The Lindsay Clancy case demonstrates how fragmented healthcare and poor communication between providers can have devastating consequences, highlighting the critical need for dentists to actively coordinate with other clinicians, maintain current medication lists, and recognize behavioral changes in patients rather than operating in isolation.
- Dentists regularly see patients over long periods and can notice changes in medications, behavior, and overall health that other providers might miss.
- Medication reconciliation must occur at every visit, not just initially, and dentists should ask clarifying questions when medication lists seem complex or recently changed.
- Closed-loop communication between providers -- including direct phone calls when something doesn't align -- is essential; relying on faxes or electronic records alone is insufficient.
- Dental teams should coordinate internally to share observations, such as missed appointments, declining oral hygiene, or patient anxiety, which may indicate underlying health concerns.
- The dental office should serve as a connected checkpoint in patient care, using clinical expertise to ask questions, clarify information, and connect patients back to appropriate care when needed.
The case of Lindsay Clancy, who is being held in a state-run psychiatric hospital after her legal case ended in a mistrial, has left some discussing failures of the healthcare system that could have prevented the death of her three children.
Clancy, who claims her postpartum psychosis led her to strangle her three children, sought help from multiple healthcare providers about her deteriorating mental health before the tragedy. However, providers reportedly never discussed Clancy with each other and gave her conflicting advice and a dozen-plus medications.
As the justice system figures out what happens next for Clancy, some say dentistry also can learn from this case. DrBicuspid asked dentists and others to share their thoughts.
Dr. Laurence Schimmel of Schimmel Orthodontics Associates in the Bronx told DrBicuspid that this case raises an important problem for dentistry: the dangers of fragmented healthcare.
Dr. Laurence Schimmel.Schimmel Orthodontic Associates.
“Dentists and orthodontists often see patients regularly over long periods of time, which gives us an opportunity --and, arguably, a responsibility -- to notice changes in medications, behavior, or overall health,” Schimmel said. “But dentistry is still frequently siloed from the rest of a patient’s medical care.”
With that in mind, Schimmel said healthcare professionals need to better communicate across specialties.
“A dentist may know about medications prescribed by a physician, while another specialist may be unaware of what someone else has prescribed,” Schimmel said. “Medication reconciliation, shared medical histories, and appropriate communication between providers can help prevent conflicting treatment and identify potential concerns earlier.
Dentistry shouldn't operate in a vacuum. Oral health is part of overall health, and dentists can play an important role in recognizing when something warrants communication with a patient's broader healthcare team while staying within the appropriate boundaries of our profession.”
Dr. Niels Oestervemb, founder of Winchester Dental Implant & Sedation Center in Virginia, agreed that fragmented healthcare can be dangerous.
Dr. Niels Ostervemb. Winchester Dental Implant & Sedation Center
“Dentists often see only one piece of a patient's health, but we prescribe medications, provide sedation, and treat patients who may simultaneously be seeing several other clinicians,” Oestervemb said.
“A medication history cannot simply be a box that gets checked once a year. When a patient has numerous psychoactive medications, rapidly changing prescriptions, multiple prescribers, or significant changes in their mental or physical health, that should trigger a deeper medication reconciliation and, when appropriate, direct communication with the physicians involved.”
Oestervemb added this is especially important in sedation dentistry.
“Benzodiazepines, opioids, antidepressants, antipsychotics, sleep medications, and other centrally acting drugs can have overlapping effects,” Oestervemb said. “An electronic medication list tells us what was prescribed; it does not necessarily tell us what the patient is actually taking, why they are taking it, who is managing it, or what has recently changed.”
Additionally, Oestervemb said the larger lesson is the need for closed-loop communication.
“Sending a referral, faxing a note, or assuming another provider is coordinating care is not the same as actually coordinating care,” Oestervemb said. “When something doesn't make sense, someone has to pick up the phone," he said.
“I hear a patient every day telling me, ‘Oh, I didn't know I was supposed to tell you I took that medication.' Or 'I didn’t know you needed to know I had this wrong with me.’ Dentistry could not presume that it could have prevented a tragedy like this. But every healthcare profession can learn from it: We cannot allow the fact that we treat only one part of the patient to prevent us from seeing the whole patient.”
Dennis Marvel, founder and CEO of Marvel and Associates, who has experience coaching dental and medical practices, told DrBicupid that the Clancy case should have dentists looking at leadership, communication, and technology.
Dennis Marvel.Dennis Marvel.
"The Lindsay Clancy case has a lot of clinical scrutiny, but I see an operational pattern underneath that also needs to be dealt with, and it starts with awareness,” Marvel said.
Marvel said dentists need to be aware of all providers that patients are seeing, and practice staff need to coordinate with them.
“Dental and medical records don't come together in most practices, and that needs to be built,” Marvel said. “This isn't some software problem, and blaming that misses the point. It's something a practice owner is accountable for with systems that determine whether the team is coordinating with outside providers or not, Marvel said.
"Software can help, but the systems and expectations start with that owner. There should be a system in place to make sure that a patient's current medication list is taken every time they come in, not just the first time, and there should be a written hand-off process at every practice, so all providers get looped in to prevent these kinds of problems,” Marvel said.
Additionally, Marvel pointed out that he does not believe this is a software problem or a lack of electronic health records.
“From what I've seen watching practices run for decades, there's a big gap in technology and an even bigger one in leadership,” Marvel said. “When there are five different providers and none of them communicate about the patient, it's not because software didn't allow it. It's because at the ownership level, no one prioritized the coordination of patient care as a standard."
Marvel continued, "These systems won't get built until that happens, and the Clancy case should absolutely push every practice owner to ask that one most important question: If our patient is being seen by four other providers, would our team even know, and who would be responsible for making sure that's connected?”
Dr. Saravanan Thangarajan, vice president of the Global Oral Health Inequalities Research Network, piggybacked on these same ideas, telling DrBicuspid that the dental office should not become another place where important information stops. For example, Thangarajan said dentists should look at a patient’s list of medications as more than an inventory of drugs.
Saravanan Thangarajan.Saravanan Thangarajan/LinkedIn.
“It can be a map of how complicated a patient’s care has become,” Thangarajan said. “If I see recent medication changes, several prescribers, or a patient who is unsure what she is taking, I do not assume something is wrong. I ask more questions. Who is managing the medications? What changed recently? Is there anything that matters for safe dental treatment? Do I need to speak with another clinician?”
Also, Thangarajan noted that dentists often are at a greater advantage than other clinicians because many have known their patients for years.
“We notice ordinary changes,” Thangarajan said. “A patient who never missed an appointment starts canceling. Oral hygiene suddenly declines. Significant dry mouth appears after a medication change. Someone who previously managed treatment comfortably now seems overwhelmed. None of those things diagnoses mental illness. But sometimes the important observation is simply: This patient is not presenting like herself.”
Furthermore, the Clancy case highlights the importance of dentists and team members talking to each other.
“The receptionist may see repeated cancellations,” Thangarajan said. “The hygienist may notice a clear change in self-care. The dentist may see a medication history that needs clarification. Those details become more useful when the team talks to each other. That is where I think dentistry has a larger patient-safety role than we sometimes acknowledge.”
Finally, Thangarajan said dentistry is an opportunity to be noticed and connected back to care.
“We will not diagnose every condition, and we should not try to,” Thangarajan said. “But because we review medications, see patients repeatedly, notice changes in function and self-care, and often know them over many years, the dental visit can be another chance not to lose the patient," he said.
“When something no longer fits, our job is simple: Ask, clarify, and connect. The lesson for dentistry is not to step outside our scope. It is to make sure we are never just another disconnected room in healthcare,” Thangarajan said.
