There can be little doubt that modern high street dentistry is necessarily delivered in a commercial, business-like environment. However the current Dentists Act, which dates back to 1984, has always recognised both the practice and business of dentistry; indeed, it defines the latter.
Many businesses adhere to an ethical code of conduct that is either individual to that particular organisation or via membership of a trade association. As well as this, a company may subscribe to the ethos of corporate social responsibility, whereby the impact of their business on the rest of society, their stakeholders and the environment is taken into account.
On top of these considerations, dental professionals must be mindful of their professional responsibilities and the core ethical principles of practice, as set out in the GDC's Standards for the Dental Team. Standard 1.7 states that, 'You must put patients' interests before your own or those of any colleague, business or organisation,' and that, 'You must always put your patients' interests before any financial, personal or other gain.'
The snappily entitled 'Professional Conduct and Fitness to Practise, Notice For the Guidance of Dentists' publication, dated November 1984 and in force when I first started in practice, was generally less prescriptive than its current equivalent, Standards for the Dental Team.
But there was one particular issue about which the guidance was exceptionally clear. It stated, 'The Council considers it is contrary to the public interest and discreditable to the profession of dentistry for a dentist to advertise or canvass for the purpose of obtaining patients or promoting his own professional advantage.'
The professional duty to put patients' best interests first remains central to all that we do.
How far we have moved in the intervening thirty or so years, now routinely advertising and promoting our practices in a variety of ways and though various media. The GDC has even produced its own guidance on advertising which sets out what is expected of registrants.
Notwithstanding these developments, the professional duty to put patients' best interests first remains central to all that we do and so it is important to recognise the potential for friction between the requirements of successful business and the burden of discharging that professional duty.
Sales executives in commercial organisations are often specially trained to 'close the deal' to secure a sale or contract, but in a professional healthcare setting where we are required to obtain valid consent such an approach is clearly inappropriate.
The area of practice where these tensions may be most readily apparent is, arguably, the provision of cosmetic treatment where patients who may be psychologically vulnerable embark upon treatment that is often irreversible and relatively costly. Both the General Medical Council and the Royal College of Surgeons have recently produced guidance for their registrants and members, much of which, such as providing cooling off periods, readily translates to dental practice.
This edition of the DDU journal includes a number of articles which highlight issues related to the management and business side of dental practice and also includes practical tips and ideas for avoiding some of the potential pitfalls. I hope that you will find these both interesting and of practical help in your day to day work.
Head of the DDU
John Makin BDS PgDL PgCDE FHEA is head of the DDU. He qualified in Manchester in 1983 and has worked as a general dental practitioner in Lancashire and Devon before joining the DDU as a dento-legal adviser. He was involved with foundation training for many years as both a trainer and VT adviser/training programme director with the Manchester and Exeter DFT schemes.
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