CAREER COMPASS
Veracity:
How much do you tell your patient?
DURING A RECENT PERIO APPOINTMENT, I overheard a classmate explaining the benefits of xylitol to his patient in detail. “The bacteria eat the xylitol like regular sugar, but then they can’t incorporate it into their cell walls, and they die,” he said. As I scaled my own patient’s teeth, I thought about how great it was that he took the time to educate his patient to that level. Meanwhile, a young local dentist working in private practice recently received a glowing Yelp review. The patient explained how thorough the dentist was with her explanations. The conversation that prompted his kind words? The dentist noticed the patient was producing more saliva than normal and noted the protective benefits of his hypersalivation. When treating a patient, how well do you keep them informed? Both these cases involve dental providers sharing information with their patients. In both situations, the information was positive. What do we do when the truth is not so pleasant? Tough situations, such as the following three examples, are guided by commitment to the ethical principle of veracity, or truthfulness. Here are three scenarios for you to consider.
CARO L IN E S EWE L L Georgia ’19
E LYS SA S C H LO S S B E RG Southern California ’20
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Differing opinions/treatment plans You’re in clinic for a new patient exam. There are some early carious lesions you want to monitor, but they aren’t yet significant enough to treat. Your attending faculty agrees. However, at the patient’s next appointment, you have a different attending who questions why these lesions are not on your treatment plan and insists you restore them.
VOLUME 3 NUMBER 1
CAREER COMPASS
The best way to maintain patient trust is through informed consent. Do not assume that the patient will choose the option you think is best. Explain that the cavities are small and can be conservatively treated with fluoride and diet modifications, or aggressively with restorations. Give the pros and cons, tell them your recommendation and let them decide. Autonomy is an important ethical principle, but if we hurry through a condensed version of the findings and treatment options, the patient’s consent will not be informed. If you simply tell them everything looks OK, and then another dentist tells them they have cavities, they will be upset. However, if you have explained that they do have early decay that can become an issue, they won’t be so shocked and assume that you missed something.
When someone else did bad work A patient who has been seeing a dentist down the street comes in for an exam. You happen to find a crown that has poor margins and, upon inquiring, learn it was done this year. What do you tell them?
So what can we do to ensure our patients believe in us? The answer is veracity.
It’s unprofessional to negatively comment about the dentist and his or her work. Stick to stating the facts. You can explain that you see a problem now and how you can take care of it. If the patient asks how something done so recently is failing, and you should be honest: You don’t know. If you weren’t there, you truly do not know the full situation and should not make assumptions.
When you mess up Your patient suddenly moves their tongue while you are prepping a crown on No. 30, and your bur grazes the lateral border. It starts to bleed, but the patient is numb and doesn’t notice. The patient doesn’t feel it now but will later. Do you tell them?
A friend who was a dental assistant saw this happen to a dentist she worked for. That dentist told the patient that they had bitten their tongue. My friend never trusted that dentist again and searched for a new job. On the flip side, a classmate did this in clinic and explained what happened to the patient. The patient understood, and they both moved forward from the experience. It is ethically imperative that you are honest and admit to a mistake that causes damage. If you explain what happened and offer some palliative treatment based on the size of the cut, most people will be understanding. So what can we do to ensure our patients believe in us? The answer is veracity. Explain your reasoning to patients, give them options and help them understand that there is always more than one way to treat a problem. Be truthful, even in tough situations, and your patients will respect you (and the profession) and give you the trust that you deserve. #
The purpose of human life is to serve, and to show compassion and the will to help others. — ALBERT SCHWEITZER
What will you do to serve? Join ASDA chapters and members across the country in an act of service during the national Week of Service, to be held Jan. 21–27. Learn more at www.asdanet.org/NatlOutreach.
#ASDAoutreach JANUARY 2019
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