Once we have taken the time to build a relationship of trust, we can move on to treatment. But what is the right treatment? How do we reconcile "the recommended course of action" with "informed consent"?
A question of timing...
1/ The procedure that relieves pain
Identify the priority procedure: the one that will relieve the pain as quickly as possible, the way an emergency physician would. Knowing how to choose the procedure to perform, as the best "course of action", once the diagnosis has been established.
2/ Rule out any procedure that creates pain
For a caregiver, inflicting pain is never a small thing, even when it is moderate. Causing pain in order to relieve pain is something we can no longer reasonably accept today. The days when the patient endured… patiently, are over. Tolerance thresholds for pain tend to be lower today than they once were.
3/ Reach agreement on the treatment, to prevent emotional pain
Regulatory consent is sometimes signed reluctantly, with the feeling of completing a formality rather than making a decision.
This is where, to avoid a great deal of misunderstanding and even disputes, we have to go beyond consent, because there is no universal "course of action".
Faced with multiple treatment options, we therefore need to accompany the patient beyond consent. Toward the decision. Toward full and complete agreement.
The patient's agreement, but the practitioner's as well.
This approach, tested over many years, has become Wise Dentistry. It combines the relationship and clinical reasoning in a precise sequence, and makes it possible to go well beyond the regulatory signature.
Watch the video on therapeutic agreement · Watch the video on informed consent
4/ Treatment as minimally invasive as is reasonable
Within the limits of what is reasonable, so as not to compromise the quality of treatment: the more the access routes spare the tissues, the less intra-operative and post-operative pain we create.
5/ Succeed at every operative procedure
Operative failure is a potential source of pain, physical or emotional. So it is up to us to reduce it to… Zero.
Is that really possible? At first glance one might say no, since everyone knows that therapeutic risk is inherent to any medical undertaking.
But therapeutic risk, which can lead to the failure of the treatment, must not be confused with operative risk, which can lead to the failure of the procedure.
The vast majority of patients know and understand that any medical procedure carries a therapeutic risk. The same is not true when it is the procedure itself that fails.
It can be tempting to invoke it after an unfortunate gesture. But calling the failure of a procedure a matter of chance is far harder for a patient, or an expert witness, to accept.
Accepting operative risk means inviting it into the treatment. And causing pain for certain. Physical, emotional, or both.
How do we eliminate operative risk?
By planning every act, every procedure. Watch the video on planning
By maintaining the necessary concentration throughout the procedure. Watch the video on concentration
It is then possible to reach the destination. Every time. Barring an accident. As in a plane, as in a car.