1. How would you have settled the case and why? (attention to if-clauses!) In your answers agree or disagree with your colleagues by hitting "reply" to their comments.
Dental neglect – but whose? - dental case study
03 July 2009 http://www.mddus.com/mddus/news-and-media/case-of-the-month/dental-neglect-–-but-whose.aspx
Mr M had worked for the same dental practice for 35 years and was looking forward to his retirement.
One morning a letter of claim arrived at the surgery from solicitors representing a patient Mr M had treated for over 20 years from the age of four.
Mr M remembered D well as he attended over 70 times in the period that he was a patient at the surgery. His notes constituted a long list of caries and fillings with occasional antibiotics and, in the later teen years, numerous root canal treatments and crowns. In the claim it was alleged that many of the fillings and treatments were incomplete and required to be re-filled and crowned.
The patient also alleged that he was never given any advice on diet or oral hygiene. Nor was he ever referred to the dental hospital where he might have been offered preventative treatment such as fluoride washes and sealants. Such measures might have prevented the extensive dental decay suffered by D
I think that D has right at a certain point because the doctor should have told him about preventive procedures, however he could have asked the doctor about these. So it is not only the doctor's fault the D suffered such extensive dental decay, D should have paid more attention to his oral hygiene as well.
ReplyDeleteYou are right, but how could you settle this issue officially? Saying that someone is right/wrong is hardly enough when such a large amount of money is involved.
DeleteWhat do other students think?
I think that is common sense to know that you have to maintain a good oral hygiene and you must be careful with sugar, fizzy drinks , coffee or other aliments that can damage your health, but if the doctor would have give those advice it would have been the patient's fault, but the doctor settled by the thought that he had done the job well and his part was done. Mr M. should have been a dental doctor and try to tell his patients about prevention, treatment and not just a simple dental worker who fixes teeth . Not all people have access to proper education so it's the doctors job to teach the patient. In my opinion the fault is on the both sides. The patient should have figured out much sooner that something isn't right and the doctor should have been a doctor all the way and not only a simple worker for money.
ReplyDeleteHello Mihai, can I challenge you to find your mistakes in the following phrases:
Delete- if the doctor would have give
-those advice
- doctors job
-on the both sides
. I agree Mihai that the fault is on the both sides. The doctor should teach the patient about oral hygiene-how to brush the teeth; using auxiliary methods as flossing, mouth water. Also the patient should be interested about she’s or he’s mouth. Even if the patients don’t know the medical procedures the doctor can explain them understandable.
DeleteChallenge accepted :
Deleteif the doctor would have gave
these advice
on both sides
I can see that I should be more careful with my spelling .
Challenge won only partly, because:
Delete1. We cannot use "would" in an IF-clause, so the correct form is: if the doctor had given;
2. advice is ALWAYS IN THE SINGULAR: this/that advice (is)....
3. doctor"s job
As Mihai said, it is common sense to know that you have to brush your teeth regularly and avoid drinks and food that can harm your oral hygiene. D should have paid more attention to his habits and if he was 100% interested in his health, he could have searched for some answers or asked directly his dentist on how he can improve his condition. Trusting your dentist is not enough...in fact, you cannot trust anyone! I wonder why he was so angry with Mr. M? In the end you have to take responsibility for your own hygiene. D should have gone to the dentist earlier, when he first saw the signs of decay,etc. If he didn't like Mr.M, then why did he continue visiting his dental office? He could have chosen someone else. Mr. M should have undertaken a more thorough investigation of the patient's problems and done a little bit of research on why his patient needed so many fillings and root canal treatments and explained to D the best way to take care of his teeth and perhaps given him a prevention lesson. In the letter of claim, D said that he wasn't offered any preventative treatment such as fluoride washes and sealants...but as far as I know, hospitals do not offer preventative treatments for free. Mr. M should have enlisted him into a program like this, but since he didn't I believe both parties are to be blamed to some extent.
ReplyDeleteOk, Dr M may have received a letter of claim , but are we sure that Mr D is saying the truth ? Maybe , as a child , Mr D had not payed attention to the advice Dr M gave him ( washing teeth correctly , when to wash , which method to use ) and now angry because of his tooth problems has to blame somebody .
ReplyDeleteWhat is more , Mr D's problems may not have been caused by Dr M's malpraxis or lack of information but by a genetic problem. Dr M must see if Mr D's parents suffer from the same problem . If so, I belive it isn't his fault for what happened.
Finally , I think that If Mr D had asked Dr M for advice he would have answered . Patients mustn't wait for the doctor to tell them everything they know , but to ask questions if they want more information .
I think that both sides share the fault because none of them knew exactly how the procedures and the results will turn out. Mr. D should have taken better care of his teeth and Mr. M should have been more empathetic. First of all, the doctor is supposed to keep track of his patients, to have them registered in their medical chart and evaluate their state of oral health. Knowing what is good and what is bad for your teeth is common sense and like my class mates have already said, he should have brushed regularly. When a doctor finishes the medical university he has to make an oath that he will treat his patients equally and make sure that he did his job as good as he could. We can't accuse the doctor for malpractice , but we can definitely say that he didn't do his job as the patient would have expected. All in all, both the doctor and the patient are "guilty" for the situation they are in.
ReplyDeleteI think is both of their faults, because all of us need to know how important is to maintain the oral hygiene and performing daily brushing. On the other side, Mr.M should have explained to his patient about the prevention methods, and D should have had gone earlier to the dentist.
ReplyDeleteI am on Mr. M side because it isn't his fault entirely. Yes, he had to educate D on oral hygiene and advise him on preventive dental care, but you, as an individual, must take care of your owm teeth. You have to ask for advices, after all it's your health involved. Officialy, Mr M can pledge not guilty because the discussion doctor-patient is not written in the history of the patient so it can not be proven that Mr M did not educate D. Maybe B did not listen.
ReplyDeleteStefan I am totally agree with you about Mr D. He should have been the first one to take care of his teeth. But what do you make of all those fillings and treatments that were incomplete and required to be re-filled and crowned? Don't you think that Mr. M should have taken better care of his patient?
DeleteAndrei, we say "I totally agree with you" (without am - which is what we say in Romanian!)
DeleteIn my opinion the dentist should noticed that something is not right with the previous work because when a patient came to us we should examine each tooth not only the painful one.
ReplyDeleteIn this case I would try to come to an arrangement with the patient and maybe I would offer that I fix all problems that I made in a reasonable price.
From the language point of view, the correct variant is: " the dentist should HAVE notices that something WAS not right..... when a patient COMES.
DeleteI totally agree with Agnes because a good dentist can't allow himself/herself to examine only a single tooth at the same time! Nay! We have to see the whole human organism, a whole dentil, the oral mucosa, the tongue... We will become doctors, not just drillers&carvers .
DeleteIn my opinion both have a part of the blame.
ReplyDeleteThe doctor should advice the patient, he must perform full check every time the patient comes to him, but also the patient must get involved, he must ask questions, he must make research also.
So, they should find a way to solve this problem and both of them to be satisfied.
If one wants to take care of their teeth, he or she will do it at any cost. D could have asked as well. I am on Dr. M's side. Nobody can prove that Dr. M did not tell D about preventive procedures.
ReplyDeleteI think that the dentist faults. I think this because it is possible that the patient never heard about correct brushing techniques, mouthwashes, dental floss. He washed his teeth twice a day and thought that everything is all right. The doctor’s obligation is to examine the patient’s mouth and to instruct him the correct oral hygiene. On the other hand, the dentist’s work it was not punctually, but this is important in our profession. In my opinion the patient should chose another dentist.
ReplyDeleteHi Orsolya,
DeleteInteresting point of view!
In your first sentence, "faluts" is not a verb, so can you rephrase your first sentence?
Also can you correct:" the dentist's work it was not punctually"; "the dentist should chose".
I totally agree with Orsolya.It is the dentist's fault because it is the obligation of the dentist to explain to the patient methods of preventing caries and after a treatment is essential to tell him how to take care of his teeth in order to avoid any complications or relapses.Even if the dentist is not a nutritionist,he can inform the patient that a good diet,based on healthy food is a method of preventing caries.
DeleteIn my opinion, a dentist can't be held accountable for something every patient is responsible of : oral hygiene. This patient used to come to his doctor for over 20 years, several times a year. Orsolya, what do you mean that the doctor''s work was not punctual?
DeleteFirst of all, it is hard to believe that, as child, D. was never given any advice on diet or oral hygiene because, as far as I know, children are taught to brush correctly their teeth and checked up to do it properly.
ReplyDeleteOn the other hand, there is no evidence that some fillings or root treatments were incomplete just because they have gone back or have to be replaced. They have a guarantee of maximum five years, so it is irrelevant to claim a new treatment and accuse the doctor of malpractice.
I agree Cristina.If the patient notices that some fillings are not durable,he should ask the dentist what is wrong?If things continue to go wrong the patient should change dentist.People must be educated to oral hygiene,but it is the patient's responsability how he puts in practice this information he get from his dentist.
DeletePelple must be educated .............(preposition to be corrected) oral hygiene.
Delete- how he puts ............(preposition) practice this information he get from his dentist.
I think the truth is in the middle. The doctor must insist with teaching the patient and warning him about the danger he is exposed to if he don't take good care about his oral health. Also the patient must be involved more and to ask questions, try to inform by himself also and respect the doctors' indications.
ReplyDeleteI have to agree with Cristian Gliga, because both have a part of the blame. But the patient must be more attentive and thorough what the doctor said. At the end, I'm on Mr. M side, as I think he told what to do for the patient.
ReplyDeleteFrom my point of view they are both guilty.The patient, because he did not request additional information about teeth heath and prevention. And, on the other hand, the doctor, who is responsible to inform patients, to explain how they can improve oral hygiene, brushing techniques and explain the cause of developing dental problems.
ReplyDeleteFrom what I can see they are both guilty , Mr. M of not taking better care of his deeth despite having numerous problems over the years , I mean having to attend over 70 sessions should raise some allarms. And mister D should have kept his patients more informed and kept a better record of his activity with his patients if he didn't want such accusations to arise.
ReplyDeleteGiven the situation, as we are all students, preparing ourselves for the long paved way of becoming practitioners in dental care, our natural tendency is to take Mr. M’s side. Nothing wrong about it, I might say, but we can also be highly subjective.
ReplyDeleteFirst, we need to take into consideration D’s history in the “hands” of Mr. M. If the patient came back, over and over, it means he trusted his doctor, and it also means that a relationship was built between them. This relationship means the doctor knew the situation of his patient quite well, if it is to consider that he attended the surgery over 70 times, which means, more than 3 times a year. Also, the history allows and facilitates a natural communication, one in which D could easily require advice on diet or oral hygiene, or ask about preventative treatment plans. The natural conclusion can be that D was not very concerned about his oral hygiene.
Second of all, let us not overlook the fact that D became a patient of Mr. M at an early age, which suggests he was taken there by his parents, who also trusted this doctor. Let’s assume he was neglected and not treated at the highest standards for some years in his childhood, but he still continued to be treated by Mr. M when he became a young adult.
In conclusion, I do not intend to find “the black sheep”, but to challenge you to look at the situation from a more holistic perspective.
I find mysefl agreeing with what seems to be the general consensus , namely that both parties where at fault. Mr. D. should have kept a better evidence of his patients records, especialy cosidering that Mr. M. had been coming to Mr. D's office since he was a child and Mr. M should have taken better care of his teeth and practiced better dental hygiene even though Mr. D. (allegedly) hasn't formerly informed him to do so (70 trips to the dentist's office should be a big red flag for anyone)
ReplyDeleteI agree with colleagues who says that the doctor should improve patients’ awareness. I mean it is important for you as a doctor that you teach about correct oral care, ways, techniques of tooth brushing, everything that is connected to oral hygiene. All these aspects should be highlighted to the patients and given the necessary advice on eating habits and brushing methods.
ReplyDeleteZsuzsi, there seems to be a problem with "I agree with colleagues who says.........." and "everything that is connected to"please initial the corrections.
DeleteI agree with colleagues who say...... and ..everything that is connected with (?)
DeleteRight!
DeleteMr. D. as a child, probably received a piece of advice from Dr. M, regarding oral hygiene, but like any other child, he did not keep account of the advice. As time passed by, Mr. D started having serious dental issues.
ReplyDeleteHe should have gone to the dentist for checks every 6 months or at least once/year in order to prevent dental diseases.
Dr. M. could have given him different treatments for preventing teeth decay in deciduous teeth, especially the freshly erupted permanent ones. Treatment of dental diseases has been properly performed, I guess. Duration resistance of dental work depends largely on the materials used but also on the patient’s oral hygiene, diet and genetic background of teeth support.
M. should have established an appointment that included a special program for Mr. D., or he could have given him a pro-bono consultation to “educate” his patient about dental procedures and diseases. Eventually Mr. D would have followed the explanations given him by the doctor (he is no longer a child, so he could take more responsibility) and also Mr. M should have established a new personalized treatment plan, an efficient one!
Ok so my opinion is that Mr. M should have kept his patient informed about oral hygiene at all times,judging by the price of the remedial treatment very important things were neglected in his oral hygiene. If I were the dentist in this case I would support the new remedial treatment cost myself because I find Mr. M's negligence as unacceptable. Mr. D should have a good oral hygiene knowledge given the fact that he is Mr. M's patient for such a long time.
ReplyDeleteIn my opinion it’s doctor’s fault because he has the obligation to inform his patients referring to oral hygiene. Some patients don’t have the possibility to inform concerning to oral hygiene and also they don’t know how to brush correctly their teeth. If a doctor notice that you have progressively more decay, he must realize that is something wrong with brushing or with alimentation and from anamnesis he must understand and explain the causes. Many of them are determined by incorrect brushing, so the doctor must explain to his patients accurate brushing techniques and also complementary methods of oral hygiene like fluoride washes, dental floss.
ReplyDeleteMadalina, will you correct the following:
Delete- it’s doctors fault
-some patients don’t know how to brush correctly their teeth
- If a doctor notice that is something wrong
If a doctor notices
DeleteThe doctor is blamed
Some patients don’t know how to properly brush their teeth
Yes, but you can also say: it’s the doctor’s fault.
DeleteI agree. It is important for the doctor to be responsible, to give advices for the patient, to care about them, pay attention on them, tell them about the importance of the oral hygiene and to show them the proper way of brushing their teeth because lots of kids and adults did not get these kinds of informations and they don't realize the importance of prevention.
ReplyDeleteAbigel, there seems to be a problem with your nouns, can you tell me what it is in:
Delete- to give advices
- these kinds of informations
to give advice
Deletethese kind of information
Both "advice" and "information" are uncountable nouns, so we say:
Deletethis kind of information (never plural, and the pronoun is also singular: this)
My opinion is that Mr M should have given the necessary advice to his patient in order to maintain his oral health, on the other hand I think the patient is to blame as well because the treatments wouldn't have lasted so many years if they wouldn't had been done properly.
ReplyDeletePatients should ask for advice if they are not offered one and they shouldn't make claims for personal interests.
Andrea, another wrong if-clause - please find it and correct it.
DeleteThere is also something wrong in the sentence: "if they are not offered one..."
The treatments wouldn't have lasted if they wouldn't had been done properly. Patients should ask for advice if they are not offered some and they shouldn't make claims for personal interests.
DeleteYou have to pay attention, Andrea, "would" cannot be used in "if": The treatment wouldn᾿t have lasted if they hadn᾿t been done properly".
DeleteIn my opinion the relationship between a doctor and his patients is very important for his career and I don't think that this claim which was written by Mr. M was smth good for doctor's CV. I think that doctor D wasn't so focus on following his patients. He should invite his patients for a consultation to be sure that his work was in good shape. I also think that Mr.D wasn't so focus on his oral hygiene and his diet,that's why he was in trouble. So,the blame belongs with both of them
ReplyDeleteJulian, what is wrong in:1. "I think the doctor was not so focus on following his patients"? 2. "He shoudl invite his patients for a consultation to be sure that his work was in good shape.
DeleteBy reading the case study, and the comments posted by my fellow peers, I have to agree with the general idea. Both parties should be held accountable to a certain degree. Mr. M should be held accountable for not telling Mr. D on proper oral hygiene techniques outside his office, and how to properly avoid future tooth and oral problems. Mr. D should be held accountable for not looking after his own oral hygiene, and then after years of treatment going against his well trusted dentist. Mr. D kept going back to Mr. M as he was doing a good job, but forgot to take care of his oral hygiene outside the dental office. The blame falls on both parties in a way, however I do not believe that the dentist, Mr. M should be held completely at fault. The blame could be divided between both parties, not just simply put on one or the other.
ReplyDeletePeople must be educated in oral hygiene
ReplyDeletehow he puts on practice
I hope it is ok now,thank you.
The first one is correct, the second is: how he puts into practice (INTO). One way to find out the right preposition is to Google it.
DeleteI think is both of their faults .D should have gone to the dentist earlier, when he first saw the signs of decay.Mr. M should have undertaken a more thorough investigation of the patient's problems and could have given him different treatments for preventing teeth decay in deciduous teeth.
ReplyDeleteIn my opinion both have a part of the blame. I think that Mr M should have taken more care of his patient, considering the history of his dental problems, by keeping a closer eye on him while Mr. D should have taken more care of his teeth. After all it's our teeth and we should be the first ones to take care of them.
ReplyDelete