Jaimie Kaffash, acting editor of GDPUK, looks at the similarities – and differences – between dentistry and general medical practice, and finds they are closer than you might think
As I am sure you know by now, GDPUK is in new hands. Dr Tony Jacobs has done great things with GDPUK – the more I have been speaking to people within the profession, the more impressed I have been that he has been able to develop such a strong brand at the same time as being a full-time dentist. If Cogora – the new publishers – can keep its reputation going, we will have done a good job. We are building on his work, keeping Tony as a blogger, providing the same exclusive news and in-depth analysis of the issues that matter to dentists.
As for me, I have been at Pulse magazine – the biggest publication for GMPs in the UK, and now a sister title to GDPUK – for 14 years now, as editor for six and editor in chief for two. I am a jobbing journalist and, dare I admit it, I don’t even have a science degree, let alone any health training. But I like to think that by now I understand general medical practice.
Since we have started on our relaunch plans, it has been a crash course in the dentistry profession for me. Having been immersed in general medical practice for half my working life, I can’t help but draw parallels between the two professions. And despite the very different contracting, funding and employment arrangements, relationship with the NHS and (of course) day-to-day work, there is a strand that I believe runs through the two professions.
That is, the desire to be trusted. Trusted by the media, patients, the government, and regulators. Because right now, both professions are losing the PR battle – a battle which should not, in a normal society, be taking place.
Both professions are portrayed in the media as greedy, and that is the reason patients are unable to get access. In GMPs’ case, this greed is apparently their unwillingness to do anything without getting paid for it; in the case of dentists, it is increasing patient fees and refusing to do NHS work because they can fleece patients easier through private work.
This perception feeds into patients’ beliefs. The amount of times I have heard GMPs relay stories that patients are often talking to them about how poor general medical practice is and how doctors are lazy, adding the caveat ‘but not you doc’. This is a story I have already heard about dentists too, raising the idea that if every dentist and doctor is the exception to the rule in their patients’ eyes, maybe the rule isn’t actually in place.
In terms of government, previous health secretary Wes Streeting has been far kinder to dentists than to GMPs (who he has separately referred to as ‘laggards’ when it comes to online access, and ‘coasting…not working as hard as they should’). There haven’t been the same public pronouncements from Labour ministers around dentists. But actions speak louder than words, and Chancellor Rachel Reeves’s decision to initiate a Competition and Markets Authority review into private dentistry – including at the effect of apparent ‘price gouging’ – speaks volumes in this regard. This subtly (or maybe not so subtly) shifts the blame for poor access onto private dentistry, and not a failed NHS contract.
In terms of the regulators, I know how uncomfortable GDC process makes dentists feel. Co-incidentally, for Pulse we are planning a major report of the General Medical Council’s approach. I am very tempted to write a single piece and replace ‘GDC’ with ‘GMC’ and ‘GPs’ with ‘dentists’. The perceptions of the regulators by the respective professions are almost identical: the idea that the regulators start off with a presumption of guilt; the fear around being subjected to a drawn out investigative process even when they know they had done everything correct; and practising defensive dentistry/medicine that they do not feel is in the best interests of their patients because for fear of facing a tribunal.
This all comes down to a lack of trust in professions. But, speaking to grassroots dentists and GMPs as I do, this lack of trust is completely unjustified. Because what I see are two groups of professionals who want to do what is best for their patients. The dentists I have spoken to who provide predominantly private work aren’t doing so because they see pound signs in their eyes – they do so because this is the best way of providing the care they feel their patients need, and they can’t do this with an unfit-for-purpose NHS contract.
Similarly, dentists with NHS contracts are hampered by the frankly ludicrous UDA system. I had to have this explained to me three times, because I couldn’t quite believe what I was hearing (‘they get paid the same fee if they have one appointment or eight for the same issue? Practices get paid different amounts per UDA? Is this an elaborate joke?’). It means that those dentists determined to provide care to the most vulnerable are, at times, paying for the privilege for doing so when overheads, indemnity fees, potential litigation, etc are taken into account.
Of course there are some greedy dentists and GMPs. Do you know what other professions they have this in common with? Every profession that has ever existed. But the majority of dentists and GMPs don’t get into the profession for the pay – they get into it to help patients. And this, for me, deserves them to be trusted.
Give them the funding they need to provide the best care. Allow them to take decisions they think are in the best interests of their patients, without the GDC/GMC dangling the Sword of Damocles over them. Be honest about the state of the professions – the access issues come from years of mismanagement at governmental level.
Because sometimes, the doctor and dentist does know best.
Jaimie Kaffash is acting editor of GDPUK