You might have seen the news in the dental world recently that apparently it’s not a very nice place to work.
The United Kingdom has been described by Dental Protection as ‘the most hostile place to practice dentistry in the world’. Nobody would know better than them.
It has been described recently by my colleagues as ‘terrible’ ‘toxic’ and ‘unmanageable’
I could rhyme off countless people I know who are attempting to sell their practices because they simply can’t cope or don’t want to deal with the difficulty of being a dentist running a practice anymore. This of course is all over the place. A vote of no confidence in the GDC by the Local Dental Committees, a judicial review taken against the GDC by The British Dental Association for failure to consult in an enormous rise in the ARF. Hold this against the cost of General Medical Council registration at approximately £350 and you will see where we have gotten to in dentistry and how difficult it has become.
This of course has led us all into a position of defensive practice and takes us back to a blog post I wrote some time ago on ‘who are your case notes for?’.
The problem with defensive practice of course is much greater than just case notes and the time it takes to write them. The problem is that we are all becoming terrified to perform procedures which are in any way out of the norm or complicated for fear of the retribution we might have to face.
Again, worse than that, is the loss of talent to the profession of these people who are selling their practices and ‘getting out’
In a conversation with a pediatric surgeon who referred himself to our practice on reputation alone to get him out of difficulty. He told me of his recent year spent working in America where he worked as an ‘underling’ to an eighty year old pediatric surgeon. This surgeon no longer had the ability or the eyesight to perform detailed pediatric surgical procedures so they bring in Consultant level Fellows to work with him so as not to lose his experience and his diagnostic skills. The Grandfather of surgery sees patients in the clinic, decides on the appropriate treatment and sees them for their follow up and post op. During surgery he is present in theatre but his ‘hands’ are the contracted in, skilled Consultant surgeons from all around the world who gain enormous experience and exposure from working with someone so talented and experience. The eighty year old gets to continue working in his life’s pleasure for as long as possible and share his knowledge.
Does this sound like a situation, which is likely to exist in UK healthcare? I very much doubt it.
The reason for that is that we are being pushed to defensive practice. It is perhaps the time for all of us to sit back, do scale and polishes and occlusal amalgams because it seems to me that that is what the system wants.
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