Doctors

Improving Value: Prespectives from Oral Surgeons

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An interesting editorial appears in the 2014, issue of the Journal of Oral and Maxillofacial Surgery titled “The Value of Improving Value,” by James Hupp (pp. 843-845, issue 72). In this Dr. Hupp presents a formula for patient value Value = A(Q + PS)/C A = appropriateness, Q = quality, PS = patient satisfaction, and C = costs The author states “First, one can improve outcomes while keeping costs the same. Second, one can decrease costs while keeping outcomes the same. Or third, both outcomes and costs increase, but outcomes per unit of cost improve.” In the article the author discusses how in the past, value in health care was really just about cost cutting. Clinical outcomes were not really taken into account. Now that health care outcomes are being considered, physicians need to find ways to measure value using the … Read more

Few Children Under 1 See a Dentist

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Unfortunately, new research has shown that few children under the age of 1 are seeing a dentist. This was touched on in an earlier blog post over at https://blog.teethremoval.com/will-health-care-reform-result-in-more-dental-visits/ where it was mentioned that for children between ages 1 and 4 around 60% of them have seen a medical doctor (physician) during the year, but not a dentist. The new research appears in an article titled “Factors Associated With Dental Care Utilization in Early Childhood,” by Denise Darmawikarta and et al. which was published online in Pediatrics in May 2014. The study looked at 2505 children in Toronto, Canada, who were seen for primary health care between September 2011 and January 2013. The study was past of TARGet Kids (The Applied Research Group for Kids), a collaboration between doctors and researchers from St. Michael’s Hospital and the Hospital for Sick Children in … Read more

What to Do about Patients Who Call After Hours Wanting Prescription Drugs

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An interesting article titled “Addressing after-hours requests for prescription drugs,” appears in the April, 2014, issue of  JADA written by G. J Muller II (vol. 145, no. 4, pp. 389-390). The article discusses how the oral and maxillofacial surgeon has had several instances of after hours or weekend phone calls from people claiming to be current or past patients who have had a sudden onset of a toothache and want narcotic pain medication. The surgeon says that the people always agree to be seen in his office the next day or following Monday if it is a weekend. However, often the person will not follow up with the surgeon and not show up for the appointment after having received the medication. The surgeon says occasionally he checks if the person is a patient of record and sometimes the person is not, … Read more

Infection Control Lapse in Hawaii at VA Dental Clinic

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The U.S. department of Veteran Affairs (VA) has said that 20 patients treated on May 23 and May 27 in Hawaii may have been exposed to viruses due to instruments that were not sterilized. The dental instruments used were believed to be clean, but the VA monitors said they were not sterilized. Only a single load of dental equipment, which was typically sent from one medical center with a dental clinic to a different medical center for sterilization was not performed. It is believed that the risk of contracting anything like HIV or hepatitis is low but patients at risk are recommend to be tested for viruses. The source of the story is over at khon2 titled Veterans Affairs apologizes to dental patients for unsterilized instruments written by Nestor Garcia on June 27, 2014, and located over at  http://khon2.com/2014/06/27/veterans-affairs-apologizes-to-dental-patients-for-unsterilized-instruments/. Staff … Read more

More Dental Patients Warned of Potential HIV and Hepatitis Exposure in Pennsylvania

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Back in July, 2014, I discussed a case in Pennsylvania where dental patients where made aware of possible HIV and hepatitis exposure due to infection control lapses by a dentist. This led to a 74 year old dentist having his license suspended. A video interview of several students who were treated by the dentist said that sometimes the dentist didn’t wear gloves and didn’t wash his hands between patients. See the blog post located over at https://blog.teethremoval.com/dental-patients-warned-of-possible-hiv-and-hepatitis-exposure-in-pennsylvania/. An additional case of infection control lapses has also occurred in Pennsylvania. The dentist had his license temporarily suspended due to an investigation by Pennsylvania’s department of health. A press release issued said the dentist “…did not follow appropriate procedures to properly clean, disinfect, or sterilize dental tools used at his…office.” The investigation showed the dentist admitted that he and his staff do not … Read more