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Medical Forum / General / Dentistry / November 2005Prednisone
I have a patient who bit on an olive pit while on vacation and went to see a dentist where he was vacationing. He complained that tooth was sore and dentist examined, told him he'd probably need endo and gave him a script for antibiotics and a weeks worth of prednisone. I am not sure I get the antibiotics, since tooth was intact, just sensitive...nor do I get the prednisone as what I am assuming was given as an anti-inflammatory. Am I out of touch with things??? I never have heard of this approach. Then again, Dr. K does say I am an idiot! (I may add that as a signature...damn fine disclaimer!!) T Does the patient have a hip replacement or any other prosthetic implant or device... like a mechnaical heart valve? -Sue > Does the patient have a hip replacement or any other prosthetic implant > or device... like a mechnaical heart valve? > > -Sue No...a pretty unremarkable health history...uh-oh...is that a HIPAA violation?? T Tony, You know I'm not a dentist. I am just interested. I asked that because others were talking about premed procdures for those pts that have had hip replacements. So no diabetes either. I doubt that is a HIPPA violation because you do not divulge the patient's name.... (I think) Hey I have a new one.... Why don't dentists provide strep screens in their offices? (The quick test) Do you ever get pts in that have a sore throat? Would you NOT want to know if they are sufferring from strep? Maybe this woudl not be cost-effecitve though.... probably a non-issue. ************************************ SORRY. I know I am not helping to answer your question! -Sue > Why don't dentists provide strep screens in their offices? (The quick > test) Not in the realm of dentistry.  Signature/ Amatus / > Tony, > [quoted text clipped - 19 lines] > > -Sue >> Why don't dentists provide strep screens in their offices? (The quick >> test) > >Not in the realm of dentistry. Strep screens? The meshwork has to be very tiny to keep out those critters ....... Why don't dentists provide strep screens in their offices? (The quick test) Amatus wrote: Not in the realm of dentistry. -- / Amatus ***************************************** Amatus, I do not mean to be too presumptious about "turf issues." But, the medical doctors do not hesitate to jump on your turf. Many pediatricians are now providing oral health screens because more kids have medical ins than dental ins. In this way, they are helping the dentists and the patients. If they see problems, they refer. Some even have hygienists on hand in their offices (at least from what I have read.. I will have to look for references to confirm this). Pediatricians are helping educate the parents on oral health as they see this as an important aspect of overall health. If someone comes into you office for a prophy and complains of a sore throat.. do you tell them they should go see a doctor? Can you when someone opens their mouth whether they have an infected thorat? If so, then do you refer? If not, why not be trained in looking at the throat and diagnosing a "suspect" situation.. at the very least. You are trained to recognize oral cancer. Why not strep? When I was a kid, we had strep so often, the doc was 100% accurate.. just looking our throats. The culture always confirmed that he was right. I am not kidding. I think there can be a heck of a lot more overlap in turf. This would help everyone out (dentists, doctors and pts). Maybe having strep screens on-hand is not cost effective for a dental office. I am not talking about implementing this as an automatic sreen on every pt. Perhaps most often, these kits would go unused and would expire. Maybe most sick people cancel their dental appts. Maybe you do not see enough infected throats to know when strep is present. Saying "it is not in the realm of dentistry" is a little bit closed-minded, I believe. If you can diagnose oral cancer, you can diagnose strep. JMHO, Sue >Saying "it is not in the realm of dentistry" is a little bit >closed-minded, I believe. Nope. I could easily take tonsils out, it doesn't mean that is a standard of dental practice. >If you can diagnose oral cancer, you can >diagnose strep. Sure we can, but why ? In today's litigious society that would be unwise. It's not a *turf* issue, which most agree belongs on football fields. >JMHO, >Sue -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Sure we can, but why ? In today's litigious society that would be unwise. It's not a *turf* issue, which most agree belongs on football fields. >JMHO, >Sue -- W_B Take out the G'RBAGE wubbabubb...@RBAGEyahoo.com W_B, Excuse me but----> What B.S. Who makes the standards for your office? You as a dentist or someone else? Why can these screens being done at our local Target? Aee you saying that legally you cannot implement this or that you are are afraid a pt handing you a lawsuit. Why would anyone sue a dentist over a strep throat screen or a referral to see a doctor anway? Hey - your choice. No problem. But in the same token, I am sorry some dentists are real weenies. Why do I say this? From my experience on DT, this is what I observed: Some complain SERIOUSLY (are seriously bothered) about being referred to as "only a dentist" and yet when it comes to having an AED on hand, they are afraid to implement one because of a potential lawsuit. (Others say they do not want to spend the money, as then gas up their Lotus Elises, lol). Hey no problem. Your choice. But for cripes sake, the public has more balls than some dentists. A 10 year old can operate an AED and a dentist (ummmm...errr doctor?) is afraid of a lawsuit? Ever hear of the Good Samaritan law? Uggh, Sue PS If I come across gruff. Sorry, some of the irony irks me sometimes. -Sue > But for cripes sake, the public has more balls than some dentists. A > 10 year old can operate an AED and a dentist (ummmm...errr doctor?) is > afraid of a lawsuit? Ever hear of the Good Samaritan law? VCMS Signature/ Amatus / > Sure we can, but why ? > In today's litigious society that would be unwise. [quoted text clipped - 35 lines] > Uggh, > Sue VCMS -- / Amatus Amatus, I am sorry I burst out like that. I respect dentists and undertsan they have lots of pressure coming at them from all sides. That is why I am not in sales. I have absolutely zero schmoozability factor. I truly support AED use adn education, but I am not trying to sell them. If I have not ticked you off too much, can you please tell me what VCMS means? Thanks, Sue (with a sheepish look) >> But for cripes sake, the public has more balls than some dentists. A >> 10 year old can operate an AED and a dentist (ummmm...errr doctor?) is >> afraid of a lawsuit? Ever hear of the Good Samaritan law? > >VCMS Very Cool Mister Sh*t-head ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >> But for cripes sake, the public has more balls than some dentists. Three? Four? hmmmmm...... >A >> 10 year old can operate an AED and a dentist (ummmm...errr doctor?) is >> afraid of a lawsuit? Ever hear of the Good Samaritan law? > >VCMS > >> But for cripes sake, the public has more balls than some dentists. > > Three? Four? hmmmmm...... Reminds me of the prank call we made as kids... Call bowling alley..."Hello, we were planning to come bowling with some younger kids...do you have 8 pound balls?" Bowling guy..."yes"...us idiot kids..."gee, it must be hard to walk...hardee, har, har." T >W_B, > >Excuse me but----> What B.S. Who makes the standards for your office? The Dental Practice Act, Rules and Regulations of the State Dental Board, and me. >You as a dentist or someone else? Why can these screens being done at >our local Target? By whom ? One of their 'ass-ociates" There are laws that govern medical procedures. > Aee you saying that legally you cannot implement >this or that you are are afraid a pt handing you a lawsuit. Dental Practice Act. Rules and Regulations of the State Dental Board. Out of the scope of dental practice. >Why would anyone sue a dentist over a strep throat screen or a referral >to see a doctor anway? Hey - your choice. No problem. My malpractice carrier may see it differently. Streptococci are everywhere, it only causes infection in a suseptible host. <snip rest of BS> When *you* get your professional license, maybe you may feel differently. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com When *you* get your professional license, maybe you may feel differently. -- W_B Take out the G'RBAGE wubbabubb...@RBAGEyahoo.com W_B, I am not referring to you specifically, but there are some dentists that appear to whine about "everything" on the face of the earth ... from the dental schools, the ADA, the hygienists, the banks, the dental product suppliers, the insurance companies, Medicaid, geriatric patients, "stupid" patients, .....even having to deal with advertising on a board that is offerred free to them .... Perhaps they are just letting off steam. And everyone needs to be able to do that sometimes. I have never felt a need to complain about my career that way. I have never heard my husband complain that way. I never heard my dad complain that way, my sisters, my brothers....This is the honest truth. Are we just different in our outlooks or is dentistry just a VERY stressful occupation? If these dentists (not you) are truly that unhappy, if it is really "that" bad (as they seem to be saying in with their incessant complaints), and if that is what a professional license produces in a person, I really would not want to have one. I hope that my honesty does not offend you. In seriousness, I am concerned about the projected shortage in dentists. I want to undertsand the issues that are turning potential candidates away from dentistry. Although I generally have little tolerance for complaining, I would like to know more about what brings this on. I do not think that dentists are born complainers. BTW, I am sorry that malpractice is an issue for dentists. Have you been sued in the past? ...or is that a loaded question. How often does this really happen to dentists? ...oops I just realized what a dumb Q that was, as I think about some of the unhappy patients on these boards. YIKES. OK. I guess if I think about it long ebough, I start to "get it" .... I do not think I could handle being a dentist. Hats off to you (seriously), -Sue >Although I generally have little tolerance for complaining, How then does she tolerate herself ? Signature/ Amatus / > When *you* get your professional license, maybe you may feel > differently. [quoted text clipped - 49 lines] > Hats off to you (seriously), > -Sue How then does she tolerate herself ? -- / Amatus Reply. She has no other choice. The only other choice would be suicide. -Sue Why can these screens be done at our local Target? W-B wrote. By whom ? One of their 'ass-ociates" There are laws that govern medical procedures Reply. Nurse practicianers. News on Oct. 14, 2005: http://www.medpagetoday.com/PublicHealthPolicy/PracticeManagement/tb/1933 >Why can these screens be done at our local Target? ...at the same time we get our porcelain fused to metal crowns ....... >W-B wrote. > [quoted text clipped - 5 lines] > >http://www.medpagetoday.com/PublicHealthPolicy/PracticeManagement/tb/1933 >>Although I generally have little tolerance for complaining, > >How then does she tolerate herself ? Napping with sheep ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Where is all of the whining and complaining going on? I haven't noticed many dentists here on smd getting all wound up with it. However, dentistry does take a mentally tough person to remain positive and enthusiastic throughout their carreer. It isn't easy to find the 'space' between empathy and caring that will drain your life's blood and the aloof, detached snob that doesn't seem to recognize the patient as a person. It is also a very demanding profession regarding technical aspects of the treatment given. Carrabeli had a great analogy that he posted on smd some time ago. It was something like this: Imagine working to repair an expensive Swiss watch (requiring magnification to deal with the tiny parts) while being tossed around in the back seat of a New York taxi and having the driver shooting a water pistol at you during the ride. The only thing missing is that the 'watch' is really a person with feelings and is often nervous about the treatment. Finding a dentist who enjoys dentistry will help. He/she will still have the positive outlook that is so important to the office environment. The best dentists are good at more than the technical delivery of dental treatment. If the guy is stuck in a dim office, accepting capitation payments to pay the rent, and delivering dental care as if he'd never left the 60's, he ain't happy, and you probably won't be either. JMO, Dartos > OK. I guess if I think about it long ebough, I start to "get it" .... > I do not think I could handle being a dentist. > > Hats off to you (seriously), > -Sue I am replying to Dartos. I would try to have him quoted in the hidden text, but like an idiot I have not figured out how to do the quoted text so that it is hidden and clicked-on to view. Dartos, Thanks. In response to who is complaining: Answer. I got this sense on DT mostly. However I must admit, since these were random views put forth by hundreds of dentists (of whom I never really kept track), it was very easy for me (a nondentist) to lump these negatives together and view them as coming from a single conglomerate (i.e. the entire dental profession). There were many on DT who love dentistry as well. Yet my overall sense was there were many struggles going on (internally), for many of the dentists there (in reagrds to their profession). Dartos, you "quoted" carabelli: "It was something like this: Imagine working to repair an expensive Swiss watch (requiring magnification to deal with the tiny parts) while being tossed around in the back seat of a New York taxi and having the driver shooting a water pistol at you during the ride.The only thing missing is that the 'watch' is really a person with feelings and is often nervous about the treatment." Comment. This is funny analogy :-) Serious Q. What are the outside forces that are interfering with your delicate operation? Can you list these in priority of worst offenders first? Please do not be funny and say "the taxi driver, the water pistol, etc., but the real forces would be appreciated. You wrote: "The best dentists are good at more than the technical delivery of dental treatment." Comment. Agreed. You wrote: If the guy is stuck in a dim office, accepting capitation payments to pay the rent, and delivering dental care as if he'd never left the 60's, he ain't happy, and you probably won't be either. Comment. Those on DT said exactly the same thing. It seems that DT is trying to help those who are on plans to get off these plans. Q. Do you think the future (in US) is heading toward reduction of these sorts of plans, elimination of... or more of them..? How much control do dentists have over these future directions in their profession (as a whole). Will it always be left to individual choice, in your opinion? Does the last Q make sense or do I need to be more specific. Thank you. I know I have asked a lot here. So any input if you have time is appreciated. Sue >In response to who is complaining: > >Answer. I got this sense on DT mostly. > There you go. I've never been to DT. >Comment. This is funny analogy :-) >Serious Q. What are the outside forces that are >interfering with your >delicate operation? Can you list these in priority of >worst offenders >first? Hmmm........ accuracy of diagnosis difficulty of the procedure concern of patient comfort visibility patient opening unexpected patient movements saliva or blood contamination assistant performance equipment (mal)function iatrogenic damage to other teeth/tissue occlusion esthetics post op comfort longevity of service >Q. Do you think the future (in US) is heading toward >reduction of [quoted text clipped - 4 lines] >individual choice, >in your opinion? With the current trend of more dentists retiring than entering private practice, I think it will be more and more difficult to 'force' dentists into accepting shoddy discount plans. Even today, each dentist has to make their own decisions about which (if any) insurance plans they accept and what quality of dental care they will provide. JMO, Dartos > >In response to who is complaining: > > > >Answer. I got this sense on DT mostly. > > > There you go. I've never been to DT. [cut] > JMO, > Dartos It's easy to assume. It's also easy to presume. But what is particularly difficult about making assumptions and presumptions is something that one, anyone or all or us, learns over a period of time. Given a large tincture of time and patience along with an equal desire to look for the best in people even as people appear to fail... well... this is when we come to realize how little we know about each other until we truly wish to ***know*** each other. With respect to so many, The Webby >Comment. This is funny analogy :-) >Serious Q. What are the outside forces that are >interfering with your >delicate operation? Can you list these in priority of >worst offenders >first? Dartos wrote: Hmmm........ accuracy of diagnosis difficulty of the procedure concern of patient comfort visibility patient opening unexpected patient movements saliva or blood contamination assistant performance equipment (mal)function iatrogenic damage to other teeth/tissue occlusion esthetics post op comfort longevity of service >Q. Do you think the future (in US) is heading toward >reduction of [quoted text clipped - 4 lines] >individual choice, >in your opinion? With the current trend of more dentists retiring than entering private practice, I think it will be more and more difficult to 'force' dentists into accepting shoddy discount plans. Even today, each dentist has to make their own decisions about which (if any) insurance plans they accept and what quality of dental care they will provide. JMO, Dartos Reply. Thank you Fawkes. After spending quite a bit of time on DT, I was expecting different answers. (I published these below, but then erased them as I did not want to tick them off at DT) ... but basically it was "everybody else" is holding them (the dentists) back. And again... this is not a representive of everyone's opinion there,,,, but enough to leave an impression. Sue >> Does the patient have a hip replacement or any other prosthetic implant >> or device... like a mechnaical heart valve? [quoted text clipped - 5 lines] > >T What's a *meniacal* heart valve ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Does the patient have a hip replacement or any other prosthetic implant > or device... like a mechnaical heart valve? > > -Sue What would that have to do with anything? Webby What would that have to do with anything? Webby Webby, I work for a medical device company (mainly implantables). I am not a doctor, but it is my understanding that any time a foreign matieral is implanted (including devices, hips, knees, etc.), if there is any chance of an infection going systemic... these foreign materials are like BUG magnets. The infection will often localize on the foreign surface. Once adhered, these bacteria are very difficult to treat with antibiotics. Sometimes the only recourse at this point is to remove the foreign material if that is possible, and replace it with a new, sterile device. So antibiotics are often prescribed as a preventive for a patient that has a mechanical valves (for instance) and who may be undergoing procedures that could provide any chance of infection (like dental work). I suppose also if this dentist thought the patient may have an abscessed tooth, s/he may have prescribed antibiotics... ....but i am just guessing! -Sue PS According to T, it sounds like overkill... -Sue Just as follow-up to Webby's question (so I am not giving out misinformation). I really can only speak for valves, as we do NOT deal with joint replacements (at Medtronic, Inc). Here is info taken from St. Jude Medical's website for pts that have had a mechancial valve implanted: Q: Will I need to take antibiotics before surgery or dental work? Bacteria may enter the bloodstream during dental and some medical procedures. This bacteria may then cause an infection, known as bacterial endocarditis, in the tissue surrounding an artificial heart valve. Although this does not happen frequently, it can have serious consequences. The easiest and best defense is simply taking antibiotics before and after dental work and other medical procedures. Check with your physician before having any dental or medical procedures performed. Inform your dentist and any other physicians that you have an artificial heart valve. ******************************************** OK. That is all I should say. I will stay out of the conversation now! -Sue > Just as follow-up to Webby's question (so I am not giving out > misinformation). I really can only speak for valves, as we do NOT deal [quoted text clipped - 21 lines] > > -Sue I appreciate your explanations. It always helps to understand a poster's point of reference. Thank you. Webby | I appreciate your explanations. It always helps to understand a | poster's point of reference. Thank you. | | Webby A 1 week course of Prednisone?? That sounds really weird to me. IIRC my patients that have been on it were placed on a slowing increasing load, with a slowly decreasing taper. Am I missing something? From personal experience, if they are tinkering with Prednisone dosages around the same time I am doing any denture work, I can count on doing a lot more adjustments over an extended period. (anecdotal evidence). SignatureRoy rem NADA to reply > | I appreciate your explanations. It always helps to understand a > | poster's point of reference. Thank you. [quoted text clipped - 6 lines] > slowly > decreasing taper. Am I missing something? No, you missed nothing. From personal experience, I can tell you that Prednisone is often dispensed in a 7-day package with a decreasing dose. Prednisone is a very cheap medicine with very substantial benefits paired with very serious side effects. It is not something someone should use regularly without a heluva good reason. Vaughn > > "The Webby" <nospamattmjiatroepidemicnospam@san.rr.com> wrote in message > > news:nospamattmjiatroepidemicnospam-CA4685.14524928102005@news-lb-02.socal.r [quoted text clipped - 18 lines] > > Vaughn It is such a cheap medicine that it becomes too easy for careless doctors (medical or otherwise) to hand out like candy just to get a person to "feel better" but not actually be better. The big trouble is making the general public aware of this hazard -- especially so for the elderly with chronic diseases. ... :-( TW > > "The Webby" <nospamattmjiatroepidemicnospam@san.rr.com> wrote in message news:nospamattmjiatroepidemicnospam-CA4685.14524928102005@news-lb-02.socal.rr.com... > > | I appreciate your explanations. It always helps to understand a > > | poster's point of reference. Thank you. [quoted text clipped - 14 lines] > > Vaughn My patient didn't bring the meds with him, so I cannot tell for certain what recommendation was for the meds, but he said he was just told to take three a day until they (15 tabs) were gone...not the regimen I am used to...although I confess my experience is limited with such meds. T >> > "The Webby" <nospamattmjiatroepidemicnospam@san.rr.com> wrote in >> > message [quoted text clipped - 29 lines] > > T That would be a common rx for an asthma flare, or a severe case of poison ivy, although many drs. still use a decreasing dose. Mabel >> | I appreciate your explanations. It always helps to understand a >> | poster's point of reference. Thank you. [quoted text clipped - 14 lines] > >Vaughn Exactly! Vaughn Simon again .... ON TARGET. Joel >| I appreciate your explanations. It always helps to understand a >| poster's point of reference. Thank you. [quoted text clipped - 8 lines] >the same time I am doing any denture work, I can count on doing a lot more >adjustments over an extended period. (anecdotal evidence). More likely a medrol dose pak. Use them for my WT surgery pts. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Just as follow-up to Webby's question (so I am not giving out >misinformation). I really can only speak for valves, as we do NOT deal >with joint replacements (at Medtronic, Inc). Sue, did they change the name? I thought it was MedtroniX? >Here is info taken from St. Jude Medical's website for pts that have >had a mechancial valve implanted: [quoted text clipped - 17 lines] > >-Sue >What would that have to do with anything? And where is Mark Tarka when we need him? >Webby > [quoted text clipped - 25 lines] >PS According to T, it sounds like overkill... >-Sue > >What would that have to do with anything? > > And where is Mark Tarka when we need him? Do you ever get the feeling he's always here even when we can't see him? Webby ;-) [clip] > Do you ever get the feeling he's always here even when we can't see him? If Mark Tarka spontaneously exploded in the wilderness and there was nobody there to hear it, would there really be a noise? Vaughn > "The Webby" <nospamattmjiatroepidemicnospam@san.rr.com> wrote in message > news:nospamattmjiatroepidemicnospam-89AF19.07504230102005@news-lb-01.socal.rr. [quoted text clipped - 7 lines] > > Vaughn Always the philosopher ... ;-) (Would it matter if the wilderness was in Montana?) Webby Who is Mark Tarka? Geesh.. just try to say Mark Tarka 3 times in a row, very fast. It is hard to do! -Sue >> Do you ever get the feeling he's always here even when we can't see him? > > If Mark Tarka spontaneously exploded in the wilderness and there was nobody >there to hear it, would there really be a noise? > >Vaughn It already happened. I didn't hear a thing. ;-) -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >> Does the patient have a hip replacement or any other prosthetic implant >> or device... like a mechnaical heart valve? [quoted text clipped - 4 lines] > >Webby Risk of bacterial endocarditis. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> Does the patient have a hip replacement or any other prosthetic implant > >> or device... like a mechnaical heart valve? [quoted text clipped - 11 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com I know that but this post doesn't look the way I remember it with regards to my question. Oh well. I'm not going to go looking for whatever it actually was. Webby > I have a patient who bit on an olive pit while on vacation and went to see a > dentist where he was vacationing. He complained that tooth was sore and [quoted text clipped - 8 lines] > > T Whoa boy! Where was the patient vacationing? I think that's bizarre! Steve Signature{\rtf1\ansi\ansicpg1252\deff0\deflang1033{\fonttbl{\f0\fswiss\fcharset0 Arial;}} {\*\generator Msftedit 5.41.15.1507;}\viewkind4\uc1\pard\f0\fs20 Remove "nospam" to reply\par } > > I have a patient who bit on an olive pit while on vacation and went to see a > > dentist where he was vacationing. He complained that tooth was sore and [quoted text clipped - 13 lines] > > Steve Well that was my thought as well, but...well you know...the disclaimer thing...so I thought I'd see what others thought. They were in a far off, exotic land...I believed they referred to it as Cleveland....some vacation! T Maybe the dentist didn't want to spend any time actually diagnosing the case and wanted the patient to believe otherwise. Dartos >>>I have a patient who bit on an olive pit while on vacation and went to > [quoted text clipped - 22 lines] >> >>Steve > Well that was my thought as well, but...well you know...the disclaimer > thing...so I thought I'd see what others thought. They were in a far off, > exotic land...I believed they referred to it as Cleveland....some vacation! > > T >> I have a patient who bit on an olive pit while on vacation and went to see a >> dentist where he was vacationing. He complained that tooth was sore and [quoted text clipped - 13 lines] > >Steve France ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com It's basically a psychological thing... if someone is on vacation in a different country, they'll usually pay cash (or credit card, same thing), and it is assumed that they want *something* in return for their money. Also, the dentist may have been trying to cover his a.s in case the tooth was going to blow up on the plane home or sth like that. > I have a patient who bit on an olive pit while on vacation and went to see a > dentist where he was vacationing. He complained that tooth was sore and [quoted text clipped - 8 lines] > > T > It's basically a psychological thing... if someone is on vacation in a > different country, they'll usually pay cash (or credit card, same [quoted text clipped - 15 lines] > > > > T CYA is not the basis of good medicine and can certainly lead to undesirable outcomes. CYA may be the way it is but that doesn't make it good medicine. Just my opinion. Webby > It's basically a psychological thing... if someone is on vacation in a > different country, they'll usually pay cash (or credit card, same > thing), and it is assumed that they want *something* in return for > their money. > Also, the dentist may have been trying to cover his a.s in case the > tooth was going to blow up on the plane home or sth like that. Well, maybe I can buy into the antibiotics fir that reason...although I can't see what good they would do for an unrestored tooth that was traumatized...but prednisone? Just seemed odd to me. How about for someone not on vacation...does the pattern of prescription seem unusual to you? I agree with the fact that many prescriptions are written so people feel they got something, but I find that to be a pathetic way of operating. If I was so lacking in confidence of my diagnostic skills that I prescribed meds for people I was pretty sure didn't need them, I would say it was time to find a new line of work. T > I agree with the fact that many prescriptions are written so people feel > they got something, but I find that to be a pathetic way of operating. If I > was so lacking in confidence of my diagnostic skills that I prescribed meds > for people I was pretty sure didn't need them, I would say it was time to > find a new line of work. It's a bit different for you though, because you wouldn't get people on vacation coming in for a quick fix of some form or another (or maybe you do, I don't know). Dentists in tourist spots are providing part of the "vacation experience", which includes keeping the customer happy (whatever that may entail). Same goes for doctors in tourist spots - it's not about comprehensive treatment or anything like that. They might provide totally different treatment to their regular patients. Ooops, only just spotted the bit about Cleveland... yeah, that *would* make you wonder... > Ooops, only just spotted the bit about Cleveland... yeah, that *would* > make you wonder... >> I agree with the fact that many prescriptions are written so people feel >> they got something, but I find that to be a pathetic way of operating. If [quoted text clipped - 11 lines] > it's not about comprehensive treatment or anything like that. They > might provide totally different treatment to their regular patients. What are you talking about? A 'standard of care' changes because someone is on vacation? I don't think so. > >> I agree with the fact that many prescriptions are written so people feel > >> they got something, but I find that to be a pathetic way of operating. If [quoted text clipped - 14 lines] > What are you talking about? A 'standard of care' changes because someone is > on vacation? I don't think so. Food for thought: One should never tell any doctor or dentist or especially a hair stylist that he/she is "in town on vacation" -- it's better/safer to say, "I'm new in town and looking for a new dentist -- and btw, I bit into an olive pit and this tooth sure does hurt." (I never tell a hair stylist that I'm "visiting" -- learned about that the hard way. Uh-oh comes to mind.) Lesson learned: Avoid olive pits like the plague. And be very careful who you let near your hair with scissors and color!!! Restaurants and hair salons can be your worst nightmares come true!! TW ;-) > And be very careful > who you let near your hair with scissors and color!!! Restaurants and > hair salons can be your worst nightmares come true!! I am trying to picture SB coming out of a salon with a dark afro :-)) Signature/ Amatus / > >> >> I agree with the fact that many prescriptions are written so people [quoted text clipped - 32 lines] > > TW ;-) > > And be very careful > > who you let near your hair with scissors and color!!! Restaurants and > > hair salons can be your worst nightmares come true!! > > I am trying to picture SB coming out of a salon with a dark afro :-)) Ouch!!! That would be very, very painful!!!!!!!! I will be certain to tell the stylist *not* to do that **in advance**!!! Thanks for the head's up ;-) Webby > / > "The Webby" <nospamattmjiatroepidemicnospam@san.rr.com> wrote in message [quoted text clipped - 36 lines] > > > > TW ;-) > Ouch!!! That would be very, very painful!!!!!!!! I will be certain to > tell the stylist *not* to do that **in advance**!!! Thanks for the > head's up ;-) You need to keep the style you have. It looks good on you. A compliment to your present salon. Signature/ Amatus / > >> > And be very careful [quoted text clipped - 55 lines] >> > >> > TW ;-) >> Ouch!!! That would be very, very painful!!!!!!!! I will be certain to >> tell the stylist *not* to do that **in advance**!!! Thanks for the >> head's up ;-) > >You need to keep the style you have. It looks good on you. A compliment to >your present salon. But I thought the Mohawk was out of style. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> Ouch!!! That would be very, very painful!!!!!!!! I will be certain to > >> tell the stylist *not* to do that **in advance**!!! Thanks for the [quoted text clipped - 9 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com You know I don't sport a Mohawk (at least not lately)... TW ;-) > You know I don't sport a Mohawk (at least not lately)... Could you picture me with "Spiked" hair of various rainbow colors ? The stylist that Stradovari and I go to is 76 years old now. Same guy who used to take care of my Dad's hair back in the late 1950's. Stradovari does not want to go any neighborhood barber. He wants Zio Memo to cut his hair. Each hair cut is accompanied by a few cups of espresso and a canoli or two. We hope he never puts the scissors away for good. Very similar to an older dental practice. The entire business revolves around the service given by the principle. Signature/ Amatus / > >> On Tue, 01 Nov 2005 16:27:59 GMT, "Amatus Cremona" [quoted text clipped - 19 lines] > > TW ;-) No, I can't picture you with "Spiked" hair of any color ... but I can picture it after standing in the rain for awhile too long... ;-) Webby > > You know I don't sport a Mohawk (at least not lately)... > [quoted text clipped - 31 lines] > > > > TW ;-) Am still trying to picture him with any hair. <rim shot> >No, I can't picture you with "Spiked" hair of any color ... but I can >picture it after standing in the rain for awhile too long... ;-) [quoted text clipped - 4 lines] >> >> Could you picture me with "Spiked" hair of various rainbow colors ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Am still trying to picture him with any hair. > > <rim shot> ROTFL :-D Signature/ Amatus / > > Am still trying to picture him with any hair. [quoted text clipped - 15 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Two words: Limp Bizkit ? >No, I can't picture you with "Spiked" hair of any color ... but I can >picture it after standing in the rain for awhile too long... ;-) [quoted text clipped - 4 lines] >> >> Could you picture me with "Spiked" hair of various rainbow colors ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Two words: Limp Bizkit ? ? ? Signature/ Amatus / > > Two words: Limp Bizkit ? [quoted text clipped - 13 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com >> Two words: Limp Bizkit ? > > ? ? Do an ask jeeves. It's a rock band, somewhat famous. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > It's a rock band, somewhat famous. Wow, I seem to be hanging out in different concert halls. Signature/ Amatus / > >>> Two words: Limp Bizkit ? [quoted text clipped - 9 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com > No, I can't picture you with "Spiked" hair of any color ... but I can > picture it after standing in the rain for awhile too long... ;-) Thanks for NOT making a _bald_ joke like "you-know-who". Signature/ Amatus / > No, I can't picture you with "Spiked" hair of any color ... but I can > picture it after standing in the rain for awhile too long... ;-) [quoted text clipped - 41 lines] >> > >> > TW ;-) > > Ouch!!! That would be very, very painful!!!!!!!! I will be certain to > > tell the stylist *not* to do that **in advance**!!! Thanks for the > > head's up ;-) > > You need to keep the style you have. It looks good on you. A compliment to > your present salon. Thank you very much!! I deliver the compliment on the next go'round. :-) TW >> And be very careful >> who you let near your hair with scissors and color!!! Restaurants and >> hair salons can be your worst nightmares come true!! > >I am trying to picture SB coming out of a salon with a dark afro :-)) With sunglasses, bell bottoms, and platform shoes ! -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> And be very careful > >> who you let near your hair with scissors and color!!! Restaurants and [quoted text clipped - 8 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com It could happen ... maybe I'll retire the witch's hat next year and try this one on instead... Oh... well that won't work because you'll all know it's me! Sheesh .... all the good costumes are taken :-( TW > > I agree with the fact that many prescriptions are written so people feel > > they got something, but I find that to be a pathetic way of operating. If I [quoted text clipped - 9 lines] > it's not about comprehensive treatment or anything like that. They > might provide totally different treatment to their regular patients. I have never liked to think of patients as customers. Keeping a customer happy (the customer is "always right") is just not the same as keeping a patient healthy and therefore "happy" (because the patient is not in the position to be "always right"). Patients need to be listened to carefully and they need to listen to their doctors with the same care. Even with the patient is a doctor, the patient is still the patient. Webby That is an excellent point Webby. -Sue > That is an excellent point Webby. -Sue Which point was it? (You didn't leave any of the post behind.) But thanks for your interest in whatever point it was I made. Webby :-) I have never liked to think of patients as customers. Keeping a customer happy (the customer is "always right") is just not the same as keeping a patient healthy and therefore "happy" (because the patient is not in the position to be "always right"). Patients need to be listened to carefully and they need to listen to their doctors with the same care. Even with the patient is a doctor, the patient is still the patient. Webby This point is an excellent point. (I had been thinking of the pt as a "customer" in the traditional sense). -Sue > I have never liked to think of patients as customers. Keeping a > customer happy (the customer is "always right") is just not the same as [quoted text clipped - 11 lines] > This point is an excellent point. (I had been thinking of the pt as a > "customer" in the traditional sense). -Sue Thanks for the clarification, Sue. Of course, not everyone will agree with this and that's the way life is, I suppose. Webby OK... Now this is a comment coming STRICTLY from a layperson (as I really have no idea) ...but predisone suppresses the body's immune response. It seems like s/he was trying to reduce inflammation, but was worried about infection (for some reason). Prednisone alone may have increased the risk of infection, simply due to its effect of reducing the body's natural response to inflammation. So just in case, s/he added an antibiotic. In other words I do not think this dentist really knew what was going on...just trying to cover all bases. -Sue > OK... Now this is a comment coming STRICTLY from a layperson (as I > really have no idea) [quoted text clipped - 12 lines] > > -Sue I understand the basic functions of the meds...it is more their application in this situation that left me puzzled. There many other choices for anti-inflammatory meds, the vast majority of which have far fewer side effects and work well in the vast majority of dental scenarios. I have seen a lot of inflammation in my day, never once felt something like prednisone was needed...but maybe I am the one who is out of touch. From the other responses, I don't think so. T >Also, the dentist may have been trying to cover his a.s in case the >tooth was going to blow up on the plane home or sth like that. I don't think that you should use the words "blow up" and "plane" in the same sentence. Big brother and all that. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >I have a patient who bit on an olive pit while on vacation and went to see a >dentist where he was vacationing. He complained that tooth was sore and [quoted text clipped - 8 lines] > >T My endo buddy does that sometimes, it can help with a bruised PDL. Though I am not sure that I buy it. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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