A Healthcare Provider’s Greatest Gift
July 25, 2011
Don’t you hate to wait? I took my to get the oil changed a couple of weeks ago and there were three cars ahead of me. A man graciously opened my car door and escorted me to the “waiting room” like it was a 5-star resort, which it definitely was not. I sat there and waited and waited, constantly looking through the glass at the garage bays to monitor the progress. As I sat there I was thinking, “can’t they move any faster; there seems to be a lot of standing around doing nothing going on.” Then of course I realized that there was more to the story as there was someone under the car and “behind the scenes” doing something they were waiting for. I waited patiently from then on realizing I had no real control on how long it takes to change oil in a car.
One of my pet peeves in dental practice is running behind. I hate to make people wait. However, the reality of it is that things don’t always go the way you planned. Most patients are very understanding. Occasionally I’ll hear over my shoulder, “Doctor, your next patient would like to know how much longer it will be?” I’ll usually jokingly respond, with my current patient on their back in front of me, “Mrs. Smith, I’m sorry, I have to rush through the rest of your difficult filling because I have another patient to see.”
I believe the philosophy of practice revolves around treating the person as a whole and not just a tooth. It means patients, their overall health & well-being, must be foremost in the practitioner’s mind. Yes, it also means cleanings, fillings and crowns. These are often inescapable outcomes to dental disease – but, under what context are these services being provided?
Too often the dentist views a patient as just a mouth. The goal is to fix as many problems in as many mouths in as short a time as possible. The patient becomes the object of the “fix” instead of a participant in the treatment. How degrading is it for a patient to experience that type of environment? Where is the quality, attention and care when the dentist is busy running room to room? Although for some, this is the type of care they desire because the fees are often lower in this type of setting.
The dentist also suffers. How satisfying can it be for a dentist who sees 40 patients a day? What kinds of relationships can that dentist build with his or her patients? How can that dentist spend the necessary time with the patient to really know the patient’s needs and desires?
In a truly health-centered practice, each patient should be treated as a unique, whole person. Each patient should be treated with dignity and respect. The dentist gives each patient his/her most important gift: TIME.
Taking the time to listen; taking the time to do a complete examination; taking the time to teach the causes of existing and potential dental problems and taking the time to explain alternative treatments and modes of prevention. It means that each patient be given the opportunity to choose the highest level of health consistent with their values and life circumstances.
The Patching Theory
July 20, 2011
I would like to discuss some situations I have had over the past week with a few new patients. The common theme with these patients was the idea of “patching” things vs. treating for predictable long-term success.
There are many different ways to “successfully” practice dentistry. Success as defined by Webster’s is, “a favorable or satisfactory outcome or result.” Success can also be short-term or long-term. In dentistry, short-term success can be anything from a day to a few years. If you have a front tooth break and the dentist fixes it but it breaks a week later, it was successful for a week. The patient usually doesn’t look at it as being successful at all. The question is what problem caused it to break again? In this situation it usually has to do with bite related or structural issues and not with the fact that the dentist didn’t “bond” the tooth correctly.
I look at long-term success in dentistry as being anything over 10 years. However, there are many situations in dentistry where a short-term solution can lead to a longer-term success. But when it eventually fails (and everything fails at some point), the present fix of the current problem may involve more extensive treatment.
Let me use a specific example that we see every day in the dental office. I am sure many of you can relate to it. Let’s say you have a molar with a large filling and a piece of tooth breaks off while eating. The dentist tells you that he/she can patch the tooth with some bonding material at a cost of $200 or do a crown on the tooth for $1200. With that amount of information most people, understandably, would choose the patch if the outcome would be to “fix” the tooth. Five years go by and everything is great until another piece of tooth breaks off of the same tooth. The dentist now tells you that there is not enough tooth structure left to do a crown and the tooth needs to be extracted. The only problem is that it is a molar and you need it to chew, so you decide to replace it with a dental implant to the tune of $4000. Some may choose not to replace it, which is free, but you have just lost function. What happens if you have a bunch of teeth with big fillings that have been “patched” over the years?
Patients love dentists who patch teeth. They get a quick fix that costs a lot less….in the short-term. This is very understandable. When given the choice, I too would always like to spend less money to fix something than more. However, investing in a fix that gives you a long-term success is usually always a good investment.
I do believe that you should always be given a choice. They’re your teeth, not the dentist’s teeth. One of the problems is that there are those dentists who have very “successful” practices who don’t give the patients the choice. Their philosophy may be that patching is the way to go. That is fine. For the more progressive dentist, giving the choice to the patient means education….. and education takes a lot of time. Spending time talking with patients seems to be a lost art in the dental world.
I’ll say it again….. they are your teeth and you are the one who makes the decision on what is done with them. Just remember, investing in more predictable long-term care will usually mean having more teeth when you are older or spending much less over time. Studies show that the quality of life decreases with every tooth lost. Invest in your teeth; it’s better than any other investment out there right now. Your teeth don’t depreciate in value.
