A reminder: Don't let patients dictate what you do
Again I find the need to remind myself that we are the health professionals and we are responsible for our actions so we should never let anyone else dictate what we do. Don't let the eye rolling of your dental assistant or the begging of the patient force you into a situation that you are uncomfortable with. Of course you should be working for the improvement of health of the people you encounter but not at the risk of your professional ethics or personal values.
An example: A patient comes in with a toothache begging you to do something. You take a PA and lo and behold it is a carious lower 8 with divergent roots sitting right next to the IAN. Your options are to send for an opg for a better view of the situation and attempt the extraction yourself or refer off to someone more experienced. In this case I was not confident with the extraction but was won over by the patient's need and the fact that there was a large PA lesion around the mesial roots which (despite logic), I thought would make things easier. In the end the mesial root is the one I got out and the patient was left with a distal root which he had to have extracted in a delayed manner by another dentist. Have I done a favour to the patient? I think not. Perhaps I should have listened to my better sense and given a script for analgesia, gotten the proper radiographic records and reassessed the situation in a better frame of mind.
Just as you cannot force a patient to agree to any treatment, they should not be able to force you into doing any treatment. This particular patient had years to get his dental condition sorted and chose to wait until the pain was unbearable. Dentists are only human and we can't be expected to take onto our backs the problems of everyone else around us. Does he deserve my help? Of course. But when and only when convenience allows. In this case patients afterwards were cancelled and delayed due to the extended appointment and my confidence has dipped albeit temporarily.
Never be afraid to ask for help. Never be afraid to take charge and stand up for yourself. Never be afraid to say no!
An example: A patient comes in with a toothache begging you to do something. You take a PA and lo and behold it is a carious lower 8 with divergent roots sitting right next to the IAN. Your options are to send for an opg for a better view of the situation and attempt the extraction yourself or refer off to someone more experienced. In this case I was not confident with the extraction but was won over by the patient's need and the fact that there was a large PA lesion around the mesial roots which (despite logic), I thought would make things easier. In the end the mesial root is the one I got out and the patient was left with a distal root which he had to have extracted in a delayed manner by another dentist. Have I done a favour to the patient? I think not. Perhaps I should have listened to my better sense and given a script for analgesia, gotten the proper radiographic records and reassessed the situation in a better frame of mind.
Just as you cannot force a patient to agree to any treatment, they should not be able to force you into doing any treatment. This particular patient had years to get his dental condition sorted and chose to wait until the pain was unbearable. Dentists are only human and we can't be expected to take onto our backs the problems of everyone else around us. Does he deserve my help? Of course. But when and only when convenience allows. In this case patients afterwards were cancelled and delayed due to the extended appointment and my confidence has dipped albeit temporarily.
Never be afraid to ask for help. Never be afraid to take charge and stand up for yourself. Never be afraid to say no!
If an attempt makes you run late and you're not confident you will be done soon, better to bring the patient back in at the end of the day (if you still think you can do it). It happens to all of us - a learning point.
ReplyDeleteThank you for your comment. Things are also always easier after a break. When you are stressed in the moment after multiple failed attempts the risk of more failures is increased. There's no shame in offering the patient time to rest and to come back and try again another time.
DeleteThe real discipline is in knowing your limits and judging that you will run late before you start. Then you must communicate to the patient that you are not willing to attempt their treatment right now and would like them to return at a more convenient time.