If most of our buying decisions are based on price then the danger is we may ignore the longer term implications. Short term thinking can have a detrimental impact anywhere in a practice, but particularly so in the design and fitting of a surgery.
In my opinion, and indeed from my experience, a vast number of dental surgeries are poorly laid out and the cabinetry is inappropriate. Working to a budget is understandable and sensible, but if that budget forces you not to focus on the comfort and health of you and your team, then you are risking a great deal.
Those risks include suffering increasing levels of neck and back pain, repetitive strain injury, headaches and even indigestion which, although it may not sound serious, is no fun to work with. The bottom line is that you and your team may have to work through the pain or take time off from practice. So very quickly your decision to save money could actually cost you, even if that is just in locum fees. Statistics from Dentists’ Provident, in last year’s claims paid, show that 35 per cent of females and 26 per cent of males were paid for musculoskeletal disorders, with claims totalling over £1.2m.
The first thing I would advise any dentist who is thinking about having his or her surgery designed is to give the job to an expert; someone who understands how a dental practice works and, most importantly, takes the time to establish how youwork, and through experience can even recommend better working positions.
Having studied the way you and your team work, a good designer will be able to utilise available space to best effect; so you will get a design and layout that is practical and empathetic with your preferred protocol. The design will also take into account any specialist treatments that are undertaken in the surgery and whether those who use the relevant equipment are right or left handed. Additionally the designer will watch how you and your team work with a patient and will take into account the optimum positioning of the treating position and delivery of instruments from your nurse. This attention to detail is a key factor in designing a surgery that does more than look good. Most importantly, it helps to create a surgery that is comfortable and healthy to work in.
Cabinet issues
You can buy the cheapest dental cabinets on the market that will satisfy basic clinical procedures. However, these will not allow for the correct and optimum working position of keyboards and monitors, and they will generally pay little regard to keeping to a minimum the need to access materials by bending down or reaching up. These are small details, but vital when you bear in mind how many patients you see in a day.
Where viable, I believe curved cabinetry is preferable to the traditional ‘L’ shaped configuration. Whereas L shaped cabinetry allows the dentist only two conveniently positioned access points, curved cabinetry is focused on the patient position. Over the years I have debated the pros and cons of curved versus L shaped cabinetry and, in the main, feedback I have received confirms that the former involves far less reaching and stretching.
Practice makes permanent
If you are working, day in, day out, in a poorly designed surgery, then there are likely to be health implications for you and your team. If you are regularly sitting uncomfortably and constantly making unnatural movements then, sooner or later, signs will show.
“It’s no surprise that lower back pain is one of the most common musculoskeletal issues for dentists,” explains Bryan Gross, head of claims and underwriting at Dentists’ Provident. “But shoulders, necks, hands and wrists are also areas where dentists experience problems, due to the demands of their work. We regularly hear accounts of rapid onset back pain – one day you’re sitting happily in surgery, caring for a patient; the next day the pain hits and you’re barely able to move.”
What you have to keep in mind is that consistently working in conditions that do not encourage good posture will, almost certainly, have a long-term detrimental effect. Taking care of the oral health of your patients shouldn’t be at the expense of your own health and wellbeing. Problems can also occur at any age. Dentists’ Provident’s 2012 claims statistics show that the average age of a claimant was 45 years old. There are also cases of a 26 year old dentist claiming over £10k for 12 weeks for back pain and a 38 year old claiming nearly £80k for two years for a musculoskeletal problem.
It’s important to remember there are not only future repercussions for your own health, but being out of the practice can put undue pressure on your team and cause disruption for your patients and their care. So a well-designed surgery, with everything in the right place, should be considered an essential investment for your health, your team, your patients and your business.