Our house, with two cats in the yard…

 

 

 

 

 

 

I first heard this song nearly 50 years ago, I was hitch hiking from Cardiff to London at the start of a trip that eventually took me to the Greek Islands via Yugoslavia (as it was then). I got a lift in a mini and the driver played Crosby, Stills, Nash & Young’s album Deja Vu on cassette. (I could not imagine anything cooler than having a mini with a cassette player!) All these years on we have two cats in our yard and I whistle the melody of CSN&Y’s song every day…

 

The Weekend Read – Can Medicine Be Cured? by Seamus O’Mahony

Can Medicine Be Cured? : The Corruption of a Profession

I have an instinctive leaning towards any O’Mahony from Cork because my maternal grandmother, Catherine O’Mahony, was Cork born and bred. Stories of, and meetings with, members of the extended O’Mahony family have been some of the highlights of my life. 

This book examines modern medicine through the lens of an experienced physician, researcher and sceptic. This last is defined as, “a person inclined to question or doubt accepted opinions”, and shouldn’t we all, even we idealists, be doubters and questioners?

Dr. O’Mahony writes beautifully, his arguments are clear, concise and well supported. I am a retired clinician but  still very active in what I consider to be still a field of medicine, although I occasionally have my doubts. It was refreshing to able to read what at first appears to be bad news, especially as I get older, that I am not going to live forever and modern medicine will not sustain me into a glorious old age where magical medical interventions will carry me through the vicissitudes of my decline to a point of rapturous departure.

My suspicions are that like every generation before me I will become gradually, possibly embarrassingly, infirm and medicine will do little to reverse that decline. 

One of the author’s conclusions are laid down in the epilogue, “The medical industrial complex is not some vast, organised sentient conspiracy; it is as fallible, messy and irrational as the people who created it. It has become so powerful, however, that medicine has passed the *Illichian tipping point where it is doing more harm than good to the people it is supposed to serve. There are two simple questions to ask of any new development, treatment or paradigm in medicine: first, who benefits? Cui bono? And second does it make life any sweeter? Ask these questions of genomics, digital health and awareness campaigns and the answers are obvious.

*Illichian

My thanks to reestheskin, whose review goes into far greater depth than my superficial skim,  for his recommendation of this excellent book. Fine picture from ReesAcres on his web page too.

Book Depository

 

40 Years On….

Today,  April 1st, I have been classed as self-employed for 40 years. That means that I have taken responsibility for ensuring that I keep a roof over my (and my family’s) head, that I acknowledge when times are good and acknowledge that times will not be so good. I have had ups, downs, made mistakes, learned from them (eventually), met some great people and a few, a very few, “less than nice” individuals.

I have tried to ensure that I have worked with people who understand me, care for me, take the time to know me and support me these include accountants, lawyers, financial advisers, insurance people and very occasionally banks. Of course I have encountered dentists both as colleagues, clients and some who even called themselves competitors and who sadly behaved as if we were in a fight for business. I have always believed that there is plenty of work to go around and that if your offering is good, you are straight with people, tell them the truth and don’t try to rip them off you will succeed. You need a team that you can rely on and I have been blessed in working with some marvellous people. My thanks to my teams in practice, nurses, hygienists, practice managers, front of house people, behind the scenes people, laboratories who dug me out of messes and the specialists and consultants who did the same. 

I’m writing this in my studio/office/workroom at ReesAcres (approx 2.6 acres fact) in West Cork where we moved permanently in 2013. For the past twelve months I have rarely left home and can think of no better place to be. Work continues to be interesting and whilst I do miss meeting people and speaking in public, travel itself can get tiresome but I’m looking forward to getting acquainted with Cork Airport again in the foreseeable future.

Most of my contemporaries have retired but I enjoy what I do and, whilst there are people to help with their businesses, careers and challenges, editors wanting copy and all that goes with this life, I’ll keep going. Do I regret 40 years of self-employment? Not in the least. The hills, valleys and roads less travelled continue to keep me in their thrall. When I started out in coaching we had to do an exercise and choose the five values that would guide our lives. After much deliberation and thought I opted for Integrity, Independence, Co-operation, Communication and Curiosity and of all I think Curiosity has guided me most.

Communication has dropped below the level I would like so I resolved this week to write a blog post every day, starting today, if I don’t make the effort nothing happens, one of things that I learned very early on. IADOY It All Depends On You.

March 23rd 2021 my first cup of coffee for more than a dozen years. Thanks to Will and Susan for choosing the coffees and the kit for my birthday.  I’m back on board.

 

The Monday Morning Quote #651

“Most runners run not because they want to live longer, but because they want to live life to the fullest. If you’re going to while away the years, it’s far better to live them with clear goals and fully alive then in a fog, and I believe running helps you to do that. Exerting yourself to the fullest within your individual limits: that’s the essence of running, and a metaphor for life — and for me, for writing as whole. “ Haruki Murakami

Chosen for today because, after a month off my (active) feet with what I hope will be the final attack of Gout*, I hope to renew my relationship with the roads and hills of Castlehaven about the time that this blog is published.

The CQC post-Covid

Quote of the Day. “There is nothing I can think of that the CQC can bring to a post-Covid NHS, other than irritating everyone and wasting their time.”

From Roy Liley’s regular blogpost, I often disagree with what he writes, probably because my experience of working in large organisations is so small to be non-existent. When he talks about the pointlessness of inspections as he does here, he is spot on no matter what size of organisation.

Lilley continues:

“I can’t think of a single thing that anyone, serious about managing a chip-shop, never mind a hospital, could imagine that inspection brings to modern management… neither a jot nor a tittle.
Even before Covid, turning up and inspecting was generally agreed to be futile. 
  • Turn up and it’s good, you wasted your time. 
  • Turn up and it’s bad, it’s too late. 
Everyone knows, page one, chapter one, paragraph one of the dummies guide for managers, says… don’t waste time on inspection.
Dare I quote… again… the grandfather of management gurus, Edwards Demming;”
‘Quality cannot be inspected into a product or service; it must be built into it.’
If you don’t know about Demming, and you should, start here.
My take. The ham-fisted, wrongly targeted, imposition of compliance, in all its forms, has done more to reduce morale, eliminate joy, and distract from the ideals of patient care. It has contributed to making the practice of Dentistry a far more miserable existence than any other single thing over the last 50 years.

The Monday Morning Quote #650

“If you do not tell the truth about yourself
you cannot tell it about other people.”

Virginia Woolf

 

The Monday Morning Quote #649

“If you like things easy, you’ll have difficulties: if you like problems, you’ll succeed.”  Laotian Proverb

The Monday Morning Quote #648

One thing that’s so disappointing about the people I’ve met (in tech) is that they are mostly motivated by what they can take from others, rather than what they can build working with others. So often they could make so much more money by doing the latter. Stupid. (And of course money is far from the most motivating motive.)

Dave Winer http://scripting.com/2020/10/25.html

 

The Monday Morning Quote #647

“Faced with the choice between changing one’s mind and proving that there is no need to do so, almost everyone gets busy on the proof.”

John Kenneth Galbraith

via “How to be a Complete and Utter F**k Up by Steve McDermott (possibly the best self-help book ever written – but then again, possibly not)

Why the Uber decision isn’t the end for self-employed Dentists

As usual the sky falling in faction in UK dentistry have taken the High Court’s decision in favour of the Uber Drivers as the signal that the floodgates will open and this is the end for all self-employed associates.

In my opinion this should lead to more dental principals, associates, therapists and hygienists becoming more careful about their positions, taking advice from their financial and legal advisers and ensuring that their positions are secure and transparent.

As the Financial Times reported, “The judgment, however, rests on specific facts about the relationship between Uber and its employees. The court asserted that Uber set maximum fares, drivers had no say in their contracts and the application imposed penalties if drivers cancelled too many requests. This level of control meant drivers could not increase their income using “professional or entrepreneurial skill”, the court concluded, meaning they worked for Uber and not themselves.”

In the case of associates there are, or at least there should be, opportunities to increase their income through, “professional or entrepreneurial skill”. If there is not then of course their situation might attract the attention of HMRC. More to the point if there is no variation, no risk and no opportunities then there has never been a genuine argument about self-employed status.

This has been rumbling and gaining momentum since the introduction of fixed UDA contracts in 2006 and both sides (Providers and Performers) have been allowed to let things to roll on, hoping that nothing will change.

Of course, much of what is spoken on forums, and social media is opinionated and not valid, but it has put the wind up younger associates, many of whom are wrestling with the implications of Covid to their professional lives.

The advice remains the same. If you are an employer or principal ensure that anyone and everyone  who claims self employed status has that claim supported by their accountant in writing at the start of every financial year. In turn if you are an individual claiming to be self employed there is a responsibility to work with an accountant who understands the variations of dental employment status and will support your claim.

Meanwhile both sides should be careful what they wish for.

And of course there had to be one of these.

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