Is Seeing Believing?
October 24, 2012
Last night I heard a commercial for a cholesterol medication in which the person playing the doctor says, “I wish my patients could see what I see.” I believe there are two ways to look at that statement.
The commercial showed an image of animated artery walls clogging with particles of plaque clinging to one another making the opening of the artery smaller and smaller. This is a visual that is easy to understand.
The second, and more subtle way to take this statement, is the doctor wishing that patients could see what happens to patients over time with and without compliance to taking medication or changing their diet. If patients could only understand and use the vast experiences of the doctor to make better decisions for themselves, wouldn’t everyone choose to do all the “right” things for a better and healthier life? Conventional wisdom would say “yes” but reality says something different.
I have been photographing teeth for over 18 years. When I tell a patient that I am going to take a series of pictures of their teeth the response I often hear is, “I just had x-rays taken.” When I explain that they are pictures and not x-rays it is not uncommon for the patient to ask, “Why?”
I had a new patient in yesterday for a consultation who said these exact words. The patient then said something that I also hear frequently, “No one has ever done this before.” My response is that I take pictures of teeth for two reasons. The first is for my own documentation and the second is to be able to show the patient what is in their own mouth.
Showing a patient visual images of their own teeth is by far the most powerful tool I use in practice. How many times have you been to a dentist where treatment is explained and recommended but you can’t see it? A picture is truly worth a thousand words.
When I started displaying the images and giving the patient above a tour of her own mouth the patient said, “Wow, that doesn’t look good. I can’t believe that is in my mouth.” I hear that a lot too. After the “tour” I continued to explain why things look a certain way and what to expect in the future. I proposed both long and short-term plans for the patient to consider. Photographs are invaluable for this exercise and most patients appreciate being able to see what I see.
The next part of my consultation is to try to get the patient to look beyond the pictures and envision where they want to be 5, 10, 20+ years down the road. My goal is to bring my own experience of knowing, based on all the patients I have seen in practice, where the patient is headed and give them the opportunity to potentially change the course of their future.
This approach may be different for some people. It is easy to get overwhelmed by any new approach and I always encourage patients that this is the beginning of a relationship and decisions to do or not do something do not have to be made today. My new patient said, “I am X years old and I don’t know if I am even going to be around in 10 or 20 years.” Crystal ball or not, it still seems like a long time to me.
You, as a patient, should look beyond today and make choices for ANY aspect of your health based on where you want to be in the future. Take advantage of the knowledge you gain from all your experiences and make decisions that you feel are right for you.
The Soda Ban
October 5, 2012
On Sept. 13, at New York City’s Mayor Michael Bloomberg’s urging, New York City’s Board of Health approved what’s believed to be a first-of-its-kind ban on the sale of supersized sugary beverages. In six months, if there’s no lawsuit filed to block it, containers of Coke, Pepsi and sugar-laden flavored drinks larger than 16 ounces will be outlawed at restaurants, movie theaters, food carts and sports arenas. Business violators would be subject to a $200 fine.
This ban doesn’t stop someone from buying two 16-ounce cups or bottles of soda. Nor does it apply to convenience stores or grocery stores. And, of course, New Yorkers are free to drink however much they want at home.
It is said that at worst, the new soda ban will inconvenience some hard-core soda drinkers. However, my contention is whether or not this is the right way to approach the war on obesity? Critics contend that this ban is an assault on our freedom to choose. I have mixed feelings on the subject. Does the ban on large beverages and the previous Bloomberg-inspired ban on trans fats lead to a ban on the number of hamburgers one can purchase at the same time?
Last week, the American Dental Association (ADA) gave a thumbs-up to Mayor Bloomberg’s initiative. ADA president, Dr. William Calnon said, “Health professionals, including dentists, have long stressed the importance of a healthy diet; yet obesity and lack of exercise — associated with chronic diseases and conditions such as heart disease, cancer, diabetes and hypertension remain high.”
On the ban itself Dr. Calnon said, “When it comes to a ban related to a particular food or beverage, is a stick rather than a carrot approach the best way to get people to adopt healthier diets? Perhaps not, but the attention alone that the mayor’s ban has generated on this issue is certainly a huge step in the right direction.” Dr. Calnon seems to believe that the attention to the subject is worth more than methodology. Most of us are aware that super-sizing anything is probably not in the best interest of our health. If we ban certain food products to fight obesity, should we make exercise mandatory?
As with any lifestyle choice, the lessons need to start early in the home. What we choose to buy in the grocery store to provide for our families on a consistent basis is the backbone of the impressions our children get, which will help them make better choices on their own. Our children need to grow-up in an environment where we respect what we put in our own bodies and take care of ourselves with exercise. It seems to me that banning or limiting what can be purchased is an attempt to make up for the lack of discipline in the home. But, will that work?
Is the limitation of allowing smoking in public places the reason for a decrease in smoking? Smoking in public places puts others at risk and is the main reason, but smoking in general has decreased because of the increased awareness of health risks. Does the ability to buy a 32-ounce soda have a direct effect on anyone surrounding the person buying it?
I’m all for increased awareness of what science has shown is good or not good for us. Armed with that information, we have the personal responsibility to make choices that we feel are right for us as individuals.
