Interview Continued »
electronic orthodontic referrals and two Cochrane reviews requires several hours at the laptop each week when I shouldn’t really be working,” he admits. But the discovery aspect of research and publishing the research findings is something he enjoys. Moving away from research,
when asked about his thoughts on the introduction of the Index of Orthodontic Treatment Need (IOTN) in Scottish orthodontics, Grant believes that it hasn’t made as big a difference as was possibly expected. He said: “A couple of years ago I was part of the Scot- tish Government Orthodontic pathways group, and at that stage we did discuss within the group the introduction of IOTN 3.6 and what would that mean for Scottish orthodontics. “To be honest I don’t think it has
made a huge change to the patients I see on a day-to-day basis. I think the ebb and flow of referrals
would be there anyway. It is a fairly arbitrary threshold but it is probably what most orthodontists are working to and I don’t think it will make an enormous difference across the board.” And the anticipated wave of
patients being turned down for orthodontic treatment just hasn’t materialised. He said: “I haven’t seen that and I certainly haven’t heard that from my colleagues in specialist practice.” Grant has been involved with
the Tayside appeals process and he believes it is working well. He said: “I think it is fair and right that there is an appeals process but ultimately if the appeal is not successful then the patient will have to either accept that they are going to have some sort of minor malocclusion or they have to seek private treatment. “Unfortunately, at the end of the
day there is not an endless amount of money available, especially in the midst of this recession we find ourselves back in again.” The economic situation of
“It is a fairly abitrary threshold... I don’t
think it will make an enormous difference across the board”
working within a consultant post also means that there are a number of technologies available to private clinicians that Grant and his colleagues in the NHS hospital sector are unable to take advantage of. He said: “It would be brilliant if we could provide lingual orthodon- tics within the hospital service. I think that would really extend me as a professional and that is something that I am really conscious that I do miss out on. Some days I wonder whether I should do some private practice, but then I think ‘where would I fit it in?’” Grant explained that they don’t have
the opportunity to use aligner-type appliances either, but for many of the cases that they treat, he concedes that it wouldn’t be entirely appropriate. Looking to the future, Grant
acknowledges that the main chal- lenges facing orthodontics in the hospital system are the age old prob- lems of missed appointments and simply getting compliance among patients to actually wear the retainers they have been given.
26 Scottish Dental magazine
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