The Student Professionalism & Ethics Association (SPEA) is a student organization that helps prepare dental students for the difficult choices they will face in practice. When you look at your patient’s medical history, the state of their teeth and gums, their finances and their commitment to hygiene, you are incorporating these variables into a decision for treatment. You try to make the decision that is best for the patient and for you. One challenge of providing oral health treatment is combining the many variables into the best treatment decision. Dentistry is not a binary profession with simple inputs and outputs. Comprehensive care requires comprehensive thought and foresight. The actions we take as professionals affect the patient, us and the profession. What ought to be done and what you will actually do may differ. SPEA is there to help guide those decisions.
“My tooth hurts when I drink water and coffee.” Your patient is staring at you, hoping for a solution to her problem. In your mirror, you can see that the existing MOD placed on #3 by her previous dentist is questionable. It’s covering more than half the tooth, the shape is suspect and there is some staining around the margins. It may be compromised. Your patient laments how her old dentist convinced her to get the filling instead of another option. You now stand at a fork in the road. Perhaps you’ve never seen work by this dentist before. There may have been complex circumstances that led the dentist to restore the tooth this way. You don’t know the veracity of the patient’s explanation. Do you openly comment on your colleague’s questionable work?
The new assistant you hired is vivacious, personable and helpful. Your office was in desperate need of a good assistant. She learns fast, arrives early and is always willing to stay late. While working together on a patient she makes an off-color comment to the patient that would make your mother raise an eyebrow. You’re in a rush and move on. This happens again a few days later, then a couple times after that. You pull the assistant aside and explain that her comments may be inappropriate. She becomes defensive and says that the last dentist she worked with didn’t care and she can go find another job if needed. You speak with your office manager and she doesn’t have an issue with it, but you do and you’re worried that your patients might. Your office needs her help. Do you let her go? Do you wait and see what happens with time?
You will face scenarios such as these many times throughout your career. Dentistry is unique in terms of the scope of practice in which we can work. Difficult choices can present in many forms. Through awareness, education and experience, SPEA empowers dental students with the knowledge to assess autonomy, veracity and justice, strengthening them as leaders in the community.
~ Erik Klintmalm, MBE, MPH, Arizona ’18, 2016-17 contributing editor