This is a blog which is superficially about legal matters in dentistry but more deeply applies to everybody so even if you’re not a dentist read on, you still might get it.
The profession of dentistry is not a collection of hunters, it’s a collection of wildebeests. It’s a herd or a tribe. Its strength lies in its numbers and its collective responsibility for protection, not it its ability to pick off vulnerable individuals, feast on them as a group and then pick off others in order to survive.
Dentistry and healthcare is not about picking off the weak or the sick at the edges of the tribe, its about acting as a tribe and protecting each other; causing minimal long term damage to a sustainable environment and prospering as a group ‘protection in numbers’
This philosophy has been thoroughly and extraordinarily eroded over the past 5 – 10 years from within the herd. In the first instance there is a group within the herd who do not care about the herd at all, who are in fact about themselves entirely. For their own protection they stay in the centre, they eat the best grass, they s&^t on the other members of the herd and apply to the principle of ‘survival of the crappest’
The difficult is that the animals outside of the herd cannot see them or cannot see them for what they are. Their coats are shiny and bright but otherwise they are death; with no long term strategy or philosophy and merely the urge for singular survival.
Secondly though, and perhaps more poisonous are the people inside the herd who claim to be protectors but are in fact only protectors of themselves. Let’s call these agents ‘the defence unions’ for want of a better phrase.
You could be mistaken for thinking that these were organisations or societies that were set up by dentists for dentists with the interests of dentists in mind, but it would appear that over the last 5 – 10 years for one reason or another that they have merely turned to protect their own environment, their own interests and their own people.
Over the past few months and years I have seen this on countless occasions and coming to a head today when a colleague of mine reported a conversation with their defence union regarding a patient complaint.
It has become clear that the agenda of defence unions is to relay back to the dentists that because they are not ‘perfect’ they are at fault and revenge, recourse or settlement must be undertaken.
There is now no longer anywhere to hide in the medico legal game of wildebeests versus lions. It is impossible to stay away form the carnivore.
Do not write any notes and you will be crucified for not writing notes. Write copious notes and what is contained in those notes with crucify you.
Send patients 11 page letters warning them of all sorts of horrible potential consequences of the treatment that they may face and imbed those in a computerised patient record but still be criticised for the fact that they are ‘not listed in the records’.
Photograph your cases for it to be discounted. Offer remedial treatment for patients for that to be seen as an admission of guilt. The best outcome you can possibly hope for is a ‘settlement’ where no admission of liability is given.
That is the most ridiculous state of affairs I can possibly imagine.
“Thank you for your complaint regarding clinician X. In general clinician X’s treatment existed at approximately 97% of perfect and as a result of the lack of 3% we are paying you this enormous sum of money and pretending that we’re not scared you might come back for more. We refuse to admit liability in this case and you will of course ignore that completely and tell everybody that you know that because that ba%$£rd of a clinician f^&*ed up you got paid money and you will propagate the problem over and over again.” Explain to clinician X that you intend to settle (whether they like it or not in all honesty) because it’s cheaper to do so. Entirely forget about integrity, honesty or professional reputation and just chuck money at these people pretending it’s not going to make the problem worse and worse.
That’s just the way it is, it’s like that in the herd. Some of the lions pick off some of the outer animals and the rest survive. This of course, assumes that the herd isn’t riddled with disease. Nobody in the herd is out to protect anybody else.
Don’t worry about changing this, it’s already too late. Continue to pay your multiple of thousands of pounds per year to the defence unions because, in all honesty, you have very little choice; It’s professional misconduct if you don’t, you can’t practise without it and continue to practise in the hope you’ll stay as close to the middle of the herd as will protect you from either the disease that exists within it or the predators from without it.
It’s a terrible and horrible existence but it’s on that ‘the powers that be’ (whoever thy are) have decided we must live.
I love dentistry and I love being a dentist. I love the challenge of building a team and trying to provide exceptional care for my patients but God knows I don’t get it right all the time. I will continue to do this until someone tells me I have to stop, but more and more I feel it’s likely they will tell me I have to stop.
The only solace I can take from all of this is that I will laugh out loud when the last prosecution barrister turns around with a raging toothache to find there is no one left to help.
Blog Post Number: 1101
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