Column Word of mouth with Dr Paul O’Dwyer


Time to cool off T


here is a phrase which has recently crept in to the lexicon of purchasing goods, called the ‘cooling off’ period. Those reading who have ever


signed up for a mortgage will know all about it. At its essence, it’s that finite period where you can back out from the purchase of a product or agreement. It’s recognised as a protective mecha-


nism for consumers. It allows them to have a proper think about things – before absolutely committing to proceeding with the purchase. With bigger decisions – like a 25-year mortgage – it’s a vital step. You will have a long time to regret a bad decision. In dental practice, it’s recognised that


full explanation of a treatment plan is vital. It’s one of the most demanding aspects of healthcare, providing patients with enough information for them to make an informed decision. Consistency in treatment is everything.


In attempting to standardise the level of care, the UK has already addressed levels of compliance with regard to cross-infec- tion and other standards. This is inspected by the Care Quality Commission (CQC). It is just a matter of time until the new Dentist Act here in Ireland will also bring in similar standards. These measures are there, it is suggested, to protect patient safety, ensure a reproducible standard across the profession and also to safeguard the high standards dentists are taught at dental school. But what of communication? Is there the


potential that a cooling off period could become mandatory before treatment is commenced? The soft skills learned over the years chairside are hard won. The patient with the pursed lips, folded arms staring at the ground will inevitably take longer to communicate with, rather than the open armed, smiling, attentively head- nodding one. And yet, if asked, we dentists believe that our patient information is uniform. A recent thought-provoking article by business consultant Kevin Rose looked at


this in light of the ‘cooling off’ period. In everyday life, how often have we


heard the phrase “calls are recorded for quality monitoring and training purposes”? Will this become the norm for conversa- tions with patients, both in the surgery and potentially over the phone? How many of us have been led down the garden path by the patient who insists that “the nurse told me over the phone that you would take this tooth out today”? Our clinical notes provide the only mechanism at present to record our conversations with patients. The printed treatment plan is also useful. But what of the cooling off period? If the proposed treatment is not immediately essential, should we as clinicians offer a cooling off period before elective dental treatment commences? Also, from a standards perspective – will


this herald a call for a soft skills standard? Could this be regulation gone mad? These are questions that I feel sure will be addressed in time to come. At the IDA’s Annual Conference in


Kilkenny last May, Professor Tickle talked about quality in dentistry. At the lecture, he outlined one such definition based on research that is ongoing in his depart- ment. The over-riding factor for patients to choose a dentist was (in descending order): trust, accessibility and cost. In thinking about trust, it’s a very subjec-


tive thing. I wonder how many of us have succumbed to an impulse buy when shop- ping? And on the flip-side, how many of us have embarked on a complicated treatment plan with a patient, only to find, mid-treat- ment, that the patient had changed their mind, or worse, abandoned treat- ment midway through? Our recent national


fiscal mess has seen regulation of every sort being heaped on banks, to safeguard the saver and, potentially, the state. Could this


Ireland’s Dental magazine 19


“Recent articles talk of patients as consumers”


same principle be applied to elective dental treatment? What would it look like? Recent articles in the dental press talk


of patients as consumers. The ‘old school’ readers among us will find this uncomfort- able, and with good reason. The training received in dental school is the ideal/ utopian and is the standard which we as clinicians should aspire to in practice. However, we also have to pay bills, run surgeries, and satisfy the tax man. A few years ago I was training up a new


dental nurse and explained the distinction for her: when a person attends for treat- ment, they are a patient within the surgery. When they leave the surgery room, close the door and walk to reception, they are a client/consumer/customer. This may seem like the ultimate in pedantic English, but it is essential in separating out treatment need from financial necessity. Maybe we can take a leaf from the


recent financial fiasco and use that experience and the cooling off period to improve our communication, deliver higher quality dentistry and keep the roof over our heads.


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