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JUL
05
3

GDC Watch: Bringing the profession into disrepute - Part One.

Lookout_GDC_Watch_July_18 Lookout: Image by Dave Bleasdale

The GDC have recently being taking a stance over professional conduct and particularly in regard to social media.   The Standards say that we must not publically criticise colleagues unless this is done as part of raising a concern.  I should like to make it clear at the outset of this blog that what follows is part of me raising concerns.  Concerns that I feel are not being taken seriously enough, and some not even acknowledged as being concerning at all.   This blog is in 2-parts.  Part 1 will look at ‘bringing the profession into disrepute’ in the context of social media.  It is perhaps timely in view of Mr Hill’s recent effort of justification over the need to suspend retired dentist Mr Pate under the pretext of ‘protecting the public’.   Part 2 will look at my concerns over conflicts of interests.  Both will, as usual, look at this in terms of recent events and cases. 

So my part 1 concern relates to a fellow dentist who is a Clinical Advisor providing early advice reports to the GDC and the material posted on the public stream of their Facebook page.  Our regulator tells us that we must not post material on public media that may undermine public confidence or bring the profession into disrepute.   On this public-facing social media page, there is a joke about a sexual act, several slang references to parts of male anatomy and masturbation, a profile picture that is potentially racially-offensive (depending on the generation of the particular panel that might be selected by the GDC), but the finest one has to be the picture which blames patients for their gum disease and tooth decay because they are “*insertslangformasturbators*’’.  Yet this Clinical Advisor, wrote in an early advice report for the GDC that a dentist who communicated with a patient using Facebook Messenger, was unprofessional for doing so. This would be funny apart for the stress that the registrant was put under as a result of it being included in their initial allegations which contributed to the case being forwarded for a full hearing. There will be more of this to come in another blog.   

I emailed the current Director of Fitness to Practise to ask him what he thought about the content on this Clinical Advisor’s Facebook profile page, and whether he felt it was appropriate for someone affiliated with the GDC.   The GDC ought to know how their Clinical Advisor was behaving whilst giving potentially life-changing advice about other registrants’ professional conduct.  Perhaps my tip-off might assist them in getting their own house in order after a run of bad hearing outcomes for them and at a time when the mood of the profession is resembling that at the time of the ARF debacle.  At the time I had started to draft this blog I had not received any reply, and suspected that the GDC’s email filters might have kicked my email with its supporting attachments of profanities straight into their Spam Folder. I have now received my reply, so I will come back to that later.

On this particular issue of ‘unprofessional’ social media comments, 2 registrants recently received letters from the GDC reminding them of their need to uphold standards when using social media.  They had both used an inappropriate word, albeit on a single occasion, on a Facebook thread and a helpful colleague had very kindly pointed this out to the GDC without raising their concerns with the group moderators or the registrants themselves.  The digital evidence suggests that the anonymous informant was another registrant. In terms of the naughty word used, it was quoted ‘verbatim and in italics’ in the GDC letter.   If the GDC think that word is inappropriate they ought not visit the Dr Rant page and see their ‘affectionate’ nicknames for Jeremy Hunt which are used on an almost daily basis.  The GMC don’t seem to concerned however, but perhaps doctors do not refer each other to their regulator over spats and spite instigated on social media platforms.

Anyway, I felt pretty strongly that this particular display of conduct on social media referred to above really should not go unquestioned, all things being considered.  

 

The Standards apply to all and this Clinical Advisor who is a fellow dentist, is held to the same standards as us all.  No-one should believe that they sit above us mere-registrants, somehow ‘protected’ by a relationship with the GDC.  A colleague has a four-month suspension for alleged religiously-offensive statements made visible only to other dental registrants, yet I found his comments less offensive that this advisor’s silly, misogynistic and sexist posts. Also, someone with the infantile mentality that is publically displayed arguably unfit to assess whether any other registrants’ behaviour is professional, surely.

Whilst waiting for my email to be replied, rather hilariously, another registrant got a letter from the GDC courtesy of another anonymous informant reminding them of their professional obligations, and advising them to take action so they too could be better behaved in the future.  However, the letter gave no information on what was posted that caused offense or deserved some kind of GDC-referral retaliation.  An SAR sent the GDC may well clear that one up in time. 

Taking screenshots from Facebook and using them to make complaints to the GDC is a rather petty way to retaliate against another dental registrant in my opinion.  Those doing it really need to take a long hard look at themselves, especially if they are in the subset of registrants whinging about our high ARF.

As it happens, the GDC Annual Accounts and Report show that by 2018, 9-10% of incoming GDC complaints (as per my little infographic below) currently arise from other registrants.  This is a record year.  Well done registrants!!  Keep this rate of progress up and in a few years we might actually beat the patients. 

Table 1 GDC Watch July 18

So actually, never mind the GDC: we also need to get our own house in order here.  Please can we all stop being so childish? If you don’t like what’s on Facebook, get off social media, leave the groups that aren’t to your taste or contain people you don’t like, block people who wind you up, or if what’s being said is about you is that bad, spend your own money on legal proceedings rather than wasting all our money artificially inflating the ARF telling tales by the use of screenshots.  Still, it’s nice to see that the GDC has healthy reserves of £20 million against a back drop of a decreasing number of incoming complaints.  Maybe this is in preparation for the day we achieve a level of 100% of complaints arising from all the back-stabbing and bickering going on between ourselves. 

This is the problem with the ‘duty to report concerns’:

LEGITIMATE CONCERNS REPORTED TO THE GDC OFTEN END UP IN ONE OR MORE REFERRALS IN THE OPPOSITE DIRECTION.

This is the sheer reality of the dire situation that faces us.  The minute you act on a professional duty to raise concerns with the regulator, you are at risk that ‘concerns’ will be raised about you, and there will be GDC referrals all round.

But back to my email:  I did get a reply regarding my Clinical Advisor issue.  I was advised that I should use the online form to report the matter to the Initial Assessment Team.  

It looks as though we are not the only group happy to throw dentists under the bus, which is always nice to know. 

 

Image credit - Dave Bleasdale under CC licence -  modified.

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Recent Comments
Mike Wanless

GDC Watch

Thanks Vicky Very interesting and thought provoking blog. Is it possible to look at your dissertation, or if not could you be temp... Read More
Wednesday, 11 July 2018 07:38
Victoria Holden

Response to Mike Wanless

Hello Mike, Many thanks for your comments. I have messaged you via GDPUK. I am not sure if the complaints about social media sp... Read More
Wednesday, 11 July 2018 20:57
Mike Wanless

Thanks

It would be difficult to establish a trend in terms of numbers, but I think that on reflection I am probably more interested in te... Read More
Wednesday, 11 July 2018 21:22
6554 Hits
JAN
13
1

You don’t have to do this - letter to a wavering dentist.

You don’t have to do this - letter to a wavering dentist.

You don’t have to do this - a letter to a wavering dentist.

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

Many students have made their decisions to study dentistry at university in their mid-teens, an age when they are neither mature nor in possession of great insight.

Parents, family and teachers see dentistry as a well-remunerated, successful profession with a secure future. Well positioned on any socially acceptable list that makes it traditionally attractive to the children of immigrants. My mother, a migrant from Ireland was determined that both her children would have professions, her background, in nursing, favoured the medical. I became a dentist, my brother a doctor.

How many of us have the nerve to say that it’s not what they want? Many dentists are ill suited to a profession that makes extensive physical, mental and emotional demands on its members. I am not convinced that the undergraduate course prepares students for the rigours of general practice.

After 5 undergraduate years and now carrying a large student debt it takes a brave new graduate to dare admit to parents and family that they have studied the wrong subject. If you have a degree in humanities or pure sciences you are fortunate to be able to continue with your subject. Only with a “vocational” degree is the graduate able, and expected, to follow a career pathway.

Socially, turning away is akin to failing to show up at your own wedding. An individual might be secretly admired for admitting that they don’t feel the commitment needed for a happy marriage but it’s a brave dentist who says that they have done the wrong thing.

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

Far too many dentists have plodded on through degree, foundation training, associateship, partnership, marriage and children all carrying with them increasing financial pressures.

They thinking that this is the way that it has to be, that it will get better, easier, less of trial to get out of bed in the morning - next year. They live from holiday to holiday and get absolutely no fulfilment or satisfaction from the clinical work that they do or the people for whom they are supposed to care.

Often they succumb to the stressors. One of my contemporaries only accepted that he had a problem when he needed a quarter bottle of vodka to start work in the morning and was facing his third drink driving conviction.

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

These problems are not unique to dentists and many people “live lives of quiet desperation” so I would encourage them to change also, if they can.

What else is possible?

The answer is anything that you want to be. There are ex-dentists who are successful architects, writers, lawyers, musicians and businessmen. I know of one former specialist orthodontist who now builds dry-stone walls (and will also teach you how to build them). The discipline of your training means that you are suited to re-train in many disciplines.

Let’s not forget those people who are stuck in a rut. NHS dentistry has never embraced excellence, though lots of good work is done in spite of the system. You will never perform at the highest level on the conveyor belt of UDAs or whatever imposed system of production is in vogue this year.

If you are having second thoughts then I suggest that you examine your reasons. If you feel that you aren’t right for a job that demands a high standard of manual dexterity in order to practice at its best then you should explore your options.

Darwin says that empathy is instinctive not learned, so if you are not a person-person will you be happy going against the grain and attempting to gain the trust of your patients day in day out for the next 30 years?

If you are doing it just for the money, you will probably be disappointed at the amount of further training, dedication to a career pathway and sheer hard work that it will take. You might get a better return on the invested time in some other field.

On the other hand if you stay and you choose to dedicate yourself to a unique discipline, then every day will give a new challenge. You have the opportunity to grow as the leader of a team in a niche where you help your patients not only to achieve and maintain an important element of their general health but also to have an enhanced sense of confidence, comfort and function.

If you want to be happier then say so, and do something. This isn’t a rehearsal, there is no second chance, no re-run, no “it’ll be all right on the night”. If you want to be better nobody can do it for you. If you need help ask those who have already done it, study excellence and embrace it.

Polonius said to his son:

“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.”

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Recent comment in this post
Gaurav Vij

Great post....

Great post and sums it up succinctly. My experience is very few are cut out to be dentists. You are basically a surgeon in the cla... Read More
Saturday, 16 January 2016 07:20
10066 Hits
MAY
27
0

An Open letter to the New Chief Dental Officer

Dear Colonel Hurley,

The profession would like to congratulate you on your appointment to the post of Chief Dental Officer. As someone with a reputation for professional change management, then your appointment is seen as a welcome one by many.

The profession has not recently been blessed with a CDO who it can feel it truly relates to, and many may feel that the last few years have been detrimental to the quality of dental care available in the United Kingdom. Whilst the position of CDO will always be to do the will of its paymaster, Her Majesty’s Government, I am sure you will continually keep your professional responsibility to the profession at the forefront of your mind.

At a time of unprecedented change and pressure within the profession, you will have the opportunity to rebuild the bridges that have been lost over the years. One of the ways of doing this would be to listen very closely to the concerns of the profession, and most importantly do not be afraid to tell the truth of the problems we are experiencing. After all, you are a member of our profession first and foremost, and what is bad for the profession is bad for patient care.

A New NHS contract will no doubt be a priority; but in whatever incarnation this takes, it needs complete and total clarity as to what treatment is available for patients under the rules. There should be no room for abuse by those who use a lack of definition to perpetuate the problems of the current system. Contract negotiations based on honesty are a must; and if the government cannot afford what it wants, then it should be told in no uncertain terms that this is impossible to achieve. Not only do our representatives the BDA have this responsibility, but so do you. Only by listening to and working with the profession in a fully engaged and mutually respectful manner can this be secured. If this means a core service for the NHS, or a new way of thinking that benefits both patients and teams alike then it should be piloted properly and not forced on the profession in the manner it has before; please don’t forget that the success of dental care depends on those delivering it. You have a track record in delivering high quality change within a budget; but do not underestimate the suspicion of the profession as to how government will treat them.

The inequities of dental care must be addressed; and the continued lack of a joined up policy on dental health in the nation is still something that makes dentistry a poor cousin to other health issues. When dental problems are the number one cause of admission to hospital for children, can nobody actually see it would be cheaper to fight the problem at source rather than wait until the problem occurs? There would be no better long term legacy for a CDO than to have truly changed the face of dental health in the UK for the better. A public face of the profession that is prepared to stand up for the patient and not hide behind government spin and empty promises is what the profession requires if faith in the position of CDO is to be renewed. A clear message is what the public need.

The situation with our young practitioners having to play some kind of bizarre lottery to gain a job on graduation is another aspect of the profession that you must turn your attention to. At the very beginning of their careers, we have an increasing number of them considering whether or not they have made the right choice for their futures; and by association this is the future of the profession too. Whilst part of this lack of morale lies at the door of our failing regulator, to then heap on the uncertainty of a tiering system will eventually result in the profession being devoid of is youngest talent, without which it will wither.

So, as you approach the start of your tenure as CDO, the profession can only really ask one thing of you.

After years of obfuscation, spin, and confusion;

We need clarity.

Yours Sincerely,

 

The Profession.

 

Image credit - Jason Dean  under CC licence - not modified.

 
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8872 Hits
OCT
04
0

BDA is eating itself

BDA is eating itself
 
 
The BDA is eating itself. This has been going on quietly for a few months, since the figures secretly emerged from the membership changes implemented in early summer. News on this topic has been sketchy, the BDA has been trying to keep a lid on it.
 
There is a battle raging at the BDA, but there is a silence, a purdah from those involved. The membership needs to know, and must be told.
 
b2ap3_thumbnail_220px-Leonhard_Kern_Menschenfresserin_White.jpg
 
There has been a major shortfall in income, and the organisation has to respond to this, or face dire financial consequences. The PEC met on Tuesday 1st October there has been no press release about this. The GDPC Executive met on Thursday October 3rd. No news from there either. Today [October 4th] the GDPC will be having it's say in London. By then, many more people will be in the know. But the membership should be told what is happening, and what the outcome will be.
 
On one side, the executive and the PEC has set course to retain the costly premises, and salaries of leading executives, make some cutbacks but carry on with the rest of its functions.
 
The other side is both concerned and very angry that cuts will be made to frontline services, directly affecting members and that no-one at the centre of the organisation is taking responsibility in the form of resignation. Cuts that may be made to BDA services include many staff redundancies, potentially in more than one wave. Major concerns are that BDA spending on the trades union side of the organisation will be severely cut. In addition, there are whispers that funding to the BDA branches, its true roots, will be cut to zero next year.
 
My opinion - although decisions were made collectively by boards and committees, the membership plan changes were brought to the fore by a group, and that group should take responsibility.
 
The membership, in their thousands, continue to subscribe millions of pounds, and the majority chose the simplest membership option, which includes the trades union activity. Therefore my prescription - this part of the BDA's work must not be cut.
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8740 Hits
AUG
18
0

Take a second look at Heart Your Smile

There have been many questions about the dental charity Heart Your Smile (HYS). I have been asked why is an organisation needed to get more people to visit the dentist?

The vision from the outset at HYS was that improving engagement between the profession and the public would lead to increased trust and improvement of uptake of oral health messages and care at local level.  Many organisations in this space concentrate on the messages themselves, but we felt the messages were well established, so to elicit behaviour change we decided to concentrate on breaking down barriers to the uptake of oral health messages.


Heart Your Smile (HYS) has 4 key goals.

These are to:

1.            Change the public's perception of Dentistry

2.            Increase attendance and uptake of care

3.            Emphasise the dental team's position as trusted members of the local community

4.            Restore positive morale in the profession



We went through a rigorous process with the charity commission.  Our charitable objects are:
1.    to promote and protect the physical and mental health of sufferers of [oral diseases] in [the UK] through the provision of financial assistance, support, education and practical advice.
2.    to advance the education of the general public in all areas relating to oral health
 

All funds we raise go towards promoting our charitable objects.  To advance the education of the general public in all areas relating to oral health is a very costly undertaking.


Our initial campaign was to seek out the professionals who already had the energy and interest to support their local communities through:
*            oral health promotion
*            general health and healthy living support and advice
*            support in the community in schools, homes, local organisations etc, by giving their time and gaining their trust


We decided these behaviours could be packaged as the “9 habits” and are a positive way of raising the public's confidence in seeking timely dental care, by reducing anxiety, one of the biggest barriers.



Meanwhile, as these professionals were getting in touch, we needed time, funds and supporters to develop an online presence through which any team member in the profession could make a positive contribution in their community and share their work to create a ripple effect. We established a flat organisation and anyone was and still is welcome to join in and take on a workstream.

We also used this time to create mentoring resources and oral health promotion resources and the trustees wanted to get robust support from public health advisors for the resources we were producing before we announced them, so the whole process of getting to where we are now took 12 months.

The mentoring platform has been developed in conjunction with Fiona Ellwood, who has the level 7 postgraduate certificate in Mentoring from FGDP (UK). Our first group of 24 Mentors and Mentees start working together on 18th September.

Heart your Smile is committed to promote civic responsibility and good citizenship amongst members of the dental profession in a sustained campaign to achieve our objectives. We started off with trade stands and engagement online, we have launched innovation 360 to crowd source innovation and spread the message through local action, as well as pilot new methods of engagement and to roll out the best ideas. The first round of applications has closed and we are working with 14 teams to roll out their ideas.

We would love all dental teams as well as members from GDPUK to get involved and perhaps lead a workstream of their choice or apply to be mentors or mentees. The future of the dental profession is in our hands.

 

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