Practice faces drastic change

Returning to dentistry, owners need to be provided with financial support and high-quality PPE

15 June, 2020 / indepth
 Patricia Thomson  

y diary from February to June of 2020 was busy. It encompassed formal duties in my role as an FGDP national board member, travelling to Switzerland mid-March to visit my son Andrew, who lives in the ski resort of Verbier, visiting Canada in May for my nephew’s wedding, and attending two weddings in Scotland in June. All the above was in addition to working as a part-time associate.

I was aware of the spreading coronavirus in Wuhan but, like many, I thought it was a problem that would be contained. The outbreak in Northern Italy made me more anxious.

I attended an FGDP Board meeting in London on 28 February with a growing unease. I travelled by air, used the underground and socialised. The next Wednesday, 4 March, I attended a NES Committee meeting in Edinburgh in my FGDP capacity. I was scheduled to return to London again the following week for the Faculty’s Diplomates’ Day and Annual Dinner, where I was to have the honour of delivering the citation for Prof Jeremy Bagg on his Honorary Fellowship of the Faculty. Travel to Switzerland was planned immediately on my return from London.  

NHS funding will need to change; the model is now completely obsolete

All was going as intended until I was phoned by Public Health Scotland and informed that I had contacted a COVID-positive person at work. The practice was immediately closed, and all of us who worked there had to undergo isolation for two weeks. I realised that the world was about to change; this effectively vetoed my trips to London and Switzerland and had much graver implications.

The health board where I live, which is different from the practice health board, subsequently reclassified me a non-contact. It was too late for the London trip, but I still wanted to visit my son.

Later that week, Andrew phoned us to say he wasn’t feeling well. He was short of breath, had a terrible headache and no energy. All his friends reckoned they had had the virus, all strangely losing their sense of taste and smell. The Swiss policy was to test only symptomatic over 65s but, being asthmatic, he was tested. It transpired that Verbier was a virus hot spot, and the hotel where he worked was an epicentre. The ski slopes were closed on the Friday, and Andrew got his positive result early on the Saturday morning. Thankfully his health had started to improve markedly by then. Although the flight took off that day, we didn’t go.

After the two-week period of isolation was over and the practice was preparing to reopen, we all realised that routine dentistry was about to cease. I didn’t make it back to work before all face-to-face patient contact stopped. 

I have not worked in practice since 5 March. The only dentistry I have undertaken is one session at the out-of-hours service. I extracted three teeth and offered advice to patients by phone. I have not been involved in triage of patients as my principals have assumed this duty themselves. I have volunteered online for redeployment and the UDC hubs.   

I have grave fears for practice owners, especially those who provide an entirely private service and for those with mixed practices whose private income enables financial viability, but also for those embarking on a career in General Practice Dentistry. At the West of Scotland FGDP, we will run virtual tutoring for the MJDF exam, and intend to open this resource to new graduates and VDPs who are finishing their training year unsure of future employment. We want to keep them involved in the community of Dental Practice. Anyone else who wishes to keep their knowledge fresh is welcome to join us.

I first assumed practice ownership in 1985 and have since weathered many crises which we all considered existential at the time. We adapted to HEP B and C, AIDS/HIV, vCJD, the introduction of LDUs, and the fees cut of the early nineties after the introduction of the new contract. All of these were a threat to our financial viability, but our service is essential, and we are a very resilient professional group. We have very dedicated and effective leaders in the BDA, LDCs and FGDP. Please, take note if you do not see the relevance of such organisations; we need them, need to support them and owe them a huge debt of gratitude. 

I look forward to the day that I can return to practice, but practice owners will need to be supported by the Government. They need to be provided with financial support and high-quality PPE and not left to fight others in the marketplace. NHS funding will need to completely change; the funding model of the mid-20th century has been long outdated and is now completely obsolete. 

We are facing a drastic change in operating procedures, but dentistry will survive.

Patricia Thomson is a General Dental Practitioner in Glasgow and represents the West of Scotland and North of Scotland regions on the National Faculty Board of the FGDP(UK).

Tags: june2020 / Scottish Dental Magazine

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