it will help to have the doctor come in and do the exam and then tell the pt they need XYX radiographs. Usually if the doctor tells them they need the X-rays the pt does it. I had a pt refuse for years and we finally told the patient that we could not do our job because they were preventing us from properly diagnosing any conditions they may have and we told them to go elsewhere.

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We have a new doctor/owner who is adamant about xrays. No more refusals. If money is the problem (especially with our older pts) he will have us take them at no charge. If they “just don’t want them” or some other excuse, he is dismissing patients if it has been more than 2 years since last radiographs. And all those patients who say “I won’t sue you if I have a problem” are liars. Supervised neglect is becoming more of a problem.

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We have many patients like that as well. Stating at the beginning that the Dr has prescribed the X-rays specifically for today’s appt, and going over their specific X-ray schedule ( all our patients are different based on dr recommendation) and how long it’s been since last X-rays, their specific decay risk and history etc all can help but some still refuse. Not much else you can do if someone refuses.

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It seems it is a wide spread problem of those few patients who refuse. I explain standard of care the whys of needing them. If a patient refuses I try to get them to commit on what their idea interval would be and then hold them to it. If I can get them to tell me when they want them, it is better then not getting them at all. We do have the few hold outs but we have not dismissed anyone from the practice.

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