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Re: A LNT Experience !!NOT!!

Title: Re: A LNT Experience !!NOT!!
J. Muckerheide wrote:


Mass. Adv Council on Rad Protection has had this before us for many years - ALWAYS on the case for lower dose!

Are the opinions of this advisory council a rule? Does the state enforce it by rule? How is the action of the council being implemented?

I expecta more typical state Adv Council, led by rad protection people with Drs. and vendors, would readily put out such 'guidance,' and more.

I was responding to the statement that "The local Dental Board requires him to use fast film and not to use slower film." This is either accurate (the dental board does require it and he must follow their guidance) or it is not. I would like the facts as to the actions of the board and their regulatory or quasi-regulatory authority BEFORE I would accept that the doctor was not responsible for this treatment decision.

You're also wrong on "dentist responsibility." They have, and need, no rad
health effects knowledge, and little of doses, beyond what's "written on the
box."  They, nor MDs, know little more than the literate public about
radiation, and most even go so far as to believe the crap put out by the
regulatory agencies and their NCRP 'fellows.'

Sorry but in this case the statement was that "because of his patients' [this would have to be this specific dentist and not a board or the state] fears of cancer, he uses extremely fast film, which does not have the definition of the slightly slower film." Such a decision may make him responsible. Why? because he has made a decision that, if it decreases the standard of patient care, he can be held responsible for.

Example of the two situations are:

Att - Tell me Dr. you use the faster film that does not, in your opinion, give a good image?
Dr. - Yes.
Att - And you do not agree with the use of this film?
Dr. - No.
Att - Why do you disagree?
Dr. - Because the image quality is such that I miss things that are important to see for patient care.
Att - Then why do you use it?
Dr. - the XXX board requires it and I must follow their rules.
end

OR

Att - Tell me Dr. you use the faster film that does not, in your opinion, give a good image?
Dr. - Yes.
Att - And you do not agree with the use of this film?
Dr. - No.
Att - Why do you disagree?
Dr. - Because the image quality is such that I miss things that are important to see for patient care.
Att - Are you REQUIRED to use the faster film?
Dr. - No.
Att - Then why do you use it?
Dr. - Because of some of my patients' fears of cancer.
Att -  So you do what some of your patients want - even when it unnecessary and results in giving lower quality of care to another patient (such as poor xyz who is sitting here with brain damage from an infection you missed because of your decision to address irrational fears of other patients)?

From here on it is a downward spiral.

Why is the surgeon who put in a defective (from the manufacturer screw) sued by the patient? The Dr. had no knowledge of strength of materials, angular forces, or test results. Or the surgeon who puts in the hip joint that will not mend because of contamination on the metal by the manufacturer.

You'll have to kill the problem at the root. Blaming the dentist is as bad
as blaming the media! :-)


I was blaming the dentist because the decision was [perhaps erroneously] attributed to the dentist. A dentist who makes a decision to decrease patient care when he knows there is no valid reason to do so and that decrease results in harm to a patient can be held responsible.

I would continue to hold the dentist responsible until I could determine the authority of those advising/ordering/ruling/etc. that he MUST use the faster film.

Paul lavely <lavelyp@uclink4.berkeley.edu>


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