Monday, April 16, 2012
An emergency patient gets stuck in the schedule in the worst possible time. Harriet the harried dental assistant wonders, again, for what seems like the thousandth time, “What are those front desk fools thinking!”
Dr. Paperman runs in, sees the facial swelling, tells Harriet to take an x-ray then he flies down the hall. Harriet carefully positions the film and tube head. The patient, Mr. Grumple, is uncomfortable but Harriet is gentle as always. She leaves the room, pushes the button, goes back in the room, (did the patient move? Maybe, he was hurting.) Harriet retrieves the film, goes down the hall to the dark room, waits for the hygienist to finish and let her in; she unwraps the film in the dark, puts it in the processor, finds a film mount, scribbles the patient name and the date, then escapes back into the cool fresh air of the hallway.
Five minutes later she wanders back to the dark room. The door is closed again. Eventually the other assistant lets her in. Harriet finds her film, holds it up to the light and…there is a wide white half circle taking up the lower left corner. Cone cut! Harriet doesn’t want Dr. Paperman to see so she trashes that film and heads back to the patient.
The patient is still in pain, she tries to be gentle. She goes through the process again; position, leave, push, retrieve, wait, unwrap, insert, leave the dark room and wait.
There are other patients waiting, Dr. Paperman needs help in room 3 and the dirty trays are piling up over the edge of the sink. Harriet gets busy then fifteen minutes later remembers the film. She heads back to the dark room, finds the film lying on the deck of the processor she holds it up to the light. Great, there is no white circle but then she looks closer…missed the apex! She trashes that one and heads back again.
On the way back to Mr. Grumple Dr. Paperman catches her in the hall. “Where’s my x-ray?” he asks. “I don’t know,” she says, “The machine ate it.”
The patient is still in pain and now he is also irritated and impatient. Harriet tries again; position, leave, push, retrieve, leave, wait, unwrap, insert. Remembering the chaos on the other side of the door Harriett decides to hide out in the darkroom for five minutes despite the smell and the heat. She waits, no film.
She waits some more, no film. The hygienist starts knocking on the door, no film. This time the machine did eat it. Harriet pries off the lid and there it is stuck between two rollers. She pulls it free and holds it up to the light. It looks really dark from over processing and there is a jagged white scar across the middle from the rollers.
Back with the patient Harriet is ready to try again. Mr. Grumple has been here almost an hour, he is still in pain and now he is clearly ticked off. Judy the front desk fool person is standing in the hall frantically gesturing toward all the people in the waiting room and pointing at her watch. Dr. Paperman steams in, sees what is going on and asks, “Where is the x-ray?”
Harriet bursts into tears.
“I’ll never understand women.” Paperman mumbles.
If Harriet and Dr. Paperman had a digital x-ray system things would have been much different. It is entirely possible that the first image may have been cone cut, however Harriet would know it in about five seconds without ever leaving the treatment room. More importantly the sensor and tube head would still be in place, she could quickly re-position and take another perfect image in seconds.
There would be no wait for the dark room. No wait for the processor. No worry about chemicals and machines.
Once the radiographic image was captured Dr. Paperman could view it anywhere there was a computer, he doesn’t have to wait for it to be mounted, returned to the patient room and placed on a view box.
We hope Harriet was able to get a good diagnostic radiograph with her fourth try. Mr. Grumple has been waiting, taking up a room, and feeling poorly served for an hour. If the office was using a digital system he would have been taken care of in just minutes.
Later that evening at the local study club a colleague asks Dr. Paperman if he is “going digital?”
“Nah,” Paperman replies, “The system I have now works great, and besides my staff would never go for it.”
Digital X-rays for dentistry have been available in the US for over twenty years. Yet about half the dentists are still using film. Give Harriett a break, the future is coming and it will be amazing!