The True Treadmill

I hear it said time and again that nGDS was introduced to removed dentists from the dreaded treadmill. Well, if you believe that, then I have some American Subprime debt I would really like to sell you.

Let's get this straight. Under the old contract, the treadmill was NOT a creation of the system, it was a result of how the dentist worked in the system. By cramming your appointment book with everything that decided to walk through your door you:

• Ruined your cashflow (because nothing ever got finished)
• Ruined your health (because you never got a break and were working too hard)
• Ruined your ethical standing (because you missed things, rushed things and patched things)
• Ruined your skills (because you never spent the time to go on those courses and do the job properly)

So you worked harder when the government cut the fees, proving that you could earn the same by doing more work. NEVER do that to a bureaucrat, because he will just carry on doing that until steam comes out of your arse. Instead, we should have slowed down, spent time with our patients to find out what they actually wanted. To do this, you had to purge your appointment book of those individuals that didn't appreciate your time.

• The late arrivers
• The late payers
• The obnoxious
• The lecherous
• The non attenders

Why did we as a profession continue to treat these people? The vast majority of the people who sue you are those people that fall into these categories. And yet we, as a profession put up with them.

But I'm getting distracted. OGDS was a treadmill by choice, nGDS/PDS is a treadmill by design. To stay in this system, you have to work towards targets that were invariably calculated unfairly. Many dentists were asked to do too many UDA's, resulting in a shortfall and clawback. How can a dentist tell how many UDA's he can ethically do in a year when the system is untried and untested. Targets in Healthcare is a disgraceful concept. Whoever thought this up should be ashamed. You have a fixed monthly payment, based on a level of activity that was greater than most dentists actually did (whilst removing actual items of treatment that the dentists can do to meet the targets - e.g. Ortho), in a system where the costs of running the practice are rising year on year. The only way to offset the rising expenses is to do more private work. But this risks not leaving enough time to meet your targets, which risks clawback and a reduction in contract value. It's a vicious circle, with no way back if you should choose to step off the treadmill and risk going fully private.

And the fact that we have targets PROVES that the new contract is not about preventing disease. The whole point of prevention is to stop people having work done. Thus if you successfully run a preventive practice........ how the hell can you meet targets when targets are based on the surgical intervention of the disease process. So by being an ethical dentist, and by actually improving the health of your patient base........... you get penalised. It's absolute fricking insanity, and ANYONE who promoted this as being good for dentist and good for patients needs to be strongly informed that they are wrong.

Just a thought