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Many years ago patients would come to my office either in pain or all swollen and tell me that they didn't have dental insurance and they didn't have much money in an effort to have me change my diagnosis to a less costly one. What I would say to my patient was:
Whether you are the Queen of England or the lady that cleans her castle, an infection is an infection. I cannot change the diagnosis (the reason for the problem.) However, the TREATMENT that the Queen gets IS different than the castle cleaner because the Queen has more assets to pay for the best treatment.
Where am I going with this?
On the international dental forum XP there was a dentist that was treating a 45 year old patient because her root canal and bridge failed (Hmmm you never heard me talk about that before lol) and he wanted to place 2 implants. The dentist was ecstatic about the implant protocol that he had invented and was showing off his work and asking for comments. My response to him on the forum was:
"Don't you feel the need to find out WHY the bridge would fail?"
What dental problems existed that made the failure of the bridge a forgone conclusion? I then presented a treatment plan that I believed needed to be followed to insure the survival of the new implants.
The young dentist responded with:
"I 100%
agree with you that this patient would benefit from more dentistry but the
reality is - she does not want it."
And my final word was:
"Lastly,
when we discuss cases on the forum, we are discussing dentistry; we are not
discussing how much money your patient has or doesn't have or whether they do
or do not want to have more treatment. Those issues are irrelevant to the
larger discussion of what the right thing to do is. If you need a new roof
because your roof is flooding your dining room, it is not helpful to say,
"but I can't afford a new roof."
If our patients want physicians or dentists to fix a problem, they must consider all of the
reasonable options that will allow us to do so. When a patient says, "I don't want to..." it means that they feel like they have the power or option to determine their own treatment.
Yes you may not have the money or the desire to truly fix your problem but then you must be prepared to have TREATMENT FAILURE because you didn't or won't do the right treatment. (PS The right treatment is not always the most expensive.)
