Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Point of discussion
Referral And Consultations
Learning objectives
At the end of this session student have to be able to explain the referral and consultations with other professionals
6. The treatment provided was warranted and has been satisfactorily completed (quality assurance)
7. The oral health of the publics has been secured, maintained, and promoted
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COMPONENT OF REFERRAL SYSTEM AND CONSULTATION GENERAL DENTIST HOSPITAL AND PUBLIC HEALTH SERVICES
DENTAL SPECIALIST
MEDICAL SPECIALIST
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REFERRAL FORM Referring Physician Prompt Sheet The beginning of the letter should include the following: 1. Patients name, address, date of birth, health number and contact information, (e.g. telephone number or email address) 2. Referring physicians name and contact information, (e.g. telephone/fax numbers and email addresses) 3. Consulting physicians name, address and contact information 4. Urgency of referral - urgent, semi-urgent, routine or elective
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REFERRAL FORM Referring Physician Prompt Sheet Other Important Information: Reason for referral Provisional diagnosis (is an initial guess, to be narrowed or confirmed
later based on further examination.)
Succinct history of problem related to reason(s) for referral and/or other problems Relevant information on patients medical status morbid conditions and relevant past history or old notes Current and recent medications Clinical warnings / significant findings on examination
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REFERRAL FORM Referring Physician Prompt Sheet Other Important Information: Copies of test results What the patient has been told Any factors possibly mitigating against particular treatments or arrangements Special considerations, (e.g. psychiatric/social problems, concerns about compliance or patients understanding; need for an interpreter; any other concerns/wishes of patients family) Follow-up / role of referring physician who will resume care after consultation Finish with a note of thanks for help in managing patient and a list of other recipients to whom copies of the consultation letter should be sent. 17
Other Important Information: Reason for consultation Chief complaint / relevant history Additions to problem list and/or summary of current status of medical conditions Findings - clinical findings on examination, including test results Investigations / Interventions Diagnosis confirmed or differential
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CONSULTATION FORM Consulting Physician Prompt Sheet Treatment and management plan
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o o o
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o o
Aim of treatment Options considered and supported / not supported Recommended treatment and management Proposed treatment schedule with reasons Anticipated benefits and risks of treatment Changed or newly prescribed medication(s) Likely short and long-term complications Possible effects of treatment on patients quality of life and functional capacity Contingency plans in event of adverse events from (or failure of) first-choice treatment
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Communication from the Referring Dentist to the Specialist or Consulting Dentist: (The information may vary on
an individual patient basis, it could include) :
Name and address of the patient Scheduled appointment date and time with the specialist or consulting dentist Reason for the referral/diagnosis General background information about the patient which may affect the referral Authorization or release of records
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Referral and Consultations Elements of dental patient referrals Medical and dental information, which may include:
o o o o
Medical consultations and specific problems Contributory dental history Diagnostic casts Radiographic or digital images
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If known and if requested by the patient, providing information about the specialist or consulting dentists fee for the consultation or evaluation
Giving instructions that will assist the patient's introduction to the specialist or consulting dentist, i.e., preoperative instructions, educational pamphlets or a map with directions
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Initial report from specialist or consulting dentist indicating the preliminary diagnosis and anticipated treatment Progress reports as necessary, if treatment is extended over a considerable period of time
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Some of the legal and ethical considerations pertaining to referrals are noted below
Legal Considerations:
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The law may bear on whether and how a referral may be made. For example the refusal to treat a patient with HIV would require a scientific basis;
A referral to a clinic with more experience treating persons with HIV or any disability cannot be based solely on the dentists personal level of comfort.
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Some of the legal and ethical considerations pertaining to referrals are noted below
Legal Considerations:
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Communication from the referring doctor may be mandatory, in others it may be permitted, and in others patient consent may be required.
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Dentists should recognize that separate and possibly conflicting legal interests may be involved during a referral.
Particular attention should be directed toward patients or providers whose interests and requirements are detailed in contract form. When dentists or patients participate in such arrangements related to dental services, these arrangements should be reviewed carefully
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OUTCOME
CONSUL TANT
PHYSI CIAN
Goals
: 1. Diagnostic 2. Health care 3. Patient status 4. Second opinion : 1. Material 2. Patient 3. Scientific
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PATIENT
Items
Referral System
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Chief complaint
the disease
Patients perception What is the complain is the facts What is the disease abstract in nature
Doctors perception What is the complain abstract in nature What is the disease is the facts
Examples : Ulcer patients fact doctor ?
!
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Complaint
Sign & symptom
Complaint analysis
The actual problem Treatment planning Treatment
The disease
Structural problem Functional problem Treatment planning concept Medical risk analysis Drugs risk analysis
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Treatment
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Problems related to the chief complaint Problems related to medical complications Problems related to oral disorders Inflammation and infection CongenItal abnormalities Immunology disorders Traumatic lesion Compromised Neoplasm Others
Treatment prep
Oral assessment Treatment planning
Concept
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