Moral appointment dilema

whitewing

I think professionally you can deregister her without any kind of personal guilt (ie if she did subsequently succeed in suicide and even left a note saying it was because her teeth worried her, I still don't think in any way, shape or form you would have contributed to her suicide).

As a kindness (which I don't think is anything that you should feel obliged to do), could you do a standing appointment on specific dates, send copies to family, and make it the last appointment of the day? If she doesn't turn up, then she doesn't get treated and you go home early, so yes you lose money but does it matter in the grand scheme of things as a planned loss/karma? But don't reschedule the appointment; she just awaits the next one? I think you would need to have the patience of a saint for this option, but the fact that you've posted makes me think you are perhaps more compassionate than average.

Loopy_Girl

I work in dental, am community based and work for the NHS, and the number one gripe WITHOUT FAIL I hear......"why can't I get an NHS dentist"!!!!!

I'm telling you nothing new here tirednewdad but trying to find an NHS dentist is near on impossible sometimes and as you say, this patient is 'clogging' things up.

I think you're concern for her wellbeing is admirable but I think as a health professional you have to think well, like a professional. You are concerned about her mental wellbeing, why don't you turn it round? Instead of feeling guilty that you may have to throw her off the books, I would be more inclined to feel guilty for a potential patient who is searching for an NHS dentist and can't get one and yet this patient is calling the shots and deciding when she will turn up.

You have done everything you can. This patient clearly has serious issues and to be perfectly honest, sounds like she doesn't want to be in this world anymore, and I don't think you having to de-register her will make any difference.

belfastgirl23

I'd say try once more. Inform her family members that the appointment has been made and ask them to take responsiblity for getting her there. Make it clear that the consequence of her missing any further appointments will be deregistration. And then follow through.

if her family are so concerned about things then they can get her there. By giving her one final chance you're clearing your conscience in my view.

tealady

Hi You are a dentist not a social worker, not a mental health nurse, not a doctor or psychiatrist. So my advice would be to spend your day doing what you can do (providing a service for the people who want it) and not trying to support someone whose problems you cannot solve.
If you still wish to treat the lady then I think Whitewings suggestion was a good one. Just remember it is not just your time and money she is wasting but that of the rest of the staff as well.

Ms_Chocaholic

Could you try contacting social services/health to see if she has an allocated worker; if she has that's great because you can explain your concerns and, as her suicidal thoughts are to do with losing her teeth; the allocated worker or another support worker may be able to accompany the patient to any appointments.

If she's not got any workers involved, I'm not sure what you can do, other than refer her as she is clearly in need of some support.

brightonman123

are you allowed to contact her doctor? or would you consider a home visit?

otherwise, best to deregister, then up to her / social services to sort..

alison999

As someone that works at a dentist I can completely understand the situation. At the practice where I work I BEGGED two dentists to give two seperate patients 'another chance' they had already missed many appointments. One failed the next appointment, the other failed after 2 more appointments. You cant help people that wont help themselves.

I would de-reg and give her the number of the PCT or another practice that may be able to take her on. You cant give people chance after chance, honestly, they just take the !!!!.

Since those two patients both dentist will NEVER give another more chances then they need to. So those two patients have really messed it up for the genuine people that do miss appointments because the cats sick etc.

De reg defo or this will continue for years.

tirednewdad

I really apprecaite the range of replies that everyone has given. You've all made a decision, that i think i had already taken in my mind, but was too nervous to put it into practice.

I have decided to deregister her but given her the name of a NHS dentist who is taking on. I have informed her family and socail workers- who did beg for one more chance, but i explained to them that she had already had one last chance too many.

I still do feel completely S%$t about it though.

feelinggood_2

Don't feel bad tirednewdad.

I've suffered from severe mental health problems in the past, and haven't been able to get to the dentist regularly. However, I've always been careful to schedule appointment for my 'best' times, and if I didn't feel up to it the day before, to cancel. It isn't impossible to be considerate whilst suffering from severe mental health problems.

She had been given many chances, and didn't want to take them. There is only so much you can do, and as this situation isn't resolved by now, it is unlikely to.

whitewing

tirednewdad wrote: »

I still do feel completely S%$t about it though.

Don't feel bad. You've already done much more than most people