Re: A LNT Experience !!NOT!!

[Paul lavely <lavelyp@UCLINK4.BERKELEY.EDU>]

Title: Re: A LNT Experience !!NOT!!

> I have just had the following experience that has
>
> brought home to me once again the poor risk choices forced on us by
>
> slavish adherence to the linear non-threshold
>
> theory:

This had nothing to do with the LNT theory. This was a BDBAD, a BUSINESS Decision By a Dentist.

As you stated he (or she) did this because of his patients' fears of cancer. Why did he do it? Because it was easier than doing his job -- to explain to his patients the clearly apparent benefit of the better quality x-ray. Why else? To pander to patients fears to assure that they would not seek a dentist who would do what they wanted. He made the conscious decision to sacrifice patient care so as to quell the uninformed concerns of other patients.

He could have had supplies of BOTH films (and protocols for use) and made a decision as to which was needed to get the ADEQUATE (not the best) medical information REQUIRED to treat a patient.

 

Had this developed into a serious medical problem because of the poor quality of the pictures and the patient had been harmed, a case could be brought against the dentist that could hinge on the quality of care and did the care rise to the standard of care required. In this case, his admission against interest would make it hard to defend. That is, he admits his decision was based on "because of his patients' fears of cancer, he uses extremely fast film." That is, he allowed some patients concerns to decrease the medical care he gives. Additionally, (and perhaps his worst statement) was "he agrees with me entirely about the foolishness of forcing the use of lower-definition film." There was no force here, he made a BUSINESS decision to do this.

You state that he choose to use poorer quality x-rays to pander to his patients fears. His duty here was to get not the best, but the adequate x-ray. Did he? What other quality of care decreasing decisions has he made solely to satisfy his patients irrational fears?

You have already been given treatment that unnecessarily resulted in two days of intense pain. A suggestion? "Let your fingers do the walking through the yellow pages" and then ask some questions about the quality of care.

You wrote that "Here we have x-ray, one of the most fantastic diagnostic tools ever invented, and we are hampering its use because of groundless fears brought on by a theory that has had no direct experimental confirmation, and precious little indirect evidence, of its validity." Sorry but the hampering was motivated by profit - not radiation fears.

You wrote "Isn't it time we took a public stand on this?" YES. Therefore, you should immediately notify the regulators over dental care in your state that this dentist is giving poor dental care to maximize his profits and that he is well aware that the concerns he is addressing are baseless. An editorial to the newspaper regarding dentists/doctors putting profits above patients is also in order.

Lets not blame poor dental or medical care on LNT, especially when the poor care is motivated by profit and not a health concern or LNT.

Finally, do you really believe that these peoples fears will change if we adopt a new model? Not likely.

     

Paul Lavely <lavelyp@uclink4.berkeley.edu>

>   The tie-in with the LNT is that, because of
>
> his patients' fears of cancer, he uses extremely fast film, which does
>
> not have the definition of the slightly slower film.  So he had
>
> to take the second x-ray (which sort of defeated the advantage of the
>
> lower definition film anyway) and then had to take a chance drilling
>
> through a crown into a healthy tooth.  Ironically, I had a
>
> regular checkup last month, and had his technician been using
>
> higher-definition film, the infection might have been caught much
>
> earlier.  Even if I had still had to have the root canal, it
>
> might hav! e saved me a few days of intense pain.  By the way, he
>
> agrees with me entirely about the foolishness of forcing the use of
>
> lower-definition film.  Thank you, I'll happily take the putative
>
> risk that goes along with better-definition x-ray
>
> film!

> Here we have x-ray, one of the most fantastic diagnostic tools ever
>
> invented, and we are hampering its use because of groundless fears
>
> brought on by a theory that has had no direct experimental
>
> confirmation, and precious little indirect evidence, of its validity.
>
>   Is this happening elsewhere in medical and dental
>
> practice?  Isn't it time we took a public stand on
>
> this?

>

> Ruth Weiner, Ph. D.

> ruthweiner@aol.com

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