One man’s opinion...

“There are ructions in our profession with many being concerned by Corporate and Insurance owned practices prescribing how their employed dentists should perform dental treatment and who is ultimately responsible for an adverse outcome if the employee dentist was following instructions?”

By Georges Fast

e live in interesting times. It would appear that reason and common sense take second place behind how people feel or what they believe in, no matter how bizarre these beliefs may be. One can’t help but find parallels between the current world situation and the scenes depicted in the film “Cabaret” which screened in 1972 and depicted life in Germany during the Weimar Republic in the 1920s when morals and social morays were replaced by anarchy and debauchery in a breakdown of a rational society.

On the one hand, anybody in a position of power must assess every word they utter to make sure that it can’t be misinterpreted as being racist, sexist or offensive to some self-selected minority group that identifies as being disadvantaged at some time in the past, no matter how long ago and how tenuous the link.

On the other hand, people promoting the latest fashion and fads can dictate to the rest of society how they should live their lives. A few of the many examples of this new imperative...

In an attempt to eliminate the use of cars, certain municipalities are forcing developers to restrict the number of car spaces in new developments to 30% of apartments. That this results in full shopping centre car parks and congested streets appears to be of little concern to these people. The inconvenience caused to the largely silent majority who still have to rely on using their cars for transport is seen as a price worth paying in the pursuit of their new religion.

My practice is located in an older suburb that has seen a rapid increase in density with older homes being demolished and replaced by new apartment blocks. Parking for my patients is becoming progressively more difficult and yet our local Council, despite many objections has (for a fee) let cafés and other food outlets occupy so called “parklets”, thus further reducing the number of parking spaces that are available to the public. These things might have made sense during the COVID lockdowns with restrictions on the number of people allowed indoors. It will be interesting to see how many of these will remain viable during a cold and rainy Melbourne winter.

The saying that “If you don’t have a plan you will become part of someone else’s plan” has never resonated as much as it does now. We have a situation where we are getting rid of coal-fired power stations before we have built viable alternate

Wsources of energy. We are virtually forcing people to get rid of petrol and diesel powered cars before we have effective substitutes, let alone sufficient power generation to keep these charged. The result of this can already be seen in Switzerland where there were periods recently when the population was told not to charge their cars or blackouts would occur.

We have governments that have restricted gas exploration and placed a cap on the price that producers can charge. Inevitably this will drive explorers to move somewhere else if they find it more profitable to do so and thus reduce the amount of gas available to our community. It seems not to have occurred to our parliamentarians to follow this reasoned train of thought!

Thus replacing what logic would dictate makes sense by what sounds good in theory is the “New Way”.

Dentistry is not immune from this trend, where the use of “influencers” is encouraging patients to choose their health providers so that they can feel connected with these glamorous, self-defined “leading lights” of society instead of considering logically if this is best for them.

There are ructions in our profession with many being concerned by Corporate and Insurance owned practices prescribing how their employed dentists should perform dental treatment and what treatment they should perform. There is also the issue of who is ultimately responsible for an adverse outcome if the employee dentist was following instructions from their employer. We have instances where Health Funds have redirected patients who had been referred to specialists to their own non-specialist dentists by claiming that their employees could carry out the procedure. It’s just another example of what can be achieved when marketing subsumes logic.

The ADA, which in reality is little more than an association of dentists and has no legislative authority, is powerless to deal with this problem other than by lobbying AHPRA and the Dental Board. The Boards, which are no longer controlled by professionals, possibly don’t understand the reason for our concerns and are more likely to be swayed by well-funded corporates who will try to convince them that they are more efficient at providing cost-effective treatment to the public.

The time to deal with this issue was many years ago when investors were first eyeing off dentistry as a source of revenue. Our only hope now is that common sense will ultimately prevail and the market, that is our patients, will figure out that this is not the way they want their health services delivered. This will take time and a lot of people in the meantime will suffer unnecessary grief.

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