Bringing About Healthcare Change

There is a very interesting piece that appears in AAOMS Today in the May/June 2011 issue on page 16 titled “The power to change: Our specialty’s revolution”

The article opens up with the following

The power to effect change is one of the most distinctive characteristics of being human. Mankind has the ability to change our surroundings not just to survive, but also to thrive

The article draws parallels to the foundations of the United States of America and the Declaration of Independence.

Then the following appears midway in the article

Our power lies in our own leadership in research and education. Our motivation is to prevent any other organization or entity from dictating to OMS what we can do, what we should do, and how we should do it.

Then a donation is asked for to help support research by each of the 9,000 AAOMS members for a $1,500 gift each year which would equal over $13.5 million dollars. There is quite a large sum of money and certainly would help to provide important and much needed research.

I’m not entirely sure why the American Association of Oral and Maxillofacial Surgeons (AAOMS) thinks any organization or entity is trying to dictate what they can or can not do.

This may have something to do with the management of third molars (wisdom teeth) though. For example in a recent article by Thomas B. Dodson in the Journal of Oral and Maxillofacial Surgery titled Science, Not Politics, Delivers Wisdom. 69. page 1851. 2011, he says

Because third molars are the bread and butter of most oral and maxillofacial surgery practices, our tenacity in seeking to understand and report their behavior has often been viewed by critics as “self-serving.”

Thomas B. Dodson is exactly correct that some critics see this as self-serving. In a recent article by Sanjivan Kandasamy (from Midland, Western Australia, Australia) titled Evaluation and management of asymptomatic third molars: Watchful monitoring is a low-risk alternative to extraction appearing in the American Journal of Orthodontics and Dentofacial Orthopedics pages 11-17, vol. 140. issue 1. July 2011 he says just that

By placing an exaggerated emphasis on the relationship between periodontal disease and systemic disease and linking this to the AAOMS’s self-serving arbitrary definition of disease (pockets of 4 mm or greater), the AAOMS claims that 70% of third molars will develop significant periodontal disease, therefore recommending the routine removal of asymptomatic third molars. This is misleading and inappropriate.

Sanjivan Kandsamy’s article is well worth the read and he ends the article with the following

…in the 21st century, the routine removal of asymptomatic pathology- free third molars has become a dated practice that is rapidly running out of valid excuses, and it has no justification in contemporary dentistry and medicine.

Clearly it appears some in the field are trying to dictate what can and can not be done.

I tend to argue that it may be better to provide patients with more information so they can see the debate as it stands and help them make a more informed decision about the decision to extract or not to extract healthy wisdom teeth.

As an aggregate extraction may be the best choice or it may not be the best choice for healthy wisdom teeth. Certainly more research is needed and this requires funding. However there needs to be balance in this research that is not trying to support an agenda and research that allows for others to be able to compare the research with other papers and not just report percentage differences. There certainly needs to be an emphasis accounting for known risk factors of disease and potential risks factors such as smoking, diabetes, genetic predisposition, socioeconomic status,  physical inactivity, and obesity.

There is quite an interesting quote from a article on KevinMd.com http://www.kevinmd.com/blog/2011/07/implications-technology-catches-medical-practice.html

To use a military analogy, the medical profession appears to me like an army engaged in a battle against the enemy of disease, with the latter using patients as soldiers, and politicians, managed care and administration as allies.  The battle conditions are changing, the enemy (you are welcome to think of patients as “the enemy” for the purpose of this analogy – I’m not for a moment suggesting this in reality) are rearming and using newer weapons.  In this battle, intelligence is everything, and to be forewarned is to be forearmed.

If AAOMS or any other physicians or groups of physicians think of someone like me as the enemy they are sadly mistaken. The goal of this website’s owner is to provide information with patients to better be able to make health decisions.

I was left with a 24/7 headache as a result of elective surgery to remove wisdom teeth partially due to AAOMS’s definition of disease and practice of removing healthy wisdom teeth by dentists and oral surgeons in the U.S. and the failure of these organizations and physicians to alert someone like me to the truth that healthy wisdom teeth are not extracted in the U.K. in most cases due to lack of scientific evidence and that some patients are left with lasting pain and problems which more severe than I was led to believe such as paralysis, chronic headaches, and trigeminal neuralgia. Certainly it is my opinion that this is unethical, irresponsible, and tantamount to malpractice. I had no access to the court system in the United States to be compensated for my pain and suffering and the failure to provide proper informed consent.

In addition to this I was left having to deal with a piece of crap healthcare system in the United States of America. I saw well over 20 if not 30 doctors at least in a short time period in an effort to find out what happened to me and do something to rid myself of the pain. This never occurred.  I had to meticulously keep track of all of my own medical records on paper and imaging studies on CDs by requesting them after each doctor visit. In addition I had to pay out of pocket for some of my care since insurance only picks up some and am stuck in a system where healthcare is not a right. At any point none of the doctors really tried to work together as a team to come up with solutions or even had any idea who I had seen previously.

A doctor can injure a patient in the United States and leave them having to fend for themselves in a chaotic system where they have the added burden of having to deal with insurance companies. Then they are left having to work their ass of like the rest of working class America in order to be on health insurance. Unfortunately for over 50 million Americans they don’t even get to be on health insurance. To add insult to injury those luckly enough to have insurance are often left bankrupt and insurers are constantly looking for ways to drop their ‘customers’ so they do not have to pick up the tab when they get sick and have health problems.

For those young and healthy and have not had to experience dealing with the U.S. healthcare system I encourage you to watch the video below.

If AAOMS and other physicians or groups do not like what I am doing with this website I encourage them to buy me out. Isn’t that how a lot of things work in this country you spend a little money to have your own views supported and the rest of the views suppressed in order to get what you want even those this is often at the expense of doing what is right and in the best interest of the majority of the citizens.

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