January 13, 2008 at 3:31 pm by Ian Kerr
Filed under Behind the Headlines
The media (in all forms) were quick to report that a saliva test to check for certain proteins that are present in patients suffering with breast cancer is being developed in the USA. This is very exciting news as it will make diagnosis quicker, easier and crucially, earlier.
What the news reports were less clear on was the likely time scale for this test to become readily available. The research group involved are just looking to begin second stage clinical testing with a 2 year study planned. They hope to receive FDA approval within 5 years, meaning that realistically we have at least 6 years to wait before it becomes available, with no indication, as yet, on cost.
Hopefully the tests will live up to expectation and if it does I PROMISE that StoneRock will be actively looking into providing this for our patients but it is going to be a very long time before something like this becomes routine. In the meantime the advise from doctors is for patients to continue with their usual regular self examination and seek immediate help if they discover a lump or are concerned about something.
January 13, 2008 at 3:20 pm by Ian Kerr
Filed under Behind the Headlines
Wow! A full front page spread, whatever have we done to deserve this.
The banner headline, front page spread of the Saturday edition of the Independent, Saturday would indicate that it was rather a slow day at the news desk. “The Great Dental Rip Off” screams the headline, although a more factual, but clearly less exciting headline and story would be “Consumer buys product that breaks after a year”. A disappointing result for the consumer, for sure, but hardly front page news of a national newspaper. (The scare tactic photo of drill and mask, shows very little consideration for genuinely nervous or phobic patients but we have come to expect this by now).
The inside article repeats the often stated but factually inaccurate comment “that patients are paying wildly differing costs for the same treatment”. THEY ARE NOT! The statement that “all crowns are the same” is as wrong as the statement ” all cars are the same”. Fees differ wildly because practices differ wildly in the amount of investment they put into to their facilities, their training, their staffs training,the laboratory they use (to make the crown), the materials used to make the crown, the cementing procedures to fit it, the after care they provide and the guarantees they provide with it. Clearly the crowns are not the same (although they may be used to do the same thing, in the same way that two different cars will) and the golden rule of buying applies - “you get what you pay for”. Dental surgeries can be accurately described as “Health Care Businesses”. The “Health Care” aspect means that we have a legal, moral and ethical obligation to provide treatment of a clinically acceptable standard, or above, but the “Business” aspect means that we must do so under the normal rules of profit and loss that apply to all businesses, regardless of what product or service they provide.
Any way enough grousing, lets get down to discussing the article, which does actually raise a very important issue, that of patient dissatisfaction and how they can resolve it. The article concentrated on the newly formed “Dental Complaints Service, set up in May 2006, which is a body concerned with private dentistry only, not NHS. This service is for patients who have a complaint about treatment that cannot be resolved directly with the dentist. This is a vital service and one that should have been set up a long time ago but it is one that no one should ever have to use. Every dentist is required to have a complaints system in place within their practice that is clearly worded and accessible to all patients, existing or prospective. All ethical, well intentioned dentists have one of these and stand by it.
Unfortunately it is probably true that the ones who have this procedure well developed within their practice are the ones who least need it. This sort of dentist will avoid virtually all need for the procedure by spending time listening to their patient’s wishes and providing detailed verbal and written explanations of treatment needs, alternatives, procedures, costs and expected outcomes. By working in this fashion the dentist and patient can collaborate together in the treatment, achieving shared goals that match the patients desires and budgets.
It is also sad truth that good dentistry done well can fail. Well informed patients, warned in advance of possible outcomes will accept this fact and the matter will resolved by repeating the procedure or choosing an alternative; no complaint procedure will be needed or considered. Dentistry carried out at StoneRock Dental Care can, and does, fail. Russell and I know this and deal with this as part of our normal working practice. We have a complaint procedure for all to see and use if they every feel the need and our management staff are fully compliant with it but it is not how we like to handle things. We prefer to minimise the risk by providing written costings and explanations ahead of treatment and by listening to our patients comments to make sure that we are providing the service that our patients want.
At StoneRock we make the following promises
- To listen to our patients wishes
- To provide detailed explanations of treatment needs, alternatives, costs and expected outcomes
- To provide a guarantee for all work completed, unless otherwise stated
- To respond promptly and appropriately to any negative comments or complaints with an aim to resolving things amicably within the practice
In a recent “Kitchen’s Nightmares” programme Gordon Ramsay said that at his restaurants his staff don’t listen to the positive comments, only the negative ones. I suspect that this is a central reason for his phenomenal success and useful lesson to all of us in any business.
October 22, 2007 at 8:33 pm by Ian Kerr
Filed under Behind the Headlines
A recent Channel 4 programme called “How Toxic are Your Kids” identified certain “risk” factors in your toothpaste. Sadly this programme has chosen to follow the now all too popular approach of “pseudo-science” and scare tactics to push home a very poorly researched agenda.
The so called risks related to the active ingredients of Fluoride and Triclosan and the ever popular sodium lauryl sulphate. I’m not going to go into a point by point argument here about the science used in the programme (things like this are dealt with much better on far superior websites such as badscience.com) but I would like to make the following points.
- There is no such thing as zero risk; only balance of probability
- It is very easy to make arguments based on emotional grounds but very difficult to accumulate sound scientific data
- It is, to all intents and purposes, impossible to prove that a risk (or a link) does not exist, only that one does exist
- Fluoride toothpaste has been shown to half tooth decay rates in children. Triclosan has helped improve on this
- Tooth decay is, of course, highly toxic and can cause pain, infection and severe suffering in young children in particular
I should also add that the suggested alternative of a mixture containing lemon juice and rock salt may just be the worst idea for a toothpaste ever suggested. Lemon juice is highly acidic and would dissolve dental enamel very quickly and high levels of salt, if swallowed would be very dangerous for children.
A lot of this can be summed up in a photo I took in California on a recent trip. The following warning sign appears in front of every restaurant in the state, and is quite clearly utterly pointless. Warning people of every theoretical risk does not help them make meaningful decisions, it merely confuses the issue and, in the case of this sign, eventually becomes completely redundant
September 25, 2007 at 9:28 pm by Ian Kerr
Filed under Behind the Headlines
If, like me, you want to have your science well debated and not simply sliced up in to “bite sized” chunks of pseudo science then you might enjoy these websites.
www.badscience.net and www.behindthemedicalheadlines.com.
Enjoy.
PS StoneRock Dental Care cannot be held responsible for any injuries resulting from having the “rug pulled from beneath you” when reading these sites!