#69 Value Based TMD/TMJ Treatment (Part 4) Minimal Side Effects and Unintended Consequences

This is part 4 in a series of articles focused on describing the features of “Value Based Healthcare” as it applies to the diagnosis and treatment of TMD/TMJ using the Urbanek Device and Protocol. “Value Based Healthcare” is defined by Dr. Robert Pearl, M.D., retired CEO of Kaiser-Permanente Health Care System, and author of the book “Mistreated, Why WE Think We’re Getting Good Health Care—And Why We’re Usually Wrong”.  He describes Value Based Healthcare as the solution to the current uncoordinated, generally confusing, barely stitched together, overly expensive, self-serving, and overly controlling healthcare system Americans currently endure.  Part 4 of this series answers the question: Does the service provided create minimal side effects and unintended consequences?

Medical and dental care is a very personal topic since it has to do with care of the body. How much more personal can you get than care you’re your body. That is why health care providers who are trusted with the responsibility of a person’s body other than their own are carefully trained, and monitored by federal and state governments who issue licenses and maintain authority over the providers assuring the best care possible.

However, like anything devised by human beings, medical and dental healthcare can create problems for the patient that are not intended.  These are called “side effects” when referring to drugs, “complications” when referring to surgery, and unintended consequences when referring to all other services. Whatever treatments are rendered or proposed, they need to be evaluated as to their side-effects, complications and unintended consequences in addition to the proposed benefits.  This evaluation should be expressed, discussed, and known by both provider and patient before every service provided.  This process is known as “Informed Consent”.  Informed consent is important because if the patient feels the possible side effects, complications, or unintended consequences outweigh the benefits the service should not be done.  This decision must be made by the patient and may vary among patients and depends upon how much risk the patient is willing to take based on the information provided, the experience of the provider, and the history of the service.

A good example of this process is the informed consent associated with anesthesia for surgery.  I am intimately experienced with consent for anesthesia, having delivered office anesthesia for the removal of wisdom teeth thousands of times throughout my career.  Of course, the statistical history of office anesthesia delivered by an Oral and Maxillofacial Surgeon throughout the United States is exceptionally safe and effective, but occasionally an unexpected problem can occur, and a complication can arise including the possibility of death.  These possible complications are carefully written out on the consent for surgery form which is read and signed by every patient before surgery.

Fortunately, a non-surgical device and protocol for the treatment of TMD/TMJ has very limited side effects and unintended consequences.  In the case of the Urbanek Device and Protocol these are clearly written on the “Consent for Treatment Form” and the package insert provided the patient before treatment.

Informed consent and Consent for Treatment is the Standard of Care.  Unfortunately, many other types of treatment recommended and used for the treatment for the symptoms of TMD/TMJ do not adhere to this Standard of Care.  Whether the treatments include drugs of various kinds, botulinum toxins, physical therapy, dry needling, or phycological care, unintended consequences do and will occur.  It is not appropriate here to enumerate every and all of these consequences that can occur during or after treatment elsewhere.  It is only appropriate for me to extend the knowledge to the patient that informed consent is the standard of care for both surgical and non-surgical care.  Compared to other modes of treatment for the symptoms of TMD/TMJ, the Urbanek Device and Protocol creates very limited unintended consequences.

We list all the known unintended consequences of using the device on our Consent to Treatment Form and package insert.   At TMJ Services of Brentwood, we take pride in following all aspects included in the Standard of Care for medical/dental services.