Void at the top
Dentistry’s ability to deliver and sustain effective patient care demands strong leadership
In March, on the eve of International Women’s Day, I attended the first Royal College of Physicians and Surgeons of Glasgow President’s Lecture since the installation of their new President, Dr Jackie Taylor. It was delivered by the Chair of the GMC, Dame Clare Marx, and the subject was Clinical Leaders – your patients need you. Following the lecture, I had the absolute privilege to join 50 other specially-invited female guests at a dinner to celebrate the role and achievements of women in healthcare, with a continuing focus on leadership.
So why am I mentioning this? In putting this edition together, with its focus on dentistry from the patient perspective, what struck me more than anything was the importance that good leadership has in the patient experience. Whatever the clinical pathway, and whatever the eventual outcome for the patient, good leadership ensures strong, efficient, effective teams who are able to focus on using their skills and expertise to the benefit of their patients, providing excellent and safe care. Poor leadership, and unfortunately there is much of it out there, negatively impacts teams and patients, as well as the healthcare services, organisations and practices in which it happens.
It’s easy say you are a leader by dint of your role and responsibilities, but being called upon to lead, and being a good leader are two very different things. Leadership is more than a job description, it is the behaviours you exhibit; the way you communicate – the very fact that you do communicate; the way you make your colleagues act and feel, and how you support them to develop, whether you can bring out the very best in them; the confidence and trust you inspire in your patients and the relationships you build with them. Good leaders display, among other things, integrity and honesty; creativity and innovation; commitment and passion; and they inspire and motivate their colleagues.
It is important to remember, therefore, that this means anyone can behave as a leader, whatever their role. It is very true that in a clinical environment there needs to be a clear chain of leadership, a person in charge who is responsible for the situation and the team. They might be a GDP, a DCP, a surgeon, or someone else entirely, but they are usually where the buck stops in that particular clinical situation. But one of the qualities of a good leader is that they are not afraid to be challenged. No one is infallible, and team members must feel able to show their own leadership, to challenge, to put forward ideas, and to step up and take responsibility, when necessary and appropriate. After all, there is significant evidence to show that teams who have a dictatorial, micro-managing leader who exhibits no compassion for or faith in their teams, who will not support their team members to grow, develop and take on responsibility, and who might exhibit bullying and undermining behaviour – in the very worst cases – will be dysfunctional, inefficient and ineffective. This is where mistakes can creep in, and where patient safety and care can be compromised.
One of the other things that became evident while putting this edition together is that there is increasing concern about a void in leadership for dentistry in Scotland, and what impact that might have. It is now some nine months since Margie Taylor announced her retirement from the post of CDO, and three months since she actually retired. Despite all this time, there is still no sign of a process to replace her permanently. It is true that there is an interim CDO in Tom Ferris, but, unfortunately, an interim post does not bring the stability and permanency that is required for such an important role. If this were not bad enough, it is now clear that dentistry as a key healthcare profession has been downgraded from being a Cabinet Secretary remit, to a ministerial one, with Jeane Freeman having divested herself of it, passing it down to Joe Fitzpatrick, Minister for Public Health, Sport and Wellbeing. This is concerning as it implies that dentistry is not seen as being as important as medicine by the Scottish Government. But this risks an alarming vicious circle. If dentistry is not seen as important enough for the Cabinet Secretary portfolio, then what is going to drive the recruitment of a new CDO? And without a permanent CDO, who is going to raise the profile and status of dentistry with government? Who is going to put the case of dentistry forward? Who is going to support and deliver the investment and change that the professions needs? After all, isn’t true that nothing can live in a void?
Perhaps, therefore, this is where everyone working in dentistry needs to become a leader? Perhaps it is the responsibility of all dental professionals to speak to politicians, the public and colleagues in other areas of healthcare and demonstrate the critical importance or oral health and the dental profession as a whole. It’s a big ask. Particularly in the context of increasing stress, anxiety and disillusionment, but surely true leaders can lead and inspire however bleak the situation appears. They can find the good and magnify it, they can see the opportunities and follow them through, whether this is on a micro level, or on big public platforms. Perhaps.
So that is why I mentioned the RCPSG President’s lecture on leadership. But why was it relevant that it particularly celebrated women leaders. Well, that’s simple. There’s a lot of evidence to suggest that women are better natural leaders than men, and that having them at the top of organisations changes culture and drives positive organisational change. I’ll just leave that there.