It's a medical practitioner's worst nightmare: a disgruntled patient with a lawyer.
This past June saw the prosecution of an anesthesiologist who made exasperated comments about her patient while he was under sedation. Unfortunately for the doctor, the patient had turned on his phone's recording app to capture any post-operative instructions he might forget, and saved the entire episode.
The behavior of the anesthesiologist in question was pretty absurd, so it's easy to think "well, I'd never do that in front of a patient." But have you ever grumbled about a squirmy patient or crown that just won't fit during a sedation appointment? Do your staff have an amusing nickname for a particularly rude or troublesome patient behind the counter? If so, be exceptionally careful of how and when these topics are expressed.
We try to do good work and protect ourselves from frivolous lawsuits, but everyone slips up sometimes with a particularly difficult patient or procedure. Still, if the patient is sedated without his phone, he won't remember anything, right?
This may not be the case, according to a study in the Japanese Journal of Anesthesiology. The researchers report that as much as 35 percent of patients under sedation with triazolam have some memory of the operatory, and an additional 35 percent have memory of the pre-operatory period.
Overworked clinicians defend private comments about their patients as therapeutic and necessary, allowing them "re-set" and enjoy working with the agreeable patients. Others argue that to discuss a patient's demeanor or actions unrelated to their treatment is unprofessional, and opens one to avoidable liability.
Remember, sedation in many cases will carry amnesiac effects, but this does not guarantee complete forgetfulness on the patient's part. While it may be hard to remain silent over a patient's brushing habits or inability to open wide enough, remember to be professional at all times, and save that much-needed venting for the drive home. You never know who might be listening, and medical ethics boards are becoming more sensitive to quips about patients showing up on their records, however accurate they may be.
The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.