Tag Archives | patient

Is it okay for dentists to not tell a patient everything wrong?

An interesting article titled “Is it unethical to not present a patient’s treatment plan in its entirety?” is written by Emily Ishkanian and appears in the June 2016 issue of JADA. The article discusses that a dentist gets a new patient in for only an examination, cleaning, and radiographs. However after the exam, the dentist determined that the patient has extensive treatment needs. The dentist is concerned that if they tell the patient everything wrong then the patient will be scared to return to the office. The patient went to the dentist for just a standard visit. It is likely they thought there was nothing wrong with their oral health. The dentist is concerned that the patient will suspect overtreatment which could lead them to decline the treatment plan or seek another opinion. The ADA code says that dentists need to be truthful and straightforward with their patients. The article states “The dentist should inform the patient of his or her oral health status by disclosing a treatment plan that addresses the patient’s needs in addition to presenting alternative treatment or treatments…Although a patient may find an extensive plan to be daunting, the dentist has an obligation to educate the patient about how to […]

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What are the ethical issues of terminating a patient?

An interesting article titled “The ethical issues of saying good-bye to a patient” appears in the July 2016 issue of JADA and written by Gary Herman. The article addresses the ethical issues that result from terminating a relationship with a patient. There are certain reasons for terminating a patient. This includes discharging a patient who is difficult or noncompliant, a patient who notifies you that he or she is choosing to go elsewhere, and a patient who just seems to disappear. A dentist of course is always concerned with treating a patient well. If you terminate a patient the practice goes against this goal. An article on risk management lists failure to recognize problem patients and failure to dismiss those patients properly as some of the biggest mistakes dentists make. The article states “When patients make unreasonable demands, have impossible expectations, or prevent you from meeting the standard of care, it is important to maintain control of your practice and terminate relationships with those patients from your practice, both for their benefit and yours.” The article states that it is essential to let a patient know you are discontinuing care. Dentists should follow up with a written notification detailing the reason for the termination and providing […]

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Shared decision making in cases of conflicted evidence

An interesting article titled “When clinical evidence is conflicted, who decides how to proceed? An opportunity for shared decision making,” appears in the October 2015 issue of JADA (vol. 146 issue 10, pp. 713-714) and written by Arthur H. Friedlander and et al. The article discusses the concept of shared decision making “…particularly necessary in dentistry at this juncture, given recommendations but inconclusive data available to support abandoning the provision of prophylactic antibiotics to patients with total joint prostheses.” I have previously talked about shared medical decision making in the blog post The Well Informed Patient http://blog.teethremoval.com/the-well-informed-patient/. The article talks about how historically patients were expected to consent to the recommendations of their doctors without much discussion. However, since this is not enough to be legally and ethically correct shared decision making can be used which is a “…collaborative process encouraging patients and their providers to make health care decisions together, taking into account the best scientific evidence available as well as the patient’s values and preferences.” The authors go on to state “This bioethical, patient-centered, informed consent process demonstrates respect for the patient’s autonomy and supports their empowerment at a time when illness renders them dependent and vulnerable. Furthermore, it enhances […]

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Is the health news you are reading accurate?

An interesting article titled “Keeping up with the news: Separating fact from fiction,” appears in the Oct. 2015 issue of JADA and written by the American Dental Association (vol. 146, no. 10, pp. 792). The article encourages dental patients to make sure that they know the source they are receiving their news from is trustworthy. The article discusses a few things to look for to make sure this occurs. The article tends to focus on receiving information from websites. If you are looking at a website, the first thing to look for is an about us section. This is because you want to know who is responsible for the article. It is good to know who pays for or sponsors the website. Also if you are looking at a website the domain name can give a hint. If it ends in .gov it is a government website, if it ends it .edu it is an educational institute website, or if it ends in .org it is usually a non-profit organization. These types of sites are generally more trustworthy. The article states “…[some websites] may have a particular position on a topic that causes them to slant the story in their favor. […]

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How safe is deep sedation or anesthesia in dentistry?

An interesting article titled “How safe is deep sedation or general anesthesia while providing dental care?” appears in the Sept. 2015 issue of JADA (volume 146, issue 9, Pages 705–708) and written by Jeffrey D. Bennett and et al. The article discusses how deep sedation and general anesthesia are given daily in dental offices or practices and this is usually done by oral and maxillofacial surgeons and dentist anesthesiologists. Sedation and anesthesia is given to patients to be able to more easily perform procedures and keep the patient safe and comfortable. Unfortunately in rare cases problems can happen and hence the authors were interested in exploring this. The authors state “Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month.” The authors feel that a patient safety database for anesthetic management in dentistry would provide a more complete assessment of the mortality and morbidity involved. This would be beneficial to developer safer anesthetic care. The authors further state “Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained […]

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