tx oms

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Ha, made you look. Of course I don't believe that, but do you? In light of a few conversations I've had lately and a lecture I had the other day, let me pose the question: is your patient's overall health your responsibility?

For example, is it your responsibility to harass them until they stop smoking? Should you council them about diet, obesity, and excercise? Even more interesting, if you are sedentary/obese can you honestly tell someone else they need to loose weight or quit smoking? If you like to binge drink on the weekends can you tell your patient to stop smoking? If you like a good cigar every now and then can you tell someone else they can't enjoy their smokes?

The only time I care what someone else does is when they're on my tab. I don't like people on medicare/medicaid participating in health risks b/c I'm paying their bill. In fact, if you smoke/drink/do drugs/etc I think you should be ineligible for handouts b/c you're spending too much money on your vices.
 

TucsonDDS

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tx oms said:
Ha, made you look. Of course I don't believe that, but do you? In light of a few conversations I've had lately and a lecture I had the other day, let me pose the question: is your patient's overall health your responsibility?

For example, is it your responsibility to harass them until they stop smoking? Should you council them about diet, obesity, and excercise? Even more interesting, if you are sedentary/obese can you honestly tell someone else they need to loose weight or quit smoking? If you like to binge drink on the weekends can you tell your patient to stop smoking? If you like a good cigar every now and then can you tell someone else they can't enjoy their smokes?

The only time I care what someone else does is when they're on my tab. I don't like people on medicare/medicaid participating in health risks b/c I'm paying their bill. In fact, if you smoke/drink/do drugs/etc I think you should be ineligible for handouts b/c you're spending too much money on your vices.

I think you just walked past the thin line to banishment. I feel it is our responsibility to inform them of potential health risks but it definitely is not our responsibily to harrass them. Honestly I could care less what their health is if they don't care enough about their own body. Unless of coarse any ADCOMs are out there listening then I just changed my mind.
 

toofache32

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tx oms said:
...The only time I care what someone else does is when they're on my tab. I don't like people on medicare/medicaid participating in health risks b/c I'm paying their bill. In fact, if you smoke/drink/do drugs/etc I think you should be ineligible for handouts b/c you're spending too much money on your vices.
These are the people I rarely give pain meds for. I pull their teeth and tell them to take whatever they use at home for headaches (Motrin, ASA, APAP, etc.). Their prescriptions are also on our tab. It sounds rough, but routine extractions do fine with ibuprofen. If I cut bone, then I'll give a narcotic.

Some of the other guys I work with are the opposite. They will even write a script for ibuprofen so medicare will pay for it.
 

USAF_Dentman

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tx oms said:
For example, is it your responsibility to harass them until they stop smoking? Should you council them about diet, obesity, and excercise? Even more interesting, if you are sedentary/obese can you honestly tell someone else they need to loose weight or quit smoking? If you like to binge drink on the weekends can you tell your patient to stop smoking? If you like a good cigar every now and then can you tell someone else they can't enjoy their smokes?
QUOTE]

Just what a man needs another nagging person in addition to his wife..no a dentist is not responsible
 

north2southOMFS

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tx oms said:
Ha, made you look. Of course I don't believe that, but do you? In light of a few conversations I've had lately and a lecture I had the other day, let me pose the question: is your patient's overall health your responsibility?

For example, is it your responsibility to harass them until they stop smoking? Should you council them about diet, obesity, and excercise? Even more interesting, if you are sedentary/obese can you honestly tell someone else they need to loose weight or quit smoking? If you like to binge drink on the weekends can you tell your patient to stop smoking? If you like a good cigar every now and then can you tell someone else they can't enjoy their smokes?

The only time I care what someone else does is when they're on my tab. I don't like people on medicare/medicaid participating in health risks b/c I'm paying their bill. In fact, if you smoke/drink/do drugs/etc I think you should be ineligible for handouts b/c you're spending too much money on your vices.

yah right, look at our pt. base here. We might as well have a stamp in our clinic that states

PmHx: IDDM, HTN, Obesity, Hypercholesterolemia, ESRD(b/c i never controlled my HTN b/c i was too lazy to take my free meds)

PsHx: Cholecystectemy, Tubal Ligation(b/c i have 4 illegitimate children)

Meds: "i take about 6 pills, i didn't bring them, one is reddish, I haven't take a couple in a few weeks because I missed my last 3 appts and the ER said they wouldn't refill my script any more until I went to my clinic appt."

Allergies: "PCN, Codiene,???Epinephrine???"

Our pts are completely unreliable.

I am quite sure our pt's have been told umpteen times to "better their lifestyle" to become healthier, and I think it went in one ear, straight through an empty cranium and out the other.

I just fix the Oral problems, let God sort out the rest.
 

gryffindor

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north2southOMFS said:
Our pts are completely unreliable.

I am quite sure our pt's have been told umpteen times to "better their lifestyle" to become healthier, and I think it went in one ear, straight through an empty cranium and out the other.

I just fix the Oral problems, let God sort out the rest.
Agreed.

I'll make an attempt with "Do you want to quit smoking? Think of all the $$$ you'd save if you didn't spend it on cigarettes. Smoking is a very bad example you're setting for your 6 year old daughter." I don't think any patients believe me or listen to me anymore when I tell them the bad health effects of smoking because of the empty cranium phenomenon, so I try to go for something they might understand better - $$$. I'll do the math outloud with them to give them an actual dollar amount.

If you're gonna make a stamp, send me one for my clinic as well.

If the patient isn't in acute pain and starts with a medical hx that goes "I take 8 pills, I don't know the names," I have no problem writing up a consult form to the primary med. doctor ("Pt. is a poor historian, please provide PMH, meds, ...") and sending them out the door.
 

Fullosseousflap

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tx oms said:
Ha, made you look. Of course I don't believe that, but do you? In light of a few conversations I've had lately and a lecture I had the other day, let me pose the question: is your patient's overall health your responsibility?

For example, is it your responsibility to harass them until they stop smoking? Should you council them about diet, obesity, and excercise? Even more interesting, if you are sedentary/obese can you honestly tell someone else they need to loose weight or quit smoking? If you like to binge drink on the weekends can you tell your patient to stop smoking? If you like a good cigar every now and then can you tell someone else they can't enjoy their smokes?

The only time I care what someone else does is when they're on my tab. I don't like people on medicare/medicaid participating in health risks b/c I'm paying their bill. In fact, if you smoke/drink/do drugs/etc I think you should be ineligible for handouts b/c you're spending too much money on your vices.

I drill and/or extract teeth all week long! And have been doing it for over 25 years!

There is as much decay and problems today as there was when I started. Dentists have educated, cajoled, harassed, fluoiridated, re-educated and what has it accomplished? Well, people are keeping more teeth now.....and we have implants.

Is dental health better...yes.... because of us and in spite of our patient's poor health choices.
 
OP
tx oms

tx oms

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My dental school and medical school both required/require that we ask questions about "risky" behavour. In dental school most people didn't care b/c they felt it was up to the pt and their primary care doc. Most medical specialists, surgeons, and med students who want to specialize or do surgery don't care either.

However, several of the primary care attendings (family practice, medicine, Ob/Gyn) and students interested in primary care are dogmatic in their view that the doctor's great mission is to help people overcome themselves. Come to think of it, all of my public health dentistry profs thought the same thing. I just don't think it's the doctor's responsibility.

As a matter of public policy, I wouldn't mind if medical conditions brought on by bad life choices weren't covered by insurance and madicaid/medicare. I'm not sure I could really support that decision, though, when I think about specific people I care about who are overweight/smoker/drinkers/etc.
 

KY2007

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I have another question for anyone who has already completed or has started their oms residency. Is it feasible for the wife to stay home and pop out some puppies? This is pretty much the only concern my wife has. She doesn't want to wait 8 more years to have another baby (2 years left of dental school + 6 oms). When we have another baby she also wants to be able to stay home with him/her.
 
OP
tx oms

tx oms

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KY2007, what the hell does that have to do with this thread? The answer to your question is yes, it is possible. Several of my co-residents have kids.