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The scales of justice

Colin Campbell
by Colin Campbell on 21/02/16 18:00

I have thought long and hard over the past year and more about the position that dentistry finds itself in in relation to regulation and the punitive measures that are taken against dentists who have ‘fallen short of the standard required’.

It’s clear that the situation is indeed all messed up.

It came to me in a flash at work the other day that the problem is the scales upon which we are measured in our ‘fitness to practice’ or clinical aptitude or attitude to patients are weighted in the wrong direction.

Fair play and fairness is ingrained in the human psyche from the earliest possible age, it has been my huge privilege to be involved with Primary School education as a parent and Governor for the past ten years and it is absolutely clear when you look at that, or when you coach a boys football team (as I have recently started to do) that fair play is at the heart of everything that people expect from the earliest possible age. The real resentment and problems arise where fair play is removed or the playing field is not level. It’s why we’re outraged at drug cheats in sport, it’s why we hate the fact that politicians that we ‘trusted’ are shown to be lacking in integrity or are downright deceitful; it’s why Lance Armstrong broke the cyclist’s hearts.

For us though, living in the shadow if the current regulator in dentistry, the scales seem already to be tipped massively against us. This may well be a political imperative, it may be deliberate, it may be part of the strategy to demoralise and defund which I wrote about in a previous blog but it exists nonetheless. The example of what happens to a dentist on exiting an investigation committee process (without further action) shows exactly how badly the scales have tipped towards punishment. Just take my case as an example (I know that one particularly well, obviously) My patient suffered a complication which was remediated by another individual using questionable techniques (as far as four other Consultants believed) but that part of the story is irrelevant. On examination of the process that the patient went through – the case notes, the correspondence, the audit trail, the training of the individuals associated with the treatment and the follow up there was almost no flaw in the system whatsoever. Due to a spurious expert report it was suggested that it would have been possible to offer the patient even more options for treatment which included taking longer to provide the surgical treatment than we did even though the outcome would have been the same had we done it and questioning whether or not I had explained to the patient that he had a complication despite the fact I had written to the referring dentist on two occasions to apologise and explain what the complication was (hard to believe I would have not told the patient). This resulted in a full Investigation Committee hearing (which I was not allowed to be present at obviously) and then two lines of ‘advice’ in a letter from the GDC. The advice I can handle and the Investigation Committee I can handle but it is the ongoing effect of a ‘fitness to practice’ history which is entirely wrong. Surely it must be possible to look at a case where almost everything is correct, albeit a complication has occurred (these will occur in any event), and be able to say to the patient “I am sorry but we have investigated this individuals practice and it is sound. They are not a rogue practitioner; they did little or nothing wrong in your case. A complication arose and you chose to have remediated by someone else”

Is it not simple to put a system like this in place so that the patient can be reassured that other people have investigate the case and it was infact watertight and the practitioner can be rest assured that a fair process is in place.

I am not suggesting that there are not people in dentistry who must be weeded out – who are unprofessional, unethical verging on criminal and I see them everyday on social media and in magazines. I will be at the front of the cue to get rid of these guys from the profession but let’s not execute indiscriminately in a system of unfairness.

The change starts with you though. It starts with every single dentist and now DCP in the country and we must continue to let our voice be heard for the benefit of patients going forwards.

 

Blog Post Number: 866

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Colin Campbell
Written by Colin Campbell
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