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Features / December 1, 2014

‘Now that I am HIV-positive’

by Guy Hiscott

How a touching interaction with one HIV-positive patient lead John Seward to consider the importance of comfort and care in the dental profession

Taking a phone call from a patient during Coronation Street isn’t something new; I’ve always believed that we need to be there for our patients.

A recent one-day endodontic course with US endodontist Dr Richard Mounce reinforced this when he said that we need to complete endo treatment in one visit (if appropriate) to suit the patient – not a second visit to suit ourselves.

This particular phone call was more difficult as it was from a patient I had treated since their teenager years, for almost 25 years. They informed me that although they had booked an appointment for the following afternoon they would no longer be attending. Probing gently to see if there were any issues on our part, the patient said: ‘You probably won’t want to see me now that I am HIV-positive.’

What was hard for me to hear from one of my patients must have been brutally hard for the patient to deal with. I explained that I’d had a similar case recently where a colleague had refused to treat a patient who tested positive for Hepatitis B. This patient was told to go to a dental hospital but asked me for advice before pursuing that course. I explained that it was unethical, as we cannot always rely on a patient’s knowledge or honesty of whether or not they are a risk patient, so our only course of action is to treat everyone as a risk patient.

We owe each patient, ourselves, our team members, our families and our other patients the same duty of care to prevent the transmission of any pathogens.

 ‘You probably won’t want to see me now that I am HIV-positive’

I had thanked both patients for their honesty and proceeded in asking how they were coping – both, thankfully, were in good health. Later, after discussing it with my wife, I realised what a unique position we, as dental professionals, are in to build up a relationship with patients over the years, conquering fears and improving the health, comfort and appearance of our patients. Not many other healthcare professionals can boast the same.

While I was thinking about all this, I found myself annoyed by the usual portrayal of dentists as ‘expensive’.

I was, and am, annoyed by the failure of us as a profession to sell this caring aspect to the public, and exactly how much emphasis we place on patient safety and the cost implications to us.

I am annoyed that the Health Service Executive (HSE) can introduce unilaterally new requirements and a practice examination where a new associate seeks a panel number. New costs on top of already spiralling costs.

All this done in the face of the virtual removal of state-funded dentistry and the consequent impact it has had on our practice finances, but more importantly, the oral health of the most needy in our country.

What was hard for me to hear from one of my patients must have been brutally hard for the patient to deal with

I’m annoyed that our representative association isn’t perceived to be mounting a persistent major campaign to reinstate even a basic service/entitlement to positively impact the oral health of our patients, pointing out that if the HSE wants new criteria, there has to be a quid pro quo.

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