GDPUK is a community of practice. It is a group of people that share in the same activity; dentistry.

This means that in a community of practice, our members are encouraged to share their best advice, filter out the good from the bad, and steer discussions towards what lies upon the cutting edge of the sector or profession. So for instance what changes in the political, social, economical, or technological environment are impacting upon the sector? From observing GDPUK over the last few years, that seems to be the majority of threads that prove popular!

In the last couple of weeks we have seen a different side to the community. The GDPUK community have rallied behind the profession, shown amazing engagement and made something happen. I am course talking about the recent case of Keith Watson. Brief details below:-

Keith Watson lodged the defamation action against Andrew McIntosh, relating to claims that led to him being investigated by the dental industry's governing body.

Mr McIntosh made a series of allegations about Mr Watson's professional conduct at Discovery Dental Centre in Dundee and the case was taken to a full hearing by the General Dental Council (GDC).

Mr Watson was subsequently cleared of all misconduct and lodged a £50,000 defamation damages claim at Perth Sheriff Court, but court officials have now confirmed that he has instead been granted a Minute of Abandonment and ordered him to pay £10,050 in expenses to Mr McIntosh, from Invergowrie, Perth and Kinross.  

So Keith was suddenly in the bizarre position of having to pay £10,050 legal fees, after he had won the case at the GDC!

This is where the GDPUK community spirit came into action. Victoria Holden, one of the GDPUK Moderators setup a gofundme page and within 5 days over £10,000 has been donated. An amazing achievement by all and a fantastic demonstration of the power of a community.

From a GDPUK perspective we think that it is amazing that within a few days, over ten thousand pounds was raised and at the same time we saw generosity and charitable behaviour from the dental community which should make us very proud.

Moving forward, we believe GDPUK can be a force for the good of the profession in getting involved in situations that need support from the ground up and as the sites influence and popularity continues to grow, we will continue to facilitate great achievements like the one mentioned above.

An amazing example of the power of the GDPUK community, where else can this be seen in UK Dentistry, where thousands of dentists are actively engaging on a daily basis?

http://www.gofundme.com/keithwatson

In forming the ideas for this blog, I have thought about the changes that have occurred in the leadership and role models for the dental profession in the UK in the last decade or so. Some bodies have not changed their style, nor the stature of their dental leadership. In some government controlled ones, they have.

I will consider two leaders, Chair of the General Dental Council [GDC] and the Chief Dental Officer [CDO] of the Department of Health [DH].

As you will know, an era is over with the retirement of Dr Barry Cockcroft as Chief Dental Officer, NHS England. I am sure the whole profession wishes Dr Cockcroft well, we hope he has a long and healthy retirement.

The dental profession knows the role of CDO was downgraded when this incumbent was moved sideways from the Department of Health, giving advice directly to Ministers. Of course this role has always been a civil service post, but included advisory duties as well as the expectation of leadership qualities.

During this recent tenure, the role of CDO seems to have changed to a more "director of dentistry" style, implementing imposed changes from the DH, in order to carry out the political will of the DH.  Not necessarily changes which benefit patients, nor the public, nor the profession, sad to say, but changes which have benefited HM Treasury. No doubt this would be argued against by the outgoing CDO, the changes under his watch have been dictatorial, and controlling, often based not on evidence, but on political expedience. In fact that concept of lack of evidence base is a marker for his term, of course dentists must follow an evidence for all our decisions, but UDAs and HTM01-05 demonstrably lacked any proper evidence. Only one person would argue that they do.

The historical model was that a highly respected, highly qualified colleague fulfilled this role, and often with a public health aspect, and watched over dental developments emerging from the DH, supervising in a more nurturing, parental style. We do not know how internal battles were fought with the DH over dental policy historically, but the role of the CDO appeared to be protective of patients and the profession. Will these days return?

Now over to the GDC at Hallam Street and now Wimpole Street, and from 1956 to 2012 leadership was provided by a President, who served a fixed term, elected from the body of the elected GDC.

The Presidents of the GDC over the years have included some of the heavyweight names from the surgical and scientific fields of the profession. Those dentists may have been in positions of authority, but they were colleagues that other dentists could look up to, admire their achievements, and accept leadership in thoughts, philosophy and deed.

The same thoughts would also go for the holders of the post of Chief Dental Officer.

But, as we know, the present Chair of the GDC, imposed by the Government, and put into position by the  Privy Council, has been a lay person, Dr William Moyes. Not a leader of the profession, and indeed, someone who has shown little insight into the way the UK dental profession ticks. For example, in a speech, he suggested that UK dentistry should be comparable to the supermarket industry, with shoppers able to choose between the Waitrose style practice, or the Aldi/Netto/Lidl style.

Colleagues in dentistry shudder to think who will be appointed to be the next CDO. I personally hope the appointee will be able to show the profession the way forward, to be able to speak to the profession, and not be one who is planning further degrading downgrades to professional status, or perish the thought another appointee who sets in train solutions which offer lesser results for the people of the country, or which transfers the blame for reduced outcomes back onto the profession. We need a CDO who stands up for the profession and professional ideals.

We have figureheads of the indemnity societies, the faculties of the Royal Colleges, the universities [who seem to be inward looking], trade unions, private care providers, corporate bodies, online groupings, in place, all carrying out their roles, but none of them have yet emerged as a true leader, widely recognised.

My hypothesis is there is a vacuum in strong, thoughtful, highly moral leadership of the profession, this vacuum has been created by barmy ministerial edicts over a decade or more, when politicians have either not had advice or ignored it, and have chosen to appoint different types of people, the wrong people. What do you think?

Who will provide the leadership? From where will this person or people of stature emerge, when the profession so badly needs the core values of moral, philosophical and intellectual guidance?
 

http://www.gdc-uk.org/Newsandpublications/Publications/Publications/Thefirst50years_Gazetteinsert_summer06[1].pdf

http://www.thetimes.co.uk/tto/health/news/article4081701.ece

http://www.breathebusiness.co.uk/blog/make-a-visit-to-the-dentist-more-like-a-supermarket-trip/

https://www.flickr.com/photos/pedrosimoes7/


 

When I qualified back in the early 1990’s, social media wasn’t exactly on the radar. The thought of being able to connect with a multitude of people instantly was the stuff of imagination. The Pub was our Facebook, and the only ‘likes’ we had were the various guest beers.

Now it’s such a part of our everyday lives that normal channels of communication are seemingly used in the minority. When you can connect with the entire world’s population from the comfort of your home, and carry on multiple conversations about multiple subjects simultaneously, the days of popping out for a beer and a chat with a mate seem numbered.

But what about the social etiquette, and more importantly the professional etiquette we employ when online? The GDC have standards that we should adhere too, and indeed GDPUk is actually specifically mentioned in them such is the impact social media has made on the profession. Specific specialist sites like GDPUk aren’t generally the issue, and whilst there are sometimes a few comments made that might get the GDC or lawyers a trifle interested, these sort of sites are generally appropriately populated and commented upon.

The problem are the wider platforms especially those such as Twitter and Facebook. Some users don’t seem to get the fact they are in no way whatsoever a place to remain private and anonymous despite what you might think.

Whilst the ‘more mature’ professionals seem to have the general hang of the way we should conduct ourselves, I worry that some of the younger members of the profession haven’t quite got the gist of what being a professional is yet and how they should present themselves in public to the public. Because no matter what steps they take, if they have a social and professional presence on media like that, they are well and truly exposed to public scrutiny.

There are a multitude of Facebook pages for Dental matters. Some are better than others, but all suffer from the same fundamental problem. They are not private. In order to use them you have some sort of visibility. For instance, if I wanted to discuss a case over a beer in the pub with a mate, I wouldn’t be doing it whilst posing in a mirror with oiled muscles. But that’s what communicating with some of the personas on social media is like. Some of the fairer sex seems to be somewhat less than modest in their attire on occasion, and one has to wonder if this is what the public expect of its professional classes. A couple of clicks and you generally have a range of private information about ‘friends’, particularly the more self-obsessed ones.

What about commenting into the perceived anonymity of an electronic device in such a way that you wouldn’t do in person? I’ve witnessed many an argument that would never happen in real life due to the social ethics the majority of us have; but once in the safety of the digital world the ‘keyboard warriors’ tend to lose all sense of propriety and the moral compass seems to have lost its direction.  And then there are the artists of self-promotion who feel every other comment has to be some form of pseudo advert for a business venture, or course you can’t possibly miss. I’m becoming guilty of the last one as my Twitter account now is used almost solely for the promotion of this blog and GDPUk. You see, the boundaries of who you are as a person, and who you are as a professional are becoming so grey with social media like Facebook that it feels safe to make that sort of comment, and think there is no comeback.

Finally, there are the vast numbers of photos of patients and cases that we see bandied around social media. The GDC is very clear on this,  in standard 4.2.3, where it states ‘You must not post any information or comments about patients on social networking or blogging sites’. Period. We can use ‘Professional Social Media’ but social networking sites are a no-no according to the exact wording. Personally, I think the GDC are possibly a little behind the times on this, as there are a good number of very good Facebook pages where some quite good discussions take place; however it remains to be seen if the GDC feels this is ‘professional social media’ when used in this way, as after all, they are the ones who get to decide….

The big problem though is that many people forget just what can happen to these comments and photos once they've been posted.

I’ve heard stories of people using screenshots of comments made on social media and then threatening to use them as evidence to send to the GDC. Screenshots can be shared outside the domain we think we are posting in, and as such can be disseminated far more than we might have considered when we posted. Unfortunately the self-righteous are rife on social media, and often mistake what is only free speech for something to get offended by, and take draconian steps.

I’ve seen the fallout when comments in a public section of a site then get even nastier privately; and I’ve seen wholesale bar-brawls break out in some places (although they’re usually involving musicians ? ). This is like taking a voice recorder or video camera to every meeting you have with a professional in case they say something that offends you so you have evidence and can report them. Since the GDC love nothing better than a good old Fitness to Practice case, we need to really be aware of what we put on social media, how we do it, and the persona we use on there. I think it is only a matter of time before there will be a full-blown case against a registrant involving some indiscretion or inappropriate comment on social media.

Now I’m no Luddite, prude, or some ‘holier than thou’ observer; as a forthright Yorkshireman I tend to say how it is and if you don’t like that then that’s your problem not mine. I’ve got patients as Facebook friends, and I tend to be exactly the same person online as I am in real life. I’m aware that anything I say there is something that I should be happy to share in a professional environment. I’m a real person and don’t have any airs and graces or chip on my shoulder that mean I think I’m some sort of superior being because I’m a dentist. But I can’t help thinking that some of the comments, personas, and attitudes we see as the public face of some of those in dentistry give the GDC every right to be concerned about the public perception of the profession, because if people can’t differentiate between a digital persona and a real one when they are posting then they really do deserve the attention of our regulator. The rationality and politeness filters seem to disappear from some of our profession when they get infant of some kind of keyboard. Couple all this with a competing bunch of the self-righteous, and the self-obsessed and we have a recipe for the profession to start imploding.

It certainly feels like it is one rule for the GDC and one for us where social media is concerned; the sheer fact you can ‘like’ the fact a colleague has been struck off, suspended etc, is not what I call professional. There’s also no associated comment when a colleague has been exonerated, like in the case of the Scottish dentist Keith Watson, who then attempted to take a vexatious patient with an apparent history of suing dentists, to court for defamation, which unfortunately he has had to abandon at great financial cost to himself.

But, this case shows there can be huge good come out of social media and its immediacy. In the space of less than 24 hours a fund had been created to support Dr Watson, a newly qualified member of our profession who would no doubt be financially challenged by a huge legal bill this early in his career.

http://www.gofundme.com/keithwatson Not only that, the messages of support for Keith have been flying around social media all day and latterly on GDPUK itself.  When used appropriately then, we have a fantastic medium to help people.

We need to embrace social media as its here to stay; it can be hugely useful, and massively informative; but we must use it appropriately, and think about the consequences of our presence in the virtual world. That’s what it means to be a professional.