The Smell of the Place….

I was searching around for inspiration for an upcoming presentation where I want to talk about the culture of a business; I came across this address by Professor Sumantra Ghoshal at the World Economic Forum.

He talks about the “smell of a place” and individuals working within the context of a business. His opening statement blows away all sorts of cobwebs of preconception.

Excellent stuff and well worth investing 8 minutes plus the thinking time to follow.

The Weekend Read – The Behaviour Gap by Carl Richards

Some of the things that I tell my clients when I start working with them:

  • I am not a solicitor although I have a working knowledge of the law as it affects dentists and their practices. I do know good solicitors and I am able to help them choose one.
  • I am not an accountant although I know enough to be able to interpret figures from most dental businesses and make vaguely relevant comments and suggestions, but they need someone who they trust and understands their business.
  • I am most definitely NOT a Financial Adviser or Planner. Again they need an independent who understands them, takes time to listen to their needs and wants and will be there for the long term.

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I regularly come across dentists and other individuals who will issue statements about what to do with your spare money, where the next ‘big thing’ is coming from and the strategies they have used. When I ask them why if they’re so hot how come they’re still having to work (as opposed to choosing to) I’m usually told that they caught a cold on “Peruvian Shellac futures” or something equally esoteric.

Often I wonder if the time they spend poring over the Daily Telegraph on Saturdays and with their noses in the Investors’ Chronicle wouldn’t be better spent doing something with more relaxation and less worry about the choices you have made. I’m always curious about these apparently savvy people who spend small fortunes on cars in order to park them on their driveways or car parks for 99% of the time; but that’s a tangent.

So back to the book. Carl Richards is an American financial planner and New York Times columnist with a refreshing attitude to money. Some years ago, in order to explain points to his clients he started drawing simple diagrams on napkins; these are the book’s illustrations. He defines The Behavio(u)r Gap as the distance between what we should do and what we actually do. From the opening chapter, ‘We don’t beat the market the market beats us’ through ‘Financial Life Planning’ and ending with, ‘simple, not easy’ he shines light on important questions.

To quote Seth Godin on the sleeve notes, “smart, tactical and practical advice for anyone who has done dumb things with their money.”

Hands up if you’re not one of those – worth a read then!

Available from Amazon here

The Greatest Breakthrough Since Lunchtine #20 – Lasers ‘could prevent’ need for root canal treatment

In the second book of the semi-autobiographical series describing the progress of an Edinburgh medical graduate, Colin Douglas describes his hero, David Campbell’s, involvement with medical research. The book’s title is The Greatest Breakthrough Since Lunchtime and the cynic in me always remembers it when I read headlines like this one from BBC Health.

Lasers ‘could prevent’ need for root canal treatment

From BBC Health

Lasers have been used to regenerate parts of damaged teeth and could one day be used to prevent root canal treatments, claim US researchers.
The laser beam triggered a series of changes that led to the formation of new dentin, the layer below the enamel, in animal tests.
The results, in Science Translational Medicine, showed stem cells in the dental pulp were activated.
Experts said it was intriguing, but a long way from the dentist’s chair.
The team at Harvard University used a drill to remove part of a tooth in mice and rats.
One dose of laser therapy on the damaged tooth led to the production of a partial layer of dentin 12 weeks later.

New tissue
It was not a perfect match for natural dentin, but the researchers argue it would be easier to achieve with human teeth, which would be larger, and by refining the laser.
The scientists could not produce a new layer of the hard enamel that protects the tooth from wear and tear.
However, Dr Praveen Arany said his research could have a role in preventing root canal treatment – the dreaded and painful procedure involving the removal of a tooth’s nerve and blood vessels.
Dental cement is currently used to trigger new dentin formation, but it is not always successful.
Dr Arany told the BBC that lasers may be a better option: “The laser tool and the mechanism we have outlined would ideally be used in pulp capping that would prevent root canal treatment and hopefully preserve the tooth without the need for it to be eventually extracted.
“But once you reach the pulp and the pulp is necrotic, the cells you have to work with are no longer there so this would not work in those cases.”

Prof Ian Needleman, the director of the International Centre for Evidence-Based Oral Health at University College London, said full tooth repair was still a distant prospect.
“What wouldn’t come out of this is that a whole tooth could be regenerated. One tooth tissue could show some signs of regeneration or repair, but that’s a million miles from regenerating a tooth.
“It is interesting as a model of whether laser light can play a part in regenerative medicine, but in terms of dentistry it’s not offering an innovation at the moment.”

Stem cells
The source of the new dentin was traced back to stem cells in the dental pulp.
Experiments showed energy from the laser light was creating highly reactive oxygen inside the dental tissues.
It in turn activated growth chemicals that stimulated the stem cells to produce a new layer of dentin.
Chris Mason, a professor of regenerative medicine at UCL, said: “I was intrigued that shining a little bit of light triggered stem cells to differentiate.
“It’s incredibly low-cost and would be patient-friendly so it seems to have a lot going for it, but they can’t grow the enamel.
“The tooth is like a house, the dentin is the inner walls, but it still needs a roof and outside walls.”

The Monday Morning Quote #267

“Someone once asked Somerset Maugham if he wrote on a schedule or only when struck by inspiration.

220px-Maugham_retouched

“I write only when inspiration strikes,” he replied.

“Fortunately it strikes every morning at nine o’clock sharp.””

Steven Pressfield

220px-Author_Steven_Pressfield,_June_2011

Is there a race to be the biggest dental chain?

Oasis completes acquisition of Apex

Full article from Yorkshire Post here

OASIS HEALTHCARE has announced the acquisition of Apex Dental Care, following closely on the heels of its takeover of Smiles Dental last month.

The deal was completed for an undisclosed sum, the company said.

The acquisitions mean the company’s turnover will increase by 40 per cent from £160m to more than £225m. Now it will be providing dental care to more than three million patients on the NHS and privately, as well as specialist dental work.

As a result, too, of the acquisitions the network of practices has risen from 204 to 310 in just six weeks. Of these, xx (sic) are in Yorkshire.

Apex was founded seven years ago and had 31 practices across England, offering a variety of care options to patients. Its focus had been to deliver clinical excellence, both privately and on the NHS.

Oasis says it is already committed to working with the Department of Health to ensure better access to decent dental services. A number of NHS pilots are already being trialled within its existing practices.

Justin Ash, chief executive at Oasis Healthcare Group, said: “We are delighted to welcome the Apex to Oasis. Both companies share the same commitment to providing high quality, easily accessible dental care and have developed a patient-led culture.”

Mr Ash said adding both Apex and Smiles to the company’s portfolio rapidly transforms its size and scope. “It underlines the rapid progress we are making in building a strong, trusted and customer focused dental brand in a fragmented market. Our ambitions for growth do not stop here and we have a strong pipeline of acquisitions and new builds.”

Last September, Sir Stuart Rose was appointed as chairman of the Oasis board as part of its vision to create a consumer-focused chain of dental practices.

Apex Dental’s CEO, Ben Chaing, said he was pleased.

“Following initial discussions with the Oasis team, it soon became apparent that we shared the same vision for how the dental market should evolve,” he said. “By combining Apex’s dental practices with Oasis the group will be well placed to continue improving the breadth and quality of our service to patients with the benefit of an expanded network and an even stronger clinical support team.”

Doctors suicides investigated. Now it’s time for someone to take dentists’ deaths seriously too.

A recent article on the BadMed blog site by ‘Dr No’ made me think –

The piece opened with, “It emerged last year that doctors facing General Medical Council Fitness to Practice hearings have a remarkably high death rate. Over the last decade, these doctors have been dying at between fifteen and thirty times the expected rate, depending on the comparator group used to do the calculations. Some of these deaths are known to be suicides, with others suspected but not so recorded.”

The full article is available here: better-read-dead.html

So a good thing is happening in the wake of the concerns shown – whether the results will ever be fully available is another matter, of course.

I’d like to talk about the problems that are facing dentists. There have been several suicides in dental practitioners that were without doubt related to the heavy handed manner in which the CQC was imposed on the profession. There is no doubt that its introduction was wrong; it was untried, inappropriate (it examines many of the wrong things), the inspectors were poorly trained, badly briefed and from my experience were less than objective when dealing with dentistry. Most of the concerns shown by dentists’ representatives before April 2011 have been proved correct. There is still no procedure to examine quality of clinical care in practices. The financing of yet another bit of unnecessary bureaucracy has been passed to the practices by “the unaccountables”.

To return to the original article by Dr No, the numbers of complaints with which the General Dental Council (GDC) is dealing has sky rocketed in recent years. The UK has gone from a culture renowned for its stoicism to one where, in healthcare at any rate, patients are encouraged to complain. The GDC is close to overwhelm with fitness to practice hearings that are, of course, being funded by the fees of every other registered professional.

In my 12961 days on the GDC register I was fortunate enough to have only one complaint made against me (it was rejected at the first hurdle I would add). Were I qualifying today I know that I would not be so lucky and I could expect several more letters from Wimpole Street. From the notification that there had been a complaint to the final “no case to answer” letter took a couple of months. There wasn’t a single day that passed without my thinking and wondering about the “case” several times – I knew I had done nothing wrong and if the circumstances arose again I would have done the same thing.

What it must be like for individuals that have to climb the ladder of escalation I can not guess. The letters asking for more and more information, the requests for further sets of notes so that evidence of other misdemeanours can be found which drag out the process thereby putting greater and greater stress on an individual whose livelihood and personal life can be ruined.

So two points really to be made.

Firstly. Isn’t it time to introduce the excellent ‘Dental Complaints Service’ , which at the moment only deals with private complaints, across the board. I know that prevention is best and it is every practitioners’ job to ensure that complaints are minimised and the GDC tries to take a lead in that. However in these years of dentists adopting a minimal intervention philosophy shouldn’t the regulator do the same?

Second. Is there any evidence, anecdotal or otherwise, into the pressure that the ‘accused’ dentist or DCP endures and the damage caused whether that be suicide or mental illness? Is there any organised assistance in place to help them?

The Monday Morning Quote #266

“Don’t let people steal your time with petty requests.
People want to get into your space.
Only you decide who gets into your space.”
Sir Alex Ferguson