REASONS FOR CONSULTATIONS

In the latter part of 1999 the general public was made aware of over 98,000 deaths that occur each year in the United States due to medical errors.

It became quite clear that one of the main reasons for these errors was poor communication skills on the part of medical personnel.

The most common lawsuit involving oral surgery is for the extractions of the wrong tooth. All of us have had the experience of having a  very busy and hectic day in addition to a  "work-in quick extraction? situation. This is a perfect situation for a mistake to occur resulting in a malpractice suit. Talk about time away from your practice and mental anguish! All easily avoided by a  pre-surgical consultation visit.

How can we establish better communication with our patients?  One way is to take the time to have a consultation visit prior to treatment when at all possible. This helps to clarify treatment options, plan the staging of treatment, plan the formation of a team approach, if necessary, for the success of the final goal and outcome of the treatment plan as well as providing the opportunity to discuss financial obligations with each patient.    

There's an old saying that relates ?when things don't work it's not because we plan to fail but because we fail to plan.?

There is no question that consultation prior to any surgical procedure, other than for a true emergency, creates a better and more professional relationship between the surgeon and the patient. Both diagnosis and treatment plan can be established in a more relaxed atmosphere. Alternative treatments and aesthetic choices can be more intelligently discussed. A relationship of confidence and trust can be established between doctor and patient, patient and staff. Financial obligations can be discussed in a relaxed and professional manner. Pre-operative instructions, post-operative patient care and patient escort arrangements are more easily arranged with a pre-surgery consultation visit.

I have found that patients invariably are more relaxed when they return for surgery or treatment if preceded by a consultation visit.

One of the problems highlighted in the current crisis of medical mistakes is drug reactions and prescriptions miswritten or misread.  Often this also is the result of decisions made in haste and not thought through.

The simple fact is that there are really very few "true" emergencies in the oral surgery or dental practices. Pain is not often an  emergency requiring immediate treatment other than palliative. Staging and proper treatment can be delayed to insure the best overall result for each patient.  

If we, as oral surgeons or specialists, say to a referring dentist's office "send the patient right over" it does not necessarily mean or imply that we MUST proceed with surgery or treatment stat.

Without careful evaluation, we may wind up taking out the tooth 10 minutes after the patient arrives for their "emergency" only to then face a true emergency when we realize that in our haste we failed to realize that this patient is on blood thinners (or has some other compromising aspect of their medical history). In addition, if medical clearance is needed prior to surgery this can only be done with a pre-surgery consultation visit.  This is just one of hundreds of example situations we face daily in oral surgery that makes us want to take our time with each patient and proceed with treatment in an orderly and predetermined fashion. Believe me, your patients will appreciate this approach much more than the "march them through the corral" approach.

There is the additional issue of the Informed Consent process.  No surgery should be done without completing the informed consent process. An informed consent hastily done under time constrained conditions and emotional duress will not stand up to court scrutiny nearly as well as one done in the appropriate time period between a consultation visit and the actual surgery date.

Article courtesy of:  T.  Osborne, D.D.S. Benchmarq Healthcare Systems

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