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Today is a mentoring day, it’s Wednesday morning, and I’m travelling to someone else’s practice to assist them and help them develop their implant services.

I stopped this for a long time due to busyness but it’s crept back in with some really nice guys although now it seems like every Wednesday and I’ll have to change the format!

Mentoring and training though are fascinating and interesting dynamics, particularly when working on ‘real’ patients.

The same is true when considering work carried out practitioners that are less experienced or more experienced and the value that the second may give against the first.

Let’s not pretend the patient is likely to get the same degree of quality from an individual who has placed 50 implants against an individual who has placed 500.

Although that differential isn’t a given for increase in quality, the amount of experience and consideration gained over 500 implants is a very different animal to that of 50.

Why then do we persist in a crime of omission with patients where we don’t front up and tell them where we are in terms of the procedures we carry out?

In our practice we introduced two new practitioners placing implants on our patients under supervised arrangements and reduced the cost of the procedure to the patients accordingly.

I would have a conversation with a patient where I would say “Beatriz Sanchez will be doing your implant but you will get money off your treatment because she has less experience than me, although I will supervise the treatment overall”

I find that conversation rare even in mentoring situations but in fact, it doesn’t exist outside of mentoring arrangement.

Practitioners leave courses and start to place implants on patients without telling them the true level of experience they have and without discussing possible options with them to go here, there or anywhere else.

I see this around me all the time, the interesting thing is that we train many dentists and we know the capability of the people who leave us, but after training, in certain circumstances, we never hear from the dentist again and we’re pretty sure they don’t refer to anywhere else.

Where do the patients go that they don’t have the level of competency to treat?

Thinking deeply about these things is distressing because it would suggest that there are significant numbers in the profession that look at the balance sheet of their business ahead of the care of their patients, which to me is entirely the wrong way around.

Ask Shaun Sellars and he will tell you that there is a name for this in medical ethics.

Training is essential, either hospital based, practice based or otherwise but it’s also important to explain to patients clearly and honestly what they’re getting for the reduction in cost in a training situation.

Also, though, perhaps worth us all considering is how we frame that discussion with a patient when we carry out procedures for which we are less experienced.

Blog Post Number: 1819