QUESTION: What do you advise if a patient of record refuses to fill out a medical history form? We had one yesterday who said, "I'm not filling that out." I noted it in the chart and told the patient that I documented the refusal in the chart.
ANSWER FROM JAN KELLER, Jan Keller & Associates, consultantonthego.com.
This is one where the doctor needs to make a decision – can he treat someone without knowing their medical history? Considerations:
* Does the patient understand the importance and link between their medical health and dental health?
* Did you offer to work in “private” with the patient to complete the form and have them sign it?
As health-care providers, we need to understand why patients might refuse to sign a form. For instance, is it because they have trouble seeing? Reading? Comprehending? Are they afraid to make a mistake? Are they unable to write or spell, which could be a source of embarrassment to them?
Having a child who is dyslexic, I know it can cause stress when having to complete a form, especially if they feel they will be judged on their spelling and writing. Also, my mother has macular degeneration, and completing forms is impossible for her. For years I have attended appointments with my parents to assist them in completing forms and signing on the correct line.
On a related note, this is an opportune time to discuss the link between medical and dental health, and an opportunity to educate patients about its importance. As you know, patients do not feel it’s important for their dentist to know about their medical history, so we need to start asking direct and leading questions, such as:
- When was the last time you visited your doctor, urgent care, or any other health-care provider? (This question often makes them think a little more about their last visit.)
- What medications, vitamins, or supplements are you currently taking? (If they are returning patients, review their medication list with them.)
- What is your family history of periodontal disease, diabetes, heart disease, cancer, etc. (This is helpful as a risk assessment.)
- Have you had any hospitalizations since your last visit? (Give them the exact date they last visited your practice.)
- Are you taking any new medications? Are you using any eye drops? Vitamins? Dermatology meds? Fish oil or herbal supplements?
- Are there any changes in the dosage of your medications?
- Do you have a need for antibiotics before your dental treatment?
- Is there any reason we cannot take dental X-rays today? Pregnancy? Recent medical X-rays?
Taking the time to understand why a patient might not want to complete the forms, as well as making an effort to inform them of the importance of their medical health to their dental health, is vital to providing the best possible dental care to all of your patients, all of the time.
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