For a short while there I was off around the country telling people how great I was at stuff, pretending to be a little bit of a minor D-class celebrity, speaking to audiences in different places including Gloucester, London on two occasions and Glasgow not to mention the stuff I did for our academy in Nottingham.
The main thrust of many of the talks was sinus grafting and the numbers we are presenting on sinus grafting which are quite extraordinary and the limited and low numbers of complications associated with that procedure in our hands. But of course pride comes before a fall and I returned back from Glasgow from the final sinus grafting talk to provide a sinus graft the following day on one of my patients and it did not go awful well. We had a complication, the membrane tore and we had to change the plan entirely.
I’m delighted to say that the patient is very much onboard with the treatment we did provide and understood exactly the risk of the procedure but, as a result of this which is a rare occurrence in my practice, we decided to de-brief the surgery as closely as possible to find out whether I could learn something from this that would enable us to avoid it in the future but could not open the CT scan!!
It turns out that the provider of the CT scanner says that the file has become corrupted and it’s quite unusual, but in a more sinister development the back up system that we have appears only to back up the last 150 scans. This is the back up system that was put in place by the CT provider. If the back up system only backs up the last 150 scans what about a provider like us who over the past three years on this system has done closer to 700 scans? This would mean that 550 of the scans are not backed up and should there be a crash of the system we would lose all that material for all those patients.
I’d like to tell you that this is an isolated incident related to IT providers but in fact it seems to be the norm and not the exception. I have had two hard drives on the server ‘blow’ at our practice over the years and on both of those occasions, despite the best back up in place, the majority of patient material was lost. We have back up systems now with two separate individual providers – one is the provider of the scanner itself and one is an independent IT provider, both of who are telling us that they’re unsure as to whether the back up will be complete. It seems the only way to check if back up is effective is to have a catastrophic situation and to find out that it is not.
What if the guarantees that we were providing our patients at the practice were the same?
I suppose it’s time that dentistry moved into this horrible situation of service level agreements (SLA’s) SLA’s are what corporates use to pin down people that supply them products because they don’t trust anybody.
An SLA is important because when you buy something from a reputable provider you expect that they will help if a problem occurs. We have significant problems in the practice with various aspects of kit that we have purchased, not least the milling machine which broke whilst I was on sabbatical for us only to find out that there was very little back up should something like that happen even though it was in its one-year guarantee.
An SLA would have stated that the company providing the product should have arrangements in place to either replace or restore function within a certain period of time (24 /48 hours) but we take this on trust because we’re being guaranteed something by sales people from a large organisation.
It turned out that there was no access to a spare milling machine, nor was there a network of people we could send files to to have them milled for us. The same issue applies to back up on the CT scanner.
This is not related to individual and specific companies, I think it’s across the industry because we’ve encountered it on many occasions with different products. It’s probably time for dentists to get a lot smarter at the way they buy things and to not buy independently but as a group. For some years now there has been mutterings about a proper ‘group of buying dentists’ (did you see what I did there? I had to change the name!!) Some sort of co-operative buying group would have standard SLA’s in place and would have negotiation abilities. If ten CBCTs were being purchased in a single month the cost would likely be a lot less.
The good things for suppliers is that it’s hard to see that dentistry will ever get itself together enough in order to buy these things but if we’re looking to be treated by the suppliers in a way we’re expected to treat our patients then perhaps the goal posts have to change.
Blog Post Number - 1253
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