The Monday Morning Quote #369

“And I won’t sit down
And I won’t shut up
And most of all I will not grow up”

Frank Turner excerpt from Photosynthesis

– thanks to Colin Campbell whose superb presentation “My Fitness to Practice (FtP) case and other more important matters” was one of the highlights of the BDA Conference in Manchester this weekend. Colin quoted Frank Turner’s lyrics during the conclusion of his presentation.

To read more about Colin’s case and presentation take a look here, here and here and subscribe to his blog.

Whilst you’re reading enjoy Frank’s song.

South West Young Dentist Group – One Day Conference

Wearing my Western Counties BDA President’s hat I’d like to bring your attention to the second YDG Conference. This year the venue has moved down the M5 from Bristol to Sandy Park, Exeter home of the Exeter Chiefs Rugby Club and a recent World Cup Venue. Date Saturday 20th February 2016.

There’s a good line up of speakers and the organising committee under the chairmanship of Ahmad Nounu are working hard to ensure it’s as successful as last year.

Here’s a link to their Facebook Page

 

YDG JPEG 1

YDG JPEG 2

2016 #8

Dental Showcase Day 2

IMG_0742The photograph above is of the entrance tunnel to the exhibition hall, I heard it called disturbing, weird, uncomfortable and off putting. It reminded me of an 80s pop music video with something of David Bowie’s Stage about it.

On my second day I enjoyed several successful meetings and had some time to catch up with friends and colleagues. Amongst the conversations were a few of the “what the hell did they think they were doing?” and “how can they get away with that?” with Jonathan Jacobs. Stories of broken partnerships and misunderstandings that could and should have been avoided by conversations at the start of a relationship whether business or clinical.

Thirty odd years ago I was “turned on” to perio by the late Marsh Midda, John Zamet and Bernie Keiser, I was considered odd by some of my turbine toting contemporaries. I presumed that by now, with caries under control, all hygienists would be fully booked and at the heart of every practice. According to the BSP it seems that a large number of dentists still don’t do the BPE as a matter of routine and screen for periodontal disease with their eyes only. Two concerns, firstly there is the obvious clinical one of under-diagnosis and second why let work, cash and profit walk out of the doors?

At the far end of the hall were the booths where societies including ADAM, the BSP, BSDHT, BADN and Dental Fusion had representatives. These volunteers do great work on behalf of their members and are well worth taking the time to visit.

I dropped in for a catch up with Ian Pinner of Ceramic Systems, CADCAM and Cerec is alive, well and flourishing I’m pleased to say. Yet again I am forced to eat my words of two decades ago when my uncle described CADCAM and its use in engineering to me. “That would work well in dentistry” he said, “I very much doubt it” was my reply. Wrong for not the first, nor the last, time.

After my comments yesterday about the BDA, I spent some time having BDA Expert demonstrated to me, it’s impressive and all the better for being easily accessible on-line. I still think they (I know that should be “we” as I’m a Branch President) could and should do more to try to attract new members.

Once again towards the end of the day neatly branded FMC Bar was welcoming, there is a great sense of professionalism in everything that FMC does.IMG_0739

I spent the evening at the Bridge2Aid Bash. At the supporters’ reception before the “Bash”, Mark Topley gave an excellent summary of the charity’s work and future plans. His passion for the “project” is clearly undiminished.IMG_0743

At the end of the night I was fortunate enough to be able to cadge a lift back to my hotel in downtown Birmingham – thanks to Richard from taxis4coaches.

A Change in Consent

A good article in the BDJ by Messrs D’Cruz and Kaney from Dental Protection about the change in the law regarding consent following the judgement in Montgomery v Lanarkshire in March 2015.

The link to the full piece is here for BDA members.

I advise any dentist to read it in its entirety but here are some excerpts from the piece:

“…Legally, clinicians, including dentists, must now take reasonable care to ensure that patients are aware of any material risks involved in proposed treatment and of reasonable alternatives. This case now brings the law in relation to the disclosure of risks when obtaining consent to treatment in line with the guidance issued by regulatory bodies, that is, the GMC and GDC…”

“…What the judges in Montgomery said was that the extent of information given to a patient about the risks of a proposed treatment is not to be determined by the clinician or what other clinicians in the same situation would do. Rather the test is what the particular patient sitting in front of the clinician wants to know. Patients must be told of material risks. The test of materiality is whether, in the circumstances of the particular case, a reasonable person in the patient’s position would be likely to attach significance to the risk, or the clinician is or should reasonably be aware that the particular patient would be likely to attach significance to it…”

“…The requirement is that a dentist, in respect of consent, should tell the patient everything they want to know as well as everything the dentist thinks they might need to know…”

“Conclusion
The Montgomery case clarifies that clinicians must recognise a patient’s legal and ethical right to autonomy and informed choice and sweeps away any notion that doctor (or dentist) knows best. Patients must be fully informed about the risks to them that any procedure carries and be permitted to decide whether to proceed at all or whether they wish to pursue alternative options or no treatment at all.
It is for the profession now to determine, clinical area by clinical area, what the risks that ought to be disclosed are and then it is for the individual clinician to decide what emphasis they need to place on those risks to the particular patient they have in their dental chair.
The moral of the story for dentists is that it is prudent to get to know your patients so that you can discuss with them risks that any patient would want to know, plus any risks that you would consider would be relevant to the particular patient concerned. In order to be able to satisfy the latter requirement, patients need to be asked if there is anything of particular relevance to them that they would want to know. The clinician’s advice must be both ‘fact sensitive and sensitive also to the characteristics of the patient.'”

My take:

  • Know yourself.
  • Know your patient.
  • Communicate effectively.

Some things don’t change

An open letter to the Chief Executive of the General Dental Council – BDA

As the dust settles on the judicial review, the 2014 award for Brass Neck goes to Evlynne Gilvarry.

An open letter to the Chief Executive of the General Dental Council

The British Dental Association (BDA) has published an open letter to Evlynne Gilvarry, Chief Executive of the General Dental Council, following their press statement on today’s High Court judgment.

The regulator was found to have acted unlawfully in its handling of the consultation on the Annual Retention Fee (ARF). In the statement the regulator appeared to sidestep the substance of Justice Cranston’s judgment.

Evlynne Gilvarry
Chief Executive
General Dental Council
37 Wimpole Street
London W1G 8DQ

Dear Evlynne

We have been alerted to your press statement with regard to today’s judgment by Mr Justice Cranston. You quote, highly selectively, from paragraph 36 of the judgment, which credits the GDC for its public announcements on a commitment to transparent consultation. However, that specific paragraph goes on to outline that ‘a transparent consultation meant that consultees had to be put in a position to test the validity of the assumptions purporting to underlie the suggested fee increase’.

Elsewhere in the consultation, Mr Cranston is unambiguous that, whilst the GDC may have made these public announcements, it did not live up to them. For example:

–          ‘In my judgment…there was a gaping hole in the GDC annual retention fee consultation’ (paragraph 37)

–          ‘The GDC’s answer to the freedom of information request…was distinctly unhelpful’ (paragraph 37)

–          ‘In my judgment this substantially increased projection of the number of fitness to practise hearings clearly required a transparent explanation and adequate information as to how it was calculated. […] None of the key information as regards closure rates and fitness to practise trend information was disclosed as part of the consultation (paragraph 38)

–          ‘The gap [in information] was fundamental to the whole edifice. As a result the consultation was not transparent’ (paragraph 40)

Therefore, to highlight this extract from the judgment, without recognising the context – that the GDC has been found not to have lived up to its public announcements on transparency, which is the basis for the finding of unlawfulness of the consultation – is enormously misleading.

It is also interesting to note that today’s release sits just above the GDC’s position statement on the duty of Candour and Honesty.  In light of the fact that a High Court Judge has today handed down a judgment that finds the GDC to have acted unlawfully, I would be interested in your views as to whether your reportage properly accords with the underlying principles of such duties.

Yours sincerely

Peter Ward
Chief Executive
British Dental Association

A copy of the draft judgment is available for download here: https://www.bda.org/news-centre/press-releases/Documents/bda-gdc-judgment-18-dec-2014.pdf

‘General Dental Council statement on the outcome of the BDA’s judicial review’ published 18 December 2014 is available here: http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/General-Dental-Council-statement-on-the-outcome-of-the-BDA’s-judicial-review-.aspx

An Open Letter to the General Dental Council – GDPUK

I try to not get too involved with dental politics on this blog – I save that for my work with the BDA and so on, but in the wake of the Judicial Review result this morning regarding the hike in Annual Retention Fee I am happy to share this. Originally posted on GDPUK.

An Open Letter to The CEO & Registrar, Chair of the GDC, and the Council Members.

Dear Ms Gilvarry and Mr Moyes, and the General Dental Council members.

Today has been a landmark day for the UK dental profession.

It is now apparent that it is not only the Dental Profession that had doubts over the veracity and legality of the case presented for the increase in the Annual Retention Fee, but our legal system has also condemned the process.

This is in addition to the questions now being asked at Ministerial level about the problems behind the doors of Wimpole Street.

To Ms Gilvarry and Mr Moyes, as the heads of the now tainted and damaged General Dental Council you must both take full responsibility for the situation you now find yourselves in.

To the Council Members, your failure to call to task publically an Executive that has lost its way so completely renders your continued membership of the council untenable.

Never has a profession been so united against the unjust and inappropriate measures its flawed regulator sees fit to employ, its mechanism of operation, and the double standards from within which it operates.

Such double standards as the redaction of personal information that reveals the directorship held by Chief Executive on the grounds it has a duty to protect privacy since this might identify the home address. Yet the GDC fail to acknowledge that this same risk exists publishing registrants addresses without allowing any discussion as to their human rights privacy and considering an alternative. It is ironic, considering how easy it is to find details of the directorships held by individuals which then reveal the personal addresses, that the Council still believes you are owed more privacy than a registrant deserves because of the risk of publishing that information.

The double standards present when Council meet in private in a shabby and undemocratic manner to rubber stamp the ARF increase, and then pass it with the words ‘Are we Comfortable with that’, when we as registrants are expected to have full transparency and openness with our patients.

This situation can no longer continue. Not only has an entire profession voted ‘No Confidence’ in its regulator, now our Judiciary has weighed, measured, and given a verdict that is a final indictment of your leadership.

It is time for you to show some of the insight you so rightly expect of your registrants.

You fall far below the very standards by which you judge us at every opportunity.

It is time to resign.

This letter has been placed in the public domain for members of the dental profession to support by sharing on social media, by tweeting, sharing, or any other method of rebroadcasting it appropriately.

Yours Sincerely.

The Dental Profession.

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