An interesting article titled “Keeping skills current” appears in the May 2015 issue of JADA by Don J. Ilkka. The article discusses the ethics of what a pediatric dentist should do who used to perform sedation on his patients over 20 years ago, but now wants to do so again. For the around 20 year gap the pediatric dentist had an anesthesiologist in his office to monitor the sedation.
The article discusses how there are many issues at work here. This includes if the dentist can legally perform the sedation and if he is qualified to do so or needs any additional training. Furthermore, there is a question about whether the staff of the dentist is qualified to support him. Working without an anesthesiologist may cause the dentist to perform less cases a day. The article states
“As the dentist you describe has spent many years working with an anesthesiologist and has not directly conducted sedation, he may have lost some or all of the skills that are developed while learning and administering the medications and their respective effects on patients.”
The article says the rusty skills the dentist has could be updated through a program. By doing so the dentist offers his patients the best of his abilities and reduces the potential of harm and adverse events. The article states
“To ensure that he is practicing ethically, before the doctor severs his relationship with the anesthesiologist, he should participate in a training program in conscious sedation to enhance and update his skills. He should consider a dental school or hospital-based program that will encourage him to bring his staff along with him for the most current training.”
It is not entirely clear to me why the dentist wants to no longer use an anesthesiologist. My guess would be he wants to reduce his case load and cut back on hours, which makes sense as he has been practicing for decades.