Ethical treatment planning: The eternal struggle against instant gratification
This is more of a conceptual post of a thought that popped into my head. Treatment planning is important for sure, but having the discipline and authority to carry out this treatment plan is necessary to make things work.
I was discussing futures with a younger family friend who is thinking about his choices for university study or trade. He was discussing his aspirations to be a chiropractor "because he likes cracking backs, can help with pain and if he's good he can make $400k a year." Firstly, I voiced my skepticism but did suggest that he does some proper research into his future but did suggest that with his goals there may be other careers that could fulfill his requirements. avenues such as psychology and physiotherapy are just as involved in rehabilitation, maybe he could broaden his choices to them. We got on a discussion about physiotherapy vs chiropractic fields. This is a long discussion which isn't entirely relevant but his conclusions were interesting. He felt as though physiotherapists didn't really help people because all they did was tell their to do exercises whereas with chiro, you could see an immediate effect. Mind you, I was talking to a 16 year old.
What I found interesting about this was the attitude not only these days but as a human trait about rewards and delayed gratification. It is easy for the inexperienced to shy from the responsibility of self empowerment that a good physiotherapy program can provide and go towards an instant miracle cure that a chiropractor can offer. This is all gross generalisation, but personally I find it true enough that younger generations lean towards instant rewards and "how can I gain as much benefit in the shortest period of time".
Perhaps this is all the ravings that come with time, but I do find this concept has relevance for treatment planning and carrying out treatment plans. Our patients may be seeking amazing results that require the least money, least time and least involvement on their part. We may be tempted to plan crowns to fix orthodontic problems, or restorative to fix periodontal problems. To an extent, the versatility of dentistry allows us to do this but significant compromises in the name of convenience may amount to negligence in some cases. I trust that we will all use our clinical judgement and that feeling in our gut to know what is right and what is wrong.
Patients may also not want to participate in their treatment. They may not want to wear their splint for deprogramming or protection. They may not want to improve their oral hygiene. They may not want to stage treatment and go straight to the final product. This may be in direct opposition to our advice. In these situations, we have to see a treatment plan as a table with 4 legs. Nothing is not important, otherwise we wouldn't do it. If we treatment plan something, it should be because it is necessary to achieve the final goal we seek. If the patient doesn't want to brush their teeth, they remove one of the table legs that holds up our plan and the whole table topples.
It is our role as the health professional to rise above compromise and dictate to the patient what they can and cannot do with the work we provide. If we let ourselves be weighed down by the pressures of their finance or lack of time in their lifestyle we take upon our backs an unbearable amount of responsibility. Sometimes the refusal of treatment is necessary for the preservation of our conscience and sanity.
I was discussing futures with a younger family friend who is thinking about his choices for university study or trade. He was discussing his aspirations to be a chiropractor "because he likes cracking backs, can help with pain and if he's good he can make $400k a year." Firstly, I voiced my skepticism but did suggest that he does some proper research into his future but did suggest that with his goals there may be other careers that could fulfill his requirements. avenues such as psychology and physiotherapy are just as involved in rehabilitation, maybe he could broaden his choices to them. We got on a discussion about physiotherapy vs chiropractic fields. This is a long discussion which isn't entirely relevant but his conclusions were interesting. He felt as though physiotherapists didn't really help people because all they did was tell their to do exercises whereas with chiro, you could see an immediate effect. Mind you, I was talking to a 16 year old.
What I found interesting about this was the attitude not only these days but as a human trait about rewards and delayed gratification. It is easy for the inexperienced to shy from the responsibility of self empowerment that a good physiotherapy program can provide and go towards an instant miracle cure that a chiropractor can offer. This is all gross generalisation, but personally I find it true enough that younger generations lean towards instant rewards and "how can I gain as much benefit in the shortest period of time".
Perhaps this is all the ravings that come with time, but I do find this concept has relevance for treatment planning and carrying out treatment plans. Our patients may be seeking amazing results that require the least money, least time and least involvement on their part. We may be tempted to plan crowns to fix orthodontic problems, or restorative to fix periodontal problems. To an extent, the versatility of dentistry allows us to do this but significant compromises in the name of convenience may amount to negligence in some cases. I trust that we will all use our clinical judgement and that feeling in our gut to know what is right and what is wrong.
Patients may also not want to participate in their treatment. They may not want to wear their splint for deprogramming or protection. They may not want to improve their oral hygiene. They may not want to stage treatment and go straight to the final product. This may be in direct opposition to our advice. In these situations, we have to see a treatment plan as a table with 4 legs. Nothing is not important, otherwise we wouldn't do it. If we treatment plan something, it should be because it is necessary to achieve the final goal we seek. If the patient doesn't want to brush their teeth, they remove one of the table legs that holds up our plan and the whole table topples.
It is our role as the health professional to rise above compromise and dictate to the patient what they can and cannot do with the work we provide. If we let ourselves be weighed down by the pressures of their finance or lack of time in their lifestyle we take upon our backs an unbearable amount of responsibility. Sometimes the refusal of treatment is necessary for the preservation of our conscience and sanity.
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