Blind Spots in Dentistry™: Your patient does not want to sign a form. What do you do?

This is one where doctor needs to make a decision: can the doctor treat someone without knowing their medical history?

Considerations:
— Does the patient understand the importance and link between their medical health & dental health?
— Did you offer to work in “private” with the patient to complete the form and have them sign it?

As healthcare providers, we need to understand why a patient might refuse to sign a form.

For instance, is it because they have trouble seeing? Reading? Comprehending? Are they afraid to make a mistake? Are they unable to write or spell, which could be a source of embarrassment to them? Having a family member who is dyslexic, I know it can cause stress when having to complete a form, especially if they feel they will be judged on their spelling and writing. For elderly patients who may have macular degeneration, completing forms is impossible.  

On a related note, remember, this is an opportune time to discuss the link between medical and dental health, taking the opportunity to educate the patient as to the importance, and why. As you know, patients do not feel it is important for their dentist to know about their medical history, so we need to start asking direct and leading questions, such as:

1. When was the last time you visited your doctor, urgent care, or any other health care provider? (This question often sparks them to think a little more about their last visit.)
2. What medications, vitamins or supplements are you currently taking? If they are a returning patient, review their medication list with them?
3. Ask them about family history of periodontal disease, diabetes, heart disease, cancer, etc. This is helpful for as a risk assessment.
4. If there were any hospitalizations since their last visit. (Give them the exact date they were last at your practice.)
5. Any new medications? Are you using any eye drops? Vitamins? Dermatology meds? Fish oil or herbal supplements.
6. Any changes in the dosage of your medications?
7. Is there any need for antibiotics before a dental treatment?
8. Any reason, we cannot take dental x-rays today? Pregnancy? Recent medical x-rays?

Taking the time to understand why a patient might not want to complete a certain form or forms, as well as making a concentrated effort to inform them of the importance of their medical health to their dental health, and vice versa, is vital to providing the best possible dental care to all of your patients, all of the time.