Dental News - Whose choice is it anyway?

Angie Stone, USA

Wed. 22 June 2011

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Let’s imagine you went to your doctor for an annual checkup. Nothing was wrong, you just needed to have a once over. While the doctor was checking you out, he noticed a mole on your back that looked a little strange … you know, the infamous, “suspicious mole.” For me, that saying always conjures up a vision of a mole in a trench coat with only its eyes sticking out above the collar.

The doctor recommended you have the mole removed and biopsied, but you were getting ready to go on vacation and didn’t really want to deal with a bandage over the excision site. Also, you were not sure if your insurance was going to cover the procedure, and quite frankly, you were not all that concerned about the mole. You mentioned these things to your doctor and he said, “OK, well we really should do this, but the decision is up to you.”

Do you think your physician agonized over the fact you opted not to have the procedure done? Do you think he was saying to himself, “Well, if she can go on vacation, I don’t understand why she was worried about the cost of this procedure.” Do you think that for one minute the doctor thought about not telling you about the mole he felt needed to be removed? Seems absurd doesn’t it? But yet, this scenario takes place every day in dental offices.

I hear my colleagues complain that patients will only “do what their insurance will pay for.” I hear them talking about other things they know the patient spends money on. Even worse, I have heard about hygienists not discussing patients oral conditions because, “the patient will not do anything about it anyway.”

When I was in dental hygiene school, never once was I taught to consider a patient’s insurance coverage when reporting my findings. I was never taught to judge patients if they opted not to accept recommended therapies. I am not sure at what point all of this became OK in our profession.

We need to remember it is our responsibility to inform patients about their oral situation, and just because we tell them does not mean they need to do anything about it. Remember something called informed consent? Patients need to be advised of their situation, informed of the recommended treatment and what the expected outcome is, what the risks of treatment are and what the risk of no treatment is. Nowhere in informed consent does it say the patient must chose to do something.

Dental professionals need to operate more like medical professionals: the patient decides what is right for them and we honor their wishes because it is not our decision to make.

Editorial note: This article was originally published in Hygiene Tribune Vol. 4 No. 6, June 2011.

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