We Did Not Sign Up For This

I thought I'd share this latest opinion piece by a young dentist in the latest BDJ, entitled:
"Defensive dentistry and the young dentist- this isn't what we signed up for."

Read it here 

So what are THE main problems here in Dentistry in England worst of all, but relevant to all the UK too?

My shortlist would be:

1. An impossible UDA NHS contract that publicly promises unlimited care for needs, in a very limited system

2. Onerous regulation using the slide-rule of 'perfection' instead of 'seriously below' reasonable standards.

3. An increasing Claim/Blame culture that takes little or no SELF responsibility for prevention or resolution in the first place. It's like they are given an 'exemption' ticket and thus can claim/blame/complain with impunity, even when fraudulent.

4. A CLAIMS culture driven by some enhanced-fees Lawyers selfishly, resulting in the UK having the worst reputation in the World for FALSE or exaggerated claims, just to get free easy money, from car whiplash claims to holiday insurance etc.

5. Some very Poor Expert witnesses who seem to readily use a yardstick of perfection, without the experience or TRUE NEUTRALITY to act in the public interest first, regardless of WHO engaged/paid them and not applying No.2 above properly.
The trouble is those prosecuting/claiming are only too happy to send MORE work to those who seem to write the worst reports - this may be SO bad that it needs a lookback exercise - if it's good enough for our dental records then why not ?

5. Some indemnity organisations feeling vulnerable because of the above and/or struggling to put up a timely/full defence, make a Corporate decision to minimise THEIR future liabilities in years to come and payout early. It's a tough call for them I know, but many now want to see more pushback and earlier payouts may be just pouring petrol on the fire and thus encouraging more claims, fishing and efforts to get more payouts. It's like a feeding frenzie and that's bad for all.

6. Due to pressures and cuts from the DH and HEE on the undergraduate curriculums, clinical teaching is downrated and research and other targets get all the qudos/funding, so our Undergraduates are getting less clinical exposure, training and preparation for the 'real' world = more like walking into a Gladiator ring and surviving the first few years, but with early scars already from the above. Increasingly even after FT/VT not all are surviving those first few years after qualifying and already experiencing GDC, Lawyers letters, Complaints, Compromises from systems and Corporate limitations and high stress etc - certainly not looking forward to a happy Career!

7. Our Profession - yes we must take some of the blame, but currently we are taking ALL OF THE BLAME whilst Society is overlooking or even encouraging further the above 5 aspects for short-term gain and anyway those Dentists have it easy so let's see them suffer, right ?!? 

So at what stage do we reach breaking point - at what point do we say enough is enough and start acting together in Unity.???

UNLESS we start making it someone else's problem, this will continue and in 10 years when our Profession is decimated and dental care is so defensive it's do nothing or refer for extractions, the population suffers greatly.

Read that article again in the BDJ - our young graduates are rightly saying, this is NOT what I signed up for .

Tony Kilcoyne.

1. A. Al Hassan.  Defensive dentistry and the young dentist – this isn't what we signed up for. BDJ 223, 757–758 (24 November 2017)
2. M Kelleher. State-sponsored dental terrorism? BDJ 223, 759–764 (24 November 2017)
3. Discussion on GDPUK forum 

Image credit - hierher under CC licence modified