Recently someone who reads my blog asked me if I would write some notes about how my practice has changed following my GDC case which came to a conclusion in January 2015. You can read about my experiences here.
I thought about this for a few days before I was able to put something together and I hope that it helps other people who perhaps haven’t been through the same thing to see what the reflection process is like.
The GDC (whatever that means and whoever that is) would obviously feel that the effect has been positive on me because it has encouraged me to reflect upon my practice. I would perhaps disagree with that to in some respect and do not believe the trauma that I underwent was not proportional to any benefit from the reflection I have electively undertake. Here we go with the results of the reflective process
Case notes. People are extremely interested to find out, when I talk to them about my case, how it affected the recording of patient experiences under my care. The surprising answer to this is very little. I believe we had an exceptional case note system in place already, it just wasn’t 100%, but from personal experience I can assure you that the GDC systems are not 100% (for a short while they lost radiographs that I had sent to them and had contacted me asking me to send more – among other things)
I did add a section onto my consent letter which basically warns people that if they are unable to accept the fact that complications do occur they should postpone their treatment or have it somewhere else.
I reviewed my warnings for sinus grafting case (my case was a sinus grafting case) but changed those very little and perhaps for changes sake.
I continued with exactly the same assessment pro forma and a similar process of writing a consent letter which is modified in the practice on a regular basis based on discussion between the clinicians.
I continued to dictate all of my case notes and have these entered onto the system days after the treatment was actually carried out as they were dictated contemporaneously. This was not criticised in any way during my GDC case.
I dictate all of my letters and the majority of my emails in relation to clinical matters. I have accepted alterations and changes to my consent letter from clinicians within and outside the practice as we are happy to share letters and pro formas in the name of improvement.
Perhaps the biggest or only change is that I ensure my case notes are written strategically. What does this mean? It means that they are written in such a way to protect me should a similar circumstance happen to me again. They are written from the point of view of someone who has been an expert in GDC cases but also a registrant under investigation. They are written from the point of view of someone who has extensive medicolegal experience and the sad thing about that is that they are not written for the patient. We are not encouraged to write for the patient anymore, we have to write for ourselves, the risk is too high to have it any other way. The slip towards defensive dentistry and defensive case note writing is awful and it is only by standing up as a profession as a whole and writing guidelines on minimum case note requirements that we will ever change that.
Blog Post Number: 813
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