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General anesthesia: Office or hospital?
LETTERS TO THE EDITOR J Oral MaxlllofacSurg 41213,1983
COMMERCIALISM
IN THE SCIENTIFIC MEDIA
GENERAL ANESTHESIA: OFFICE OR HOSPITAL?
To the Editor: -Authors and speakers, possibly biased for various reasons, have again lowered their standards to commercialism from the rostrum of our scientific forum and through attempts at publication within the literature of our specialty. The use of trade names of drugs, materials, or equipment from the scientific podium or in the printed scientific page in refereed journals is frank advertising. The title of a scientific paper or presentation which blatantly uses a trade name is an especially unacceptable format. Such action should be considered as improper by those who select papers for presentation, those who review manuscripts for scientific literature, and by those who prepare and present such papers in the scientific arena. Generic descriptions of such items, with proper footnotes for references at the bottom of the page or slide, would certainly be in better taste. Our most recent annual meeting included several presentations in otherwise excellent scientific abstract sessions and symposia where such references to trade materials and equipment were made. Many comments were heard regarding the commercialization of such actions, especially in two scientific sessions. For me to identify the sessions, however, would be advertising in itself, but they were quite obvious to those who care to preserve the integrity of our forum and publications. References to materials by trade name have also been made in manuscripts and abstracts submitted for publication. The use of a trade name as a generic name with a lower-case first letter has also occurred lately. These actions are advertising in the true sense. There is a place for paid commercial advertising in a journal, but not on the scientific page. 1 believe that it is essential for those responsible for preservation of the scientific format within the AAOMS to carefully monitor such activities. It is also my strong request to colleagues who might be tempted toward involvement in such commercialism to reconsider their actions. Such activity only leads to criticism by your friends, peers, colleagues and others who read and listen to your efforts. The AAOMS is one of the most highly respected organizations in the health care professions, and my plea is that it remain so. WADE B. HAMMER, DDS Augusta, Georgia
-After reading Dr. Gracia’s letter in the October 1982 Journal I feel compelled to respond. I am particularly concerned with his views on general anesthesia in the office. 1 too cannot agree with the statement “the practice building of most of our offices is good safe outpatient general anesthesia.” However, to state that because we practice good safe outpatient general anesthesia we have fallen into a trap is begging the question. It is certainly no secret that dentists have pioneered in pain control measures and in the prevention of the fear and anxiety that have historically accompanied dental procedures. But I take exception to the statement: “Do we hide in our offices feeling that our basic surgical services are not as worthwhile as those of our surgical colleagues? There are many techniques of pain control, and certainly the sedation/local techniques have made great strides. Yet, we remain the only surgical specialty that has the patient determine the type of anesthesia.” My patients do not determine the type of anesthesia that I use; I make that determination. Many times I elect to use general anesthesia in my office because I can do a better job in a shorter period, with greater patient acceptance, at certainly less cost and above all with less risk than in a local hospital. I agree that oral surgery is certainly in the mainstream of other surgical specialities, but I feel that our unique ability to perform in and out of the hospital setting is of great value to the patient and the public alike. Dr. Gracia talks about the safety record of office anesthesia and how admirable it is, but he fails to note that the safety record of outpatient office anesthesia is greater than that for comparable procedures performed in the hospital, with less morbidity and lower mortality rates. Does he mean that we should subject the patients to greater risk by admitting them to a hospital? I fail to see the logic in this thinking. On the other hand, I would agree that some patients, particularly those with involved surgical procedures or those who are at risk, are better served in a hospital setting and I, for one, treat those patients accordingly. I think Dr. Gracia’s attitude is harmful to our speciality, but unfortunately it is not untypical of those oral surgeons who have been trained in the double degree programs. To The Editor:
ALLAN
C. HIRSCH, DMD
Lebanon, New Hampshire
213
COMMERCIALISM
IN THE SCIENTIFIC MEDIA
GENERAL ANESTHESIA: OFFICE OR HOSPITAL?
To the Editor: -Authors and speakers, possibly biased for various reasons, have again lowered their standards to commercialism from the rostrum of our scientific forum and through attempts at publication within the literature of our specialty. The use of trade names of drugs, materials, or equipment from the scientific podium or in the printed scientific page in refereed journals is frank advertising. The title of a scientific paper or presentation which blatantly uses a trade name is an especially unacceptable format. Such action should be considered as improper by those who select papers for presentation, those who review manuscripts for scientific literature, and by those who prepare and present such papers in the scientific arena. Generic descriptions of such items, with proper footnotes for references at the bottom of the page or slide, would certainly be in better taste. Our most recent annual meeting included several presentations in otherwise excellent scientific abstract sessions and symposia where such references to trade materials and equipment were made. Many comments were heard regarding the commercialization of such actions, especially in two scientific sessions. For me to identify the sessions, however, would be advertising in itself, but they were quite obvious to those who care to preserve the integrity of our forum and publications. References to materials by trade name have also been made in manuscripts and abstracts submitted for publication. The use of a trade name as a generic name with a lower-case first letter has also occurred lately. These actions are advertising in the true sense. There is a place for paid commercial advertising in a journal, but not on the scientific page. 1 believe that it is essential for those responsible for preservation of the scientific format within the AAOMS to carefully monitor such activities. It is also my strong request to colleagues who might be tempted toward involvement in such commercialism to reconsider their actions. Such activity only leads to criticism by your friends, peers, colleagues and others who read and listen to your efforts. The AAOMS is one of the most highly respected organizations in the health care professions, and my plea is that it remain so. WADE B. HAMMER, DDS Augusta, Georgia
-After reading Dr. Gracia’s letter in the October 1982 Journal I feel compelled to respond. I am particularly concerned with his views on general anesthesia in the office. 1 too cannot agree with the statement “the practice building of most of our offices is good safe outpatient general anesthesia.” However, to state that because we practice good safe outpatient general anesthesia we have fallen into a trap is begging the question. It is certainly no secret that dentists have pioneered in pain control measures and in the prevention of the fear and anxiety that have historically accompanied dental procedures. But I take exception to the statement: “Do we hide in our offices feeling that our basic surgical services are not as worthwhile as those of our surgical colleagues? There are many techniques of pain control, and certainly the sedation/local techniques have made great strides. Yet, we remain the only surgical specialty that has the patient determine the type of anesthesia.” My patients do not determine the type of anesthesia that I use; I make that determination. Many times I elect to use general anesthesia in my office because I can do a better job in a shorter period, with greater patient acceptance, at certainly less cost and above all with less risk than in a local hospital. I agree that oral surgery is certainly in the mainstream of other surgical specialities, but I feel that our unique ability to perform in and out of the hospital setting is of great value to the patient and the public alike. Dr. Gracia talks about the safety record of office anesthesia and how admirable it is, but he fails to note that the safety record of outpatient office anesthesia is greater than that for comparable procedures performed in the hospital, with less morbidity and lower mortality rates. Does he mean that we should subject the patients to greater risk by admitting them to a hospital? I fail to see the logic in this thinking. On the other hand, I would agree that some patients, particularly those with involved surgical procedures or those who are at risk, are better served in a hospital setting and I, for one, treat those patients accordingly. I think Dr. Gracia’s attitude is harmful to our speciality, but unfortunately it is not untypical of those oral surgeons who have been trained in the double degree programs. To The Editor:
ALLAN
C. HIRSCH, DMD
Lebanon, New Hampshire
213