With the legacy of a Fitness to Practice history, an overbearing regulator who wants to turn patients into customers and a professional riddled with defensive dentistry.
On my return from my sabbatical and seven weeks off work, the first patient I had to see was a complex surgical case of a compound block graft and sinus graft in the upper left region. This is something I am entirely comfortable with, in fact I enjoy the surgery, and in general terms the surgery went extremely well - we photographed every aspect of it and the result was excellent. There was a very small tear in the sinus membrane when we raised the lining and I was able to fold this over and provide an excellent graft with a great post-operative result and a post-operative x-ray to show that all was well (in our practice, perforations of sinus during sinus grafting occur approximately 18 – 22% of the time)
Ten days later the patient attended to see me with mild symptoms of sinusitis – a smell from the nose and pain over the cheek. They had done everything right in looking after this and we had done everything right in providing the treatment but the complication had occurred. The issue with this particular complication is that it’s exactly the same complication that led to a complaint to the GDC and a FtP history for me. Whatever those of us who have been there would say, it’s impossible to take this out of our mind and impossible not to push us towards a path of defensive dentistry.
The patient themselves has had some further antibiotic treatment and is due for a review this week. I am nervous and scared that the complication persists and, although I can say that’s because I’m worried about the patient, what I’m worried about is the regulator. I’m not free to act the way I would like. I’m not able to act with freedom, creativity and empathy to treat the patient the way I think is best, I have to act defensively because I’m terrified I’ll go to that same place again. For those people who work in regulation who don’t understand defensive dentistry, this is the essence of that. It’s the fear that although we’ve done everything right, a single patient complaint can lead to overbearing regulation and an appearance at the GDC.
Regardless of the noises being made I don’t see this being corrected and it will never be corrected until local resolution exists where anybody who has a complaint can first of all address it through the practice and then ‘experts’ locally who can explain the situation. Only then can it be escalated to a higher authority.
Secondly, to have a clinician at the top of the GDC who can understand the essence and important of working with the profession and not working against them.
The patient in question has not complained about anything and was in fact very pragmatic and understanding, feeling that their treatment has been exceptional and that a complication is ‘just one of those things’. But it still doesn’t stop the sleepless nights and the horrible aging process that all of us working in dentistry have to suffer as the burden of the profession we have chosen to serve.
Blog Post Number: 1209
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