Dr Susie Sanderson looks at the positive benefits of being asked a potentially difficult question.

Read this article to:

• Understand the importance of self-reflection
• Find out why it is important to difficult conversations with colleagues
• Learn there is no shame is asking for help

Can I just have a quiet word with you?

Guaranteed to create a surge of adrenaline in even the least insightful of us, those words mean that it is likely that someone has given a huge amount of consideration to what they are about to say.

In the category of ’information I never want to receive’ is the conversation with a colleague who thinks you are underperforming as a dentist. Unless the communication is inappropriately driven by malice or personal gain, the approach will not have been taken lightly. Nor should it be dismissed lightly, although an immediate reaction of denial, anger, hurt, betrayal and bewilderment is entirely understandable.

If you are the messenger delivering such news, you will have carefully examined all the available facts beforehand, but then things are never as simple as they see.

A critical moment

Such conversations are extremely uncomfortable for both parties. The good news is that one colleague has discharged an ethical obligation by alerting the other one to their concerns. The exchange between colleagues has been done quietly, in confidence at this stage, and deserves respect and professional courtesy. This is also a valuable opportunity for the other registrant to listen calmly to the concerns, explore why they have been raised and address them swiftly if that becomes necessary.

There are no mistakes, save one; the failure to learn from a mistake
Robert Fripp

This episode could be an opportunity for the same colleague to suspend frustration, delay denial and take an honest look at themself to see if there could possibly be some shortfalls in their professional development. A far riskier situation lies in not recognising the possibility.

Is it me?

Although it’s hard to believe in this age of digital connectivity, it is entirely possible for a practising dentist to be effectively isolated. Life events can sometimes overwhelm us and may last many years; relationships, home making, a growing family, responsibilities outside work feel as though they deserve our close attention.

During that time, it’s easy to function on autopilot in our working hours and before we know it, everything has moved on without us. Dentistry is a dynamic area of healthcare moving at an astonishing pace.

Is it appropriate to continue using outdated procedures in automatic mode simply because we didn’t question or even realise that there may be something better? Is it appropriate to rely on the comfort of “it’s always worked for me” to justify a procedure that has a more effective or safer alternative?

Even in a large multi-chair practice, a clinician can come and go on a daily basis with no professional interaction with peers. If that is coupled with little or no engagement with professional development or peer networking, the opportunity to see what is currently considered best practice might be lost.

Awareness

In dentistry, our awareness of an associated risk of harm to those people, who put their trust in us to look after them and their best interests, should be a constant niggle in our minds. Poor performance is not a calculated behaviour in anyone other than those with criminal or psychopathic tendencies.

More commonly, when accepted standards are not maintained, an underlying pattern can often be identified in retrospect. Burnout drives disinterest, poor motivation, isolation and ill health. Hubris can create an aura of unchallengeable confidence, particularly in situations in a small community where dentists can develop a self-perception of indispensability.

How many times do we hear our patients say to us, “I just don’t know what I would do if you weren’t here?” Such affirmations need to be heard with an understanding of the fickle nature of being indispensable.

One risk is that a dismissive culture develops, where small mistakes and minor complaints are ignored as unimportant or blamed on staff members or patients themselves. Early warning beacons can be missed, especially in an environment where there is an autocratic communication and governance style.

Unfortunately, it may be that the first “light bulb” moment follows the raising of a concern about the practitioner to the Dental Board or Council. The process of investigating a dentist’s fitness to practise can, in some cases, be lengthy, intrusive, demoralising and personally devastating in its outcome.

Surely it is far better to employ a healthy, honest and energetic degree of insight and to do everything possible to demonstrate current knowledge, well-practised skills, continual use of self-audit and an openness to constructive criticism.

Dental Protection works with dentists in many countries, who find themselves under investigation, to assist them in planning and extending their professional development. A first step on the part of the practitioner is an honest reflection about the issues that have triggered the concerns. The process can provide powerful reassurance that there is light at the end of the tunnel.

Ask yourself

“Would anyone feel it necessary to raise concerns about me at the moment?”

In taking the first brave step to ask such a question, the wise and insightful practitioner is looking for a reality check to provide reassurance one way or another. There is absolutely no shame in asking for help to consider this from a trusted critical friend, colleague or professional mentor. Even an informal chat in a safe place over a cup of coffee can be a valuable experience.

The only way to mitigate the risk of unconscious incompetence is to put yourself in a position to know what you didn’t know before. We are naturally curious and intelligent beings. In Dental Protection’s experience, the re-awakening of the joy of learning is an unexpected pleasure described by members who have taken advantage of feedback from a colleague to reflect and improve their knowledge or behaviour.

You see a person when you look in the mirror that no one sees but you. Other people see a person when they look at you, but you’re not that person, either.
Roy H. Williams

It may be that a discussion with a mentor (formally or informally) will reassure you that it is simply a lack of confidence in your own skills and breadth of knowledge that has led you to question your own competence and safety. Or it may be that the realisation that there really is a problem provides you with the incentive to sort it out.

Getting to the bottom of the reasons for your concerns about yourself may be harder to achieve. If they involve health issues, then it would be wise to discuss these with your GP or an adviser from a confidential agency that supports the wellbeing of healthcare workers. In any event, taking time to reflect and plan your actions will pay dividends.

Advice and assistance from Dental Protection

Dental Protection can offer advice and support and access to confidential counselling for members in any of these situations:

If you find yourself in receipt of information that may lead you to think that another registrant is repeatedly underperforming or is a risk to patients, you may wish to call and discuss the situation in confidence with one of our dentolegal advisers.

For members who have been alerted to concerns about their own professional performance, a conversation with one of our dentolegal advisers may help to give some direction to your next actions.

If you are concerned about your own professional performance, please take advantage of this benefit of membership, or perhaps discuss the issue with your own doctor.

For more information visit our contact page.