Two important ‘documents’ hit the inboxes of dental professionals this week, one was an update on the Standard Operating Procedure – Transition to recovery from the ODCO and the other was a survey put out by the General Dental Council. One was something you really needed to take in, the other was something you had a choice of participating in, even if it was just for a laugh.

The Survey

It appears the General Dental Council has spent a chunk of your hard-earned ARF money on commissioning a survey so that they can understand “your views and perceptions of them and why you hold those views.”

Apparently, the results of this survey will help the GDC “to improve the way in which they communicate and engage with you in the future.”

As if they aren’t fully aware of how the GDC is perceived. I mean, it’s not as if they don’t monitor social media for example. I know from personal Twitter experience that the GDC monitors traffic going through my Twitter account, since one unfortunate dentist was picked up and chastised a few months ago for criticism of the ORE examination process after it was retweeted.

Just from Twitter, they should surely know what the general feeling about the GDC in the dental profession is. And they shouldn’t be in any doubt that what they are seeing on Twitter and Facebook is a true snapshot of the general consensus within the profession. Since there are some very distinguished members of the profession on social media, it would be foolish of the GDC to dismiss opinions expressed on various popular platforms as ‘trivial.’

And yet they seem to be truly not aware of how they are perceived. I find it incredibly hard to believe that every member of the Executive doesn’t know EXACTLY how the GDC is perceived. I find it difficult to believe that the Media Department at the GDC isn’t constantly up and down the stairs at 37 Wimpole Street tell-tale twitting on people on Twitter who have made some reasonable criticism of our regulatory body.

I’ve been through the survey and couldn’t fathom for the life of me how the GDC is going to get a clear idea of how they are perceived from the questions posed. Truly, if Messrs Moyes and Brack spent a week on Twitter, they would be in no doubt as to how the GDC is regarded. In fairness, a sample of participants in the survey will be approached for further questioning later in the year, but that is the only way there will be any useful information gleaned from this survey. There were no open questions at all in this survey, and it’s almost impossible to see what possible useful or relevant information the GDC will glean from such a waste of time and money.

I will analyse these pointless questions, one by one.

One of the first questions was on gender. They want to know what gender you were assigned at birth.   This question often bugs me. What on Earth has it got to do with the price of fish? Whether you are a male or female has no bearing on what you think of the GDC. And as for the “are you intersex?” question. WHAT??? I’ve personally never seen that question on a survey ever and how it is relevant in any way, shape or form to whether you think the GDC needs a complete makeover or disbanding (I’d be happy with either), is beyond me. They fact the survey also gives the “prefer not to say” option, proves that gender is largely irrelevant.

 

 

The next question was about age ranges. If you hold an opinion on the GDC, what matter is it what age range you belong in? Is the opinion of someone in the 18-21 range less valid that someone in the 61-65 range, or MORE valid? The only point of information gathered from this is surely that at the end of the survey the GDC can present all sorts of superfluous information in order to try and impress, this is pointless information.

So far then, we can perceive that the GDC is both sexist and ageist!

The next couple of questions ask roughly where you work and in what capacity. Again, why asking whether you’re a dentist are a DCP? They already know exactly how many DCP’s and dentists they have on the register, and even what variety. Are they going to dismiss criticisms from dental nurses or hygienists and take more notice of dentists, or vice-versa?

The survey then gets into the nitty gritty and ask for participants to score on the strongly agree to strongly disagree scale, on the GDC’s consistency, effectiveness, relevance, efficiency, accountability, transparency, responsiveness and fairness. For some bizarre reason, the survey asks if the GDC is ‘agile.’ Well I’ve never seen William Moyes or Ian Brack on the parallel bars, so how would I know?

 

 

This section also asks if the GDC is proportionate or targeted? Well once you’re in their crosshairs, yes, they are very much targeted. As far as accountability is concerned, that has to be a resounding ‘NO.’ The Professional Standards Authority seems to be toothless when it comes to pulling the GDC up over wrongdoing. The PSA is powerless to intervene (or at least, they say they’re powerless to intervene) in any ongoing processes that the GDC is engaged in (for example the fact that the GDC is registering overseas dentists as therapists without any test of their practical clinical skills), although the PSA does occasionally get involved after the fact. They DID refer the GDC to the High Court after they withheld crucial evidence from their own disciplinary committee, which resulted in a fraudulent dentist being restored to the dental register - and the PSA DID carry out an investigation into the GDC’s poor handling of a whistle-blower complaint a few years ago. Whether lessons were learned by the GDC, only time will tell.

As to whether the GDC is ‘fair,’ that would depend on whether you’ve been through their processes. Certainly I would have thought DCP’s would think their handling of the payment by instalment debacle early in the summer wasn’t in any way fair, compared to the way the GDC topped up its furlough staff’s salaries.

As for ‘transparency,’ I understand they haven’t been open with a couple of Freedom of Information requests, refusing to reveal full background details of PBI discussions and details of property owned in Birmingham, as well as refusing to disclose information about the legal opinions and appeals they bowed to, with regard to registration of overseas dentists as DCP’s.

Next, participants were asked to select three words they associated with the GDC. In fairness, they do include ‘fear’ and ‘aggressive’ in the list, as well as ‘unrepresentative’ and ‘defensive.’ I doubt whether ‘supportive,’ or ‘helpful’ will get a lot of votes.

Anyone who has had any sort of disciplinary encounter with the GDC will know that they are aggressive – the manner in which they rip practitioners apart on every aspect of their practice even if a complaint focusses on one small part of it, is well-known. The process borders on the vindictive and ‘fear’ doesn’t seem to quite cover the range of emotions that practitioners experience through the whole lengthy process.

 

 

A further question asks participants their preferences for receiving information – like journals, social media or meetings.  For some reason, the GDC Website is in there. If you wanted information about anything dental, the GDC website surely isn’t the place you would go. For example, during the lockdown and dental shutdown, the only information you would have gotten from the GDC website would have been how hard the people at the GDC were working and how they were worried about their financial future. Diddums. I probably wouldn’t have ticked the ‘GDC website is my oracle’ box.

I think the organisations representing the dental therapists would currently disagree with the notion that the GDC cares about their opinions, and the idea that the GDC is currently improving, is laughable as far as I can see. They also ask if the GDC is currently improving. Laughing hysterically emoji.

There was then an incomprehensible preamble prior to trying to elicit an opinion on the GDC’s new approach to strategy development. WHAT?

The gobbledygook went something like…

 

 

I would have thought quite a few ‘I don’t know enough about it to comment’ boxes will be ticked for that one. Similarly, asking if people are aware of the GDC’s new Corporate Strategy would elicit quite a few ticks in the ‘no’ region I would have thought. To be honest, who in the dental profession CARES about the GDC’s corporate strategy? Maybe if it helped fairness and made them seem more human, they’d get more interest, but the very word ‘corporate’ immediately diminishes the concept of the individual as an entity to be listened to.

Asking the average dental professional in practice how they feel about the GDC’s abilities to process applications to the registers or quality assuring dental education and training is, I feel, pretty pointless. How would they know? But that doesn’t stop the GDC from trying to get an “honestly, you are just stars in completing the Annual Renewal process.”

The GDC just doesn’t seem that great with regard to ‘investigating illegal practice in the UK’ – another question. Online orthodontics and tooth whitening being a classic example.

A few questions asking what medium registrants use for getting their dental news and also pinning them down on which journals or online publications they favour, specifically, does little to deflect the growing feeling within the profession, that the GDC is a regulatory body both out of touch and out of control.

Having closely looked at it, I very much doubt whether this spurious survey is going to bring changes to the GDC, anytime soon.

The SOP Update

Later in the week, the Office of the Chief Dental Officer of England released an update to the Standard Operating Procedure Transition To Recovery.

I confess that I only skimmed a similar document back in June, so didn’t really appreciate the content. I was therefore really surprised to find that in Appendix 5 there was a clinical guideline on Advanced Minimally Invasive Restorative Dentistry with regard to caries management.

I thought that the point of an SOP guide and update would focus purely on the changes needed in practice on a practical PPE/infection control level, not going back to 3^rd BDS basics, useful though it might be to an idiot who hadn’t done any CPD for the past 15 years.

Now I’m pretty sure the OCDO didn’t intend to give the impression that it was patronising the profession, but…

There it was, in some detail “Carious lesion management (selective caries removal.”

From removing unsupported prisms (a phrase I haven’t heard since 1988) to identifying caries-infected dentine – if you didn’t know, it’s soft, wet and often dark brown – it was all there. Even chisels got a mention – again, not heard of since the late 80’s. The last time I saw a chisel used in dentistry, Barney Rubble was teaching Wilma Flintstone how to cut a primitive, yet effective Class 2.

 

 

I’ve met quite a few dentists over the years and even the most inept of them have a fair idea about how to identify and remove caries with hand instruments. In general, dentists and therapists are a pretty switched on bunch, and unless SARS-CoV-2 has an effect on caries progression, I think they would have worked out themselves how to prepare cavities without AGP’s. Even I can still remember stuff I learned in a lecture from the Australian king of minimally invasive dentistry, Geoff Knight, in the 2000’s.

There was even a bit in the document about placing fissure sealants. Seriously. Using 37% orthophosphoric acid-etch is apparently important, as well as washing and drying. Again, has this changed since the arrival of the pandemic?

And if the working UK dental profession needs guidance on mineralisation control via fluoride varnishes, then we’re all doomed.

As (mercifully) an outsider, I can see that the profession is absolutely swamped with information and critical paperwork. This document was 61 pages long and although it did say that changes from the last document were highlighted, most dentists and dental care professionals are anally-retentive and will still go through documents thoroughly just to make sure they don’t leave themselves legally prone. I resented going through that document and I have all the time in the world. If I’d been working, I’d have despaired at having to trudge through the extraneous bilge.

Anyway, now inspired, I’m off to put a survey up on Twitter.