GENERAL DENTISTRY, IMHO

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Keith Hayes
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I often seem to write my views from the Regulators prospective. This time, I want to write my thoughts on how to meet the challenge from the general dentists’ point of view. Ok, so what is General Dentistry? I belong to GDPUK and I visit maybe 100+ practices every year. I’ve been a General Dentist for 40 years. I try to walk a fine line between Regulator and Dentist and I sometimes feel that the General Dentist(ry) (GD) is seen by some as a derogatory term; “Jack of all trades, master of none”. But, this is wrong on many levels :-
  1. GD see the majority of patients
  2. GD delivers the majority of dental care efficiently and effectively.
  3. GD is the hub of dental care in UK.
  4. GD is the first point of contact (usually).
  5. GD listens to, examines, diagnoses and treatment plans and cares for the majority of patients.
  6. GD suggest the right direction for future treatment pathways, maybe referral and finds and signposts the right patient journey, (or it should do).
  7. GD provides the main stay of prevention and maintenance of the patient’s care for the vast majority of patients. Being the first person to turn off the tap of oral disease and the providing the Continuity Act for maintaining the patient’s health, (or it should do).

So General Dentistry is the pivotal part of Dentistry. I am proud to be called a General Dentist. In 1977, I wore the NHS GD badge, is that it for the next 40 years? I used to wear the NHS GD badge.  Then 20 years later, I honed my skills and decided to wear a Private GD badge, why? Because it gave me more opportunity to determine my future direction. Giving up the Queens shilling was a big step, but almost immediately it was like a yoke lifted. I was still a GD, still am and still proud of it. Why? Let’s look again at the 7 bullet points;- 1.  GD sees the majority of patients, but that is nowhere near 100% of the population. 50% maybe aren’t attracted by the NHS offering. I want to focus on those who actually choose to come and see me and not just an NHS label. 2.  GD, if we mean GDS services have become a seriously cost/time limited service. We are burdened with a ridiculous contract which will de-skill those of us who restrict ourselves to the UDA treadmill and punish us for thinking outside of this. The Regulators may pay peanuts, but they expect better than that and if you cut corners, will punish you. 3. Because GD operates as the hub, we should be able to direct patients in the right path to access the most appropriate services. Unfortunately, we find the spokes from the hub to the wheel of Specialist services are often broken or missing in the NHS system. It is at least a postcode lottery. 4. GD is usually the first point of contact. We should be the person who has TIME to gather the information, examine and diagnose and then discuss the best options relevant to that patient (Montgomery) and then to offer the treatment or refer to the best person. TIME is the most valuable commodity you sell, yes I said SELL because you are not salaried! 5. Treatment Planning -this is the real skill. The best plan for the patient by considering all the options. To do this a GD has to have abilities, experience and understanding of all the other aspects. We must be Expert Generalists, and not “Jack of all trades”. 6. & 7.  We may be generalists and yet we can also be experts. My particular interest was Minimal Intervention Dentistry and Preventative Dentistry, what is yours?  Having a particular interest and skill will bring you many patients who particularly seek this. I don’t know many people who are especially keen on having dental SURGERY or sinus lifts, but I did find lots of people who were just looking for CARING and PREVENTATIVE dental approach from a friendly TEAM. Conclusion GD needs to have a clear picture – the whole picture NOT tunnel vision. If you want to excel at GD you will need to have the right tools used by the team. Here is an example of tools I had in my box:-
    • Digital X Rays
    • EPT (yeah I know it’s a simple bit of kit) but why is it often missing?
    • Loupes (just 2.5 x to avoid the tunnel vision) with a headlight and screen to show patients
    • Enough TIME
    • IO camera
    • A TOGETHER simple GOVERNANCE system used by a TEAM
A well led TEAM will give you the opportunity to be an Expert Generalist.
If you want help to generate a well led practice team, speak to an expert. Funnily enough, that is what the Regulators want as well. Keith Hayes BDS www.rightpath4.com




Treatment Planning -this is the real skill. The best plan for the patient by considering all the options.
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