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CATEGORY EV NTS

The most important time is the time we dedicate to patients

Giving bad news isn’t easy. Getting bad news is even harder. How can clinicians ease understanding and support patients when the risks of complication are high?

Dr Marjan Gilani | Switzerland Manager Medical Communications Geistlich Pharma AG

Dr Rocchietta, patients love a miracle. What do you do when you know that the results patients expect cannot be achieved? Dr Rocchietta: I never promise perfection, even though I know the results could be close to perfect. Perfection and 100% success don’t exist in medicine, by de nition. Instead, I try to under promise and over deliver. For example, when a case demands high aesthetics, I’d rather say that we will strive to achieve “natural harmony” than “perfect results.” We need to evaluate the initial conditions, make sure that the diagnosis has been performed thoroughly, and subsequently inform the patient about all the risks and possibilities. A common mistake in clinics is that patients come in with amissing or fractured tooth, and we start the therapy by focusing only on that problem, without looking at the surrounding issues. Obviously, this is even more important when we treat a referred, failed case. We should always stay humble, understand all the risks of the procedure we perform, and explain to the patient why the situation could have a less favourable outcome. Patients get tired of all the treatment processes, and the nancial stakes are high. Patients should get all of this information, including the risks, several days before surgery in a written consent form. is way they have time to consider and understand the procedure and tend to have more realistic expectations. Does this mean you talk about technical complications? How do you help patients, who are not medical professionals, understand? Patients are di erent. Some have full trust

and do not want to hear any explanation, and some search for cases online and watch YouTube videos before the visit. We need to adjust according to who the patients are and what they can understand. A lot of this comes with experience. In school nobody teaches us how to be psychologists. But there is one unchanging fact: when we take the time to educate patients, and they understand the procedures, they are much more compliant. Have you ever found yourself worrying about complications more than your patients worry? All the time! Clinicians know what could happen, which makes them worry more. Severe periodontal disease can cause

bleeding on probing and other symptoms, but not necessarily pain. So, the patient is completely unaware of what is going on in their mouths. We need to be very strict when it comes to review and follow-up appointments. Before starting the treatment, I always make sure the patients are available for visits every week for the rst month, every two weeks for the second month, and then once a month thereafter. And they need to comply with post-operative instructions. With all the digital tools we have nowadays, telemedicine is much easier. Sometimes we have a Zoom meeting to make sure that patients understand post-op instructions, or they send us a quick photo instead of planning a face-to-face visit.

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