Friday, April 3, 2009

Third Molars, Twice Removed

Earlier today I had my lower wisdom teeth out. Before the procedure, the doctor said they were among the worst he had ever seen (called them "the wisdom teeth from hell").. They were entirely horizontal on the X-ray, except that the roots curved upwards along a nerve. He said they were gonna be tough, and my recovery was going to be especially painful... I asked him if this was beyond his expertise and he laughed and said no, that nothing was beyond his abilities. After having just read and signed a long list of horrifying potential complications, his confidence was just what I wanted to hear.

My experience with the referring dentist, however, was just the opposite. I was trying a new dentist (Dr. V), since I haven't lived conveniently near my previous dentist for some years. Dr. V seemed fine at first. He prescribed me pain medicine sight-unseen, since I was complaining of pain and he couldn't see me until Monday morning (I called on Sat morning). He seemed personable enough, and we had an interesting conversation about why some people (eg me) don't get cavities. There were two significant problems, which way overshadow any pros of the visit, though.

First, in addition to a cleaning, I wanted to get X-rays, since I suspected a wisdom tooth was the cause of some recent mild discomfort. When he showed me the developed X-rays, the two lower teeth were clearly problems, while the upper teeth looked fine to me. He suggested I have all four out. Being the analytical, developer-type I wanted to know more, and I asked why all four, and how serious the situation was (the mild discomfort had subsided after about 48 hours). He said getting all four out was "normal," and that it makes sense, so you don't have to go under twice. Since "it's normal" isn't a good reason [1], I pressed him for more information, and he said I was being argumentative! [2] I was really caught off-guard by that, and it shut me up pretty quick (you don't mess with waitresses or dentists). When I later found out that I would save $600 out of pocket if I only did the lowers I didn't have the details I needed to make an informed decision, so I had to go with my gut. Pretty weak.

People need to be their own advocates, especially when dealing with medical decisions. Doctors should encourage questions, even if they have some minor subjective issue with the tone/phrasing/whatever. The role of educator is no less important than that of practitioner, and any doctor that is unable to perform this role well has no place as a primary physician. Sadly, I found this out too late about Dr. V.

In addition, when we were finished and he was writing me a referral to the surgeon, he mentioned that he had left a small amount of calcium build-up on my teeth, since he could tell I was really not enjoying the procedure. I just smiled and nodded, which is definitely not in my nature (I must've still been thrown by the "argumentative" comment). If he wanted to make a decision based on my comfort level, he should have asked my comfort level. I would have told him I could handle it and that I wanted a thorough cleaning. To me, it's just another example of Dr. V not thinking his patients should be making their own decisions.

What I learned:
* A forty-minute drive is a small price to pair for a doctor you know and trust.

[1] I seem to recall learning the "bandwagon approach" as a logical fallacy from a logic course.
[2] Full disclosure: I can be argumentative.. sometimes it's unintentional (it's the Debate Club in me), and sometimes it's intentional (when a Best Buy employee clearly doesn't know what they're talking about). In this case, though, I think I was certainly giving the Dr. the respect that the title deserves.

1 comment:

  1. I found a typo! I found a typo! Oh what a day it is to correct you :) Under what you learned: you have "pair" instyead of pay. You can Thank me later.