The Daily Mail – what ever did we do to deserve it?
The low level of research, effort and insight that went in to two recent articles in said paper is nothing short of…….. well, expected really. The first one by Sophie Borland entitled “One in 10 dentists earn more than the Prime Minister” manages to stretch this rather pointless observation into a hopelessly confused page of ramblings. The second one by Louise Atkinson, given the spectacularly unoriginal title of “Drilling for Gold” takes the highly questionable approach of sending someone for multiple investigations (thus exposing them to multiple dose of radiation) to assess the varying levels of estimates.
Sophie Borland’s effort reviews dental salaries over the time of the “new” contract and makes some confused claims about where the salary increases have come from. The report makes such statements as ” Dentists are upping their salaries by carrying out more complicated treatments such as canal surgery, figures show. The number of difficult ‘band three’ procedures, which also include fitting dentures and crowns, rose 12 per cent last year”. Putting aside the reference to canal surgery which is a dentally meaningless term this statement makes no sense. Root canal fillings, which I assume is what is referred to, are classed as a Band A treatment attracting a single UDA fee, the same as a single filling or an exam. This means that a complex root canal filling, which may take up to two hours of treatment time and require the use of perhaps £40 worth of disposable files will earn the dentist the same fee as a single surface amalgam filling, which might take 15 minutes of surgery time. Not surprisingly, and as reported in my blogg in April 2009, there has been a significant fall in these cases, not an increase. The second statement that complex treatments rose by 12% is in some seen as a criticism. How on earth can this be? The whole point of the new contract was to tackle the lack of care provided under the NHS. Surely a 12% rise in treatment received is a good thing and the fact that dentists are being paid for it is hardly worthy of headline news.
The whole premise of this article is to stoke ill feeling about salaries earned by the profession. The utter pointlessness of the article can be highlighted by the equally valid headline “The Prime Minister earns more than the Prime Minister”. Comparing salaries in this way is nonsensical as the earning power of Prime Ministers is clearly vast as one glance at Tony Blair’s recent income will attest. My understanding is that in a free market, capitalist society if some one is successful and develops a profitable business they are allowed to be rewarded for this. If, for example, an enterprising primary school teacher set up a business to, for example, provide education services and marketing avenues for other teachers and teaching facilities that enterprising individual might find them selves earning much more than they did as primary school teacher, and, who know, might earn more than the Prime Minister. This would seem to me to be a good thing and situation worth applauding. Like wise if enterprising dentists develop successful business models, employing many people whilst providing high quality dental care to an increasing number of patients then they probably will be rewarded for this, which, again, I feel is a situation worth applauding.
The second piece really is a disappointing effort. It is a re-hash of every similar article over the past 10-15 years that try to “highlight” the discrepancy in suggested treatments for the same patient by different dentists. The belief that by seeing three different dentists you should get the same plan each time is to completely miss the point. A dental plan will be affected by, on the one hand, the dentists experience, training, equipment and approach to intervention and on the other hand the patient’s clinical need along with their wishes, desires, fears, anxieties, approach to intervention and attitude towards dental treatment. The interaction of all of these variables will determine the appropriate care for that person at that time. As a trust grows with the dentist and a working relationship is established then the plan may change to allow further treatment as per the patients wishes and needs.
These articles always seem to harbor the belief that ” a filling is a filling, is a filling”. This is as true as the statement ” a car is a car is a car”. The price, value and quality of both are equally varied so comparisons of the price of treatment at a dentist has the same journalistic merit as investigating the price variation of a Kia a Golf and a Mercedes.
The relationship between a dentist and patient is fundamentaly one that is built on trust. Dentists need to earn that trust and the best way is to give patients all the information that they need to make the decisions that are right for them. To do this takes a great deal of time along with a lot of equipment to help visualise the mouth in such away that it can presented to the patient to help them understand exactly how there mouth is. By the end of good initial examination a patient should have clear answers to the following questions.
1) What is the state of my mouth today?
2) Why is it as it is today?
3) What can I do to prevent further problems?
4) If there is work to do, what are my choices, costs and likely outcomes?
To do all this, in such away that it is clearly understandable, takes perhaps two visits and a well written report, with recommendations. At StoneRock the first visit is an hour, with a second one offered at no extra cost once people have had a chance to read through the written report. We charge £98.00 for the hour plus £41 for a further extra-oral radiograph if required. I am extremely proud of this visit and feel it is the most important visit in dentistry. It is my chance to try and build some trust whilst giving patients the knowledge and power to make decisions that are right for themselves. The discussions we have and the rapour we build at that time may lead us in completely different directions to previous dentists recommendations. I am not concerned or apologetic about this and I am not wholly right or wholly wrong but I might be just right for that patient at that stage in their life.
If you would like to find out more about the health of your mouth and what treatment options are available to you then please call the surgery on 01580 752202 and we will be happy to arrange that initial consult visit for you.