Sunday, January 31, 2016

Clinical Records.



I have a bad habit of keeping clinical records of all the patients treated by me. They say that it is a good habit to keep records. May be. But it is bad when it shows a failed case or a missed diagnosis. The patient sitting in the chair would have forgotten what his complaint was when he had visited me four or six years back or that the tooth about which he presently has a complaint had actually been treated by me earlier. It would be very nice to consider it as a new case without bothering about the inconvenient history. But for the record, I would not remember the case, the patient’s memory would be worse and I would treat it as a new case. I may even get to blame the previous dentist (Gleefully. Who doesn’t like other’s mistakes?) for messing up the case and charge a little more for setting things right and doing the patient a favour! But my record does not allow such pleasures. It places my blunder in front of my eyes in black and white. Painful. That is why I sometimes feel that I would be better off without my records.

But it has its uses. Once in a way I get a patient in whose mouth I find some really good job done. I mention it to the patient and he/she says “Oh, that was long back doctor, I do not know who did it”. It would be extremely gratifying when the record shows that it has been done by me. People get different teeth treated by different dentists as per convenience and never remember who treated which tooth, let alone where and when. Sometimes they will have totally forgotten visiting any dentist in their life at all. “No doctor, I swear that I have never been to a dentist before. This is my first visit ever.” I place the card in front of them and hear an excited “Oh, you still have my card! That was when I was in sixth standard. I never had any trouble later and have entirely forgotten about it” and it impresses them a lot.


 Some cards bear cautionary signals like “Very apprehensive patient”, “Never keeps appointments”, “Bargains. Quote more”, “Collect fee in advance” etc etc which are very useful in running a practice.

The popular belief among my patients is that winter is bad time for dental treatment. For that matter, dental treatment is considered bad in any season but worse during winter. Hence the attendance in the clinic is quite low during winter. Yesterday was one such day with just two patients.  I removed few teeth for one of them. Since that was to be followed by making an artificial set, the patient said that she would pay for everything together and walked away. No collection for the day.  Not even the milk and vegetable money.

I was about to close when the second patient walked in. It was quarter past eight. He just wanted an appointment for a filling. An appointment was fixed but I can not charge someone for just fixing an appointment. I am not that bad yet. And they wouldn’t pay even if I do. So pockets remained empty. When he was about to leave, the patient mentioned that he had visited me years back for some fillings and I took out his card just to check. He was right. I had done some filings for him but he had not paid me! That was ten years back and he owed me five hundred. I mentioned it and said that he may pay me when he came for his fillings. “Oh I am so sorry doctor” he said “No, No, I will pay  right now.”  He sheepishly took out the cash from his purse, paid me and left putting me in the black for the day!

Of all the benefits of maintaining records, I feel this is best!

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