Dental Pro's Please?

Hi fellow dental professionals. I need some advice. OK, we have a patient who comes to us who has always, always, always, got some kind of problem, which xrays/exams, etc don't always show the "problem." Sometimes they do. We never know what we'll get when he's coming in. Occasionally he's got a slight temper when the DDS can't find anything. He will yell at me, and other staff members...There have been times when we've thought of sending a letter of dismissal when he seems so unhappy. Other times, I kinda feel sorry for the poor guy; I think he may be showing early symptoms of Alzheimer's disease. What do you think???

Thanks!
Dental Assistant, N.C.

Nebula D: This is a site where people give their honest opinions and answer questions to their best ability. I am very surprised you addressed the other responders in the way you did. I am certain you would be a very difficult person to work for. Your thoughts would be valued more, I think, if you had more compassion. I never said I was convinced this man had any real dental issues, yet you accused me of believing so. What I DO believe however, is that you, with all due respect, don't have the right to talk to Anyone the way you've spoken to us. These girls have been very kind to respond to my question. No need to be so hateful in your response. A little bit of respect goes a long long way.

Sounds to me like he's addicted to pain killers... That's what we've had in our office. When a patient comes in frequently complaining of pain that you're unable to find the cause of, it's usually because they're trying to get some pain meds out of the dentist...
Especially if the patient becomes a little hostile... it's because they're not getting their way. Toothaches are, in theory, the easiest way to get pain meds. So, when a patient is unable to get any, they get angry...
That's just been my experience.


RESPONSE TO NEBULA D:


The dental assistant asking this question asked others what THEY THOUGHT. I'm sorry you feel so hostile toward hygienists and assistants. It's a pity, especially since I know how much work both sets of professionals do to keep you in business. Hopefully you can adjust your attitude and answer questions with your knowledge rather than your nastiness.

I never look forward to those kind of patients! Nothing is more frustrating than when the patient gets upset at us for something we can't help. I guess your office could always suggest referring him to a specialist if you can't find the problem. Other than that, I guess, kill him with kindness. Hope you have a good week!

I am a dentist.

First of all, dismissal is sometimes the best treatment, provided you are not abandoning the patient. If he is abusive, then the doctor has every right.

As far as his mystery problems, you seem to have convinced yourself that he doesn't have any problem at all. That is a big mistake. It affects the way one goes about the diagnostic process. If you think you're not going to find anything, you're much more likely to find nothing. The head and neck are choc full of anatomic structures and myriad tissues. Anything in this region can cause pain one way or another. Anything. Maybe the doctor simply isn't aware of what he lacks knowledge and diagnostic skill, and at this time should consider referring the patient to some specialists if he hasn't already.

Since you haven't provided us with any specifics about the HPI (history of present illness), I'm assuming that you're not looking for diagnostic suggestions.

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No! The painkiller addiction is a moronic assumption, especially since the original question said nothing about the patient requesting pain meds.

I am not in the least bit surprised that a stinking hygienist and two dental assistants (non-diagnosing members of the dental team) would jump to such a conclusion, completely disregarding the countless other possibilities.

Before you two make foolish assumptions, educate yourselves. No dentist in his right mind would repeatedly prescribe pain medications for a patient without diagnosing and treating something.

I think the pain killer answer is a good one. If a patient keeps getting angry I would let him know that is not acceptable in your office. Refer him to another dentist. To check the pain med theory call the pharmacy he uses and ask the pharmacist if there have been any other Dr's calling in pain meds.

It takes all kinds to make the world go around as my mother use to say. The best that you can do is continue to act professional and do your job to the best of your ability. There are a number of things that could be going on, but maybe this guy is just lonely. So he keeps finding things "wrong" so he can keep coming back for some company. Sad but true. There are many people who don't have anyone to talk to and gravitate toward people who are kind and understanding because they have nobody else. Now he should not be yelling at anybody. You are doing your job and you do not deserve that kind of abuse from anyone. If he is really verbally abusive then your dentist should respect you as part of his staff and dismiss this patient with a letter. The key is you have to document everything. Do you write in the chart not only his dental findings but also that he has been abusive and uncooperative? If you have excellent chart notations and documentation then it will be easier to dismiss him without legal trouble. If you have not documented everything then you leave yourself open to a lawsuit if you do dismiss him. Some of my best patients have been the ones that have started out as cranky cusses as I like to call them. When I did not react negativity to their crankiness and really sat down and listened to them they ended up changing their whole tune. An open heart and compassionate nature can take you a long way with these types of people. I always try to put myself in their shoes, and think maybe we are all that they have. It is very sad, but there are many unfortunate souls that don't have anyone to talk to because they have run-off all of their family and friends. Maybe for good reason, but I can't judge them for that, I am a dental professional I am here to serve them to the best of my ability. I draw the line at intentional verbal abuse. If they want to argue with me or talk to me in a manner that is not respectful then I get up and say I don't allow anyone to talk to me that way and I leave the room. Many times they just need to cool off and are very apologetic after the fact. You can bet that it is not you as a dental professional they are ticked at, but something that is going on in their lives and they have nobody else to vent to. Some of my most difficult patients in the beginning, are now most of my favorites. It just took some time for them to get to know me, and visa versa. Ultimately it is up to your dentist to take action, either he will dismiss the patient or learn to live with it.