Catherine Rutland on self-defence in practice

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Simplyhealth Professionals' Catherine Rutland talks about “Future Proofing the art of Self-Defence” in the dental practice

In the Dental Practice of the Future lecture hall during BDIA Dental Showcase, Simplyhealth Professionals' Head of Professional Support Services, Catherine Rutland, discussed how dental professionals should prepare to tackle both internal and external risks threatening the practice environment. What does this mean?

She began by quoting Ludwig Wittgenstein, “I don't know why we are here, but I'm pretty sure that it is not in order to enjoy ourselves.” “Dentists,” Catherine observed, “sometimes feel like that.”

She continued by explaining that, as a dentist and practice owner herself, she knows it is dangerous to focus too much on what’s happening in the comfort zone of your dental practice. The structure of the practice is changing and so is the external environment. An example, 10 years ago there were few practice managers but now there has been a massive change in the practice manager’s role.

As a result staff might become unsure about who is the leader. Is it the principal dentist or the practice manager? Who do you want the team to go to? It is important to clarify the role of each team member and their responsibilities in practice, and to get their agreement. Start shifting responsibilities around at random and people become unsure about their positions, making them nervous and unhappy at work.

What about the risk culture of the practice? Dentistry is a business as well as a healthcare profession. Business involves risk when moving forward, so you must ask yourselves where you want your practice to go? What risks are you prepared to take? How much risk is acceptable?

In some cases there has been a shift away from the dentist led team to a new type of practice where the leaders are therapists and hygienists. How is that affecting business in your local area? How do you plan to respond to it? Might you lose patients as a result?

Don’t panic

You lose a member of staff, what do you do? The usual reaction is to panic and find someone new who can duplicate the role. Why not take a deep breath and study the situation? Can that role be changed? Instead of simply replacing that team member this could be an opportunity to develop your practice in new and better ways. Get some ideas from your team; they are the ones who have to work with any new system you devise, so their input is essential.

This is also the time to break the paradigm view that dentists only look into people’s mouths and never see the world in general. For instance, clinical competency; we all understand the importance of clinical competency, it is the hub around which dental practice revolves and the latest technology focuses on constant improvements. But don’t become blinded by clinical options to the exclusion of everything else.

Are your records up-to-date? Is your note taking competent? Did you offer your patient all the options and get their agreement, and if so, did you record it? Proper records are essential in case of self-defence. It’s no longer enough to say what you did; you also need a paper trail to prove it.

The Dental Practice of the Future at BDIA Showcase

And ensure you maintain your skill-set. Clinical proficiency and efficiency means remaining up-to-date, and that means staying aware of the latest techniques and earning the relevant CPD hours. Before something goes wrong ask yourself, am I defensible? If not, put it right.

Will Brexit affect us?

We live in an increasingly aged dental population, and members of the team could become affected by underlying health issues that might reduce the quality of their dentistry. The team must support each other but also keep an eye on each other for the sake of the patient. If a dentist has issues due to age they need to be addressed before something goes wrong.

And Brexit, the big external risk factor; will it affect us? If so how? We can’t adopt a head in the sand policy and wait for problems to knock on the door. We need to prepare; we need to plan for change. Take note of the increased cost of materials due to Brexit’s effect on the pound; keep an eye on your supply bill.

Big normal costs will steadily rise and eat away at your bottom line. How you get paid should always match what you want/need, and while Catherine was not prepared to discuss the state of the NHS contract she advised that there are always alternatives. The NHS is still the largest supplier of dentistry in the UK, but will that remain supportable? Not much will happen while the government is focused on leaving the EU, but change must come.

Patient expectations and the media

Once the dentist told the patient what was going to happen in the surgery – such is no longer always the case. Younger people see dentistry as a commodity. They have raised expectations regarding treatment outcomes and if they don’t like what they get they might ask for their money back. We must avoid this situation. It is important to make sure the patient is kept fully aware of what we’re doing and understand and agree to the realistic outcomes, and then record it. Otherwise we must learn to say no. We tell the patient we can’t match their expectations and wish them luck elsewhere.

And finally; communication with patients and potential patients on social media such as Facebook and Snapchat, which is where some people get most of their information input. If you don’t subscribe to any of this ask if one of the younger people in your team are involved and invite them to take charge, so long as they stay within practice guidelines. But don’t forget your older patients who still prefer emails, texts, or an old-fashioned phone call.

Catherine had started with a quote from Wittgenstein and ended with one:
Resting on your laurels is as dangerous as resting when you are walking in the snow. You doze off and die in your sleep.