Tattoos and other things.

I sometimes get calls for advice from clients on what they can and can’t demand or forbid from staff, tattoos and piercings seem to be high on the list. In my case I had a dilemma about nurse who boasted about her multiple, hidden, piercings  which were her business as far as I was concerned. What made me cross was the fact that she made it clear that she also had a pierced tongue from which she removed the stud before she arrived in the morning, and therefore would not advise a patient about the risks of oral piercings if she had been requested to do so. As it was she walked out after 3 days giving the reason that our standards were ridiculously high – hey ho.

From the informative “briefings digest’ from The Lawyer.

My HR adviser in “the main hoose” said, “well that would be the case, it’s an extension of a dress policy, amend your policy to include visible tattoos and piercings and you’re fine.”

Recent newspaper reports of “a business executive … sacked for having a visible tattoo on her foot” raise modern-day questions of personal taste and choice – and potential legal issues for employers wanting to set standards of appropriate dress and appearance.

While tattoos are becoming more acceptable in our society – the Prime Minister’s wife has one, and even David Dimbleby famously had a scorpion inked on his shoulder recently – many employers feel uncomfortable with visible tattoos, especially worn by customer-facing employees.

In the press story, the business executive (a contract worker), was quoted as saying that she was consulting a solicitor to see if the termination of her engagement was “discrimination under inclusion and diversity laws”.

So, does she have a claim?

Clearly, she felt unfairly treated. But does she have any cause for action under UK law?

Only employees with more than two years’ service can bring a claim for unfair dismissal. In this case, the person was an independent contractor who, reportedly, had only been with the company for five months. So, on the face of it, such a claim would not be open to her.

In addition to any claims arising from the end of employment, employees and contractors have the right not to be discriminated against on the grounds of a ‘protected characteristic’. This includes gender, race, religion, belief and disability. It does not – at present anyway – include (of itself) having a tattoo. Indeed, tattoos and piercings are specifically excluded from falling within the definition of disability discrimination (as constituting a “severe disfigurement”) under the Equality Act.

Employers do need, though, to consider whether the standards they wish to set are equally applied regardless of gender, race, religion or belief. Last year, a case[1] involving BA’s introduction of a
new uniform policy for customer-facing staff was brought in the European Court of Human Rights, after the employee failed to establish her claim in the UK courts.

The right balance, said the Court, must be struck between the protection of an individual’s rights (in this case wearing a visible cross) and the rights and interests of others. In this case, the right balance had not been struck and the claimant was successful.

In the case of the contractor with a visible tattoo, as long as the policy applied equally to all genders and the tattoo was not a manifestation of religion or belief, it is difficult to see on what basis a successful claim could be brought.

Employers have rights, too. And one of those is the right to tell people who work for them how they should present themselves on their behalf (striking the right balance, of course).


The Monday Morning Quote #276

“We have to do the best we can.

This is our sacred human responsibility.”

Albert Einstein


The Weekend Read – Putting health at the heart of your practice by Sheila Scott

Sheila's bookI was reading this book when the sad news of the death of Colin Hall Dexter reached me. Never could such an apt tribute have been written to Colin and his philosophy of practice. He was known as a champion of prevention, of private practice and of communication but if there is one phrase that summed Colin up it would be the title of Sheila’s book “Putting health at the heart of your practice.”

It’s a slim book and an easy read, which is exactly what one would expect from someone who has been working with dentists and their teams for a quarter of a century. The old saying, “Keep it Simple” is one that has always come to mind when listening to Sheila. Far too often dentists try to complicate things, whether it be their explanations, their treatment plans or their ideas about what makes a good practice.

What you will get from this book is a blueprint for both simplicity and success. In the opening four chapters Sheila explains how by using basic messages of dental health and paying attention to detail you can win patients over to your way of thinking. She leads the reader through the path that starts with finding out what people really want from their dentists, not what the dentist thinks they need.

Following on, she explains the importance of the Dental Health Check, please abolish the phrase ‘check up’ from your practice and, whilst you’re at it, get rid of ‘just a’ as well. Half of the Dental Health Check is done before the patient gets round to opening their mouth, as dentists we are way too keen to get to the teeth with our mirrors and probes. We’re taught at dental school that the history is everything, yet, once in practice, so many of us can’t wait to dive in past the lips almost before we have said, ‘hello’.

From a personal point of view she is preaching to the converted, I started calling the new patient examination a Dental Health Assessment and the recall appointment a Dental Health Review in 1988. These are longer phrases which place an extra emphasis on their importance.

Sadly in too many practices the pre-examination conversation is only used to try to find something, anything, that can be ‘sold’ to the patient. As you would expect, Sheila deals with the blatant and repetitive use of ‘Smile Checks’ in her typically forthright manner.

Of course what every dentist will tell every business consultant (trust me I’ve been both sides of the net) is that their practice is different from the others and what works elsewhere will not necessarily work for them. Quite right, my practice was a one-off too. That said the majority of my patients had two legs, jaws that hinged on both sides, teeth that decayed if they were treated badly and gums that got inflamed in the presence of bacteria. In Chapter 5 Sheila encourages this difference and  says you should make your unique dental health check an integral part of your marketing.

In chapter six she deals with how to ensure that the 14 point examination is done fully each and every time. As a disciple of Atul Gawande and the check list manifesto I loved the way she explained it.

Finally, Sheila deals with the role of the dental hygienist in practice. Again she’s pushing at an open door here. I used to preach that the dental hygienist when properly deployed was the cornerstone of 20th century dentistry but have had to modify that for the new millennium, for those that still don’t get it.

I try to limit these reviews to 500 words, I have gone way over the top because I think that this deceptively short book deserves fulsome praise. I wish I had been able to read it in 1978 when I qualified, in 1981 when I entered general practice and in 1988 when I started out on my own. It would have saved me a lot of trial, error, experimentation and failure.

Sheila is to be congratulated on “Putting health at the heart of your practice”, Dental Protection deserve praise for publishing it, I hope that this is read and, above all, acted upon by thousands of dentists and their teams.

It’s available from Sheila’s website here.

& the converse to yesterday’s blog – do you check your employer?

As a follow on from yesterday.

From HBR.

Reference-Check Your Future Boss

What do you wish you had known about your manager before you started your current job? Work style? Personality? Approach to management? Ability (or inability) to empathize? Most advice around job searching and interviewing has become common knowledge: Research the company, ask questions about the company culture, send a thank you note, and so on. But while this routine might inform you (and get you excited) about any given company, it doesn’t really tell you about the person you’ll be working under.

My advice: Reference-check your future boss.

Think about it: Do you want to work for a tyrant? A know-it-all? A manipulator? Or do you want to work with a great coach? A developer of people?  A thought-leader? You may know exactly what you want, but it’s difficult to pick up on these traits in an hour-long interview — especially when you’re the interviewee. All the stars might be aligning for you (promising company with great growth, dream job description, attractive compensation and benefits), but one person (your manager) could affect your career more than everything else combined.

Potential employers certainly aren’t shy when it comes to asking about your background. From cover letters and on-sites to criminal background checks and logic challenges, you’re more or less asked to bare your soul. Why? They want to get to know you — to make sure you’re the right fit. Shouldn’t you be doing the same? And couldn’t you be using some of the same tools?

Hence, reference-checking your future boss. Don’t believe it’s a viable option? Well, we recently had a candidate ask for references – from his potential manager’s colleagues and direct reports – and have seen others do the same in the past.

While we don’t see this strategy all the time (and it’s usually just for senior level roles), it raises the question: Why don’t more people take this approach? It not only shows how seriously the candidate is considering the decision, but it also establishes a more transparent, bi-directional conversation between both sides.

We’d be remiss if we suggested this as a one-size-fits-all tactic. Our candidate — who is now an employee — was able to successfully reference-check his manager both because of the relation to the position he was applying to and the fact that Medallia is simply more open to unconventional hiring approaches. But plenty of proxies exist for a reference check. You can ask other interviewers what it’s like to work with that person. You can use LinkedIn to find your potential boss’s former direct reports or business partners and reach out for their thoughts. Social media can help you identify shared connections and point you to who can give you insights. Through both digital and analogue means, you can also find out if he or she is in any clubs, associations, or alumni groups where you have contacts and can seek information.

Your job hunt should never be thought of as anything but a two-way decision. You will be investing your time, skills, and passion into a company and spending untold hours and energy working with a future boss. Make sure you’re making a good investment by asking the right questions and doing the right research. If that means asking for references, go for it. Otherwise, you might find yourself looking for a new job… to escape your new job.

Do you check social media on new employees?

From CIPD mini polls

Social media for recruitment

Do you check potential job candidates’ profiles on social media sites?
Total votes: 451

23.06%:   Yes, as soon as we get the application
17.96%:    Yes, but only at the final stage
58.98%:   No, we never check social media sites

What do you do?

The Monday Morning Quote #275

“I would rather have questions that can’t be answered,

than answers that can’t be questioned”

Richard Feynman

Sharon Shannon at De Barra’s

De Barra’s is a great little pub / music venue in Clonakilty. It’s hardly a place that you would think was associated with Jimi Hendrix but De Barra’s was, for many years, the haunt of the one time bass guitarist with the Jimi Hendrix Experience the late Noel Redding who lived at Ardfield.

It’s a venue where all sorts of musicians love to play but it’s primarily a folk club. Last Friday night the Sharon Shannon trio were performing for a full house and they went down a storm. I first heard Sharon when John Peel played a couple of tracks one Saturday afternoon in 1994 during Glastonbury where she had been playing with Mike Scott & The Waterboys. I remember dancing around the soon to be demolished kitchen in our house in Gloucester with William (aged 15 months) in my arms.


The trio comprised Sharon playing accordion, fiddle and tin whistle, Jim Murray – guitar and Alan Connor – bass & keyboards.

Guitarist Jim Murray is local to West Cork and had a few family members and their friends in the audience to support him. One man sitting in front of us caught Jim’s eye and having used the usual mime of a hand tilting a glass and getting a nod in return went to the bar and came back with a pint of black stuff a few minutes later.

Jim set about downing the porter with relish. The man sitting next to the drink purchaser said, “Ah, he loves his pint.” The provider replied, “He fair sucks it down.”

Wonderful language.

Enjoy Sharon & Jim (without his pint)

Private buyers and small groups gaining ground over large corporates in practice sales

From the most recent bulletin from Alan Suggett at UNW.

Private buyers and small groups gaining ground over large corporates in practice sales

The latest NASDAL goodwill survey reaffirms the ongoing appeal of an NHS contract, with NHS practices and mixed practices still commanding higher prices. In the quarter ending April 30th the average goodwill value of NHS dental practices in the survey increased by 20% to 138% of turnover, and mixed practices stood at 106% of turnover. The average goodwill for all practices was 97% of turnover, which is consistent with the previous quarter.

A major change in the dental practice sales market can be seen in the acquisition strategies of the large corporates. Whilst they are still acquisitive, there are more instances of private buyers and small groups outbidding the large corporates.

Said Alan: “I am aware of a dental practice on the market in Essex where a corporate chain had been ready to pay just under £1m but they were outbid by a private buyer willing to pay £1.5 million in order to secure the deal.”

Alan continued: “Dentists looking to buy, expand or take on another practice must always carry out a viability forecast to make sure it is affordable.” He went on to advise that if a practice isn’t affordable, it is sensible to presume that it is overval- ued, and if price reduction negotiations are not successful, to walk away.

He went on to stress that the figures in the goodwill survey are helpful and interest- ing, but they should be treated as “simply an interesting point in time average.”


PRACTICE OWNERS—Do you know what “normal” looks like?

Year to year fluctuations in fee income, associate payments, investment in equipment, and tax bills, can make it difficult or even impossible to see the wood for the trees.

We have recently started carrying out “Practice viability forecasts” for existing practice owners.

The ability to perform “what ifs” can be very interesting. Looking forwards rather than backwards can help you take important financial decisions. The cost of this is usually £500 plus VAT, and can sometimes be subsidised by a grant.

If you are interested in participating in a forecasting exercise please get in touch with Alan Suggett: / 0191 243 6009.

The Monday Morning Quote #274

“If you can imagine it, you can create it.

If you dream it, you can become it.”

William Arthur Ward


Colin Hall-Dexter, R.I.P.

Colin Hall-Dexter, whose death has just been announced at the age of 84, was one of the finest dentists and teachers I met in my career. Not for his clinical skills which were excellent, not for his qualifications which were BDS, LDSRCS the basic ones needed to practice dentistry and certainly not for seeking high political office, although his career was marked by honours from BDA & BDHF, amongst others.

Colin’s skills were those of a communicator and of one who provides space and support for the recipient to motivate themselves. I met him on only a handful of occasions the most valuable being when Susan (my hygienist, now my wife) and I were participants in his course, “Private Practice: How and Why” held in his practice in May 1990.

That weekend took place immediately before Susan joined me in my practice in Gloucester and it marked the transformation of the practice from “we wish” to “we can”. The change to private practice took another couple of years but Colin’s philosophy of prevention, of knowing and educating your patient and above all of striving for excellence in every aspect of your professional and personal life provided something to which we could aspire from Monday 14th May 1990.

That several generations of dentists were similarly inspired and influenced by his teachings is testament to his influence. The tributes paid to him on GDP-UK show that it wasn’t just a handful of us who felt the way we did.

Colin’s own story of how he transformed his NHS practice in Tooting to a private practice following his lunchtime conversations with George Hamerschmidt, his brother-in-law, was a revelation. He moved to Harley Street so that he could prove to himself that, using his philosophy, he could compete in that area. The Colin & George tag-team went out on the road, extolling the benefits of preventive practice, marketing and ethical selling, to groups of dentist throughout the country. The latter part, ethical selling, brought him into conflict with the GDC who, as much out of touch with the real world of dentistry then as they are now, did not approve of such blatant commercialism.

His fundamental belief, that he shared with whoever would listen, was that there was no point in doing what he termed “trinket dentistry” unless the fundamentals had been achieved. This can be summed up as ensuring that the patient understood what it would take to control the diseases in their mouths so that the work that he provided would last as long as possible.

The way that he worked with a hygienist was an inspiration to hygienists and dentists alike. We adopted immediately the “hygiene led recall” which meant that hygiene was placed at the heart of the practice and meant that for many patients a visit to my chair was a rarity and the cycle of restorations was broken.

Not everyone agreed with his approach, but I think it’s relevant that for those who did the usual result was a successful practice with stable, grateful patients.

The profession and, above all, patients owe a lot to Colin.

Rest In Peace.

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