Doug Hamilton says the MDDUS can offer advice and support on many issues arising from clinical practice.

In comparison to many other occupations, the life of a dentist is fairly isolated. This somewhat unsupported environment does tend to limit discussion and analysis of professional problems that, almost inevitably, will be encountered from time to time.

Certainly, dentists are part of a team, the members of which, aside from cooperatively delivering care, also offer one another a degree of support. But it’s a small team, which often works with a degree of intensity that is not conducive to anything but the most essential interaction. 

Of course there are daily conversations with patients; however, these discussions focus on the patient’s concerns rather than those of the practitioner.

A degree of perspective can be obtained by, for example, attending CPD courses rather than simply accumulating all of the requisite verifiable hours from journals. These seminars are usually quality assured so that some development of skills and knowledge is virtually guaranteed. However, they often offer an opportunity (usually at the tea-break) to exchange anecdotes and tales of woe.

Advice and support

Yet, these courses rarely coincide with the ‘day from hell’. It is therefore important to have another, readily available source of advice and support. This is, of course, one of the many advantages of membership with a defence organisation such as the MDDUS. Though MDDUS cannot offer clinical opinions, there are many issues arising from clinical practice with which we can assist.

Now and again, members will call simply to discuss a hypothetical scenario. Sometimes, there is no immediate issue, but conflict is anticipated, in which case a management strategy can be discussed. If a complaint has already been made, members can receive immediate advice regarding the relevant processes.

The NHS Regulations in Scotland now provide for a five-day window during which informal resolution can be explored.

If these negotiations are impracticable or unsuccessful, formal processes must be implemented – within three working days, a written acknowledgement must be provided, ideally accompanied by a copy of the practice complaint policy. Compliance with this, and all other NHS complaint management obligations, will be double-checked if an NHS case is appealed to the Ombudsman. So, the potential hazards of going it alone, even for a short time, are all too apparent.

The subsequent composition of a formal complaint report can be a surprisingly painstaking process. Clearly, the aim is to resolve the matter in a quick and fair manner. Irrespective of the nature of the complaint, a defensive reaction must be avoided. This is easier said than done when the practitioner is faced with a personal and inflammatory series of ostensibly vexatious allegations. Objective input from a dental adviser, based upon years of experience in drafting response letters, can therefore be helpful.   

Many practitioners will decide that the receipt of a complaint signals the end of the working relationship with that particular patient. Again, precipitous action can lead to further difficulties – the General Dental

Council specifically advises against the cessation of treatment just because the patient has expressed dissatisfaction.

Following relevant regulations

However, if there is no real prospect of an ongoing working relationship, the relative merits of withdrawal from that patient’s care can be analysed. MDDUS can also ensure that deregistration of NHS patients complies with the relevant regulations.

If the GDC or solicitors become involved, there are a new set of time limits and obligations that must be observed. Attempting to deal with these developments without assistance is liable to be very stressful and may leave many hostages to fortune. In fact, the GDC makes a point of encouraging registrants to seek immediate advice in these circumstances.

Sadly, some members are reluctant to take advantage of this advisory service, usually because of concerns about ‘score-keeping’.

However, it is complete nonsense. The 24/7 advice line is there for pastoral and technical support. We would much rather that you contacted us sooner rather than later. Therefore, members who have any professional concerns, however trivial, should not hesitate to call.