Pointless treatments

treatment‘Patients (are) sometimes being offered treatments that have only minor benefit.’

We hear that doctors have been told to stop doing pointless treatments and tell patients that doing nothing can often be the best approach.

Patients often expect their GPs to give them a prescription or refer them for an operation, rather than being told to take control of their own condition, by changing their lifestyle.

For dentistry, in many ways, it is worse.

Patients may welcome being told ‘nothing needs doing’, but resent being asked to pay a patients charge of £17 for the privilege of hearing this.

Many may well prefer having a scale and polish to be told that it is their responsibility to keep their mouths plaque free.

Professor Dame Sue Bailey, president of the Academy of Medical Royal Colleges, said that there are some treatments where each college would say: ‘Look, there’s absolutely no point having this’.

The Academy also says that even when a patient clearly does have a problem, often what they are offered by doctors will not help.

Similar problems

In dentistry our patients’ problems are similar.

The two main conditions our patients experience, caries and periodontal disease, are both preventable and manageable.

The answer lies in their diet and their oral hygiene regime.

The answer we offer is to paint their teeth with fluoride or do a scale and polish.

When intervention is necessary, we demand that the NHS tells us what we should or shouldn’t do, or perhaps can or cannot do.

Then of course there is the ticking clock that is your Unit of dental activity (UDA) target.

In the end, of course, the patient should be given the options and allowed to decide.

In an ideal world their decision would not be influenced by the NHS regulations nor the cost to them of their treatment.

Back to Dame Sue: ‘A culture of ‘more is better’, where the onus is on doctors to ‘do something’ at each consultation, has bred unbalanced decision-making.

‘This has resulted in patients sometimes being offered treatments that have only minor benefit and minimal evidence despite the potential for substantial harm and expense.’

Wise words which our profession should heed.

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