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• Raising concerns


SPEAKING W


Raising concerns about a colleague’s behaviour is diffi cult for any dentist, but it can be especially challenging for trainees. MDDUS dental adviser Claire Renton off ers some advice


HEN it comes to the complex matter of raising concerns, the General Dental Council has a clear message for all dentists. The regulator’s core


guidance, Standards for the Dental Team, reminds us that we “must put patients’ interests fi rst and act to protect them. If you fail to do so by not raising a concern, your own registration could be at risk.” Scary stuff indeed, but what does this really mean for the dental profession? What should you do if you feel a colleague is under-performing or has health issues that put the care of their patients at risk? Most dental treatment is carried out to a good standard but we all have off days, don’t we? Perhaps it’s just me but, despite our best eff orts, not every treatment is perfect every time, not every root canal treatment is precisely at the apex and sometimes we break teeth during what should be a simple extraction. Such mistakes tend to return to our surgery


when we are given an opportunity to rectify any problems. These experiences often present a unique chance to identify areas of weakness in our knowledge and skills. And by refl ecting on our patient care we can use this knowledge to discuss diffi cult cases with our colleagues and also to inform our decisions on what CPD to do in the future.


Recognising problems In real life, however, it’s sometimes hard to recognise our own failings. It’s a real eff ort to constantly keep an eye on our own performance and occasionally a head in the sand approach kicks in. It’s easy to see how this approach could in


time lead to a dentist underperforming. MDDUS has received many calls from members concerned about a colleague’s behaviour and the threat it poses to patient safety. Often they contact us after having noticed warning signs such as alcohol on their breath, signs of medication overuse (drowsiness or detachment), frequently arriving late to practice, lack of care with their appearance or taking too long to complete routine tasks. It may be that a number of patient


complaints have been made about the dentist, perhaps they haven’t completed part of their work or colleagues have found them unusually short-tempered or slow to respond to requests for assistance.


“Your colleague may smell of alcohol or be frequently late“


Stepping up So what are you to do if you are working in a practice and you believe a colleague is providing substandard care? Where do your responsibilities lie? Should you send the GDC a dossier of your evidence at the fi rst sign of a mistake? Or is there a better approach to take? Clearly you are under an obligation to do


something. Once you feel a colleague is struggling you just have to step up to the mark. Be in no doubt, this will not be easy. However,


we are at our most professional when we support a colleague in need. There are, of course, several ways of doing


this and it’s up to you how you approach it. Firstly, ask yourself if you are considering the matter objectively and be sure your concerns are not infl uenced by other factors, such as your personal feelings towards the dentist. Remember the key consideration should be whether this dentist’s behaviour could risk patient safety. You might consider taking time out to discuss the matter directly with your colleague. Over a coff ee, lunch or even a pint at the end of the day are all possibilities but it’s a good idea to fi nd a time and place where you won’t be disturbed and are not under any time pressure. A quiet word is hopefully all that’s


necessary: an indication that you’ve noticed they’re having diffi culties and an off er of support and assistance might be very welcome. Hopefully that’s it, your colleague will admit they have problems and take the necessary steps to get the help they need. But often it’s much more diffi cult than that. Your workmate might not be aware of any


failings and feel you are over-stepping the mark in raising concerns about them. This can be particularly true if you, as a trainee, are raising an issue with a more senior team member (perhaps even your boss). This is where it is useful to discuss the matter with others in the practice to see if they share any of your concerns. A fellow associate, the hygienist or practice nurse can all be good allies. Keep the discussion focused on your specifi c concerns, what can be done to help and then perhaps consider approaching the dentist to discuss the matter as a group.


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