In an age of independence and overscheduling, it is not uncommon for minors to arrive at your practice unaccompanied. The risks of treating a minor when a parent or guardian is not present can include: informed consent issues, behavior management issues, unexpected necessary emergency response and the need for additional treatment.

Posted in Malpractice Insurance on Tuesday, February 23, 2016

A recent article in Healthcare Risk Management Review (HRMR) focused on the issue of treating unaccompanied minors and the need for consent. While the article was addressing a minor arriving at an urgent care setting, minors are just as likely to arrive at your practice unaccompanied. In an age of independence and overscheduling, a parent/guardian may drop a patient off or the patient may drive themselves to the appointment. How should your practice handle this situation? 

It is best to have a policy in place prior to the situation presenting itself. First and foremost check with your local dental society for reference to state statutes in regard to treating unaccompanied minors. It is important to know that some states recognize circumstances which do not require contacting a parent/guardian and that the age of majority differs between states. 

The risks of treating a minor in your practice when a parent or guardian is not present can include: informed consent issues, behavior management issues, unexpected necessary emergency response and the need for additional treatment.

When creating your office policy, a conservative approach is often the most prudent:

• Reschedule:  Can the visit be rescheduled to a time when the parent/guardian can be present? As the provider, you have the right to insist a parent/guardian be present at treatment.
• Require the parent/guardian sign a consent form that permits the provider to treat the patient when they are not present, stating specifically what it covers and not deviating from those boundaries.
  • Make sure the consent form is from the parent/guardian legally authorized to provide consent. Remember, the parent/guardian who is authorized to provide consent may not necessarily be the one who is paying for treatment.
  • Confirm all parental contact information is current
• Pick up protocol - If a parent/guardian is leaving the office while treatment is being provided:
  • Determine at what age you and your staff feel comfortable treating unaccompanied minors
  • Confirm that all consent forms and documents are completely filled out prior to the parent/guardian leaving
  • Require the parent/guardian be available by phone during the treatment time 
  • Be sure you are alerted to the fact that the parent/guardian will be leaving prior to the start of treatment
  • Provide an estimate of the treatment time and require the parent/guardian return just prior to that time for pick up