IHCE – Fall 2021 “Doing the Right Thing” Case No: 2
A new patient Harry Kim is referred to “Lux Care” – the dental offices of Maxwell & Jerod, by one of their long-standing patients. Mr. Kim presents with generalized 4 mm to 5 mm probing depths, classified as moderate chronic adult periodontitis, which has been treated in the past. The patient has type II diabetes and high blood pressure, which are both controlled with medications, he has normal Al C scores.
Thamani Judge, a dental hygienist and recent graduate, has only been at the practice for three months. She was assigned Mr. Kim. He is on periodontal maintenance recalls every three months. Mr. Kim had requested a 6-month schedule care due to financial difficulties, but the dental hygienist recommended that 3-month appointments are what the patient needs to improve his oral health. The patient had initially told Ms. Judge that he had a traumatic experience with a previous dentist & periodontist. He stated that he would comply with treatment but will refuse any periodontal surgery or future supportive periodontal therapy beyond periodontal maintenance visits.
On Mr. Kim’s second visit to the practice, after receiving scaling & root planning, Ms. Judge noted that his periodontal pocketing is still out of control, with depths now ranging from 4 mm to 9mm with bleeding on probing. The dental hygienist is beyond frustrated because she feels she is in over her head. The dentist, Dr. Jerrod does not think the patient will consider a periodontal referral due to his age, prior experiences, and phobias; thus, no referral is offered.
The dental hygienist has two additional concerns. She feels professionally Dr. Jerrod doesn’t take adequate time with her dental examinations, and although she pointed out the seriousness of Mr. Kim’s deteriorating dental health, to Dr. Jerod, dentist basically hold her “it’s up to the patient, if he refuses treatment that is on him…” “We did the best we can do.” Ms. Judge noted that often Dr. Jerod often picked a course of treatment she thought was best for some of her older patients, skipping over alternatives. She did not like to deal with difficult patients or bad cases as a general rule. Ms. Judge felt exasperated, disrespected and that her clinical judgement was being undermined.
After just a few weeks of working in the office, the dental hygienist observes that Dr. Jerod leaves early upon completion of her own scheduled appointments and after finishing all hygiene exams. Dr. Maxwell her partner works mornings only. Dr. Jerod is expected to work until closing. The dental hygienist is familiar with the laws in her state and knows she needs to work 1 year before becoming eligible to practice under general supervision. The dental hygienist discusses her concern with Dr. Jerod, but she continues to leave the practice early, even when the dental hygienist has patients to complete.
Case Analysis Grid ”Fillable” – Revised Fall- 2021
Facts & Interested Parties Ethical Issues & Points of Conflict
Actions/Consequences Obligations/ Ethical Principles
FINAL RECOMMENDATION(S)
