The lunatics are running the asylum

Had a bit of a situation this week. Got a phone call midday on Thursday from Cornwall Primary Care Trust asking us to send in invoices for some washer disinfectors that we were invited to express an interest in 3 months previously. All the paperwork was completed and sent off in good time and we heard nothing until the phone call when we were asked for invoices by Friday at the latest. This gave us less than 48 hours to order the equipment, have it delivered and submit the invoice to the PCT. All this for a possible funding of 30 percent of the cost. Obviously this is impossible to do, but this is the reality of government announcements about 'increased funding for dental practices'. If this didn't happen time and time again it would be almost funny.

When all the lights go out..

Challenging day Thursday. Power cut right in the middle of the afternoon. As I desperately tried to find out if there was a problem inside the building, more and more patients were arriving. One poor woman had had her injection for a wisdom tooth extraction, but it became increasingly clear that we would have to abandon any treatments as it wasn't safe to continue with no power. Generally patients were very good, although one woman was complaining about her taxi fare in and I ended up offering to pay her fare for her! About 5 hours later Western Power got the electricity back on. Still the emergency lighting works..

A load of old cobblers..

Spent the weekend looking for a granite cobble. Generally I suppose that we suffer a very small amount of theft and vandalism compared to other businesses and certainly in other parts of the country. Our front car park however seems to be a destination for skateboarders and invariably our tree feature keeps getting damaged (we've had to replace the tree once). This time the cobbles around the base of the tree have been dislodged and thrown into the bushes. We couldn't find all of them and that's why I've wasted 4 to 5 hours of my weekend to date trying to find a replacement. This low level thoughtlessness and pettiness is probably endemic in our society, but I just find it all a little depressing. I've resisted it but I am finally considering CCTV to start catching these vandals in the act .

Sometimes its the little things that make all the difference..

I was struck today how some businesses consistently seem to get things right and how some seem doomed to struggle. We had arranged for a firm to pick us up and drive us and the car back home after a night out. As time went by eventually we decided to phone them only to be told that they had us down for tomorrow night! As the realisation that we were stranded hit home I took the opportunity to tell the dispatcher what I thought of him! (this was the second time this firm had got the night wrong in us using them only 3 times) Shortly afterwards I was attempting to put up an Aga pan holder only to discover that the wrong size wall fixings had been sent with the screws. Sometimes its just the smallest of human error that can completely spoil the relationship between a client and the business. Please if we ever do this sort of thing for a patient, let us know so that we can learn from our mistake. My mobile number is 07779044321

A Knights tale..

Staff party this week. I always try to do something a bit different and this year we'd hired Carn Brae castle. What a great venue - very atmospheric and reminiscent of an earlier age. The girls had played a trick on Jon and convinced him that it was fancy dress - although he complained loudly about being dressed as a king I think he actually revelled in the extra attention! The maitre'd looked rather unimpressed though - I think he thought Jon was a complete madman...

Practice Politics....

Tensions were high in the Practice this lunchtime. We've one member of staff who has been working 6 to 6 and a half days a week. Now although she's asked for the extra hours it has inevitably made her more tired and I think irritable. Anyway whereas we usually have a very good working relationship it came to a head today as she threatened to throw away a bouquet of flowers we'd been given as they gave her hay fever... I'm going to have to bring her hours back down to a more reasonable level irrespective of how much she wants the extra income..

RIP NHS?

Received some unsettling news about the NHS locally today. Apparently rather than recommissioning NHS provision when a dentist leaves the NHS the PCT has been keeping the money to pay off the losses in what is called the 'patient charge revenue' throughout Cornwall. While this will help the PCT in the short term, in the longer term this funding will end up being permanently lost to Cornwall. In our case despite taking on an extra dentist we've been informed that we've been failing to reach our targets (the letter helpfully informs us that 70 percent of local dentists are also failing to reach their targets). Our argument has always been that as these targets were simply guessed at rather than being worked out according to the government formula they were wrong from the beginning.. It is all really worrying and in particular its bad for those genuinely poor patients and their dependants who will be absolutely stuck if we lose our contract. I am really starting to think that the government will be happier if they can drop dentistry from health care all together. RIP NHS dentistry

Serves me right!

A funny weekend. Went to the dentist! I was up in Birmingham at an exhibition and met up with an old University friend. Back at his Practice we gave each other check ups... He had a filling done and I had my teeth cleaned. Bearing in mind that I consider this a routine thing that I do many times a day I'd forgotten how painful it can be! I was lying in the chair pushing myself into the headrest as hard as possible to try to get away from the sensation. Afterwards I convinced myself that it was a good thing to remind myself what its like to be on the other end of the mirror, and also not to leave it so long next time..

Goodbye Mr Hobkinson

Jon's retiring. He'll be going from the end of February. I suppose that he's 67 or 68 now and we've all noticed him slowing down a bit but we'll still be sad to see him go. We'll still have him along to staff outings etc. As they really wouldn't be the same without him. I think as well that as dentistry has become more and more reliant on high technology and new gadgets you have to work harder and harder to keep up to date. I just hope that when I get to Jon's age I've managed to keep my integrity and keep my standards up to his level. He'll be sorely missed.

Trench mouth in 2007..

Sad case today - young girl in her early twenties. Came in complaining of bleeding gums and it transpires that she's suffering with Acute Necrotising Ulcerative Gingivitis... A long name for a very unpleasant condition which was particularly prevalent in the trenches in the first world war. ANUG eats away quite quickly at the bone loosening the teeth. Already some of her lower front teeth were getting loose. Nearly always in smokers, although we can treat it in all likelihood she will have permanent damage and an ugly shape to her gums around her teeth when the treatment is finished. Maybe she will stop smoking now but really I doubt it

Look out look out the GDC's about!

I was interested to read that the General Dental Council has started hiring private detectives to crack down on beauty salon's offering tooth whitening. Apparently there are 80 salons up for prosecution at the moment.. with several being sued by patients unhappy with their results. I have always thought that tooth whitening should only be done by registered dentists as sometimes patients need work on their gums before going ahead, and may need some existing dental work changed before having the whitening done. Also certain whitening products can harm the enamel... It looks as though people are waking up to the fact that really we need properly trained professionals dealing with aspects of a patients appearance.

The Germans are coming..

Its been a surreal two weeks. We've had a German dental student over and Sabrina has been in with each of the dentists to see how we work. In fact I've been really impressed with the quality of the questions she's asked and with her professional approach. Interestingly she's been told by dentists in Germany that she should move to the UK once qualified as the opportunities there are much better! It seems that about 10 years ago budgets for dentistry were capped (which is similar to the new NHS system just starting in the UK) and Germany has become a net exporter of dentists ever since. Its been a bit of a baptism of fire for her though - she was staying at the Reef surf lodge and one of her room mates came in and threw up on the floor before going to bed. Still shows that not everything is rosy here in the UK..