This week I performed the ultimate form of defensive dentistry, I went on my first holiday of the year! With no clinical dentistry being performed hopefully I slightly reduced my statistical risk of being sued or worse.
On returning home, my heart fluttered when I saw the letter from my dental indemnity company waiting for me along with a pile of junk mail. To my somewhat relief it was just my yearly indemnity renewal and a summary of how much it was going to cost me.
Rise in fees
My last year’s subscription was £3,635 now this year it has increased to £4,818 (includes an added premium that covers the occasional implant retained restoration I fit). So that’s an increase of over 25% on last year.
This is following the heinous uplift of the General Dental Council (GDC) annual retention fee renewal last December to nearly £900. Not to worry, I do recall that this year, an NHS uplift of a whole 1.34% has been applied, which should help ease the burden.
What is really going on here? Are we rapidly reaching a point where we as dentists are so at risk of a complaint or GDC investigation that it is becoming unviable to carry on providing clinical dentistry?
Recently, my wife attended a midwife appointment following her becoming pregnant. As I sat there, my mind could not help but wonder what her clinical notes would be like. Would they clearly justify the rationale of every blood test taken? Would the advantages and disadvantages of performing these procedures be recorded? Would there be an entry stating that valid consent had been obtained and witnessed?
I often say to young dentists, we rise and fall by our clinical records. The situation seems that a poor standard root canal treatment that is well documented is less at risk of a GDC enquiry, than an excellent root canal treatment that is poorly documented. We are now in a culture environment where we are actively encouraged by the Care Quality Commission (CQC), NHS and GDC to highlight to patients all the available opportunities to complain.
In the depths of GDC paperwork, the costs of a public hearing are laid bare. A typical ‘fitness to practice’ hearing costing approximately £78,000.
I often wonder if the complainant was offered a fraction of this amount to withdraw the complaint and go away, how many actually would. Don’t get me wrong, it is important to have a proper protocol and process for dealing with poorly performing dentists, but looking at the sheer number and nature of the hearings – it seems that the GDC are really losing the plot.
Why are dentists being subjected to such layers of charges that have no relation to the patient’s original complaint?
A patient complaining about a lost filling sees the GDC’s lawyers sifting through the clinical records and finding issues such as smoking cessation advice not being given or a missing X-ray justification. This surely cannot be right and is leading to many members of the profession having low morale.
Only the actual issue of the patient complaint should be investigated and not lawyers just looking for something ‘to stick’.
Maybe more holidays are the answer.