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New office under diagnosing periodontal disease

I just started working at a new office and am so excited to have this job. I have only worked a total of 9 days there. I really enjoy the staff and patients and hours but there is no perio protocol. It looks like the office has had some serious issues with past hygienists’ (now retired) record keeping so I feel lost on what is even going on. We had a meeting and it looks like the dentist really wants to make some great changes with record keeping, but anytime I have reported perio to him he has blown it off. He is definitely not production driven and has caring (maybe misguided) intentions for his patients. He really stresses getting to know the patients and making them feel welcome. It is hard to say for sure but I think maybe he is afraid of offending the patients. It is really hard as a new hygienist to come in and overhaul things, but I need to have a conversation about it with him. I am not sure how this is all going to turn out and want to approach it in the best way. I really want to keep my job but I want to do the best for my patients.



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2 Answers

I agree that you need to have a conversation with him to get on the same page as far as periodontal protocol. Failure to diagnose periodontal disease is supervised neglect, in which a patient can file suit against the doctor over. When you approach him, I would state it in a way that focuses on providing the best patient care (like he does with other procedures and expects all staff to do) and that its a matter of protecting his license. Remember you are concerned for him and his (and your) patients, you aren’t complaining about him or the last hygienist per se. You want the office to be operating and treating patients at the highest level possible and diagnosing perio is a part of that.
 
Here are some articles that might be worth printing out for him:
 
http://www.drbicuspid.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=318965
 
http://www.dentistryiq.com/articles/2012/07/shame-on-us.html
 
http://www.thewealthydentist.com/blog/1630/a-little-periodontitis-mistake-that-cost-a-dentist-200000/
 
You have to sleep at night knowing you provided the best treatment for your patients and the doctor needs to do the same. You also need to work for an office that shares your same patient care standard. I believe you can get this office there, it’s just going to take some effort in being bold! I’d have the conversation sooner than later to get the ball rolling and nip it in the bud. The longer under diagnosing happens under your watch, the harder it is to make a change. Best luck at your new office and with creating a perio protocol!

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I agree that changes should be made, as its in the best interest of the pts and your drs license. However, you will face great challenges as you approach existing pts who have perio but have never had it diagnosed within this office. They are gonna wanta know why no one, including the dr, ever told them before. Gotta think of a plan to approach this situation, because it is going to happen on a daily basis once you start speaking perio.

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