#1
Factor V Leiden mutation is the most common cause of hypercoagulable states, some studies put it as high as 15% of the general population, and over 60% of those with DVT's. I would think a dental pharm lecture is one place to go for that kind of material. I guess they didnt teach you guys that, or the scribe missed it. Factor V Leiden mutation has several paragraphs devoted to it in any textbook of pathology, internal medicine, or critical care. I'm suprised it isnt all over your review books. This may illustrate the fact that dental education is very different from a medical eduaction. There is some overlap, but dentists need to know a lot more in some areas, a lot less in others. A 3rd year med student would probably destroy a whole set of teeth with one click of the drill, and likewise a 3rd year dental student would not know where to even start in the ICU.
#2
I could give my 13 yr old nephew a PDR and have them look up drugs as well, can he prescribe some coumarin now? The old look it up excuse is overused. I dont want any doc taking care of me to have to look things up as he's writing the script. Some things should be known. Guess what, not everything is in PDR. Its a factbook published by the drug manufacturers, not a How-To -Manual of medicine. Although many attempt to use it that way.
#3
The sad thing is most docs in private practice do miss a lot, dont order labs when they should, and hand out drugs just assuming everything is ok. These are the guys who end up killing or hurting patients every once and a while, and jacking up malpractice costs for all of us. Most of the time all ends up ok, and they get things done faster and make more money. When they get sued (and they all do) they clean up their act for a few years and then start being lax again. I just think there should be a higher standard.
At a teaching hospital, they dont usually operate in that manner, and you do catch contraindications and interactions before they happen---this is much mroe common than you would think! Just because certain docs are lax with the rules and can get away with it 98% of the time doesnt mean the dental profession can start writing scripts beyond the scope of their practice. "you -should have- known better" is different from "you -didnt- know any better". Its all relative.
#4
Common things happen commonly is a very good way to put it. OCPs and Inhalers are certainly common. So is malpractice. Irreversible pulpitis is also a common thing, but I wouldnt know how to spot it, or even begin to comprehend it. I certainly wouldnt dare treat it, not even if it were my wife. I' d drive her to see the endodontist, thats the limit of my expertise. These things are best left to the experts. This way, the patient always gets the best possible care, even if it may be inconvenient this is what its all about.