Darkness on the Edge of Town

Friday 3.30am, a long drive after a late flight, time to go to bed.

After a full working day.

Saturday 3.30am, alarm goes, time to get up. 

For the past four years Susan & I have joined hundreds of others setting off from Skibbereen GAA ground to walk 5Km from Darkness into Light in aid of Pieta House.

I have personally known several people who have taken their own life, one would have said that all of them had plenty to live for but chose to leave their families and this world behind. Just writing about it upsets me. 

I have met dentists after my talk “Is Dentistry Making You Sick?” who have admitted to me that they have self harmed or contemplated suicide. Although I have had my share of ‘black dog’ periods I am grateful for being spared the thoughts of no return.

As we all walked in silence from the edge of town through the streets watching the sun gradually rise I thought of my friends and the thousands of others and said a prayer that no one else will take that lonely exit.

“Well everybody’s got a secret, son
Something that they just can’t face
Some folks spend their whole lives trying to keep it
They carry it with them every step that they take
‘Til some day they just cut it loose
Cut it loose or let it drag ’em down
Where no one asks any questions
Or looks too long in your face”
(Bruce Springsteen – Darkness on the Edge of Town)

The Monday Morning Quote #533

“The world is changed by your example, not by your opinion.”

Paulo Coelho

via Brian Sooy

 

What do patients really think?

From The Conversation.

Gavin Brookes and Paul Baker were “tasked” with looking at patients’ opinions. An analysis of a total of 228,000 comments from the NHS Choices website, coming in at a huge 29m words. Their results have been published in the BMJ and as a book.

They spent three years on the project and Prof Baker said, “it’s taught me more about what it means to be human than any other project I’ve been involved with. It also reveals how some staff, such as surgeons, are almost universally praised, while others, particularly receptionists, unfairly take the flak when the system breaks down.

Some conclusions:

“…complaints about the technical ability of staff to make us well are less common, suggesting that the NHS is mostly doing a good job, but is overstretched and struggling to meet demand.”

“…patients like predictability – they have a set of expectations and are generally happy if they’re met.”

“…“attitude” tends to be at the heart of the majority of complaints about the NHS,…”

Dentists.

“…some staff members do especially well, with surgeons, dentists and paramedics being evaluated positively 95% of the time.’

“Dentists, who came second in our comparison, also attracted strong praise, consistently being called “great”. The broader language used to describe dentists was also revealing, though. Many patients wrote about having a dentist phobia but then being pleasantly surprised when the actual visit was painless. The good feedback dentists received, then, was often related to a sense of relief.”

The Monday Morning Quote #532

“Every time you are tempted to react in the old way, ask if you want to be a Prisoner of the Past or a Pioneer of the Future.

Deepak Chopra

Clinical freedom in a time of austerity.

First published online in Dentistry Blog on 8th April 2019. Full article.

Clinical freedom is becoming an aspiration rather than reality.

I regularly have to straddle a line between what principals need and what associates want, whilst attempting to keep both sides happy.

Often this involves money and the phrase ‘clinical freedom’.

Amongst the things they never teach you at dental school is that you must cover your costs before you can take anything out for yourself.

Increasing overheads makes this hard.

For instance, a 13% increase in CQC fees to ‘better align the cost of regulation’ must be borne by business owners.

As far as NHS practices are concerned, the minimal rise in fees during a decade of austerity have been swamped by rising costs.

Where contracts are fixed and consume a week’s full-time work to achieve them, there is little or no room for increasing productivity.

Associates, who have the dubiously privileged position of being self-employed, must take their share of the repeated squeezes on practice owners.

Either earn more (difficult with a fixed contract) or cost less.

Because previous generations earned a bigger slice than you, unfortunately does not mean that there is any divine right.

In any profession it is time and expertise for which people pay.

The third party fee setter (the NHS) took a set of fees from a decade and a half ago and continues to run with them.

This ignores the flexibility and evolution that existed in the dental contracts for nearly six decades, which helped practices stay agile in order to remain profitable.

Sometimes these money pressures are manifested in a reduction in quality of working conditions; for instance equipment might not be maintained, materials and laboratories are chosen on cost and choice is limited and staff might be ‘bargain basement’.

As the first casualty of war is truth, so clinical freedom can become an aspiration rather than a reality.

“One third gone and what have you done?”

The Incisal Edge Newsletter for May 1st.

“Strike another match, start anew.” (Bob Dylan)

April 30th was our financial year end for nearly two decades and I still have a feeling that I must end something and, more important, start something around that date. Whilst tidying, reading and binning yesterday I came across these lines. I don’t know who wrote them originally but I like the simple message.

  • We are where we are.

  • It matters not how we got here.

  • What matters is; what happens next.

We’re a third of the way through 2019, blink and the summer will have gone, have you made the changes that you dreamed of, taken the steps you hoped  for or chosen the new path? If not now when?

I am a great fan of goals & plans and objectives & tactics sometimes what matters most is what you do in the next 10 minutes.

Many people (especially in dentistry it seems) have a tendency towards  “perfection paralysis” they want everything to be “right” before they make changes, before they start something new and, because it never will be, because perfection never quite happens, sadly they don’t start, they don’t make the move, and they are left with their dreams, hopes and aspirations unfulfilled.
If you are one of those perfectionists
this article might help.

To read online CLICK HERE

A Builder’s Lesson

How shall I a habit break?
As you did that habit make.
As you gathered, you must lose;
As you yielded, now refuse.
Thread by thread the strands we twist
Till they bind us, neck and wrist.
Thread by thread the patient hand
Must untwine, ere free we stand.
As we builded, stone by stone,
We must toil, unhelped, alone,
Till the wall is overthrown.

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