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Two things happened today made me question (yet again) how I make my clinical decisions. 

Firstly my 7:30 surgical patient turned up… 30 minutes late for their appointment (it was the second time they have had this appointment, the last time they were 2 hours late) I still have a little bit of time but I will run way over but the case itself is high value and the practice as a whole would be better if it was done. 

It will impact on the next patient and I will have to rush and do things a bit faster, my morning will run on and it will impact on the team, or I cancel and tell them I’m really sorry but you’re late again. 

What would you do? 

Next up I’m placing an implant on someone else and the socket next-door (it’s a two unit bridge) is big and I’ve scraped out a whole load of stuff from of it and there’s a hole. I could convince myself that it didn’t really need a graft and they will probably be okay, but if I graft it, it would be better and I will like the way it looks better. I think it is a better process and we get money, but it might be alright if I don’t. 

They come at you constantly these things, these choices that you make and there isn’t always a matrix or a diagram on the wall telling you yes or no or telling you which way to turn.  

I said it recently and I will say it again. Decision making and insight is probably the most valuable thing that you’ve got. 

In the end I did the graft (it was definitely the right thing to do) If everything was free, I would have done it, so I do it because it’s best for the patient. 

I cancelled the surgery too. 

The practice lost the money (for today at least) but the case that came up next was the one where I had to decide to graft or not and I think I was in a better position to decide yes or no because I had cancelled the first one and had the right amount of time for the second. 

Blog Post Number- 1969