A busy dental professional might see hundreds of patients over the week, but how many opportunities are there to meet with colleagues, discuss an interesting case, share a joke or just talk about the weekend? These human interactions with fellow professionals are precious because they help us feel part of a community of practice.

In this issue, dentist John Lewis warns about the risk of professional isolation for our mental health. It was the tragic suicide of a fellow dentist that led to the forming of ConfiDental, a confidential helpline run by dental professionals for dental professionals.

Sadly, many callers feel unable to turn to their colleagues when they are having a difficult time and want assurance of their anonymity. But as John explains, it's often a huge relief for them to talk through problems with someone who has also experienced the pressures of modern practice.

A community of practice

As an organisation run and staffed by dentists, this is something we relate to at the DDU. While we're always available with practical advice to help you pre-empt and avoid dento-legal problems, it's just as important we understand what members are going through and can support them through an investigation. We can even put them in touch with a fellow dentist who has been in their shoes.

I see the DDU as part of the community of practice I mentioned earlier, where everyone looks out for one another. One example of where dental professionals can help each other out is when the relationship breaks down between a patient and a colleague. In these situations, the patient is often obliged to find another practice because none of the other dentists in the practice wants to take them on.

However, I think burning bridges in this way can be a misstep, and one that causes unnecessary bad feeling and leaves the practice vulnerable to negative word of mouth - or even a complaint.

I'm not suggesting practices have to put up with abusive or disruptive behaviour, but relationships can break down for many reasons. It may simply be that patient and dentist aren't on the same wavelength, for example, or the patient isn't confident about a proposed treatment plan.

Giving the patient the opportunity to transfer to another dentist in the practice instead of pushing them out the door could be a chance to turn things around. It's also fairer to the patient, as it means they can access dental care without the trouble of finding another practice.

My advice to members who feel they have no choice but to stop treating a patient is to consult their practice owner - or talk to the DDU to determine how to best manage the situation, in line with the GDC's Standards (para 1.7.8). It makes sense to think about the best outcome as a practice and to work together towards that goal.

Where possible, ask your colleagues if they would be willing to see the patient instead, so you can offer the patient an alternative. Prepare for a potentially sensitive conversation with the patient so you can articulate why things aren't working, but also reassure them about their future care.

Finally, in our experience, many complaints arise from a lack of clarity and consistency, so it's important to follow practice policies and ensure patients are aware of these too (see our article on policies and procedures in this issue).

Finding a way through

While I know many dental professionals may be wary of taking on a patient in these circumstances, I'd urge them to do so if the patient is willing (provided they haven't breached your zero tolerance policy). Every relationship between dental professional and patient is different, and a different face has the potential to change the dynamic for the better.

There's generally more than one legitimate approach to treatment and it should be possible to explain the options to the patient, or offer a supportive second opinion, without undermining a colleague. And of course, that colleague might be in a position to return the favour one day.

Dentistry is a competitive business, but it's also a collective endeavour where dental professionals often achieve the best outcome (for patients and themselves) by working together. As leader of a mutual organisation that is owned by my fellow dental professionals and exists for their benefit, I know that being part of a community is a powerful feeling. Ultimately, we're all stronger when we support each other.