Jel typed:
> For Gods sake no man - to prescribe painkillers for osteomyelitis
> without making a diagnosis is negligent - same as it would be to leave
> chest or abdo pain un-diagnosed - IMHO.
Hmmmm.... not too sure about this.
Remove the specific 'osteomyelitis'...
"to prescribe painkillers for XXXX
without making a diagnosis is negligent"
I couldn't possibly count the number of times I have prescribed
painkillers without having made a diagnosis. Not a specific
diagnosis, at any rate. And I can think of numerous situations
where I have prescribed painkillers for chest and abdo pain
without knowing for certain what was going on (although I may have
been fairly certain what *wasn't* going on).
However, if someone comes in clutching their jaw, saying it hurts
when they prod one of their back teeth, that their gum is swollen
(or whatever - I'm sure you can fill in the blanks with a few
symptoms), and that they can't get an appt with their dentist for
nine years, then it *might be considered somewhat dispassionate*
to withold painkillers and antibiotics, knowing full well, as
we surely do, that this would be the first step taken by most
dentists.
Yes, I wholeheartedly agree that in an ideal world dentists would
all have some sort of easily accessed 24 hour service (hell, even
an easily accessed 9-5 service) but they don't. Sure, fight them
in the political arena, in the medical press, but make the patients
suffer in order to prove a point? Over such a (realtively) trivial
matter?
The fact is, I agree with your sentiments wholeheartedly. But when
it comes down to it, and there's a patient sitting in front of me,
I'm going to give them antibiotics and painkillers (and the advice
to consult a dentist forthwith), as, I suspect would 99% of GPs.
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