Robert F Kennedy once said, “We live in interesting times”. I really don’t think there is a more appropriate quote to describe the dental profession today. On the one hand, we live in an age of opportunity – we have access to better tools and technologies than ever before, and we can provide our patients with an outstanding level of care. Yet on the other hand, there is a darker side to dentistry, one that challenges us on a daily basis, and threatens to undermine the work that we all so love.
Litigation culture
Many colleagues live in fear of litigation, or being brought up before the General Dental Council on a charge. After all, it only takes one small complaint from a patient and whether you’re innocent or guilty, the chances are you will come out the other end questioning your career. Fears such as these mean that newly qualified GDPs are now terrified of doing many procedures, having gained little in the way of practical experience while at dental school. While they will certainly know about communication skills, vicarious liability and compliance, some may have only completed a single bridge or root canal treatment before qualifying.
And what are they to do now? Gone are the gung-ho days where dentists could try everything in the first few weeks of practice; the potential repercussions if something doesn’t go according to plan are just too great. It would seem then, that the old adage of ‘See one, do one, teach one’ – where students learn by actually practising – has gone forever.
Change
There are a number of factors behind this change in dentistry. Not least among these is the fact that people are more litigious than ever before. Often the question of right or wrong doesn’t come into it – if people feel wronged then they believe it is their right to complain, even if it means reporting a complaint directly to the GDC.
But the problems don’t just stop there. In the past treatment options were far more limited than they are today. Our job as dentists was primarily focussed on caries control and treating patients for pain. These days however, there is a completely different picture. Many new treatments today focus on beauty over health. This has brought about a fundamental change in the relationship we have with patients, and has gone hand-in-hand with an altered role for the NHS. Add in to the mix ever-increasing patient expectations associated with rising costs of treatment and dentistry today is a very different profession to that it was at the end of the last century.
Fear
Fear today, is one of the biggest threats to our beloved profession. Many colleagues now are too afraid to step outside their ‘comfort zones’ for fear of failure or the repercussions litigation might bring. Dentistry is continuing to change and one can only wonder what the future of the profession in the UK might be. Currently, in the US, negligence cases are judged by specialist standards. If these same rules were to come to the UK, would GDPs want to perform anything but triage unless they had postgraduate training? The thought just doesn’t bear thinking about, and would certainly herald the death of the generalist GDP.