Podcast with Richard Hellen

 

When Richard Hellen bumped into his optometrist in his local Post Office in Cockermouth he wasn’t prepared for the outcome.

A story of eyes, shutdown and one dentist’s philosophy of life.

https://www.yorkplacedental.com/blog/my-nhs-good-news-story

 

Urgent dental care for patients during the COVID-19 pandemic – The Lancet

 

The Lancet Vol.395 | Number 10232 | Apr 18, 2020

During the initial phase of a pandemic, when a vaccine is not available, personal protective equipment (PPE) plays a major part in disease control. Dental and oral surgery procedures using drills or ultrasonic devices cause aerosol release, and routine dentistry has therefore been suspended in several countries, including the UK, to reduce virus transmission. There is an urgent need for organised emergency dental care delivered by teams provided with appropriate PPE. This also allows for redistribution of PPE to urgent care when there is inevitably an initial shortage and distribution challenge.Timely and major reorganisation of dental care services is challenging. Early management of acute dental emergencies is important to avert patients from Accident and Emergency services and to avoid hospital admissions. One concern is that with the suspension of routine dental care, more patients than usual could need admission for the management of acute dental infections that threaten the airway and require intensive care.

Patients with substantial swellings can progress to life-threatening emergencies, which can increase risks in the setting of reduced health-care availability. For such patients, extractions of the causative pathogenic teeth should be prioritised over restorative rescue, and input from dedicated oral surgery and oral and maxillofacial services and close follow-up should be instigated as locally appropriate. This approach has many benefits, including stewardship of antimicrobials, but is a deviation away from routine dentistry that should be thoroughly discussed with patients. Decisions on undertaking treatment should therefore be made with appropriate patient consent. Clinicians might wish to follow up patients digitally (eg, through video calls), if appropriate, to ensure patient safety, but also to minimise repeated patient contact.Testing for coronavirus disease 2019 (COVID-19) in dental professionals should be undertaken with the same high priority as that of medical health-care workers in hospitals. The risk of a dental practitioner being positive for COVID-19 and potentially infecting patients attending emergency dental services should not be underestimated. Proactive and preventive measures need to be established as mainstay protocol to contain the spread of the virus.We declare no competing interests.

FULL TEXT HERE

 

Dentistry needs a safety net – support the BDA’s initiative.

The BDA continues to step up to the plate on behalf of dentists in the UK. All members will have had an email from the BDA today asking them to write to their MP regarding the fall out from the Corona Virus Pandemic.

“The impact of the COVID-19 pandemic is being felt across our profession.  
Many colleagues will have their own stories, of practices struggling to stay afloat, and personal hardship. 
We are speaking up for dentists directly with ministers and officials. You can play your part by sharing that story with your MP and asking them to take action on your behalf. 
We’ve pre-populated a letter for you that will be sent directly to the MP in your postal code. All you have to do is add in your personal circumstance at the top. 

Our immediate priority is quite rightly on supporting the healthcare effort where we can. But we also need our services to still be there for patients in future. 
1 in 5 practices say they will struggle to keep their heads above water this month. And the vast majority of self-employed colleagues will get nothing from the Chancellor’s deal.
We need to see a safety net in place for every practice, and every practitioner.
We’ve been speaking out to government and the press. And your voice can help make a difference.”

Write to your MP HERE

 

Time to give up the hand shake and replace it with…

In these times of contagion fear perhaps we should reconsider our traditional meeting gesture. Research shows that the strong handshake is responsible for sharing twice as many “bugs” as the moderate handshake or high five.

The lowest risk contact is the brief fist bump. It might take a little bit of patient education but it’s the way to go.

The men from Aberystwyth did the research a few years ago.

If it’s good enough for the Obamas…

 

 

…on the other hand, life can be good.

A contrast from yesterday’s blog where I said that many people who work as clinicians are not suited to the job, have made decisions for the wrong reasons and are unhappy.

Dentistry is rewarding in many ways, if you get the design of your job right – and I’ll talk about that tomorrow. It pays relatively well – especially in early years, it is challenging both intellectually and physically, has social kudos, it provides ways of stimulating your interest in different areas as time progresses. There are opportunities to be your own boss, to build a business or businesses, you get to work as part of a team and above all you get the thanks and respect of your patients who you are able literally from cradle to grave.

Take a look at this recent survey from US News about highest paid and “best” jobs and see where a dental degree might take you. I am aware that most of my readers are in the UK (& Ireland) and the reason that I have used this link to help you to see what might, could and should be possible for you to achieve with your degree.

But, and its a big BUT, and at the risk of using a cliche, you must think, look and act outside the box. The climate of fear, in the UK especially, is dividing the profession, helping to keep people down and constantly looking over their shoulder for the next problem. Those who want to serve their patients, who get involved in successful clinical and therefore, business relationships will flourish. Of course there is a need for personal and business resilience to safeguard yourself. Of course you need strong and effective systems to ensure that you can serve your patients to the best of your ability.

Personal and business success is achievable in any country, any jurisdiction and any health system but it will not be delivered on a plate, it takes time, dedication and hard work – if you’re willing success will come, if you’re not then prepare to be disappointed. 

 

You don’t have to do this…”Things They Didn’t Teach You at Dental School”

An excerpt from the forthcoming book, “101 Things They Didn’t Teach You at Dental School”

“This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man.” Polonius. Hamlet, Act 1, Scene 3.

Is Dentistry really what you want to do? You don’t have to.

Many dentists made the decision about what to study at university in their mid-teens. A time of life that is short on maturity, experience and insight. Parents, teachers and career advisers see dentistry as a well-remunerated, socially acceptable profession with a good secure future. 

Unfortunately a number of dentists are ill suited to a profession that makes extensive physical, mental and emotional demands. How many of us have the nerve to say that it’s not what we want?

After 5 years as an undergraduate and carrying a large student debt it is a very brave new graduate who would dare tell their parents and family that they have chosen the wrong subject to study. Humanities and pure sciences graduates would be fortunate to continue with their subjects. It is only the vocational degree where the graduate is able, or expected, to follow the career pathway without a second thought.

Socially, to turn away is akin to leaving your fiancée at the altar, yet an individual is to be admired for admitting that they don’t feel the commitment needed to make a happy marriage. 

Turn things on their head, if you know in your heart of hearts that you are unfulfilled and unhappy being a dentist isn’t it better to say so sooner than later? How many more miserable years do you want to tolerate? How much stress and heartache can you endure once you have admitted to yourself that you’re in the wrong place? 

There are far too many dentists who have plodded on through their BDS and Foundation Training then on to associate posts and partnerships without considering the future or an alternative.

They think this is the way that it has to be, it will get better, easier, less of trial to get out of bed in the morning – next year. Living from holiday to holiday they get little fulfilment from the work they do or the people for whom they are supposed to care. 

Often these are the ones who succumb to the stressors. The use of alcohol and other drugs, gambling or other addictions along with failed relationships are commonplace.

I have attended funerals of apparently happy and successful dentists who have taken their own lives because they could only see that one way out.

These problems are not unique to dentists and many people as Thoreau put it “live lives of quiet desperation”. 

What else is possible? 

Answer – anything that you want to be. There are ex-dentists who are successful architects, writers, lawyers, and musicians. I know a former orthodontist who now builds dry stone walls (and will teach you how to build them too). The discipline of your training means that you are suited to re-train.

Stuck in a government-devised rut, which rewards quantity not quality?

If you want to change then say so, and do something about it. This isn’t a rehearsal; there is no second chance at life, no re-run. If you want to be better, nobody else can do it for you.

 

The Natural Order of Things

John Naughton posted this quote from Douglas Adams on his Memex blog HERE.

“Anything that is in the world when you’re born is normal and ordinary and is just a natural part of the way the world works. Anything that’s invented between when you’re fifteen and thirty-five is new and exciting and revolutionary and you can probably get a career in it. Anything invented after you’re thirty-five is against the natural order of things.”

I agree with the principle but not necessarily the exact ages. It made me think of the “Bell Curve” or as one person in audience corrected me, “It’s a Gaussian Distribution Curve” I have since discovered (stats not being a subject of which I retained any knowledge) it’s also known as normal distribution – or extra normal if you wish. In this case it shows the Diffusion of Innovation Theory.

As Jim Lovell (of Apollo 13 fame) said, “There are people who make things happen, there are people who watch things happen, and there are people who wonder, ‘what happened’?.” In Dentistry I think that most new graduates tend to be to the left of the midline – they are curious, learners, enquiring about the world into which they have been released so they become Early Adopters and Early Majority. As time passes, excitement is tempered by experience in many who want a “simple” life, they get into groove, which becomes a rut which is of course only a grave with the ends kicked out. They slide gradually to the right of the curve and settle into the Late Majority (watching what happens) or eventually The Laggards (what happened?).

Others get a handle on things and hit their straps later on, often realising that their jobs with businesses on the right of the midline are taking them nowhere and so they head in their own direction, start enquiring and looking into alternatives, revelling in their curiosity and enthusiasm. The tide can carry you to the left but it can be hard work and it can sweep past you and, as your energy wanes, you find yourself drifting backwards to the right being passed by “the bright young things”.

I have seen this happen with dental societies that are started with energy, flourish and then consolidate and eventually wither, plus contemporaries who finish up putting in the years until they can take their pension and get out. Other dentists I know have kept striving, looking over the edge, investing in themselves and their businesses loving what they do right until they hang up their handpieces.

  • I love working with Early Adopters and Early Majority people because they keep me on my toes.
  • Innovators tend to burn me out, but that’s fine because it’s a great ride. a blast whilst it lasts.
  • The Late Majority can be fun to push and often convert into “Earlies”.
  • Laggards just can’t see the point of anything.

 

09/2020

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