Last month’s AEEDC was educational in more ways than one for dentists attending Manroor Al Awar’s lecture on superior patient satisfaction.
In an unscheduled show, attendees were treated to a rant on dental dissatisfaction by a delegate, who gave a glimpse into the realities of life as a public sector practitioner. Judging from her comments, I gather all is not well in the government dental clinics of Abu Dhabi.
Her chief complaint – which was met by a ripple of audience applause – was of managerial meddling. Government dentists, she said, are in a “constant war” with managers, who prize the quantity of patients treated over the quality of care on offer during the visit.
Turf wars between clinicians and managers are a permanent fixture on all national health service landscapes. Dentists, who once ruled the consulting room, are now finding themselves second-guessed by suits. (Apparently the letters ‘BDS’ don’t carry the same weight as ‘MBA’ nowadays.)
The main source of friction, as the Abu Dhabi-based prosthodontist said, is that non-clinical managers police decisions and have the power to weigh in against them.
The care that was once the sole remit of the dentist is now in the hands of managers (hands, I might add, that don’t touch patients directly). And the emphasis is heavily on treating more patients, for less.
Abu Dhabi’s Health Authority has declared itself keen to overhaul its healthcare system. A spread of initiatives, including piloting a privatised system and upgrading facilities, are to be introduced via a team of consultants specially selected for the task.
And it’s this implementation that has public sector dentists hot under the collar. The problem of treating patients in the thick of a corporate-style hierarchy is that clinical and management goals rarely go hand-in-hand.
The reason is quite straightforward; solutions that look good to paper-pushers typically fail in practice. And the impression that dentists are merely cogs in the corporate wheel – secondary to people who have spent less than half the amount of time at university they did – tends to prompts them to ask; Why should I bother?
So I am with our irate AEEDC dentist on this. Government dentists need top-level support. Any attempts to overhaul the system without their involvement are doomed to failure, and the cracks are already starting to show. A little timely peace making in the public sector could go a long way to ensuring we still have one (once the managers have departed).
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