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treatment plan/ communication

M

mill108

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Aug 27, 2016
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9
Hi, started the process of getting implants to replace large bridge last year.
My general dentist referred me to an oral surgeon. He seemed great - completely understood my problem which is quite complex.

I had the first stage - grafting which went well. BUT I've increasingly over the last 8 months become frustrating by the surgeons communication. The treatment plan - seems to change every time I see him. I never receive anything in writing. I'm now at the point where I'm having the second surgery in two weeks and I still don't know how many implants or where he is intending to place them. I'm sure he must have a plan but he seems to be unable/ willing to share it with me. He's currently on holiday and 'unable to receive messages' so I'm not really sure what do. I'm spending thousands of pounds - so expect information and also a certain level of diligence and 'customer service'. I'm left feeling like I'm being a tricky and demanding patient. Am I being unreasonable? Thanks all
 
carole

carole

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No, you need to know what is happening, when and how. You are paying for a service you are not getting. If you have paid up front then ask for a refund on the amount left after the work he has done. Or say you don't want to proceed until you know what the treatment plan is and that you would like it in writing. :)
 
M

mill108

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Aug 27, 2016
Messages
9
No, you need to know what is happening, when and how. You are paying for a service you are not getting. If you have paid up front then ask for a refund on the amount left after the work he has done. Or say you don't want to proceed until you know what the treatment plan is and that you would like it in writing. :)

thanks - and it just feels important to have something in writing that I can read and think about. I'm sure it's a pain the ass for him to write but I am paying thousands of pounds so quite frankly it's tough. I should get what I need.
 
carole

carole

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Yes you should. It is part of his job to give you a treatment plan. How the heck can you give 'informed consent' if you haven't a clue what is going to happen.

You wouldn't buy a dress and be fobbed off if it was only half finished and you hadn't seen the material would you?

You are the customer and as you say it isn't a cheap procedure, you really must insist on knowing what is going to happen. :)
 
C

comfortdentist

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Sometimes with complex tx you can't say exactly what you need to do but especially in these cases there must be an agreement on a general plan and the cost
 
M

mill108

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Aug 27, 2016
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thanks that is a good point and I do appreciate that. But still, I would like something in writing, even if that plan changes slightly. But he seems not to understand why it's important for me.
 
C

comfortdentist

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your request is reasonable and normal
 
M

mill108

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Aug 27, 2016
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So after requesting information in writing the surgeon has now replied.

"I am writing to let you know that even though I asked my team not to disturb me during my holiday (unless it is an emergency) I feel that I should clarify a few points with you.
I understand very well that you may be anxious and nervous about the dental / surgical treatment. However, based on your enquires and comments, I feel that you might not entirely trust us to carry out the planned surgical procedure, which puts me in an uncomfortable position. For me it is highly important that all my patients fully understand and accept the proposed treatment and that is why I spent numerous appointments with you explaining and discussing your case.
Therefore, if you are still not happy with our expertise and approach, I would strongly advise you to seek further assistance and treatment at another clinic. If you decide to do so, the deposit you paid will of course be refunded."


The thing he is not grasping is - to fully understand, accept and therefore trust him I need details of the proposed treatment - and ideally in writing. I currently don't know how many implants he intends to use, where they'll be placed or how much this Is going to cost. And yes numerous appointments with him but that certainly didn't help with any kind of clarity - he's so vague. Perhaps he doesn't know himself how many he's going to use or where they'll go until he opens up the flap - but he should explain that if that's the case.


I guess, although he can't refuse to treat me - duty of care and all that. He can decline my request for information.

I'm really unsure and unclear as to what to do. It's been a long road to get this far, and the idea of starting again fills me with horror - I'd rather just give up. My friend who is an endo specialist thinks I must go elsewhere. He thinks this is unprofessional. I'm so confused as to why he is so defensive and obviously offended at my request for more information. My email to him was I felt skilful - I just asked for something in writing so I fully understand the treatment.
 
T

Tink

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Hi -

Your endo friend is right, you should go elsewhere. Sorry, I know that's not what you want to hear. The surgeon isn't handling this well at all, and you have every right to a written treatment plan and to understand what treatment you are having. If he is failing to communicate that information to you clearly, then that is his failing, not yours (whatever he might think). He's not meeting your needs - and, importantly, he's not willing to try to meet your needs.

My dentist is aware that I sometimes have issues with trusting him (and indeed all dentists) - as far as he's concerned, it's his job to earn my trust and he's worked very hard to do that.


I'm afraid he can refuse to treat you, that is his right. But he cant refuse to give you information if he's treating you.


Sorry you had such and unhelpful response from the surgeon, that's crap. And I know it's hard to face starting again, but honestly, I think you would be much better off somewhere else. That surgeon has a bad attitude and it's not what you need when you are anxious.

For what it's worth, you won't be starting from right at the beginning, some of the treatment is already done and you will have already picked up a lot about how it works - and we are always here if you need support and encouragement!

You made a reference to spending thousands of pounds; I guess this is private treatment in the UK? There are some fantastic dentists and surgeons out there, you could do much better than this guy.
 
biffo1963

biffo1963

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I agree with Tink, it's time to move on. While I can sort of see where the guy is coming from, he still comes across as a controlling and unprofessional arsehole. You wouldn't pay a builder £10,000 to extend your house without seeing detailed plans, why would you pay this surgeon a similar amount of money based entirely on verbal discussions ? Silly idea, and all so that he doesn't have to (as he sees it) waste a few £££ on routine admin. As Comfortdentist said, what you are asking for is neither unreasonable nor abnormal.

Now, if you are good at writing letters and making points you could probably shame him into doing what he should have done voluntarily, and then go on with the treatment. But it looks like the relationship is already soured, so there's not really a lot of point in continuing.

If you wish to stir the ordure a little further you could always complain to the GDC, but I'd strongly advise you to get yourself another surgeon first !
 
carole

carole

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I would find another dentist to do your treatment. He does have to discuss with you what he is advising you to have done and if you want it in writing which is reasonable you should have it. I do wonder if your dentist knows what he is going to do himself.

Ask for a copy of your full dental records including any x rays, he should have written what has been done and why and what he intends to do. Why he couldn't just ask one of his office workers to write down for you what should be already in your records I don't know. They will probably make a charge for a copy of your records but it is worth it. As biffo has said you could also report the dentist to the GDC.

Whatever you decide to do I wish you good luck, keep us posted please :butterfly:
 
M

mill108

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Aug 27, 2016
Messages
9
Thanks so much for the replies. So helpful.

It is quite easy to fall into a trap of getting obsessed by my situation - over thinking etc, and it's also easy to blame myself creating this situation - but from your responses I am sure his response is inappropriate.

And, I do have to be sensible - it's the most amount of money I've ever spent of any one item, aside from my buying a flat - so this is a big deal. Plus there is deep wounds surround the reason why need the implants in the first place. So I have a lot going on and I could do with some empathy and understanding from whoever is treating me.

How I take this forward, I'm not sure. I'm lining up an appointment with another surgeon, but my current surgeon is still on holiday, as is my general dentist, so they'll be no communicating with them until next week.

I do feel angry - having got so far with this. And he's been so nice until this point. (though I wasn't pushing for something in writing until now).

Pursuing with GDC is something I feel could be appropriate - a letter from GDC may just provoke him into listening to his patients and responding to their needs more empathetically in the future.

Thanks again.
 
M

mill108

Junior member
Joined
Aug 27, 2016
Messages
9
Thanks so much for the replies. So helpful.

It is quite easy to fall into a trap of getting obsessed by my situation - over thinking etc, and it's also easy to blame myself creating this situation - but from your responses I am sure his response is inappropriate.

And, I do have to be sensible - it's the most amount of money I've ever spent of any one item, aside from my buying a flat - so this is a big deal. Plus there is deep wounds surround the reason why need the implants in the first place. So I have a lot going on and I could do with some empathy and understanding from whoever is treating me.

How I take this forward, I'm not sure. I'm lining up an appointment with another surgeon, but my current surgeon is still on holiday, as is my general dentist, so they'll be no communicating with them until next week.

I do feel angry - having got so far with this. And he's been so nice until this point. (though I wasn't pushing for something in writing until now).

Pursuing with GDC is something I feel could be appropriate - a letter from GDC may just provoke him into listening to his patients and responding to their needs more empathetically in the future.

Thanks again.

And forgot to mention, my endo friend wonders whether the surgeon is feeling out of is depth - so he's trying find a way out of treating me. Could be? And maybe my request for more info had made him lose confidence? It will be interesting to see - what happens when he returns from his holiday - I have a 3 hour apt booked a couple of days later for the surgery. Maybe he'll send me a treatment plan and an apology? Who knows?
 
carole

carole

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Hi I don't know if you have seen it but Comfort dentist has a thread that he has started it might be an interesting read for you. He is having an implant himself and is keeping a record of his process. I have linked it here for you.


It might help you, it is interesting to hear from a dentists point of view about the treatment being received as a patient. :butterfly:
 
T

Tink

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Hugs :XXLhug: It's a horrible feeling, isn't it? You're right to feel angry. This stuff can be so upsetting and so hard to deal with, for what it's worth I think you're handling it really well and very thoughtfully.



If you want to pursue this further - and I totally understand wanting to get him to understand and deal better with future patents, been there! - the first line is to take it up with the practice directly. Write a letter, setting out clearly your concerns and the impact it has had.

Unfortunately, a complaint to the GDC is really designed to be a last resort rather than the first thing to try. They don't just write him a letter. It's a very heavyweight process designed to tackle the most serious cases, they generally launch a detailed investigation that takes literally years and often culminates in a hearing, which is effectively a court case, held in public. Rather than stirring things up, it's more like nuking the entire site from orbit. I realise there are some cases where that's what is needed, but I'm not sure this is one of those.

If trying to resolve it directly with the practice doesn't get you anywhere, then for issues with private dentists in the UK there is the Dental Complaints Service, which is an organisation run by the GDC but is not the same as their fitness to practise process - they essentially arbitrate in complaints/disputes between private dentists and patients. It's a much faster, more proportionate process, and in cases where they felt a full-on referral to the GDC would be more appropriate, they would advise you of that.




My suggestion would be to talk it over with your endo friend - they will know dentistry from the inside and know you and your case better than we do, so should be able to advise on the best way forward if you want to take it further. If they're local to you, they probably also know who the good dentists are and might be able to recommend a new surgeon for you.
 
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