Tides of change are shaping our future

Word of mouth with Dr Paul O’Dwyer

Time is both free and priceless. You can spend it, lose it, buy it, waste it – it’s hard to make it, you can never keep it – and it usually flies.

This last year certainly flew, as I found myself making my way to the Annual Scientific Meeting of the IDA in Galway last month. It’s always a treat, and this year was no different. Like all good meetings, some of the most enlightening conversations happen at the fringes and coffee breaks. In chatting with colleagues, we all agreed that dentistry in Ireland is currently undergoing many sweeping changes, after a number of years of stagnation.

Importantly, we are all beginning to see many “long-lost” patients finding their way back to the surgery. With this opportunity to finally start reversing the damage inflicted by the harsh cuts comes responsibility and a host of
new challenges.

First we have GDPR – with which we are by now all familiar. The ever-increasing onus on practitioners to fall in line with evolving data-handling change is burdensome, to say the least. Increased vigilance on data protection is to be welcomed, however we appear now to be data guardians as well as dental guardians. Aside from the downtime to review and train our administrative staff, I am thinking of the time that will inevitably be lost in explaining this issue to patients who are blissfully unaware of it.

Next up we have the ratification of the Minamata Treaty across Ireland from 1 July. The instruction is clear in relation to the placement of amalgam and its avoidance for children under 15, pregnant women, or breast-feeding women. This can leave the general dental practitioner in a quandary – with a multitude of “What ifs?” that come to mind. What if the patient discovers they are pregnant after an amalgam placement? How do we deal with the male relative of a pregnant patient who asks, “Why is it safe for me and not for her?”. These are just two queries that will undoubtedly be raised
in the months to come. Again I am left wondering about the downtime in explaining this to our patients.

Just as we recover from GDPR and Minamata, we will (I hope) finally get to see the new Oral Health Policy. I am hopeful that this document will prove a worthy roadmap for our profession. As mentioned in these pages previously, we live in an ageing population. The census information, longitudinal studies and common sense suggests that we should be preparing for the ageing cohort and their specific needs for the longer term. I hope that we don’t lose sight of our current cohort. It will take time to digest the policy.

Online processing of the Government Dental Treatment Schemes is to be largely welcomed, though there is a note of caution in relation to the next steps as there has been no provision to recompense the inevitable downtime for this essential training. Unlike our colleagues in the UK and elsewhere, such information meetings, teaching and instruction is left to the GDP to source and provide themselves.

The ever-increasing costs associated with indemnity continue to baffle most. I have been with the same provider for almost 20 years. While I have been in the main happy with the service, I am left a little disappointed that the much-touted “listening to our members” has now resulted in a delay in applying this to our premia. I am not alone in this view. At the IDA conference, I spoke with many colleagues who feel that the fee for one year’s general practice is inordinately high. I am also left wondering why there is no administrative hub in Ireland – considering that this organisation has an effective monopoly here? I have given feedback directly to the provider on this topic, and regularly.

And final thoughts this year, in speaking with many dentists over the event, I found that there is growing acceptance of the journey man or woman dentist – a phenomenon almost unheard of 20 years ago.

Simply put: many of the class of 2018 will never own a practice, by choice. On graduation, my class and previous generations had the single aim of opening their own surgery and being their own bosses.

However, on review of the above, one wonders if the onuses discussed here (along with continued regulatory changes) have become too costly and prohibitive?

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Published: 12 July, 2018 at 14:50