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What are we doing here?
Recently, I was sharing the staff room of a practice whilst having my lunchtime sandwich, and there was some chatter about patients who had been in. Some of this revolved around seeing if they could encourage a better take-up of options involving implants. We thought of the idea of a ‘denture problem’ clinic to encourage new patients who might be aided by implant retained full dentures – actually quite a good idea.
However, I thought I’d throw a random spanner in the works and asked: “Hey folks, what is our ‘core business’?” Everyone looked at me blankly. I tried putting it another way: “What are you here for, as a practice?”
Vague answers came back, with suggestions ranging from ‘making a profit for the Principals’ to ‘making better smiles’. I was quite staggered that there was not a cohesive understanding of what dental practices actually do!
Why are we dentists?
As I think many people have lost touch with this essential driving force behind our professional qualifications and our training, I just want to play with the idea of what we are here for. More importantly, much conflict with patients, and subsequent litigation, is caused by a difference between what many patients expect and what they are actually offered.
The core business of an organisation is a statement or ethos intended to express that organisation's ‘main’ or ‘essential’ activity. So, what is the essential activity of a dental practice ? As most routine dental treatment is still provided under the National Health Service in the UK, the NHS Choices website says a practice should provide: “All treatment that is clinically necessary to protect and maintain oral health.” A more comprehensive description could be: “Dentists aim to improve the quality of life for their patients by preventing and treating oral disorders. Devoting time to patient education in maintaining good oral health. Diagnosing dental disease such as tooth decay, gum disease and oral cancer.” (Australian Dental Association)
You’ll notice some common factors to all the descriptions of the core business in relation to dental practice. Those are both the clinical nature of the activities and the base level at which they are aimed. Our job is to primarily protect the oral health of the patients in our care. Everything else we might want to offer them, in terms of aesthetic improvements or more sophisticated treatments, are an add-on and not a core function.
Get the foundations sound first!
It’s the old metaphor about building a house, which will fall if the foundations aren’t firm. We need, primarily, to be good at basic dentistry. In the QCS package is the Evidence Based Practice policy, in which there are tenets of practice including:
- ensuring that clinical treatment is up-to-date and effective
- clinicians have a commitment to Continued Professional Development in order to learn about new treatments and best practice
In other words, we need to be working in the best interests of patients’ oral health and at that core level of care before introducing other options.
Just ask that question – what are we doing here?
Dr John Shapter – QCS Expert Dental Contributor