Case Study: Gertrude Schmidt is a dental hygienist in a family outpatient dentistry practice. One of her adult patients has been coming in regularly to have her teeth cleaned since she was a teenager. Ms. Schmidt has noticed a marked deterioration in her patient’s oral hygiene. She is shocked at the number of new dental caries and the worsening of others.
The patient also displays symptoms of gum disease, which was not noted on previous visits. Ms. Schmidt also notes that the patient appears to have lost a great deal of weight since her last visit a year ago. The patient is fidgety, speaks rapidly, and has dilated pupils despite the overhead light. Ms. Smith suspects that the patient may be using amphetamines because she displays many symptoms, including the beginnings of “meth mouth,” which is distinguished by severe tooth decay and gum disease (American Dental Association, 2017).
Ms. Schmidt completes her assessment of the patient’s dental health and begins to clean the patient’s teeth. As she works, she wonders whether she should ask the patient directly about her suspected amphetamine use. Ms. Schmidt plans to tell the patient to make an appointment with the dentist as soon as possible, to treat the decay and potential gum disease. She decides to take a break from the cleaning to contact Dr. Melville, the dentist, to discuss her suspicions about the patient’s drug use, her concern about the patient’s severely deteriorated dental health and to create a plan of care to present to the patient before the patient leaves. Together, they decide to meet with the patient after her cleaning is complete, discuss their concern about her dental health, make an appointment with the dentist, and possibly provide education about amphetamine use and its consequences on dental health.
Discussion Questions
Did Gertrude Schmidt, the dental hygienist, respect the patient’s dignity, privacy, and confidentiality in this case? Explain, giving examples.
The question of whether Gertrude Schmidt respected the dignity, privacy and confidentiality of the patient in the case has multiple perspectives. Ideally, the dental hygienist should have aired her concerns with the patient before informing the dentist. Such an act could have shown that she respected the dignity, privacy and confidentiality. The fact that the patient was a loyal patient and had been her client since he was a teenager denotes that he trusted the doctor with her privacy and confidentiality. In the case study, it is noted that the patient had been a regular client since he was a teenager and currently he is an adult. However, it is not noted whether the patient was okay with the dental hygienist sharing information about him with a third party without his consent. Therefore, a conclusion that can be drawn here is that Schmidt did not respect the patient’s dignity, privacy and confidentiality.
How did the dentist and dental hygienist work to maintain a trusting relationship with the patient?
From the given case study, the dentist and the dental hygienist worked in collaboration as a team to maintain the relationship of the patient. It is noted within the case study that the two agreed to meet with the patient following the cleaning procedure to discuss their concerns regarding the dental health of the patient. Using incidental disclosure, the dental hygienist was worried about the severity of her patient and thus decided that it will be appropriate to involve the dentist who will provide insight regarding the drug condition of the patient that they are suspecting. Through provision of education to the patient regarding amphetamines and its related consequences on dental health, the two healthcare provided managed to maintain the trusting relationship with the patient.
How did team-based care contribute to acting with high ethical standards in this case?
Team based care is currently considered as one of the best models for the provision not only cost effective but also coordinated and high quality patient care. Collaboration between the healthcare providers in the case helped in enhancing transparency, honesty, creativity and commitment to progressive improvement which are at the core of healthcare. In doing this, the two healthcare providers promoted ethical standards since they were able to keep each other in check in terms of honesty and transparency thus staying in line with high ethical standards in healthcare.
How did team-based care contribute to acting with high ethical standards in this case?
Despite the fact that the dental hygienist discussed the clients condition with another healthcare provider without the consent of the patient, still they acted with integrity and high ethical standards. The act of integrity and upholding high ethical standards in the case can be deduced from the fact that at the end they were honest and transparent with the patient. After discussing the client’s condition, the dentist and the dentist hygienist structured a meeting with the patient and explained their concerns. This is an act that showcases that the professionals in the case acted with integrity and high ethical standards.
What is your opinion of the dental team’s decision to provide education and dental treatment rather than confront the patient with their suspicions that she was using amphetamines?
Since the dental team only had suspicions and had not confirmed the diagnosis of drug use, it was a good decision that they chose to educate the client just in-case the patient was addicted to amphetamine use. Confronting the client at this stage would have put the client in an ease position since drug use is illegal and many people are not open to such conversations. Provision of education is considered to be the most suitable mode of treatment. In this case, if the client was indeed an addict, then the education would still help him even in the case whereby the client was not using amphetamine.
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