When a patient says he didn’t write down a medication on his health history because he thought it was “private and not necessary for me to know,” well, Houston, we have a problem.
A 55-year-old male walked in as an emergency patient needing an assessment for severe and intense tooth pain. He was on lisinopril, OTC ibuprofen, and some old amoxicillin he dug up from two to three years ago (he had taken four).
Tooth no. 31 was irreversible, and the patient opted for an extraction in lieu of a root canal. He was in so much pain that I even dropped local in the area to give him some relief until he could fill his scripts for amoxicillin and 10 tablets of hydrocodone’s 5/325. For the record, I prescribe very few narcotics, but when it’s needed, it’s needed, and this situation warranted that call.
The patient was rescheduled to have the tooth pulled, but less than an hour later I received a call from the pharmacist asking if we were aware the patient was a frequent flier subscriber of Suboxone, a prescription medication used to help individuals overcome opioid addiction. That would have been nice to know, right? I told the pharmacist no-go on the script. I was clearly a bit agitated.
When I confronted the patient about not being truthful on his health history, he became defensive, saying it was “private information and not necessary for me to know.” Not necessary for me to know?! Since when do patients make that kind of call when they are being medically treated? I kindly, but very sternly, explained why it was important for me—and all doctors—to be privy to medical information that could have an impact on treatment and outcome.
I realize that I’m preaching to the choir when I say that the mouth is attached to the body, but for some reason that concept is still puzzling for many patients. Prime time to educate.
There are two points I want to drive home:
- Communication between colleagues is important. Had the pharmacist not called me, I’d still be out of the loop, unknowingly feeding an addiction to a recovering addict. Fist-bumps to my colleague.
- Health histories are legal medical documents, and we’d like to think they’re filled out honestly. I’d venture to say, however, that there’s likely a lot that gets left off—both intentionally and unintentionally. Is there a remedy for this? Is there a dialogue we can have with patients to emphasize the importance of thorough and honest medical histories?
Have you experienced similar situations in your practice? If so, shoot me an email. I’d love to read and share a few of them in the forum. I’m sure there are some good stories out there.
Keeping it real, raw, and day-to-day...
Stacey
Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.
Stacey L. Gividen, DDS, a graduate of Marquette University School of Dentistry, is in private practice in Hamilton, Montana. She is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. Dr. Gividen is the editorial co-director of Through the Loupes and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. She serves on the Dental Economics editorial advisory board. You may contact her at [email protected].
