‘Scuse the bad pun but something about this post needed to be lighthearted.
The good news is that I have managed to get registered with an NHS dentist in Crewkerne. However my joy was short-lived when I discovered that NHS dentists do not transfer patient records.
I’m still trying to work out why this is ‘standard procedure’ (and therefore OK?) as the receptionist at my old dentist in Sheffield assured me…
Failure to share information leads to information gaps
As a basic information principle, failing to share prior information, must by default lead to some information loss. The dentists and their receptionists whom I have quizzed about this assure me that they can see everything that’s going on in your mouth through the physical examination and X-rays. This may be true as a current snapshot, but there must be more complex situations or times when a patient changes practices part way through a treatment plan, where information in their notes would be useful to the new dentist.
Patients are not always a reliable source of information
Patients vary in how much information they choose to share with their dentist, either deliberately, through forgetfulness or because they don’t realise that certain information would be important. They also vary on how they categorise pain, whether they have hypochondriac tendencies or are dangerously stoic – all information that would help a dentist understand their patients better and be able to direct their treatment appropriately. In the case of patients with mental health and memory problems, knowing their previous dental history becomes all the more important.
Resource efficiency
Alongside the basic principle of an increased possibility of losing information, there is also the argument for wasting resources. NHS resources have gone into building up the notes at the previous dental surgery – both in dentist’s time examining my teeth; in dental nurse’s time for recording the information; in the receptionist’s time in entering the info into the system (where this happens) and in equipment and stock such as X-ray film, cleaning products etc. To have no transferable record of this seems to mean that dentists have to reinvent the wheel each time they get a new patient. Added to that my old dental practice has to keep my notes for 5 years – all of which incurs storage and retrieval costs, which are now running alongside the new set of notes being built up at the new surgery.
So, do you agree?
Is it just me who thinks this sounds ridiculous? It feels like pointing out the obvious, but the dentists and receptionists I have spoken to dismiss this as a problem. However, they can’t give me a satisfactory reason for not sharing this information as a matter of course, other than ‘it is standard practice’. As a result, and with my ‘information head’ on, I don’t think that this standard practice is OK.
I am lucky to have a fairly clean bill of health on every visit to the dentist, but many others are not so fortunate and are subjected to various different treatments. In discussion with my dentist he mentioned that 5 different dentists might give 5 different modes of treatment for the same problem. He gave this as a reason why sharing the old notes might not be necessary. I can’t say that reassured me! In that case, more than ever the new dentist needs to see what the previous dentist was planning to do before continuing or dismissing that course of treatment.
I’d be very interested to know what others think – especially those from the dental health industry!
05/02/2010 at 9:37 pm Permalink
This is a good observation, Fiona. I’d be very interested to see a dentist comment on the issue.
The same problem obtains in Canada – for both dentists and other medical environments. The cause of the poor information sharing is due to several factors; the lack of a common standard on what goes into a medical record, an overly zealous emphasis on privacy and poor technology. All hope is not lost though; I recently blogged on how Scotland is making progress in standardizing medical records.