#19-“Patient’s Frustration and My Understanding and Empathy”

Over the past 7 years I have interviewed and done consultations with more than 6000 patients with TMD/TMJ.  I could write a book about what I learned during those consultations. Several people have told me I need to write the book.  Maybe, someday, I will. But now my full attention is on how to educate other health care providers to recognize TMD and stop confusing the symptoms of TMD with other problems.  You might ask, don’t you have your full attention on treating patients with TMD/TMJ?  The answer to that question is not really.  The problem of how to treat TMD/TMJ successfully has been solved.  We now have a growing number of dentists and Oral and Maxillofacial Surgeons, including my associate in our practice here in Brentwood, Tennessee, who have taken our course on treating with the Urbanek Device and Protocol. And that number of doctors successfully treating the problem will be increasing rapidly.  The problem that remains is educating the providers in both the medial and dental professions who consistently misdiagnose, mis-direct and mistreat patients with TMD/TMJ.  I have written about this before and speak to it every time I am asked to lecture groups of providers.  Most recently I have spoken before separate groups of medial family practitioners, nurse practitioners, physician’s assistants, and Otolaryngologists.  In each case my presentation was met with agreement from those in attendance that they had been misdiagnosing TMD on a routine basis.

There are about 1 million health care providers including medical doctors, dentists, nurse practitioners, physician’s assistants, chiropractors, physical therapists, and massage therapists who routinely see patients with symptoms related to TMD.  Most of the time those symptoms are diagnosed as something other that TMD/TMJ.  This is where the frustration begins.

Unfortunately, most patients arrive for consultation with a multi-year history of consultations with multiple doctors of every category mentioned above.  The average number of providers seen previous to the arrival in our office is between 3 and 5.  It is not unusual for a patient to say 10 when asked how many health care providers they have seen for the symptoms they were having. The most number of doctors/providers a patient answered was 150.  I literally told the patient that I thought they were exaggerating and I just was interested in the real answer. The patient responded that to the best of her knowledge it was 150 health care providers over a period of the last 20 years.  That would be about 7 consultations per year for 20 years.  At that point I believed her.  Let’s say it only 10 providers over 10 years.  That’s one a year.  And each time what the provider offered as an opinion or a solution was ineffective,  otherwise the patient would not be sitting in my office.

This is the situation every day I see patients in our practice.  Three to eight consultations per day.   And every day I hear similar stories about seeing multiple providers for the same symptoms with no solution.  You can imagine how frustrated some of these patients have become.  You can imagine how skeptical patients react when we say we have a simple non-surgical solution.

You can imagine how jaded some of the patients have become.  What you cannot imagine is the number of patients who break down in tears when they realize halfway through a consultation that we understand the problem.  Usually we have not even arrived at the part offering the solution.  When they realize the provider in the room with them actually understands the problem I often see the tears begin to flow. Most of the time the patient is embarrassed and apologizes for crying.  But I’m used to it by now and ready with the box of Klennex and just sit quietly with the patient for a few minutes sharing their frustration and showing my empathy.