Know You're Covered When You Volunteer

Giving back by volunteering dental services can be one of the most rewarding aspects of your professional life, especially when your skills help individuals and families who are experiencing emergencies or barriers to access to care. Whole communities are changed by dental and health professionals who put their compassion into action. It’s essential that dentists can volunteer with confidence and understand how and when their professional liability policies cover them.

There can be several different scenarios in which you provide treatment at no charge — volunteering through a nonprofit organization or community health event, treating a friend or family member or delivering emergency care unexpectedly. A few insights may help you better manage potential risks in each scenario.

Organized Events and Community Service Programs

While your existing professional liability policies may already cover you, it’s prudent to reach out to your trusted insurance advisor prior to volunteering services. The insurer may require additional information about the event, services offered and your clinical role as well as with whom you will be working. The latter is to ensure that policyholders are not exposed to unnecessary risk, such as working with unlicensed dentists.

• Professional liability policyholders with The Dentists Insurance Company are covered at volunteer events; no additional coverage is necessary.
• Dentists insured by other carriers should contact their carriers directly to confirm their current liability coverage details before volunteering.
• Dentists who do not have professional liability insurance and who do not practice for a fee can apply for affordable annual coverage designed for volunteers from TDIC. This coverage is intended for licensed dentists who wish to volunteer services without remuneration other than actual expenses.

For large events, the sponsoring organization may coordinate and intake patients’ health history forms, medical conditions, medications lists and vital signs. In addition, it may provide patients a list of sources for ongoing care to help exempt you from future treatment needs.

Remember that, even though treatment at an event doesn’t establish a continuing doctor-patient relationship, the patients you volunteer to treat deserve the same standard of care and as your patients of record. Be sure to review each patient’s vitals and health history prior to treatment. Take time to discuss treatment outcomes, potential risks associated with receiving and not receiving treatment and any alternatives. Document why, when and what follow-up treatment is needed.

Emergency vs. Volunteer Care

Some health care providers believe that good Samaritan laws exempt them from all liability when volunteering. The federal government and 43 states have passed laws to protect medical volunteerism, known as "charitable immunity" laws. Currently, the states of Alaska, California, Massachusetts, Nebraska, New Mexico, New York and Vermont do not have such laws. Liability remains when providing nonemergency treatment or assistance in these states. 

For care rendered in a “true” emergency situation that occurs outside of a health care facility, “Good Samaritan” laws usually lower the standard of care in order to encourage private citizens, including health care professionals, to assist others in emergency circumstances without fear of litigation. Health and Safety code 1799.102 states, “No person who in good faith, and not for compensation, renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.”

Free Services for Family and Friends

Outside of an organized event or program, the risks of donating services can be more complex. Friends and family members who receive treatment at no charge must still be treated as patients of record. This means having an informed consent discussion, signed treatment plans, detailed chart entries and a thorough review of health histories prior to providing treatment — as well as discussing options for follow-up care.

It’s also important to note your liability remains the same whether the dental treatment is performed during or outside of normal office hours. And it’s the same whether the patient incurs costs or not. Understanding that the liability is unchanged, the question is if no-cost care should be provided in certain situations.

TDIC’s Risk Management Advice Line received a call from a dentist who wanted to provide treatment for a friend’s daughter at no charge. The patient was referred to a pediatric dentist for a primary tooth extraction, which her parents could not afford. The analyst who took the call advised the dentist to consider whether donating his services was in the best interest of the child. As the patient had been referred to a pediatric dentist for a reason, the dentist could help the family find an appropriate, affordable source of care another way. Instead of performing the treatment himself, he could identify a local clinic or dental school or refer a colleague who specializes in pediatric patients.

The contribution of time and skills to improve the oral health and well-being of others is a generous gift. Understand your liability coverage, follow standard treatment protocols, have informed consent discussions and align expectations so you can mitigate risk and volunteer with confidence.

TDIC’s Risk Management Advice Line is a benefit to TDIC policyholders. To schedule a consultation with an experienced risk management analyst, visit tdicinsurance.com/RMconsult or call 1.877.269.8844.