ABSTRACT
The authors discuss ways that dentistry engages silently and sometimes unknowingly in practice patterns that adversely affect public access to dental care. The concept of acceptance is explained and contrasted with treatment and with access to care. The concept of Universal Patient Acceptance (UPA) is introduced, with a focus on how it underlies and precedes access, creating a pathway so that truer universal access to dental care can be realized. The authors argue that a commitment to Universal Patient Acceptance shows promise as an important starting point in the dental profession's concern to address society's unmet oral health needs.
Subject(s)
Dental Care , Health Services Accessibility , Patient Acceptance of Health Care , Delivery of Health Care , Dentist-Patient Relations , Ethics, Dental , Financial Management , Health Care Reform , Health Services Needs and Demand , Humans , Liability, Legal , Patient Selection , Risk Management , Social ResponsibilitySubject(s)
Dentists , Ethics, Dental , Power, Psychological , Conflict, Psychological , Humans , Models, Psychological , Professional AutonomyABSTRACT
Ethics dialogue in this case is first used as a framework to initiate reflection on which forms of conflict resolution are appropriate in specific situations. This helps in planning and strategies, but does not guarantee what the outcome will actually be. Ethics dialogue, however, can also be used as a form of conflict resolution. For example, when the patient in the story wants to avoid revealing the names of her past dentists, an ethical framework could be presented that would respect her autonomy (an ethical term) and her right to privacy (a legal term), while still addressing your need to determine if the primary problem is of an ethical or dental nature, and if your role is to be that of a healing mediator or a healing dentist. This same form of conflict resolution could also be applied elsewhere in the story. For example, ethics dialogue would have been appropriate during the consultation between you and the endodontist, or between you and the patient, prior to the lawyer's formal request for the patient's records. It is difficult, however, for you to reduce conflict through an ethical dialogue once the lawyer requests information from you because, at that point, the adjudication process has already begun. The ethical reflection exercise will, however, help you negotiate through the adjudication process by providing a solid ethical reference point concerning conflict resolution. The February issue's ethics column will provide a framework for evaluating the forms of power available in conflict resolution in terms of justice.
Subject(s)
Ethics, Dental , Negotiating , Humans , Negotiating/methods , Referral and ConsultationABSTRACT
The present investigation examined the effects of contracting upon modification of oral hygiene skill and plaque indexes. Three males and one female from a VA domiciliary attended 20 oral hygiene patient-education classes during which personalized flossing and brushing instructions were given. Double-blind personal contracting procedures were applied within a multiple-baseline design across subjects and behaviors. Responses indicated that signing either the skill or plaque contract modified the related index in the desired direction. Contracting appears a viable strategy for selected oral hygiene problems.
