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Re: A LNT Experience !!NOT!!
From: Paul lavely <lavelyp@uclink4.berkeley.edu>
Quibbling. If thru Adv Council, it could go to rule or "Board" requirement.
No one way - just use the LNT to get action. (It had been before all. When
RCP didn't bite it was brought to ACRP as possible 'forcing function.' Such
issues are also in legislation - many avenues and vehicles to implement.)
It's only a matter of time until its adopted under present rad protectionist
persistence.
Jim
> 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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