Is there a future for a general dentist?

With the increasing complexity of dental practice, when does a Jack of all trades become a master of none? 

When I entered general practice in 1982, the main requirement of a dentist was to perform an examination, immediately plan the treatment (in your head) and then carry out the general dental care required. 

This general dental care mainly consisted of amalgam fillings, crowns and bridgework, extractions, some dentures, and some periodontal treatment (mainly a cursory scaling). Treatments such as tooth whitening, cosmetic veneering and short-term ortho were virtually unheard of. White filling material for the anterior teeth (it didn’t exist for posterior teeth) was just moving from silicate to composite, and bonding was being added to the process after etching. Implants were those new-fangled things that were very experimental. 

Roll on 30 years and a general dentist is now expected to have a working knowledge of all of the above and an ability to deliver most. S/he must also keep up to date with all aspects of practice compliance, ensuring they fully appreciate the current hoops being held up by the CQC (or relevant country compliance organisation). S/he must also be fully aware of the current guidelines on best practice and record keeping. 

The GDC has shown itself to be less than tolerant of even minor breaches of any of the above and are now removing the registration of many. 

Will this be the death of single-handed practice? I suspect that there are many in single-handed practice who have neither the time nor the energy to keep up to date. They may not actually be aware of what is going on around them. They may well just be getting on with the dentistry they have been doing for years without realising that they are actually digging their own grave. 

What is the minimum size of a dental practice to ensure coverage of ALL the necessary skills to deliver modern comprehensive advice and treatment to patients? I would suggest that a practice with the equivalent of 2 full-time (FTE) dental surgeons is the minimum requirement but probably 3 FTE would make life much more comfortable. 

The only other option is to ensure you are part of a partnership that actively keeps you up to date with everything and allows you to concentrate on looking after your patients – as you have always done – whilst someone else ensures the rest is up to date and working as a modern dental practice should. 

Such a partnership exists already and is carrying out this function across practices in North Wales. This is not for the benefit of some corporate organisation or someone looking to sell the whole business on at some point for massive profit, but rather for the benefit of all the staff who work in the practice. 

So, the answer to the title is “yes”. But not as we currently know it. 

Simon Gallier

 

 

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