In early 1989 I went to do work experience at a dental practice in my hometown in Scotland.
I knew nothing.
The dentist didn’t wear gloves and his examination equipment (mirror, probe etc.) were sterilized in something similar to barbicide which you may know as stuff that barbers sterilize their scissors and combs in.
This was called cold sterilizing and it was an acceptable form of cleaning instruments at that stage.
No gloves and chemicals.
This was just a couple of years after HIV had emerged and set about a crisis in dentistry of cross-infection control and redesign of how we did our work.
The funny thing was though, it took about another 5 years before gloves became compulsory for dentists in 1994 (the year I qualified from the university of Glasgow).
During that time, we’d had the HIV crisis and also the 1992 ‘fee crisis’.
The fee crisis saw the overall dental budget cut by 7% and the profit of NHS dental practices cut by around 20-25%. This was the atmosphere in which I qualified.
Dentistry was dead (apparently).
I remember working with a demonstrator from a private practice in my final year of dental school who wore a new pair of biogel gloves morning and afternoon (two pairs per day).
The whispers were that this was madness, and his practice would go bust, there was no way that this was a sustainable option changing your gloves twice a day with expensive gloves.
The practice I went to, to do VT had only recently moved away from having towels hanging on the dentist side of the chair to dry their hands on which stayed there for weeks or months on end.
A local practice in 1997 still had ash trays on the bracket tables so the dentist could smoke during check-ups (that is not a joke).
We moved through the crisis of HIV and the fee cut in dentistry was still alive in 1997 and 1998 (in the midst of a recession), swiftly we moved along to the emergence of BSE and variant CJD and the HTM 01- 05 crisis in dentistry where everybody had to redesign their practices and increase their cross-infection control due to the risk of transmission of prions.
The end of dentistry (apparently).
We struggled through that into a GDC and CQC storm which threatened to finish dentistry off entirely, all of this straddled by a horrendous recession due to the sub-prime mortgage crash in 2008.
By the time we reached 2015/2016 and in the midst of the ‘GDC crisis’ the profession was on its knees with NHS dentistry funding being cut and regulation killing private dentistry.
The emergence of corporate dentistry had been hailed as the end of the independent dental practice and everything was dark and dentistry was dying (apparently).
Of course, now we find ourselves in another and even greater crisis of the worst possible imagining and dentistry cannot possibly survive (apparently).
In a serendipitous conversation with Louise who is my clinical lead at the clinic yesterday in the kitchen (the type of conversations the practice was designed to facilitate), we discussed this as we’ve both been in the game a similar sort of time.
This will not be the last crisis like this that we see and if I continue to work for the length of time that I want to then there will be several or even many more than this.
The anatomy is always the same, even if the subject matter is different.
You need liquidity (cash) that allows you the flexibility to survive and the liquidity must remain in your business.
You need agility which is often misunderstood but is effectively the will or the motivation to change direction, either slightly or dramatically in order to adapt to the new circumstances which arrive.
And you need resilience.
Almost completely always misunderstood, resilience is not the ability to dance around with a smile on your face, that is the ability to say “Yes I will go again today” when you wake up.
At the start of the pandemic in 2020, it was clear if you watched electronic media of people who’ve been through crisis before how they intended to manage the crisis this time.
Once you stabilize you’re able to seek out the opportunities, so you stabilize with cash and when you see the opportunities you use your agility to seize them and all of the time while everybody else is fed up, you wake up and say “I will go again”.
I’m not sure what the next crisis will entail but it’s coming down the track so, as the man said “don’t pray for easier times”.
Blog Post Number - 2641