Influencing Government: Perspectives from U.S. Oral Surgeons

As has been discussed before on this site and blog, The Journal of Oral and Maxillofacial Surgery is published on behalf of the American Association of Oral and Maxillofacial Surgeons (AAOMS). They of course have their own interests and seek to help get candidates elected in government with positions favorable to theirs. This is described a bit in the article Influencing Your Government by James R. Hupp  appearing in the January 2015 issue of The Journal of Oral and Maxillofacial Surgery (vol. 73, issue 1). The article discusses how voting in an election is only part of the story and advocacy stronger than one’s vote at the ballot box. The author states “Advocacy can take many forms. The one that comes to mind for most people is campaigning for someone running for office. Similarly, one can donate to a candidate’s … Read more

Comparing Narcotic Prescribing Habits For Oral Surgeons in the U.S. and Canada

In a previous blog post titled “Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?” the issue explored was that of whether or not oral surgeons prescribe more than an adequate amount of narcotic pain killers to young adults after wisdom teeth extraction. The article that found around 25% or so of the study respondents prescribe what the authors of the article declared as too many narcotics to control pain which opened the possibility of non-medical use. A new article titled “Comparison of Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons in the United States and Canada,” sought to explore whether Canadian oral surgeons have similar narcotic prescribing habits. This article was written by Bruce R. Pynn and Daniel M. Laskin and appeared in the December 2014 issue of the … Read more

Seventeen Year Old Minnesota Teen Dies After Wisdom Teeth Extraction

A few weeks ago in June, 2015, a 17 year old Minnesota woman died about a week after having wisdom teeth surgery. Near the end of the wisdom teeth surgery her blood pressure increased, her pulse dropped, and she went into cardiac arrest. She then was transferred to a hospital and suffered from seizures and swelling in her brain until passing about a week later. It is not clear what caused the death to occur. She could have possibly had an undisclosed heart condition that has occurred in other cases. It is possible for a patient to only become aware of an asymptomatic and abnormal heart rhythm once they come in for a surgery. I have discussed other deaths from wisdom teeth removal on this website (see http://www.teethremoval.com/death.html). Based on numerous studies and publications I have said that around 1 … Read more

Improving Value: Prespectives from Oral Surgeons

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

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

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