Re: NTI consent
From: The Webby (nospamatthetmjiatroepidemic_at_san.rr.com)
Date: 06/12/04
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Date: Sat, 12 Jun 2004 16:12:08 GMT
The form seems to be much more of a "patient instruction" and "fee
agreement" than a "consent form" (which implies consent to treatment
based upon the disclosed/written explanation of the treatment plan and
its known risks and benefits.
I think the form opens the door to some discussion... if anyone wishes.
TW
In article <lvmlc0ha7c37bg73v8bjf8j87p020sdq72@4ax.com>,
"Joel M. Eichen, D.D.S." <joeleichen@yahoo.com> wrote:
> On Sat, 12 Jun 2004 06:40:42 GMT, The Webby
> <nospamatthetmjiatroepidemic@san.rr.com> wrote:
>
> >In article <dbekc058v93kd5geeav2uig36afsvfpd8q@4ax.com>,
> > "Joel M. Eichen, D.D.S." <joeleichen@yahoo.com> wrote:
> >
> >> This is from a DentalTown dentist.
> >>
> >> Any comments?
> >
> >I have some comments to share.
> >>
> >> He offers this for your use
> >
> >okay...
> >>
> >>
> >> ***
> >>
> >>
> >> Dr. B. writes,
> >>
> >> I've been re-working my information and consent forms for the NTI.
> >> Any feedback is appreciated. If you like it, feel free to lift the
> >> copy and use it for yourself...
> >
> >Standardization of consent forms would be something important to
> >consider. Obviously, not all patients are created equally so there
> >would be additional information related to the individual patient's
> >condition. (There aren't any guarantees in medicine/dentistry that I
> >know about...)
> >
> >
> Good comments. I never used any kind of WRITTEN consent form because I
> always thought it to be "patient unfriendly." Of course I always
> "INFORMED" extensively.
>
> JOEL
>
>
> >>
> >> Wear the appliance for one week, and then return for adjustment and
> >> refinement (This follow-up appointment is very important). The
> >> appliance is primarily worn while sleeping, however, daytime wear may
> >> be required in extreme situations or during stressful times.
> >>
> >
> >Is it important to have a standard "one week follow up appointment" or
> >should this time frame be flexible (fill in the blank)? If it is "very
> >important" for one dentist to see his patients at one week, should it
> >not be equally important for all? If not, then a "fill in the blank"
> >follow up might be better. This isn't so much a matter of consent as it
> >is an instruction for the patient.
> >
> >>
> >>
> >>
> >> Never wear an NTI-TSS appliance while eating (doing so may be painful
> >> and possibly traumatic to the opposing teeth).
> >
> >Why would anyone want to do that anyway? Maybe it would be because of
> >previous "splint therapy" experience with instructions that the
> >appliance was to be worn 24/7 except for during dental hygiene.
> >
> >>
> >> Avoid sleeping on your stomach. Sleeping on your stomach forces your
> >> head to be turned to the side, which may allow continued muscle
> >> strain.
> >
> >Is the NTI contraindicated in patients who find it necessary to sleep
> >prone because of back problems or other physical reasons? If not,
> >perhaps it would be better to write, "Avoid sleeping on your stomach.
> >Discuss any concerns regarding positional sleeping needs/habits with
> >your dentist if this request presents a problem." Is it reasonable to
> >expect this sort of compliance by the patient (avoid prone sleeping
> >positions)?
> >
> >>
> >> Discontinue all gum chewing.
> >
> >Why? Is other chewing activity to be discontinued?
> >
> >>
> >>
> >> During the first few days of treatment, the jaw joints and muscles may
> >> feel different. Much like you feel “pins & needles” in your leg if
> >> you’ve been sitting on it, the muscle and joint may feel different
> >> when the tension is relieved. Make a note of any concerns and discuss
> >> them during your one week follow-up appointment.
> >
> >Are the notations regarding concerns to be made only regarding these
> >altered sensations or does this apply to everything in general
> >concerning the new and continued use of the NTI?
> >
> >>
> >>
> >>
> >> The NTI-TSS should be discontinued until adjusted by Dr. Blanchard if:
> >>
> >>
> >> If it is uncomfortable, too tight or binding; if it is too loose (you
> >> should not be able to remove the appliance with your lips or tongue);
> >> or if the appliance is damaged.
> >
> >Should the patient wait until the "one week follow up appointment" or
> >call sooner if these problems occur well before that time period? How
> >often can the patient expect these problems? (Does the $210 fee apply
> >and how does it impact the return policy within eight weeks?)
> >
> >>
> >>
> >> If when wearing the NTI-TSS, your back teeth or canine teeth can
> >> somehow touch each other in various jaw positions.
> >
> >Would this happen within the first week after fitting or is this a
> >problem that occurs later in use?
> >>
> >>
> >> I, the patient understand that:
> >>
> >>
> >> The NTI-TSS suppresses muscle dysfunctions and is not an appliance
> >> that can move teeth. Daily chewing (without wearing the NTI-TSS) will
> >> maintain each tooth’s original position. The appliance may not fit if
> >> not worn for an extended period. This is due to the constant, casual
> >> adaptation of the teeth.
> >
> >Please define "an extended period" as used above? Would chewing gum for
> >brief periods daily be the same as "daily chewing"?
> >
> >>
> >>
> >> The position of the jaw is influenced by the tension of the muscles.
> >> As the NTI-TSS suppresses muscular tension, the position of the jaw
> >> may change; without extra muscle tension, the jaw will find its most
> >> relaxed, natural position. Some adjustment of the teeth may be
> >> required to allow proper bite in this relaxed jaw position.
> >
> >At what point in time would the adjustment of teeth be considered? Is
> >this adjustment done for patients who no longer use the NTI, in those
> >who continue to use the device, or those who will use it from time to
> >time as needed?
> >
> >>
> >>
> >> Joint noises, may or may not be resolved by treatment with the
> >> NTI-TSS.
> >>
> >>
> >> Complete resolution may not be immediate. The muscular disorder may
> >> be aggressive in its attempt to maintain itself. Symptoms may change
> >> and evolve as treatment progresses.
> >>
> >If complete resolution is not immediate, does this comment suggest that
> >complete resolution is expected at some point in time? If so, what
> >should the patient expect?
> >
> >What does this mean: "Symptoms may change and evolve ..."? Does this
> >mean for the better *and* for the worse or????
> >>
> >>
> >>
> >> Treatment Plan and Fees
> >>
> >>
> >> The fee for the migraine and tension treatment is $815. This includes
> >> the initial fabrication of the appliance, and a follow up treatment
> >> one week later. Insurance is very unpredictable for this service. It
> >> has been our experience that most dental plans (80% coverage) will pay
> >> about half of the total fee.
> >>
> >The fee seems high. Are those Canadian dollars? What would the fee be
> >in USD?
> >>
> >>
> >> The NTI-TSS appliance may need repair and adjustment over time, as you
> >> wear through the appliance, or as symptoms change. The typical
> >> adjustment appointment after the first month of wear is $210.
> >>
> >
> >How often should the patient plan to dish out $210 over time? Consider
> >that the patient may use this device for years. $$$$
> >>
> >>
> >> This appliance will make a dramatic difference in the way you feel,
> >> however, it is understandable if this treatment sounds too good to be
> >> true (I was very skeptical myself when I first heard of it). If, for
> >> whatever reason, you are not happy with the appliance I will buy it
> >> back from you (up to eight weeks following the first appointment).
> >
> >So the patient's $1025.00 fee/investment in healthcare (or more if more
> >$210 adjustments are needed during the second four week time period
> >(total eight weeks) is safe for up to eight weeks?
> >>
> >>
> >>
> >>
> >>
> >> Date:____________________________
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >>
> >> Signature of Patient (or
> >> guardian)___________________________________________________
> >>
> >>
> >>
> >> --------------------------------------------------------------------------
> >> Kirk
> >> Halifax, Canada
> >>
> >> "A one that is not cold is scarcely a one at all"
> >> Taken from the property of ones:
> >> "The Oneitude is directly proportional to the colditude of the one"
> >>
> >>
> >> Revisions :
> >
> >Punctuation and spelling not reviewed but noted.
> >
> >Sincerely,
> >The Webby
-- -- Sabra Broock <sabrabroock@earthlink.net>
- Next message: laura davis: "Re: periodontal decisions"
- Previous message: jitney: "Re: Fluoride or not? Is it safe?"
- In reply to: Joel M. Eichen, D.D.S.: "Re: NTI consent"
- Next in thread: Dr. Steve: "Re: NTI consent"
- Messages sorted by: [ date ] [ thread ]
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