Tuesday, September 24, 2013

Medical vs. Dental Teamwork

I am three months into my AEGD residency, and it’s going well. I’ve picked up speed, become more efficient, gained confidence and made new friends. Oh, and I’ve also done more molar endo than I did in all of dental school, got ACLS-certified, completed a subepithelial connective tissue graft, and started my IV sedation requirements.

This week, I have spent my mornings at a nearby hospital surgical prep department observing and starting IVs on patients. It’s been humorous introducing myself as a dentist at the hospital to patients and other medical professionals. They stare at my nametag for a minute reading “D-D-S.” They look at me confused and say, “You’re a dentist? What are you doing here?” After my explanation, they are intrigued to know more about the residency program and how they can help me with my experience at the hospital.

I have noticed some differences between the medical environment and the dental environment while at the hospital. Here, patients are moved from department to department – checking in, surgical prep, pre-op, operating room, recovery, rehab, etc. And there are different doctors, nurses, and staff overseeing them at each place along the way. Each member of the team specializes in their specific area, completing their duties and monitoring the patient along the way. This is efficient and should provide a high level of care, given each person’s strengths and responsibilities. Yet it demands precision in the coordination and communication between the different specialties.

When a patient comes in to surgical prep, IV placements are dictated by the specific surgery site, surgical needs, and to ease patient recovery. For example, for a patient needing to use a walker after surgery, it’s nice to avoid placing IVs in the wrist. Then the anesthesiologist comes in and discusses the method they will use and how this coordinates with the operating doctor’s and patient’s preferences. With so many different players on the team, it made me wonder who is coaching it all. Who has the bigger picture in mind? Is it the cardiologist, the orthopedic surgeon, the primary care physician, or someone else?

In comparison to dentistry, I can see clearly that the general dentist is the coach - and the captain, the goalie, the referee, the scorekeeper, etc. We are the primary care doctor, surgeon, radiologist, neurologist, pharmacist, psychologist, and more. We have a lot of responsibilities. Yet we have the ‘dental team’ behind us. Given all the requirements a general dentist has, utilizing dental hygienists and assistants to their fullest capacity without compromising care for the patients should do a lot for the efficiency of the office and the stress of the dentist.

AGD members, do you have any advice for utilizing the dental team? Is it difficult to give up control on some things? Do you find you are able to be more efficient? How do you ensure the dental team has adequate training in what they are being asked to take on?

Thanks!

Katie Divine, DDS

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