THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com
S U M M A R Y
DIARY: March 25, 2010 08:00 AM Thursday;
Rod Welch
Doctor Graham dental examination and cleaning.
1...Summary/Objective
2...2nd Opinion Extraction Tooth #2 Implemented No Complications
3...Extraction Tooth #2 2nd Opinion Implemented No Complications
4...Dead Tooth Test Pain No Symptoms #7
5...#14 Chipped Schedule Repair with Crown on April 15
6...Periodontal Pocket Examination Minimal Findings No Action Required
7...Richard Doing Better Recovering from Coronary Issues
8...Clean Procedure Dental Scaler Pick Avoid Gum Injury Pain
9...Doctor Patient Partnership Dentist Comfortable Work Intelligently
..............
Click here to comment!
CONTACTS
SUBJECTS
Dental Examination Health Care Background Review Medical History Mee
2003 -
2003 - ..
2004 - Summary/Objective
2005 -
200501 - Follow up ref SDS 13 0000. ref SDS 9 0000.
200502 -
200503 -
200504 -
200505 - [On 100430 0800 meeting Doctor Graham to make dental
200506 - repairs with gold crown on #14. ref SDS 15 TL9F
200507 -
200508 -
200509 -
200511 - ..
2006 -
2007 -
2008 - Background
2009 -
200901 - 1. On 090302 Doctor Graham performed an examination for a 2nd
200902 - opinion, ref SDS 6 0001, on the proposal to do an implant on
200903 - tooth #2 submitted on 090223 by Olsen Dental Services.
200904 - ref SDS 4 VY7W Doctor Graham was recommended by Richard also
200905 - on 090223. ref SDS 5 KU4L
200907 - ..
200908 - 2. On 090310 Doctor Graham advsied he submitted 2nd opinion
200909 - letter; however, the letter had not been received. ref SDS 8
200910 - 02BF
200912 - ..
200913 - 3. On 090210 Asked the doctor to submit an invoice for dental
200914 - services on 090302, ref SDS 8 J19H, including xrays,
200915 - ref SDS 6 RQ9N, which were used at Olsen Dental Services on
200916 - 090306 for evaluating scope of work. ref SDS 7 029N
200918 - ..
200919 - 4. On 090312 0837 letter to Doctor Graham confirms work performed
200920 - by Olsen Dental Services; requests re-submission of 2nd opinon,
200921 - and requests invoice for consultation. ref SDS 9 Y16J
200923 - ..
200924 - 5. On 100209 0944 called Doctor Graham to schedule teeth cleaning,
200925 - and examination. ref SDS 13 TL9F
200927 - ..
200928 - 6. On 100325 0800 teeth cleaned, ref SDS 0 SW86; and Mark
200929 - recommended crown for #20 with a crown for a cost of $1,000,
200930 - and this was scheduled for 100415 0800. ref SDS 0 SW49
200931 -
200932 -
200933 -
200935 - ..
2010 -
2011 -
2012 - Progress
2013 -
201301 - Meeting with Mark Graham, DDS cleaning and examination scheduled with
201302 - Lynn on 100209 0944. ref SDS 13 TL9F
201303 -
201304 - [On 101108 0807 called Graham Dental Services and learned
201305 - meeting scheduled on 101007 was missed due to mixups after
201306 - Mil's death; re-scheduled for 110202 0800. ref SDS 17 VH5N
201308 - ..
201309 - Mark asked about new medical issues since the prior visit on 090302?
201310 -
201311 - 1. Heart surgery quadruple bypass on 091022. ref SDS 10 PQWU
201313 - ..
201314 - 2. Heller myotomy surgery to resolve achalasia performed on
201315 - 091216. ref SDS 12 KE9U
201317 - ..
201318 - Mark asked about achalasia, which is explained in the record on
201319 - 091030. ref SDS 11 KE3B
201321 - ..
201322 - Was pleased today that resolution of achalasia enabled fully reclining
201323 - in the dental chair to facilitate Mark's work. During the visit on
201324 - 090302, Doctor David Graham was very considerate working with the
201325 - patient in a more vertical postion to prevent vomitting, caused by
201326 - achalasia. ref SDS 6 DX5L
201327 -
201328 -
201329 -
2014 -
SUBJECTS
2nd Opinion Implementation Report Missing from Medical Records Evalu
4403 -
440401 - ..
440402 - 2nd Opinion Extraction Tooth #2 Implemented No Complications
440403 - Extraction Tooth #2 2nd Opinion Implemented No Complications
440404 -
440405 - Follow up ref SDS 6 H664.
440406 -
440407 - Mark asked about results implementing Doctor Graham's (Mark's dad) 2nd
440408 - opinion recommending extraction and possible implant for tooth #2,
440409 - also, reported on 090302 0815. ref SDS 6 H664
440411 - ..
440412 - Work was performed by Doctor Harris and Doctor Meyer in Steve Olesn's
440413 - dental office, and implementing 2nd opinion issued by Doctor David
440414 - Graham, reported on 090306. ref SDS 7 0001 The record implementing
440415 - Doctor Graham's 2nd opinion was submitted to the doctor in a letter
440416 - dated 090312 0837. ref SDS 9 Y16J
440418 - ..
440419 - Mark looked through the file, but could not find in the medical chart
440420 - the letter on 090312, transmitting the record for work on 090306.
440422 - ..
440423 - Difficulty finding patient history in the medical chart is a common
440424 - problem, noted by Doctor Rugo at UCSF on 080219, ref SDS 3 L18L, and
440425 - shown in case study on 061024 1427. ref SDS 2 JD9L
440427 - ..
440428 - Mark asked about complications from the extraction procedure on
440429 - 090306?
440431 - ..
440432 - Advised there have been no complications.
440433 -
440434 -
440435 -
4405 -
SUBJECTS
Dead Tooth Test Pain No Symptoms #7 Medical Chart Report 090302 Poss
7003 -
700401 - ..
700402 - Dead Tooth Test Pain No Symptoms #7
700403 -
700404 - Mark read through the medical chart and noticed the report of possible
700405 - "dead" tooth, from examination on 090302 0815. ref SDS 6 0336
700407 - ..
700408 - Mark asked about complications and symptoms from tooth #7, identified
700409 - by xray during the meeting on 090302 for observation to evaluate #7
700410 - being a "dead" tooth. ref SDS 6 0336 He seemed to indicate symptoms
700411 - would include pain, bleeding, and swelled gums.
700413 - ..
700414 - No evident complications nor symptoms have occurred for tooth #7 since
700415 - the meeting at the Graham Dental Offices on 090302. ref SDS 6 0336
700417 - ..
700418 - Mark tested 3 teeth for pain.
700420 - ..
700421 - The first 2 teeth registerd pain within about 5 seconds. The 3rd
700422 - tooth, which was #7, took more like 8 seconds. Mark seemed to
700423 - indicate that any response to the test suggests nerves are still
700424 - active for tooth #7, and so immediate repair is not needed.
700425 -
700426 -
700427 -
7005 -
SUBJECTS
Tooth #14 Chipped Schedule Repair with Crown on 100415 Meeting Rod W
9603 -
960401 - ..
960402 - #14 Chipped Schedule Repair with Crown on April 15
960403 - --------------------------------------------------
960404 - Examination further showed that tooth #14, which has been chipped for
960405 - 5+ years, now has remnants of a prior filling that have become
960406 - "loose." Mark therefore removed the loose material in tooth #14.
960408 - ..
960409 - Mark explained that this change in the condition of #14, increases
960410 - exposure to decay from food getting wedged in a manner that cannot be
960411 - maintained with routine brushing.
960412 -
960413 - x
960414 - 1111111
960415 - 1234567890123456
960416 - R L
960417 - 3332222222222111
960418 - 2109876543210987
960420 - ..
960421 - Teeth layout and identification was reported previously on 090302
960422 - 0815. ref SDS 6 0336
960424 - ..
960425 - Repairing #14 with a crown will cost $1,000.
960427 - ..
960428 - Decided to do the cleaning today.
960430 - ..
960431 - Lynn scheduled repair for tooth #14 on 100415 0800.
960432 -
960433 - [On 100326 1620 letter asks Graham Dental Offices to change
960434 - the date for the work to a Friday at 0800. ref SDS 14 7I5T
960435 -
960436 - [On 100430 0800 meeting Doctor Graham to make dental
960437 - repairs with gold crown on #14. ref SDS 15 TL9F
960439 - ..
960440 - [On 100514 0730 final permenant gold crown completed on
960441 - #14. ref SDS 16 TL9F
960442 -
960443 -
960444 -
960445 -
9605 -
SUBJECTS
Dental Periodontal Teeth Gum Pockets Examination Minimal Findings No
AQ03 -
AQ0401 - ..
AQ0402 - Periodontal Pocket Examination Minimal Findings No Action Required
AQ0403 -
AQ0404 - Mark measured gum pockets, assisted by Karen. He explained that
AQ0405 - pockets in the gums greater than 4 should be further examined by a
AQ0406 - periodontist for deep cleaning and other remedies.
AQ0408 - ..
AQ0409 - Examination showed 2 - 4 teeth measured as much as 4, and all the
AQ0410 - other teeth measured below 4. As a result, Mark did not recommend
AQ0411 - periodontal examination.
AQ0412 -
AQ0413 - [On 110202 0800 Mark's dad, David, consulted on periodontal
AQ0414 - examination and indicated findings indicated healthy gums.
AQ0415 - ref SDS 18 8730
AQ0416 -
AQ0417 -
AQ0418 -
AQ0419 -
AQ0420 -
AQ0421 -
AQ0422 -
AQ0423 -
AQ05 -
SUBJECTS
Richard Recovring Well Coronary Issues Myocardial Infarction
B303 -
B30401 - ..
B30402 - Richard Doing Better Recovering from Coronary Issues
B30403 -
B30404 - Doctor David Graham was not in the office this morning. He is
B30405 - teaching at the dental college today.
B30411 - ..
B30412 - Asked Mark to mention to his dad, that Richard Popejoy is doing much
B30413 - better now, after suffering a heart attack, and difficult recovery
B30414 - during 2008 and 2009. Richard made the referral to Doctor Graham,
B30415 - reported on 090302 0815. ref SDS 6 JW9O
B30417 - ..
B30418 - Karen, a nurse assisting Mark this morning, advised that Richard
B30419 - stopped in the office a few months ago and visited with David.
B30420 -
B30421 -
B305 -
SUBJECTS
Dental Teeth Clean Procedure Scaler Pick Avoid Gum Injury Pain Excel
BT03 -
BT0401 - ..
BT0402 - Clean Procedure Dental Scaler Pick Avoid Gum Injury Pain
BT0403 -
BT0404 - Mark did the teeth cleaning procedure using a conventional dentist
BT0405 - pick, rather than the new technology using ultrasonic scaler. Thanked
BT0406 - Mark for his consideration, since prior experience with Olsen Dental
BT0407 - Offices showed ultrasonic scaler caused considerable pain, reported on
BT0408 - 050518 1100. ref SDS 1 FB6L
BT0410 - ..
BT0411 - He seemed to indicate that generally teeth are well maintained based
BT0412 - on finding minimal plack.
BT0414 - ..
BT0415 - Karen completed teeth cleaning with a polishing procedure.
BT0416 -
BT0417 - [On 101108 0807 called Graham Dental Services and learned
BT0418 - meeting was scheduled on 101007, and missed due to mixups
BT0419 - flowing from Mil's death; rescheduled for 110202 0800.
BT0420 - ref SDS 17 VH5N
BT0421 -
BT0422 -
BT05 -
SUBJECTS
Doctor Patient Partnership Dentist Comfortable Communication Interne
CJ03 -
CJ0401 - ..
CJ0402 - Doctor Patient Partnership Dentist Comfortable Work Intelligently
CJ0403 -
CJ0404 - Mark indicated he is familiar with the Internet, and was receptive to
CJ0405 - reviewing Communication Metrics on Welchco.com...
CJ0406 -
CJ0407 - http://www.welchco.com/
CJ0409 - ..
CJ0410 - A good place to start is with a typical doctor/patient dialog in a
CJ0411 - meeting...
CJ0412 -
CJ0413 - http://www.welchco.com/03/00050/01/09/03/02/03/0309.HTM#PXWX
CJ0414 -
CJ0415 -
CJ0416 -
CJ0417 -
CJ0418 -
CJ0419 -
CJ0420 -
CJ05 -