EDITORIAL IT’S GOOD TO TALK, AND LISTEN MHARI COXON DCP EDITOR
W
elcome to the first edition of 2015. In this edition we focus on communication, consent and complaints. The key to any successful business is good communication. A dental practice is no exception to this rule.
It is vital that every team member is trained on how to communicate, ensure informed consent, and handle any complaints effectively and efficiently. Good communication with patients can reduce the risk of complaint or issues around consent.
It does become tricky when the patient has difficulty giving consent, because of a disability, language barrier or another block to shared understanding. It is vitally important that we all ensure we find the right way to deliver information in these situations, and recieve the consent. Utilising the whole team to communicate effectively can really make a difference to a patient’s experience and journey. Respect, empathy, and dealing with issues in a timely manner can work to build loyalty with the practice from the patient.
I NEVER SAW A TOOTH WALK INTO MY OFFICE ANDREW TOY GUEST EDITOR FOR PDJ FEBRUARY 2015
U
nusually for this journal, there are no articles of a clinical nature in this edition. Yet every clinician (indeed, every member of the dental team) will find material that is directly relevant to their role in the practice of dentistry. In 1982, I was fortunate enough to listen to one of dentistry’s greatest communicators, Dr L.D.Pankey. I remember well the simple, powerful message that started his first presentation: ‘I never saw a tooth walk into my office’. In other words, every tooth has a person attached to it. It’s so obvious that it seems ridiculous to even highlight the point. Yet our experience shows that when things go wrong, there is usually a breakdown in communication involved somewhere in the mix. Communication lies at the heart of everything we do in dental practice
4
– whether it is between ourselves and patients, our fellow team members or ‘the authorities’, such as the GDC or NHS. As Brid Hendron comments in her article (see pages 37-39), communication is something we can already do when we first go into dentistry. So it is understandable to think that much of the guidance on ‘good communication’ is just common sense. Unfortunately, it is clear that good communication may be common sense, but it is not necessarily very common. In my experience, communication skills in dentistry rarely receive the time and effort devoted to clinical skills, with repeated practice, reflection and assessment against standards. Perhaps communication is such an everyday activity that we fail to understand how we need to develop it to suit our own professional world?
Take time as a team to discuss how you communicate, obtain consent and work to overcome and rectify a complaint should one arise. Ensure you document well how you do this to support your detailed note keeping. Great communication can really unlock the true wants of a patient as well as helping them to understand their needs in treatment. Locking these together is a recipe for successful outcomes in our treatment plans. It’s good to talk, and listen.
This edition of the Primary Dental Journal contains a wide-ranging mix of articles and I am deeply grateful to all of the contributors for the effort they have applied. It is not an easy or straightforward process! The overall remit to the authors was to demonstrate the positive benefits of good communication. As good communication is a skill, there is information from Brid Hendron and Emma O’Keefe (see pages 64-66) on how to develop the skills to become excellent communicators. There is clear advice from Janine Brooks (see pages 44-47) on how to translate this into practice in relation to complaints. You realise that a complaint becomes an opportunity for the dental team to shine rather than something to brush under the carpet. An area of dental care particularly close to my heart is the consent process. Our more medically-litigious public (that apparently puts the UK close to the top of that particular world league) brings the need to manage this process into sharp relief. Andrew Trathen (see pages 30-34) and Tim Newton (see pages 48-53) provide some of the
P R I M A R Y D E N TA L J O U R N A L
WELCOMING OUR NEW CLINICAL EDITOR DR IGOR R. BLUM DDS, PHD, DR MED DENT, MSC, MFDS RCS (ENG & EDIN), FDS (REST DENT) RCS (ENG), PGCHE, FHEA director of the Maurice Wohl Dental Academy, which is the London-based outreach teaching facility for final year dental students of King’s College London Dental Institute. In addition, he is clinical lead for restorative dentistry at Buckinghamshire NHS Trust.
We are pleased to announce and welcome Dr Igor R Blum to the Primary Dental Journal (PDJ) team as our new clinical editor. Dr Blum is a consultant and honorary senior lecturer and specialist in restorative dentistry at King’s College Hospital Dental Institute. He is the
academic evidence on why the patient/professional relationship has changed and how patients build their perceptions of what we do. Alex Holden provides a legal perspective and describes the records required to defend a claim against inadequate consent. However, he strongly asserts that the records are not worth the paper they are written on if the practitioner approaches the consent process as a ‘tick box exercise’. Ticking consent boxes is surely one expression of seeing ‘teeth walk into your practice’. My own research (see pages 19-25), reported in this edition, demonstrates how implant practitioners have developed their consent process to meet the changes in society and ensure they provide an individualised, patientcentred consent process. Consent is no longer the sole responsibility of the dentist in our new world of extended duties dental nurses and Jacqui Elsden provides some advice for those members of the dental team who are caring for their ‘own’ patients, on pages 60-63.
Dr Blum has lectured widely, both
The first of these articles (see pages 4043) is by Michael Smith, who is not a dentist. He is highly experienced in the world of ethical marketing and therefore can offer us an insight on how we present our professional services to the public. Michael’s description of ethical marketing principles matches very closely those of valid consent and, in my mind, they are one and the same. In this respect, I disagree with Andrew Trathen and would assert that, in the world of professional services, good consent is synonymous with good business. How can we most effectively manage this consent/marketing process in practice? This is where the role of the properly trained and resourced treatment co-ordinator (TCO) can come into its own. The modern TCO role could also be described as the ‘consent manager’ for the dental practice. The second article describes Janet Goodwin’s visit to The Old Surgery Dental Practice in Crewe and shows what could (should?) become a vision for 21st century dental practice
Finally, there are two articles that are designed to extend the reader’s perspective on the significance of good communication. I am sure everyone reading this publication is committed to the highest standards of patient care and providing every patient with the opportunity to enjoy a high standard of oral health. Yet, even when dentistry was free on the NHS, legend has it that 50% of the population were not regular attenders. As a profession, we have an obligation to communicate as excellently as possible so that the public can understand the benefits of oral health and choose to buy our services.
VOL. 4 NO. 1 FEBRUARY 2015
nationally and internationally. He is the author of over 30 papers in peerreviewed journals, four book chapters on restorative dentistry, and serves on the editorial board for the Journal of Dentistry and Journal of Restorative Dentistry. Dr Blum’s main areas of interest include minimally invasive dentistry, clinical primary dental care and advanced general dental practice, management of dental developmental anomalies, healthcare law and critical appraisal. We look forward to working with Dr Blum and to his contribution in taking the PDJ forward from strength to strength.
where the patient: • is cared for as an individual; • understands all of the options that modern dentistry can provide; • receives the care that is most appropriate for them, and • is delighted with the professional service they experience from the team. Throughout this wide-ranging selection of academic and practical articles, there is one common theme; it is our responsibility as dental professionals to communicate in a way that is appropriate to the individual in front of us. Meeting this responsibility will bring a host of benefits. This includes more successful marketing of our services, better outcomes from complaints and safer practice. So, to what extent do we realise that teeth ‘never walk into our practices’? When we can truly treat our patients and fellow team members as ‘people’, our professional life will be richer, our teams will be happier, and our patients will be healthier. After all, this is why we came into dentistry in the first place, isn’t it?
About Andrew Toy BDS, MFDGP(UK), MMedSci (Clin Ed) Andy qualified from Bristol in 1980 and started his own practice in 1984 – a purpose-built surgery in Loughborough. The practice gained ISO 9002 Quality Assurance accreditation in 1992. From 1990 until 1996, Andy ran the Leicester VT Scheme. In 1999, he gained a Master’s degree in Clinical Education. In 2009 he set up The Dental Business Academy, providing online qualifications for the dental team. He now lectures widely to VT Schemes on Clinical Governance and Audit. Andy has recently retired as a board member for the FGDP(UK) and Chair of the Quality Assurance Panel. Andy is also an advisory board member for The Pankey Institute, USA.
5
W
elcome to the first edition of 2015. In this edition we focus on communication, consent and complaints. The key to any successful business is good communication. A dental practice is no exception to this rule.
It is vital that every team member is trained on how to communicate, ensure informed consent, and handle any complaints effectively and efficiently. Good communication with patients can reduce the risk of complaint or issues around consent.
It does become tricky when the patient has difficulty giving consent, because of a disability, language barrier or another block to shared understanding. It is vitally important that we all ensure we find the right way to deliver information in these situations, and recieve the consent. Utilising the whole team to communicate effectively can really make a difference to a patient’s experience and journey. Respect, empathy, and dealing with issues in a timely manner can work to build loyalty with the practice from the patient.
I NEVER SAW A TOOTH WALK INTO MY OFFICE ANDREW TOY GUEST EDITOR FOR PDJ FEBRUARY 2015
U
nusually for this journal, there are no articles of a clinical nature in this edition. Yet every clinician (indeed, every member of the dental team) will find material that is directly relevant to their role in the practice of dentistry. In 1982, I was fortunate enough to listen to one of dentistry’s greatest communicators, Dr L.D.Pankey. I remember well the simple, powerful message that started his first presentation: ‘I never saw a tooth walk into my office’. In other words, every tooth has a person attached to it. It’s so obvious that it seems ridiculous to even highlight the point. Yet our experience shows that when things go wrong, there is usually a breakdown in communication involved somewhere in the mix. Communication lies at the heart of everything we do in dental practice
4
– whether it is between ourselves and patients, our fellow team members or ‘the authorities’, such as the GDC or NHS. As Brid Hendron comments in her article (see pages 37-39), communication is something we can already do when we first go into dentistry. So it is understandable to think that much of the guidance on ‘good communication’ is just common sense. Unfortunately, it is clear that good communication may be common sense, but it is not necessarily very common. In my experience, communication skills in dentistry rarely receive the time and effort devoted to clinical skills, with repeated practice, reflection and assessment against standards. Perhaps communication is such an everyday activity that we fail to understand how we need to develop it to suit our own professional world?
Take time as a team to discuss how you communicate, obtain consent and work to overcome and rectify a complaint should one arise. Ensure you document well how you do this to support your detailed note keeping. Great communication can really unlock the true wants of a patient as well as helping them to understand their needs in treatment. Locking these together is a recipe for successful outcomes in our treatment plans. It’s good to talk, and listen.
This edition of the Primary Dental Journal contains a wide-ranging mix of articles and I am deeply grateful to all of the contributors for the effort they have applied. It is not an easy or straightforward process! The overall remit to the authors was to demonstrate the positive benefits of good communication. As good communication is a skill, there is information from Brid Hendron and Emma O’Keefe (see pages 64-66) on how to develop the skills to become excellent communicators. There is clear advice from Janine Brooks (see pages 44-47) on how to translate this into practice in relation to complaints. You realise that a complaint becomes an opportunity for the dental team to shine rather than something to brush under the carpet. An area of dental care particularly close to my heart is the consent process. Our more medically-litigious public (that apparently puts the UK close to the top of that particular world league) brings the need to manage this process into sharp relief. Andrew Trathen (see pages 30-34) and Tim Newton (see pages 48-53) provide some of the
P R I M A R Y D E N TA L J O U R N A L
WELCOMING OUR NEW CLINICAL EDITOR DR IGOR R. BLUM DDS, PHD, DR MED DENT, MSC, MFDS RCS (ENG & EDIN), FDS (REST DENT) RCS (ENG), PGCHE, FHEA director of the Maurice Wohl Dental Academy, which is the London-based outreach teaching facility for final year dental students of King’s College London Dental Institute. In addition, he is clinical lead for restorative dentistry at Buckinghamshire NHS Trust.
We are pleased to announce and welcome Dr Igor R Blum to the Primary Dental Journal (PDJ) team as our new clinical editor. Dr Blum is a consultant and honorary senior lecturer and specialist in restorative dentistry at King’s College Hospital Dental Institute. He is the
academic evidence on why the patient/professional relationship has changed and how patients build their perceptions of what we do. Alex Holden provides a legal perspective and describes the records required to defend a claim against inadequate consent. However, he strongly asserts that the records are not worth the paper they are written on if the practitioner approaches the consent process as a ‘tick box exercise’. Ticking consent boxes is surely one expression of seeing ‘teeth walk into your practice’. My own research (see pages 19-25), reported in this edition, demonstrates how implant practitioners have developed their consent process to meet the changes in society and ensure they provide an individualised, patientcentred consent process. Consent is no longer the sole responsibility of the dentist in our new world of extended duties dental nurses and Jacqui Elsden provides some advice for those members of the dental team who are caring for their ‘own’ patients, on pages 60-63.
Dr Blum has lectured widely, both
The first of these articles (see pages 4043) is by Michael Smith, who is not a dentist. He is highly experienced in the world of ethical marketing and therefore can offer us an insight on how we present our professional services to the public. Michael’s description of ethical marketing principles matches very closely those of valid consent and, in my mind, they are one and the same. In this respect, I disagree with Andrew Trathen and would assert that, in the world of professional services, good consent is synonymous with good business. How can we most effectively manage this consent/marketing process in practice? This is where the role of the properly trained and resourced treatment co-ordinator (TCO) can come into its own. The modern TCO role could also be described as the ‘consent manager’ for the dental practice. The second article describes Janet Goodwin’s visit to The Old Surgery Dental Practice in Crewe and shows what could (should?) become a vision for 21st century dental practice
Finally, there are two articles that are designed to extend the reader’s perspective on the significance of good communication. I am sure everyone reading this publication is committed to the highest standards of patient care and providing every patient with the opportunity to enjoy a high standard of oral health. Yet, even when dentistry was free on the NHS, legend has it that 50% of the population were not regular attenders. As a profession, we have an obligation to communicate as excellently as possible so that the public can understand the benefits of oral health and choose to buy our services.
VOL. 4 NO. 1 FEBRUARY 2015
nationally and internationally. He is the author of over 30 papers in peerreviewed journals, four book chapters on restorative dentistry, and serves on the editorial board for the Journal of Dentistry and Journal of Restorative Dentistry. Dr Blum’s main areas of interest include minimally invasive dentistry, clinical primary dental care and advanced general dental practice, management of dental developmental anomalies, healthcare law and critical appraisal. We look forward to working with Dr Blum and to his contribution in taking the PDJ forward from strength to strength.
where the patient: • is cared for as an individual; • understands all of the options that modern dentistry can provide; • receives the care that is most appropriate for them, and • is delighted with the professional service they experience from the team. Throughout this wide-ranging selection of academic and practical articles, there is one common theme; it is our responsibility as dental professionals to communicate in a way that is appropriate to the individual in front of us. Meeting this responsibility will bring a host of benefits. This includes more successful marketing of our services, better outcomes from complaints and safer practice. So, to what extent do we realise that teeth ‘never walk into our practices’? When we can truly treat our patients and fellow team members as ‘people’, our professional life will be richer, our teams will be happier, and our patients will be healthier. After all, this is why we came into dentistry in the first place, isn’t it?
About Andrew Toy BDS, MFDGP(UK), MMedSci (Clin Ed) Andy qualified from Bristol in 1980 and started his own practice in 1984 – a purpose-built surgery in Loughborough. The practice gained ISO 9002 Quality Assurance accreditation in 1992. From 1990 until 1996, Andy ran the Leicester VT Scheme. In 1999, he gained a Master’s degree in Clinical Education. In 2009 he set up The Dental Business Academy, providing online qualifications for the dental team. He now lectures widely to VT Schemes on Clinical Governance and Audit. Andy has recently retired as a board member for the FGDP(UK) and Chair of the Quality Assurance Panel. Andy is also an advisory board member for The Pankey Institute, USA.
5
