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American association of oral and maxillofacial surgeons: Where are we?
Symposia
Americuil~~nofOreldM~~ So: Wbemh We? John F. Helfrick, DDS, MS, Houston,TX Chairman,AAOMS SpecialCommitteeon Criteria & Standardsof Care In 19% the American Associationof Oral and Maxillofacial Surgeonsdevelopeda committee designedto developthe “Parametersof Carein Oral andMaxillofacial Surgery.” This committee was composedof 27 membersrepresentinga crosssection of the specialty. The committee wasbroken down into nine subcommittees consistingof three surgeonseach and it was their chargeto developparametersof care in the following areasof practice: 1. Anesthesia 2. CosmeticSurgery 3. DentoalveolarSurgery 4. Implant Surgery 5. OrthognathicSurgery 6. TemporomandibularJoint Surgery 7. Trauma Surgery 8. Pathology 9. ReconstructiveSurgery
Becauseof the complexityof this project,the Association retained Michael Pine and AssociatesConsulting Group to assistthe committeein the developmentof the parametersof care. With the assistanceof the consultants, and following many meetings,the format for the parametersof carewasformulatedand consistsof: 1. Indicationsfor care. 2. Therapeuticgoals. 3. Risk factors. 4. The parametersof care. 5. Desirableoutcomes. 6. Undesirableoutcomes. The first phase of this project is now complete; however,it is anticipated that this documentwill be continually revised by a standing committee of the Association.It is intendedto be usedby the specialtyto improve the quality of care provided to patients with diseases,defects,anddeformities of the oral and maxillofacial region.It wiI1provide a baselinefor the provision of care,will assistin the identification of areasfor research, and will be an important tool in limiting malpracticejudgementsagainstoral and maxillofacial surgeons.This will be a living document which will continuallyundergorevisionin the future.
SYMPOSIUM: STRESS AND CHEMICAL DEPENDENCY IN THE OMS PRACTICE Presentedon Friday, September27,3:30-5:30p.m. Don P. Bowermaster,DDS, Newark,OH Each day oral and maxillofacial surgeonsencounter are generally not equippedor trained to resolve the resulting emotional conflicts and guilt in a healthy stressesthat are an intrinsic part of surgerypractice.Not only doesthe OMS facethe ordinary stressesof running manner.This resultsin the surgeondevelopingpathoa business,there are other stresseswhich are inherent logic coping and defensemechanismswhich, in turn, exacerbatethe emotional turmoil. This scenario,unrewith the practiceof OMS. The practiceof OMS is unique in that the surgeonis solved emotional conflict and guilt, manifests in the also responsiblefor anesthesia.This dual role contrib- OMS by the loss of confidencein his or her abilities, utes to the intrinsic stressespresentin OMS practice. dissatisfactionwith the practice and eventualburnout. Every daythe OMS is confrontedwith patientswho are There are reportsof surgeonswho haveleft the practice extremely anxiousand who demand pain-free surgery of OMS and evencommitted suicide as a result of this without complications. The once stable, predictable typeof situation.There do existappropriateand healthy doctor/patient relationship is now, all too often an methodsto resolvetheseinherent conflicts when they the effectof stress,morbidadvisarial relationship. Unrealistic expectations are arise.This programaddresses ity and mortality on the OMS. It providesthe surgeon placed on the OMS to perform faultlesslyand achieve with appropriate and healthy options perfect resultsevenwhen perfectionis impossible.The the emotionalimpact of OMS practice.for resolution of surgeonis frequentlyblamed for unsatisfactoryresults, which arenot under his/hercontrol. References With the OMS performing more complicated and highly technical surgery,some degreeof morbidity is Scott, C.D., Hawk, J.A.: Heal Thyself-The Health of Healthcare Professionals. New York, NY, BrunneriMazel unavoidable.The possibility of mortality in the OMS Machell, D.F.: The Battered Image. Employee Assistance, March practiceis alwayspresentand,in most cases,impossible 1989 to predict and,therefore,unavoidable.When morbidity McCue, J.D.: The effects of stress on physicians and their medical and mortality occur in the OMS practice,the surgeons practice. N Engl J Med February 1982 MOMS
.
1991
5
Americuil~~nofOreldM~~ So: Wbemh We? John F. Helfrick, DDS, MS, Houston,TX Chairman,AAOMS SpecialCommitteeon Criteria & Standardsof Care In 19% the American Associationof Oral and Maxillofacial Surgeonsdevelopeda committee designedto developthe “Parametersof Carein Oral andMaxillofacial Surgery.” This committee was composedof 27 membersrepresentinga crosssection of the specialty. The committee wasbroken down into nine subcommittees consistingof three surgeonseach and it was their chargeto developparametersof care in the following areasof practice: 1. Anesthesia 2. CosmeticSurgery 3. DentoalveolarSurgery 4. Implant Surgery 5. OrthognathicSurgery 6. TemporomandibularJoint Surgery 7. Trauma Surgery 8. Pathology 9. ReconstructiveSurgery
Becauseof the complexityof this project,the Association retained Michael Pine and AssociatesConsulting Group to assistthe committeein the developmentof the parametersof care. With the assistanceof the consultants, and following many meetings,the format for the parametersof carewasformulatedand consistsof: 1. Indicationsfor care. 2. Therapeuticgoals. 3. Risk factors. 4. The parametersof care. 5. Desirableoutcomes. 6. Undesirableoutcomes. The first phase of this project is now complete; however,it is anticipated that this documentwill be continually revised by a standing committee of the Association.It is intendedto be usedby the specialtyto improve the quality of care provided to patients with diseases,defects,anddeformities of the oral and maxillofacial region.It wiI1provide a baselinefor the provision of care,will assistin the identification of areasfor research, and will be an important tool in limiting malpracticejudgementsagainstoral and maxillofacial surgeons.This will be a living document which will continuallyundergorevisionin the future.
SYMPOSIUM: STRESS AND CHEMICAL DEPENDENCY IN THE OMS PRACTICE Presentedon Friday, September27,3:30-5:30p.m. Don P. Bowermaster,DDS, Newark,OH Each day oral and maxillofacial surgeonsencounter are generally not equippedor trained to resolve the resulting emotional conflicts and guilt in a healthy stressesthat are an intrinsic part of surgerypractice.Not only doesthe OMS facethe ordinary stressesof running manner.This resultsin the surgeondevelopingpathoa business,there are other stresseswhich are inherent logic coping and defensemechanismswhich, in turn, exacerbatethe emotional turmoil. This scenario,unrewith the practiceof OMS. The practiceof OMS is unique in that the surgeonis solved emotional conflict and guilt, manifests in the also responsiblefor anesthesia.This dual role contrib- OMS by the loss of confidencein his or her abilities, utes to the intrinsic stressespresentin OMS practice. dissatisfactionwith the practice and eventualburnout. Every daythe OMS is confrontedwith patientswho are There are reportsof surgeonswho haveleft the practice extremely anxiousand who demand pain-free surgery of OMS and evencommitted suicide as a result of this without complications. The once stable, predictable typeof situation.There do existappropriateand healthy doctor/patient relationship is now, all too often an methodsto resolvetheseinherent conflicts when they the effectof stress,morbidadvisarial relationship. Unrealistic expectations are arise.This programaddresses ity and mortality on the OMS. It providesthe surgeon placed on the OMS to perform faultlesslyand achieve with appropriate and healthy options perfect resultsevenwhen perfectionis impossible.The the emotionalimpact of OMS practice.for resolution of surgeonis frequentlyblamed for unsatisfactoryresults, which arenot under his/hercontrol. References With the OMS performing more complicated and highly technical surgery,some degreeof morbidity is Scott, C.D., Hawk, J.A.: Heal Thyself-The Health of Healthcare Professionals. New York, NY, BrunneriMazel unavoidable.The possibility of mortality in the OMS Machell, D.F.: The Battered Image. Employee Assistance, March practiceis alwayspresentand,in most cases,impossible 1989 to predict and,therefore,unavoidable.When morbidity McCue, J.D.: The effects of stress on physicians and their medical and mortality occur in the OMS practice,the surgeons practice. N Engl J Med February 1982 MOMS
.
1991
5