- 24-hour Emergency Line: 0300 30 32 442
In 2024, Dr X, an associate dentist was asked to take over Invisalign patients by a recently departed colleague. The practice assured Dr X that they could charge for treatments depending on their complexity, in line with the terms of their current agreement. Their agreement entitled them to charge 45% of the gross fees collected from their treatments.
Dr X, concerned mostly with the continuity of care for the departed associate’s patients, accepted the handover and began managing these cases. They maintained detailed clinical records, logging all treatment activities and clearly justifying each associated charge.
For August and September, Dr X received their expected share of payments without issue. However, by October 2024, the practice withheld a payment of just over £2,000, explaining that the retention fee taken from the former associate had been depleted. In addition they suggested that
Dr X had accepted full liability for those patients’ ongoing care, a fact only notified to Dr X at this point. Dr X rejected this position entirely, asserting that they had never consented to take on historic liabilities or to provide care without appropriate compensation. As a result, Dr X sought MDS’s advice on the matter.
Upon review, MDS advised that the associate agreement did not impose any obligation to assume the financial or legal liabilities of another clinician. It was determined there was no indication that they had contractually agreed to provide unpaid services, and in addition, no stipulation allowing the practice to withhold payments for completed and logged work. Maintaining this strong line of evidence, MDS additionally advised Dr X to continue maintaining their thorough documentation.
After failed attempts to informally resolve the matter with the practice, MDS issued a Letter Before Action, requesting payment for the outstanding October charges and stating that failure to comply and pay the amount owed, this would lead to further legal proceedings. Simultaneously, Dr X wrote to the practice offering to return patient care, reinforcing the point that responsibility for these cases ultimately rested with the practice, especially if it was unwilling to pay for ongoing treatment.
The practice’s response was defensive, vague, and failed to provide any substantive justification for disputing specific charges. Matters escalated when solicitors representing the practice responded with a general denial of the claims and a threat of counterclaim, though without providing any evidence to support their position. Despite the best effort of MDS to clarify and allow for evidence for such a counterclaim, no meaningful resolution emerged.
Eventually, Dr X received a formal termination letter from the practice, raising further contractual issues about final payments and deductions, particularly where certain provisions seemed to contradict themselves. Dr X consulted MDS on these discrepancies, but given the modest size of the financial dispute, they ultimately decided not to pursue the matter further.
Dr X chose to bring the dispute to a close by weighing the time, cost, and emotional toll of continued legal action against the relatively low value of the unpaid amount. MDS continued to advise them on managing potential deductions in their final pay and navigating the conflicting terms in the associate agreement. However, while no financial resolution was secured, Dr X exited the matter with their professional integrity intact and a clear record of their actions throughout the dispute.
This case demonstrates the importance of clearly written agreements in an associate-practice relationship. Dr X was asked to assume additional patient responsibilities without a corresponding amendment to the contract, leading to a dispute over payment. To avoid similar issues:
Has this case study reminded you of the importance of clear, written agreements in associate-practice relationships? If you need advice, we’re here to support you.
If you’re an MDS member, contact our team on 0300 30 32 442 or email our case managers at [email protected] .
Not yet a member? Join today and discover how our dental protection membership can support you throughout your professional journey.
