One of the things we perhaps are beginning to overlook in the world of compliance, competency, log books and everything written down is the scale of pattern recognition.
This was introduced to me years ago by my then boss and VT trainer who discussed his appreciation of pattern recognition in looking at x-rays in a General Dental Practice.
I think it can be explained in many ways but as an Oral Surgeon I have been conditioned through pattern recognition in panoramic radiographs. This is not ideal as far as faculty guidelines are concerned and minimum dosage for patients but I can certainly view situations and pathological occurrences on panoramic radiographs with some certainty and with greater certainty that many of my peers because of the thousands of panoramic radiographs I have assessed and then reflected upon after treatment.
No clearer to me is this than in the extraction of lower third molars and I can generally call the extraction pretty good about 99% of the time I would suspect (perhaps it’s less and my own cognitive dissonance is affecting me here but the result is quite high)
That’s not the point though; the point is retiring dentists or retiring clinicians in any discipline and the skill of pattern recognition that we lose.
We all sing the sing the song that says patient selection is the most important thing but then we are happy to cast aside the 60 year old clinician whose hands shake a little bit or is fed up with the grind of treatment and pass his mantle onto someone who is 30 who has not yet acquired any skills in pattern recognition.
He’s a parable that I heard recently which brings a way forward in accessing the skills of people who are perhaps tired, at the end of their career and don’t want to work 5 days a week.
I was privileged in the practice to meet a surgeon from a local hospital who is highly eminent and in his 50s. We carried out some work on him and had some fantastic conversations. He told me that even though he was in his 50s and at the pinnacle of his surgical career he had decided to take a 6 month sabbatical and travel to another continent to work with an 80 year old surgeon who was one of the most famous in his field. The 80 year old surgeon has 2 ‘interns’ of similar caliber every 6 months and they come and work free of charge to learn their craft even better. The 80 year old is too old to operate physically but he leads the clinics when the patients come in, looks at the signs, symptoms and radiographs and though pattern recognition and experience calls the treatment plan in conjunction with his ‘interns’. The patient is taken to theatre and the 80 year old ‘Mr Miyagi' (karate kid reference) advises his ‘young apprentice’ how to carry the surgical procedure out.
The case is tied up on review in clinic afterwards when Mr Miyagi discusses the outcome of the surgery and more learning has occurred.
Have you ever heard of anything better than this in terms of high quality education in surgery?
Look at the guys we are losing, look at the guys that are leaving because they are fed up, beaten down, affected by the GDC, affected by compliance or just simply worn out running their practices. Imagine you had them as a Consultant in your practice, I bet they wouldn’t want paid too much money but they would feel worthwhile and they would contribute enormously to patient care.
I have already started investigation the possibility of who I could ask to do this (I have somebody particular in mind). Advice is everything, advice and insight from people outside of your organisation is probably the most important driver to improvement.
We are missing a trick here surely?
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