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Written by: a Medico-Legal Expert
Reviewed by a Medico-Legal Expert
Published:
September 2026
Written by: a Medico-Legal Expert
Reviewed by a Medico-Legal Expert
Published:
September 2026
MDS received a request for assistance from a Dentist regarding overdue payments for completed clinical work. The practice had received payment from patients but had failed to pass these sums on to our member. This issue was exacerbated by the practice blocking the member’s access to patient statements on the dental software, which prevented the Dentist from independently verifying the payments the practice had already received.
Adding to the complexity, the dentist reported receiving monthly payments on inconsistent dates without an accompanying payslip or itemised invoice from the practice. Consequently, they had to depend entirely on their personal spreadsheet log to keep track of their earnings.
Following instructions, Medical Defence Shield (MDS) issued a letter before action to the practice to initiate recovery of the outstanding balance. However, a major complicating factor immediately became apparent: our member’s working relationship was informal and uncodified, lacking any formal provisions or agreements.
MDS explained the difficulties of the member’s situation: their working arrangement was informal, lacking fixed pay dates and sufficient formal contracts or processes to effectively dispute unwarranted deductions.
Despite continued correspondence with the practice to secure the full amount, MDS ultimately had to advise the member to accept the partial payment offered. This received amount was significantly less than the member’s claimed due balance.
The MDS team advised the member that the remaining balance would be too low to be cost effective to pursue, as the cost of attempting to recover it through the court would likely exceed its value.
The member chose to forgo a partial payment, deciding to proceed based on the principle that they were entitled to the full amount.
This case highlights the essential requirement for clinicians to maintain:
Recovering small outstanding debts can be impractical when the administrative or legal costs may outweigh the sum owed.
Some practices might choose to make the process of recovering owed money very difficult, by blocking a clinician’s access to vital payment and patient information.
To prevent disputes, clinicians must insist on a clear and consistent payment structure with practices before beginning work.
Clinicians can mitigate issues with recovering payments after contract termination, which often involves restricted access to documents or IT systems, by ensuring their invoicing is comprehensive, itemised, and kept up-to-date.
A letter before action (LBA) is a mandatory step under pre-action protocol. Clinicians must issue this letter before initiating court proceedings to pursue payment.
If you’re facing a similar situation, don’t wait to seek support. Contact MDS as soon as possible to discuss your circumstances, our team will support you in making the best decision for you and your patients. Call our office on 0300 30 32 442 or email our case managers at [email protected] mentioning your membership number.
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