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if you've had a long career in
healthcare, chances are that

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you've received a complaint.

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It could be about the way you
spoke to a patient, a mistake,

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or simply misunderstanding about
the treatment that you provided.

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And it's never been easier for
people to complain, whether it's

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through a simple online form
or just taking to social media.

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But a professional complaint
from a colleague can land very

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differently and hurt us more deeply.

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This week I'm joined by Dr. George
Wright, legal consultant and Deputy

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Dental Director of Dental Protection.

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Now, George had a complaint made against
him earlier in his career, which he

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believes led him to the work he does now,
helping other healthcare professionals

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navigate the complaints process.

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One of the things we discuss is the
often unintended escalation that

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so-called blue on blue complaints
may trigger even if the person wants

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to withdraw the complaint later.

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This often leads to long and drawn
out proceedings on both sides, and

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often no resolution for either party.

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So we talk about what to do instead of
going straight for the nuclear option and

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also when the nuclear option is necessary.

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And if you've experienced anything
like this or you'd like to know what

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to do, should a complaint land on your
desk, this in-depth conversation with

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George will give you the resources
you need to take the right next step.

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If you're in a high stress, high stakes,
still blank medicine, and you're feeling

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stressed or overwhelmed, burning out or
getting out are not your only options.

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I'm Dr. Rachel Morris, and
welcome to You Are Not a Frog.

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My name's George Wright.

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I'm a general dentist by background.

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I now work full-time for Dental
protection, Which is part of the Medical

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Protection Society as a dental legal
consultant and deputy Dental Director.

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is great to have you
on the podcast, George.

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Thank you so much for coming on.

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and I think this conversation's going
to be really interesting because the

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one thing that I know doctors, dentists,
nurses, healthcare professionals,

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fear above all things is complaints.

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And this fear of complaints drive so
much of our behavior, uh, whether it's,

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you know, avoiding saying no, because
we don't want to upset anybody, or

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just over investigating because we
don't wanna get things wrong, or just

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doing stuff that we probably wouldn't
normally do but just because we are

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so worried that, that the patient is
upset or maybe one of our colleagues

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is, is, is watching over our shoulder.

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And so we end up making these
decisions out of fear rather than

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out of our deep intuition, knowing
that that's the best thing to do.

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So obviously you are a
complete expert in this area.

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Um, just very quickly, what
sort of complaints are you

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seeing at the moment in general?

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Well, yes, there has been
a, a change in trends.

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Uh, we've had COVID, which of course
is, was, you know, a complete anomaly

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in itself, but in more recent times, the
real driver, I think, and the, the thing

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that’s really changed up the way patients
approach their healthcare is social media.

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So with social media comes a real
change in patient expectations.

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Patients are more aware of what
they are, let's say, entitled to.

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They're more aware of what can be
achieved and what can be delivered.

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Um, and they're also, uh, more aware of
what tools they have at their disposal

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when things go wrong, be that complaints
to clinicians directly or, you know,

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using social media itself as a, a tool
to, uh, criticize their clinician.

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It's a whole new ball game, isn't it?

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And misinformation that's out
there is really scary as well.

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So I, I asked one of my children
the other day, where'd you

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get your information from?

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Oh, TikTok, she said.

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I said, okay, so how do you
know if that information is

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true or not on TikTok, or right?

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And she said, oh, look at
the number of likes it has.

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Oh no.

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I said, okay, but what, what else?

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She said, well, I look at who's
commented, and like, if it's somebody

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famous, everyone knows it's commented.

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That's like, right, that, that it's
right then that's probably okay.

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And I was just like, oh my goodness.

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So we are no longer
believing experts are we?

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We, we are believing popular people.

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People that are famous people
have got big followings.

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Oh my goodness.

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Yeah.

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No, that, uh, I mean, that's
really interesting perspective.

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I suppose the answer is get a celebrity
patient into, uh, boost your exposure.

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But that, you know, I,
I think you're right.

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I think, um, misinformation is a problem.

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Where we see that in dentistry in
particular is things, uh, like,

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just to give you an example, before
and after clinical photographs.

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So a clinician can put some photographs
on their Instagram, for instance, and, you

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know, you have no way of knowing whether
those are credible photos of, of treatment

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that dentist has performed and completed.

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Um, and indeed you have no way of
knowing what sits behind the photograph.

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Was that patient actually
hap happy with the treatment?

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Was the dentist a good communicator?

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Did they deliver on what the patient
was expecting outta the treatment?

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None of that is delivered
through a, you know.

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short Instagram posting, is it?

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No, and that leads me onto my, the thing
I'd like to talk about is complaints, um,

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doctor on Doctor or dentist On dentist or,
you know, in interprofessional, because,

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you know, we've talked a bit on this
podcast before in Association of Medical

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Protection Society, and we'll, we'll put
the links in the show notes about how

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to deal with failure, manage yourself
through complaints and things like that.

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But what about when it's one of your
colleagues complaining about you?

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And I can imagine that when you see in
social media some misinformation being

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spread by some quite prominent characters
who, identify as doctors or as dentists

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or my pet bug bear is nutritionists.

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There are some absolutely fantastic,
very good nutritionists out there.

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Big shout out to, uh, the, the,
the Doctor's Kitchen 'cause they

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are brilliant and a, a, a GP
that runs that really good stuff.

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But there's some stuff out there that is
just completely wrong and making people

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spend so much money on stuff that's not
gonna help or might even be dangerous.

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And when you see that you think someone's
got to do something about this, they need

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to be reported to the GMC for, for putting
that on, on on Instagram, you know,

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but that's not always helpful, is it?

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But I think that is a reaction when
we as healthcare professionals see

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another healthcare professional
doing something we think is wrong.

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And the problem is that can be
really, really destructive, can't it?

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I mean, there's that macro level of
you don't know them at all, they're on

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social media, they're a prominent figure.

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But then there's that micro level of, of
people you might even be working with.

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Yeah, and I think, I think to the point
we've just been talking about in, in

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regards to social media, perhaps not
actually representing things, the

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same is true with the, impression that
one clinician might gain of another.

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It, it's a very, uh, narrow insight
into what's going on, and there's

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always a story that sits behind
what might be causing you concern.

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I think you're right.

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I think, you know, what we, we
would say is blue on blue, you

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know, is, is the term used for these
so-called clinicians complaining

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about other clinicians and they've,
they've absolutely got their place.

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Don't get me wrong.

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You know, if, if you see something
taking place that's putting patient

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care at risk, of course you have
a, an ethical and a professional

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responsibility to raise those concerns.

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It doesn't always have to be the case
that you have to reach for the nuclear

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option and refer them to the regulator.

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it's important I think, to look behind
what your motivation is for making

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that report and whether indeed the, the
mechanism that you have in mind is the

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most appropriate mechanism or whether
there might be something more suited.

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because.

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Why is it that most of us, most, I say
most of us, I've never done this, but

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a, a lot of blue on blue complaints
are directly to the regulator.

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They're directly already at the
escalation stage, rather than

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starting from the, the bottom of the
escalation pyramid, which is something

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I'd like to ask you about in a bit.

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Yeah, I think, I think that's
a really good question.

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I think there's probably two reasons.

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I think one is a misunderstanding of the
mechanisms that are available, so using

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that escalation process, making sure
that you are pitching your complaint or

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concern at the right level to get it dealt
with effectively but proportionately.

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And I think the other reason, and this
is perhaps more cynically, uh, pitched,

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is that if an individual has themselves
been in the recipient of a complaint to

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the regulator, particularly by another
professional, then emotionally, I think

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often the response is to retaliate with a
similar complaint to the same regulator.

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And so I think it's really important to
really, I suppose, look inwards before

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you make any reports, any complaints,
really scrutinize your own motivations

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for doing that, and take advice so you
can understand whether indeed that is

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the most appropriate course of action to
get the outcome that you are looking for.

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so much in that, isn't there?

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So I think first of all,
yes, it's a motivation.

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Like why is it that I'm making
this, making this complaint?

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Is it to correct stuff
that's factually wrong?

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In which case, yeah, why
would you go to the GMC?

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Why wouldn't you just message them?

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And I know, you know, when we put
stuff out on Instagram about burnout

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and stress and resilience, um, if we
ever get any pushback from people or

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complaints or, or people right to us,
occasionally we do get some feedback about

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stuff, I take it really seriously and
I, I always change things and I always

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look at what we're doing and thinking
is, is that, is that right or not?

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So I think people maybe assume that their
feedback isn't going to be listened to.

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I think that firstly, most
feedback is really listened to

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and it's really, really valuable.

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So there is that, that that
motivation about is it, 'cause I

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want to correct stuff out there.

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I guess when it comes to the social
media type stuff, there might be a bit

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of jealousy on people's, you know, if
there's a very, very prominent doctor or

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psychologist in the, in the media, people
just wanna have a pop at them, don't they?

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And, you know, I do think
that happens a bit as well.

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I, I think that's absolutely right.

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So I, um, I'm, I'm joining you today
actually, as it happens from Hong Kong.

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NPS has a me, uh, a, a presence all
around the world, and, uh, one of our

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significant jurisdictions is Hong Kong.

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And so I, I'm over here at the moment
listening to colleagues talk to me

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around the challenges that they face
in their own professional lives.

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' Cause Hong Kong is, so if I just give
it as an example, because I think

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it is relevant to the UK and beyond,
it's, it's such densely populated

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area that the competition is so high.

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You know, you can have a dental
practice on, you know, floor 30 of a

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building a dental practice on floor
32 and another one on floor 34.

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So it's so easy for patients to walk and
move between one practice and another.

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So there is that real competitive
spirit between the practices.

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So using that mechanism of complaints,
be it in relation to social media,

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be it in relation to advertising,
which we see particularly over here

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where it's really heavily regulated,
it is very often used unfortunately

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as a mechanism for that, I suppose,
competition for space in the market.

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And if you transfer that across
to the uk, it's, it's definitely

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the case, probably not as, um.

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Concentrated, but we do see complaints
from clinicians, uh, arising

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from the practice down the road.

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You know, it's, it's very rare that
you get complaints from somebody that

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is remote from your own practice.

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Invariably, it's linked in some
way to proximity and therefore,

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uh, competition for patients.

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I have definitely seen it in, uh,
hospitals, apartments where there's

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been some private practice going on and
there's a new kid on the block and they

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don't like, there's a sort of consortium
of consultants that don't like this

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new kid on the block, and invariably
within the first couple of years, a

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GMC referral will be made by one of the
other consultants in the department.

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I've seen that happen quite a few times.

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it's really despicable behavior.

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It, it is.

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And, and generally speaking,
the regulators don't like to

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be the battleground for these
interprofessional disputes.

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I mean, as I said at the outset, it's
absolutely right that some complaints

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are referred to the regulator, but
I think sometimes the challenge

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lies in how easily done it is.

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You know, you can report
someone now in the space of five

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minutes on an online web form.

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You press the submit button, you
shut the lid of your laptop, or

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you lock the screen on your phone
and you carry on with your day.

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But what you have just initiated in
the, in doing that is a significant

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process that's going have a huge
emotional turmoil on the recipient

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and incidentally can't be stopped.

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Once you start that process going
particularly so far as the GDC is

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concerned, they will investigate it.

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You cannot wake up the next morning
and think, actually, perhaps I was

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a bit hotheaded in sending that off.

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00:12:41,691 --> 00:12:44,121
Perhaps the appropriate thing
might have been to have a chat to

221
00:12:44,121 --> 00:12:47,691
this individual and ask the GDC
if you can withdraw the complaint.

222
00:12:47,991 --> 00:12:52,101
The GDC will say, investigation's been
opened and we need to look into this now.

223
00:12:52,531 --> 00:12:53,791
that's really quite sobering.

224
00:12:53,851 --> 00:12:56,221
And it is often very
long process, isn't it?

225
00:12:56,341 --> 00:12:56,611
Isn't it?

226
00:12:56,611 --> 00:13:00,361
Can I just ask you very quickly, how
quickly will they throw out okay, if

227
00:13:00,361 --> 00:13:05,731
it's obviously vexatious or malicious or
malignant, you know, does it still take

228
00:13:05,731 --> 00:13:08,881
them a year to sort it out or can they
like look at that pretty quickly and

229
00:13:08,881 --> 00:13:11,431
go, actually there's, there's absolutely
no grounds for investigating here.

230
00:13:11,928 --> 00:13:13,728
Well, there's two answers to that.

231
00:13:13,728 --> 00:13:15,948
First of all, if I can, let
me just indulge you with,

232
00:13:16,008 --> 00:13:17,718
um, my personal experience.

233
00:13:17,718 --> 00:13:23,718
So I was reported to the GDC, uh,
10 years ago, and admittedly the GDC

234
00:13:23,718 --> 00:13:27,258
is, has improved considerably in that
time, and I'm not suggesting it would

235
00:13:27,258 --> 00:13:32,898
be the same time scales today, but
in that situation, which related to a

236
00:13:32,898 --> 00:13:37,308
single patient that I had seen on one
occasion for an emergency appointment.

237
00:13:37,608 --> 00:13:42,828
It took nine months for the GDC to write
to me and tell me that I'd done nothing

238
00:13:42,828 --> 00:13:44,525
wrong and they were closing their case.

239
00:13:44,998 --> 00:13:48,148
And that was nine months at a
very, you know, difficult time.

240
00:13:48,148 --> 00:13:51,118
I'd I, you know, relatively
new into the profession.

241
00:13:51,418 --> 00:13:56,008
Um, you know, had just bought my new
first house, got a mortgage, um, you know,

242
00:13:56,128 --> 00:13:58,108
starting to make financial commitments.

243
00:13:58,108 --> 00:14:00,988
And then ultimately you are, you
are, you are facing a process that

244
00:14:00,988 --> 00:14:04,648
could lead to your avasia from the
register and the end of your career.

245
00:14:04,648 --> 00:14:08,469
So that's, um, you know, you can't
underestimate or understate that.

246
00:14:08,854 --> 00:14:10,084
There has been progress made.

247
00:14:10,234 --> 00:14:14,224
Um, you know, it'd be unfair of me
to suggest otherwise, but we are

248
00:14:14,224 --> 00:14:18,364
still looking at cases that take
a number of months, even the most

249
00:14:18,364 --> 00:14:23,014
straightforward cases to be closed
at that initial triage stage.

250
00:14:23,314 --> 00:14:27,124
And if you are unfortunate enough to be
in this, in the situation of a complaint.

251
00:14:27,299 --> 00:14:31,521
It goes all the, through the process
to a hearing, well, hearings are

252
00:14:31,521 --> 00:14:37,941
now being scheduled well into 2026,
2027, so you are looking at years.

253
00:14:38,001 --> 00:14:41,421
If you were to get a complaint today
that went to a hearing, you'd be

254
00:14:41,421 --> 00:14:46,221
looking at years, months, certainly not
weeks or days for that to be resolved.

255
00:14:46,521 --> 00:14:49,041
And that takes so much of an
emotional toil, doesn't it?

256
00:14:49,046 --> 00:14:51,051
We'll, we'll talk about that in a minute.

257
00:14:51,489 --> 00:14:54,999
But I guess one of the questions you'd ask
us yet, would you inflict that on anybody?

258
00:14:55,485 --> 00:14:59,369
Like even if it's someone that you
know, you don't like particularly,

259
00:14:59,719 --> 00:15:03,289
that, that toil and, you know,
doctors, you know, speaking from my

260
00:15:03,289 --> 00:15:07,129
own experience of, of, um, luckily
I've never been referred to the GMC.

261
00:15:07,129 --> 00:15:10,999
I've had complaints, but I I, I was never
referred to the GMC, but I had colleagues

262
00:15:10,999 --> 00:15:17,362
that were, and yeah, it took two or
three years and they were all exonerated.

263
00:15:17,362 --> 00:15:20,152
And, and even if you actually
know in your head, you are

264
00:15:20,152 --> 00:15:22,042
very unlikely to be struck off.

265
00:15:22,132 --> 00:15:26,170
And the, the recent, um, numbers that
I've heard from, you know, certainly

266
00:15:26,170 --> 00:15:31,540
amongst doctors, medical doctors refer
to the GMC, is that most people don't end

267
00:15:31,540 --> 00:15:34,870
up in the Fitness to Practice committee
unless they've been really bad, you know,

268
00:15:34,870 --> 00:15:38,770
unless they've done something criminal
or they've shown absolutely no insights.

269
00:15:38,770 --> 00:15:40,270
And, and actually the reality is.

270
00:15:40,570 --> 00:15:41,800
You can make mistakes.

271
00:15:41,800 --> 00:15:41,920
Yeah.

272
00:15:41,950 --> 00:15:43,000
We all make mistakes.

273
00:15:43,000 --> 00:15:43,780
We know we do.

274
00:15:43,780 --> 00:15:46,360
And if you have some insight and
you show you've learned and all

275
00:15:46,360 --> 00:15:48,370
that sort of stuff, you're very,
very unlikely to be struck off.

276
00:15:48,370 --> 00:15:52,360
So in our heads, we know, you know, in
your head you knew there was probably

277
00:15:52,360 --> 00:15:56,470
a zero chance of you being struck off
a lot or, you know, might be suspended

278
00:15:56,470 --> 00:15:58,330
for a couple of months maybe, maybe.

279
00:15:58,330 --> 00:16:00,580
But actually you're not gonna,
you're not gonna lose it.

280
00:16:00,923 --> 00:16:05,107
But it is such an emotionally
difficult process and it's there in

281
00:16:05,107 --> 00:16:07,297
the back of my mind all the time.

282
00:16:07,297 --> 00:16:11,573
You know, there must be other reasons, not
just am I gonna be struck up, off or not?

283
00:16:11,723 --> 00:16:13,823
For that process to be so prominent.

284
00:16:13,823 --> 00:16:17,723
And of course so many issues for doctors
and dentists and other healthcare

285
00:16:17,723 --> 00:16:19,163
professionals that are going through it.

286
00:16:19,313 --> 00:16:20,723
I mean, you're, you're absolutely spot on.

287
00:16:20,723 --> 00:16:21,443
Of course you are.

288
00:16:21,443 --> 00:16:26,153
And, and I think, you know, first of all,
I think you are right to say that the

289
00:16:26,243 --> 00:16:31,343
vast majority of cases will be closed
without the ultimate sanction of erasure.

290
00:16:31,343 --> 00:16:34,013
It is a really tiny, tiny percentage.

291
00:16:34,313 --> 00:16:38,223
And when you look at the cases
that lead to erasure, it is

292
00:16:38,223 --> 00:16:41,003
right that those individuals are
removed from the register, okay?

293
00:16:41,003 --> 00:16:43,463
It's, it's right for the profession,
it's right for the public.

294
00:16:43,663 --> 00:16:44,623
We not talking you.

295
00:16:44,923 --> 00:16:49,213
Isolated clinical areas, we're talking
criminality and, and such serious matters.

296
00:16:49,747 --> 00:16:51,817
But you, you do go on
that emotional journey.

297
00:16:51,817 --> 00:16:54,877
You wake up every morning, you go
to work and you have a coffee with

298
00:16:54,877 --> 00:16:57,847
someone in the cold light today,
and you, you kind of see things with

299
00:16:57,847 --> 00:17:01,207
really good perspective and you think,
no, this is gonna come to nothing.

300
00:17:01,507 --> 00:17:05,377
But by the time midnight comes along and
you've been sitting tossing and turning

301
00:17:05,377 --> 00:17:10,147
for three hours, you can very quickly
catastrophize yourself up to, yeah,

302
00:17:10,147 --> 00:17:12,997
I'm gonna be erase from the register
and this is the end of my career.

303
00:17:13,450 --> 00:17:14,290
So, yeah.

304
00:17:14,290 --> 00:17:20,680
I I, I think it's so important to keep
that in mind when you make a complaint.

305
00:17:20,770 --> 00:17:23,950
And I, you know, I, I I do want
to emphasize that I'm not putting

306
00:17:24,220 --> 00:17:28,810
the point here that you shouldn't
escalate things to the GDC.

307
00:17:29,110 --> 00:17:30,010
Absolutely right.

308
00:17:30,280 --> 00:17:33,400
You know, there are cases where
indeed you have a professional

309
00:17:33,400 --> 00:17:36,825
responsibility into not raise es
and escalate concerns, you would be

310
00:17:36,825 --> 00:17:38,925
putting your own registration at risk.

311
00:17:39,225 --> 00:17:45,525
But if the matter can be effectively
dealt with at a more local level, then

312
00:17:45,525 --> 00:17:50,595
that is in everyone's best interest,
uh, not least the person that would

313
00:17:50,595 --> 00:17:51,915
be the recipient of the complaint.

314
00:17:52,310 --> 00:17:55,370
Do you think people just go
straight to the regulator?

315
00:17:55,370 --> 00:17:57,860
Because it's the easy way to do it?

316
00:17:57,860 --> 00:18:00,710
It's the easy way out, and to me it
just seems like the coward's way out

317
00:18:00,793 --> 00:18:03,013
Yeah, I, I think certainly the easy way.

318
00:18:03,013 --> 00:18:07,183
Um, certainly, you know, it, it,
it takes a lot of resource to

319
00:18:07,183 --> 00:18:10,783
investigate a complaint properly,
particularly those that have multiple

320
00:18:10,783 --> 00:18:15,313
patients involved or systems and
process matters to be considered.

321
00:18:15,711 --> 00:18:19,593
it is helpful to have the GDC there
for those, I think cynically looking

322
00:18:19,593 --> 00:18:23,223
at it to, uh, kind of take that
burden on themselves and, and have

323
00:18:23,223 --> 00:18:25,323
the resource to investigate it.

324
00:18:25,623 --> 00:18:30,033
Um, I do however, think that a
lot of the motivation is a lack of

325
00:18:30,033 --> 00:18:36,133
understanding, that actually you don't
have to go to the ultimate arbiter.

326
00:18:36,233 --> 00:18:37,523
Let's give an example.

327
00:18:37,523 --> 00:18:42,893
You see a patient and you are, uh, a
little concerned about the approach

328
00:18:42,893 --> 00:18:44,333
that the other dentist has taken.

329
00:18:44,633 --> 00:18:44,903
Okay?

330
00:18:44,903 --> 00:18:48,908
It might not be, uh, totally
unprofessional, just, you know,

331
00:18:48,913 --> 00:18:51,833
you think actually not quite how I
think this should have been done.

332
00:18:51,993 --> 00:18:54,033
That's not the remit of the GDC.

333
00:18:54,033 --> 00:18:57,833
The GDC is there to deal with
those individuals who, you know,

334
00:18:57,863 --> 00:19:01,253
if the allegations are found,
prove would not be fit to practice.

335
00:19:01,253 --> 00:19:03,683
They, they should not be
the dentist, be a dentist.

336
00:19:03,953 --> 00:19:05,363
That's ultimately what you are saying.

337
00:19:05,693 --> 00:19:07,283
And it's got to be better for patients.

338
00:19:07,283 --> 00:19:10,373
It's got to be better for the profession,
for those types of complaints to be

339
00:19:10,373 --> 00:19:14,123
dealt with an investigated at a local
level, whether that's within the hospital

340
00:19:14,123 --> 00:19:17,873
trust department or whether that's
within a particular dental practice.

341
00:19:18,173 --> 00:19:22,103
Uh, and, and I think there's
two ways to support that.

342
00:19:22,403 --> 00:19:23,603
One is training.

343
00:19:23,663 --> 00:19:28,133
So having an effective training process
so that everyone in the practice is

344
00:19:28,133 --> 00:19:33,173
aware of both their obligations, but also
the mechanisms for escalating concerns.

345
00:19:33,703 --> 00:19:40,160
But also the need to ensure that you
have a really visible process and

346
00:19:40,160 --> 00:19:43,730
you have somebody that takes ultimate
responsibility for complaints handling

347
00:19:43,850 --> 00:19:47,930
or dealing with interprofessional
concerns within any, any setting.

348
00:19:48,230 --> 00:19:53,740
And if you have that, then anybody
with a concern, should have confidence

349
00:19:53,740 --> 00:19:58,720
in that process such that they
don't feel the drive to go to the

350
00:19:58,720 --> 00:20:01,260
regulator to deal with their concerns.

351
00:20:01,403 --> 00:20:01,583
Yeah.

352
00:20:01,583 --> 00:20:05,368
The problem with that though, George,
is that I hear, uh, there's a local

353
00:20:05,368 --> 00:20:08,153
expression, it's probably a national
expression, secondary care doctors.

354
00:20:08,333 --> 00:20:12,973
Oh, yeah, I Datixed him, I Datixed
them, and I think Datix is the reporting

355
00:20:12,973 --> 00:20:16,633
system, so it seems like, yes, the
hospital thought, right, we need to

356
00:20:16,843 --> 00:20:18,733
make this way of reporting errors.

357
00:20:18,733 --> 00:20:22,063
They probably, I'm, I'm hoping
it was from good motivation.

358
00:20:22,063 --> 00:20:25,333
They probably read the Amy Edmondson
stuff about the, you know, the,

359
00:20:25,603 --> 00:20:28,993
the good organization reports the
mistakes and errors so that they can

360
00:20:28,993 --> 00:20:32,533
learn from them and all that, but
that just seems to be weaponized.

361
00:20:32,533 --> 00:20:36,858
So you Datix someone or you just, I
ignore it totally because it's, it,

362
00:20:36,858 --> 00:20:40,518
it's too difficult to say anything
and you think it's easier not to.

363
00:20:40,518 --> 00:20:46,248
So I think even when there are structures
in place to deal with things locally, they

364
00:20:46,248 --> 00:20:48,618
either get weaponized or they get ignored.

365
00:20:48,678 --> 00:20:53,058
And so you keep putting these Datixes
in and nothing seems to ever be done.

366
00:20:53,058 --> 00:20:54,258
Nothing's fed back to you.

367
00:20:54,258 --> 00:20:56,058
So then you lose
confidence in the process.

368
00:20:56,338 --> 00:20:59,640
Yeah, I think that's really fair
challenge on both co, on both counts.

369
00:20:59,640 --> 00:21:03,575
So, uh, you know, in in general dental
practice, there are certainly, you know,

370
00:21:03,575 --> 00:21:05,730
you, you will have individual processes.

371
00:21:05,730 --> 00:21:08,910
We wouldn't have Datix process, but
you are right, certainly in hospital

372
00:21:08,910 --> 00:21:14,100
trusts, Datix, uh, you know, it, it's
definitely got its positive points

373
00:21:14,100 --> 00:21:19,710
because it allows individuals to
raise concerns without having to have

374
00:21:19,710 --> 00:21:21,810
necessarily difficult con conversations.

375
00:21:21,810 --> 00:21:24,570
And, and let's face it, not
everyone is comfortable having

376
00:21:24,570 --> 00:21:26,040
those kind of discussions.

377
00:21:26,427 --> 00:21:29,500
And okay, yes, it's
still being weaponized.

378
00:21:29,500 --> 00:21:33,490
I, I concede that point, but if I
was going to be a, you know, on the

379
00:21:33,490 --> 00:21:37,570
receiving end of a weaponized process,
I'd much rather have to have a

380
00:21:37,570 --> 00:21:41,890
difficult conversation with a hospital
manager following a Datix report than

381
00:21:41,890 --> 00:21:46,320
I would to be having to go through
an investigation with the GDC or GMC.

382
00:21:46,966 --> 00:21:50,740
And I think, you know, we have to
take a pragmatic approach here.

383
00:21:51,040 --> 00:21:52,690
There has to be a process in place.

384
00:21:52,690 --> 00:21:56,470
There has to be a system in place,
and unfortunately, I think it's gonna

385
00:21:56,470 --> 00:22:01,060
be, uh, really difficult to get to
the place where you have a system that

386
00:22:01,060 --> 00:22:03,880
is totally free of being weaponized.

387
00:22:04,180 --> 00:22:07,420
I, I should also say, Rachel, I
think it's important to, to make the

388
00:22:07,420 --> 00:22:12,130
point that yes, these things do get
weaponized, but we are talking, you

389
00:22:12,130 --> 00:22:14,800
know, relatively low numbers, okay?

390
00:22:14,800 --> 00:22:20,780
So the GDC clinician on clinician
complaints account for less than 10% of

391
00:22:20,780 --> 00:22:23,540
concerns that land on the GDC's desk.

392
00:22:23,840 --> 00:22:29,710
And by and large, clinicians
are very good, very capable and

393
00:22:29,710 --> 00:22:32,950
competent, confident to have
those difficult discussions.

394
00:22:32,950 --> 00:22:37,480
You know, I will very often receive
phone calls into dental protection from

395
00:22:37,480 --> 00:22:41,250
colleagues who say, actually I'm concerned
about my colleague, i'm gonna go knock

396
00:22:41,250 --> 00:22:44,460
on their surgery door at lunchtime,
I want to have a chat with them.

397
00:22:44,460 --> 00:22:47,160
Have you got any pointers for
how to open that discussion.

398
00:22:47,490 --> 00:22:49,440
So you know it happening?

399
00:22:49,710 --> 00:22:52,670
I think we can and should do better.

400
00:22:52,700 --> 00:22:55,310
And I think really that needs to
be the, the direction forward.

401
00:22:55,482 --> 00:22:58,272
If you, and I think that's really
good and what's really heartening is

402
00:22:58,272 --> 00:23:01,512
that actually people can phone you up
and go, what should I do about this?

403
00:23:01,542 --> 00:23:06,512
And that, is that something that the, you
know, medical protections enter protection

404
00:23:06,632 --> 00:23:08,162
would really invite people to do.

405
00:23:08,312 --> 00:23:08,942
Absolutely.

406
00:23:08,942 --> 00:23:12,272
I think in any situation where
you have concerns about another

407
00:23:12,272 --> 00:23:15,182
professional, we would always be
happy to have that conversation.

408
00:23:15,512 --> 00:23:19,262
Now, what you are not going to get
out of me, and, and I suspect my

409
00:23:19,262 --> 00:23:24,245
colleagues as well, is an answer of,
yes, you need to, or no, you don't

410
00:23:24,245 --> 00:23:26,330
need to report them to the regulator.

411
00:23:26,330 --> 00:23:29,707
We we're not there to take away
that decision making burden,

412
00:23:29,707 --> 00:23:32,617
which unfortunately has to
sit with the individual that

413
00:23:32,617 --> 00:23:34,297
is closer to the situation.

414
00:23:34,764 --> 00:23:38,410
But what we can say is, have you tried.

415
00:23:38,710 --> 00:23:40,150
Discuss individual.

416
00:23:40,360 --> 00:23:45,910
Have you explored what mechanisms are in
place in the organization you are working?

417
00:23:46,210 --> 00:23:48,970
And if you are having a conversation
with us in which you're saying, look,

418
00:23:48,970 --> 00:23:54,070
there are, you know, serious concerns
here that are repeating, that are not

419
00:23:54,370 --> 00:23:58,480
being resolved despite me following
all those processes, then it may be

420
00:23:58,480 --> 00:24:01,930
that we say to you, well, look, you
have a professional responsibility

421
00:24:01,930 --> 00:24:03,400
and you need to be mindful of that.

422
00:24:03,700 --> 00:24:07,510
And perhaps it's appropriate for
you now to give consideration to,

423
00:24:07,810 --> 00:24:11,260
um, what are the mechanisms of
escalation you have at your disposal.

424
00:24:11,472 --> 00:24:15,692
it is always useful to sense check
stuff with a a neutral party.

425
00:24:15,692 --> 00:24:18,692
I was just thinking would you go to
a colleague and talk about it first

426
00:24:18,692 --> 00:24:23,462
before you came to sort of your,
your medical, protection society?

427
00:24:23,877 --> 00:24:27,292
But actually I'm thinking some,
sometimes your, your colleague is

428
00:24:27,292 --> 00:24:31,462
sort of as invested as you are or
as sort of can be, can feel a bit

429
00:24:31,672 --> 00:24:33,472
aggrieved as well or whatever.

430
00:24:33,472 --> 00:24:36,884
And so actually getting a very neutral
perspective I think would be helpful.

431
00:24:36,884 --> 00:24:40,718
Sometimes being too close to it,
knowing the personalities, and, and

432
00:24:40,718 --> 00:24:44,618
all the negative connotations that
can come with, with that perspective.

433
00:24:44,918 --> 00:24:49,568
But also, perhaps a better example
is, you know, we get so often now,

434
00:24:49,568 --> 00:24:52,551
colleagues will go to forums for advice.

435
00:24:52,551 --> 00:24:54,321
So they'll, they'll ask on Facebook.

436
00:24:54,321 --> 00:24:58,831
There's a very famous Facebook group
with tens of thousands of dentists on.

437
00:24:58,915 --> 00:25:03,390
Now, if you seek advice there, you’ll
get the whole range of answers, and

438
00:25:03,390 --> 00:25:07,350
you'll be given answers from someone
who, again, can type a response and

439
00:25:07,350 --> 00:25:10,980
shut the lid of the laptop and they've
got no interest in the repercussions.

440
00:25:10,980 --> 00:25:16,020
So if they say, yeah, you need to
go to the GDC, then it's very easy

441
00:25:16,020 --> 00:25:18,360
to write those few words, isn't it?

442
00:25:18,390 --> 00:25:22,470
But then you are the one that then has to
make those difficult decisions ultimately,

443
00:25:22,470 --> 00:25:24,240
and you get drawn into that process.

444
00:25:24,240 --> 00:25:28,950
So yeah, it, it, it's an absolute
difficult balancing act and I think

445
00:25:28,950 --> 00:25:34,200
the objectivity which dental protection
or medical protection can provide,

446
00:25:34,500 --> 00:25:38,010
particularly because our advice is in the
best interest of the person ringing us up,

447
00:25:38,310 --> 00:25:40,950
um, can be invaluable in those situations.

448
00:25:41,100 --> 00:25:44,970
Yeah, I've certainly seen there's a
very large, um, physician's Facebook

449
00:25:44,970 --> 00:25:47,370
group and yeah, someone will say,
can I have advice about this?

450
00:25:47,370 --> 00:25:48,120
This is what happened.

451
00:25:48,120 --> 00:25:50,490
And people are going Report, report,
report, that's awful, that's awful.

452
00:25:50,490 --> 00:25:53,860
And you're thinking, well, yeah,
if you put it like that, it sounds

453
00:25:53,860 --> 00:25:57,790
awful, but there's gonna be, there's
going to be context around that.

454
00:25:57,790 --> 00:26:01,300
And I, you know, I know in our own
organization, you know, we're not seeing

455
00:26:01,300 --> 00:26:04,935
patients anymore, but when something has
been done wrong or something happened,

456
00:26:05,418 --> 00:26:09,206
I, I used to react like, and go, well,
this, this, this was wrong, this needs

457
00:26:09,206 --> 00:26:10,766
to be, this needs to be sorted out.

458
00:26:10,766 --> 00:26:13,526
Now the first thing I say
is, oh, what happened here?

459
00:26:13,556 --> 00:26:14,486
Let's hear what happened.

460
00:26:14,486 --> 00:26:18,088
And The explanation always makes me feel
far less serious than it, than it felt.

461
00:26:18,088 --> 00:26:21,028
So I really try and say, it's
like, oh, I've noticed this.

462
00:26:21,328 --> 00:26:22,198
What happened?

463
00:26:22,198 --> 00:26:24,148
They're like, oh my word, I'm so sorry.

464
00:26:24,148 --> 00:26:26,188
And often that's exactly what you want.

465
00:26:26,188 --> 00:26:28,888
You just want somebody to be aware
of what happened and a, and an

466
00:26:28,888 --> 00:26:33,688
explanation of why it happened and to
know it's not going to happen again.

467
00:26:34,149 --> 00:26:37,539
And that is done much, much better
with a initial conversation.

468
00:26:37,539 --> 00:26:40,719
But what I think people have
trouble doing, it's raising

469
00:26:40,719 --> 00:26:41,919
it in the first place..

470
00:26:42,069 --> 00:26:42,549
It is.

471
00:26:42,579 --> 00:26:43,119
You are right.

472
00:26:43,179 --> 00:26:43,689
You are right.

473
00:26:43,719 --> 00:26:44,919
I think two reasons.

474
00:26:44,919 --> 00:26:47,566
One, it's, it's just uncomfortable, right?

475
00:26:47,566 --> 00:26:51,842
And sometimes the person you are
speaking to, you will know them and,

476
00:26:51,842 --> 00:26:55,742
and they may be a, you know, difficult
character, you might anticipate some

477
00:26:55,742 --> 00:26:58,022
challenges that with that conversation.

478
00:26:58,322 --> 00:27:02,012
And also I think clinicians
are always mindful of what

479
00:27:02,282 --> 00:27:03,932
repercussions it might have on them.

480
00:27:04,232 --> 00:27:09,242
Um, particularly when it comes to these
so-called blue on blue complaints.

481
00:27:09,512 --> 00:27:13,502
The fact that it is not uncommon,
unfortunately for somebody that

482
00:27:13,502 --> 00:27:17,942
complaints about one clinician to
be the recipient of a, a similar

483
00:27:17,942 --> 00:27:19,502
complaint in the other direction.

484
00:27:19,802 --> 00:27:24,572
And so I do think those challenges
do muddy the water a bit and

485
00:27:24,572 --> 00:27:28,232
why getting objective support
and advice could be so valuable.

486
00:27:28,232 --> 00:27:32,792
I think just to your point there, Rachel,
around context being key just to kind of.

487
00:27:32,942 --> 00:27:34,513
add some illustration to that.

488
00:27:34,892 --> 00:27:41,222
I deal with cases, uh, across Asia, the
UK, Caribbean and I, I have a very set

489
00:27:41,222 --> 00:27:43,262
process for how I, how I look at them.

490
00:27:43,629 --> 00:27:46,709
I would always start with
the patient's complaints.

491
00:27:47,059 --> 00:27:49,459
And I'll get to the end of the
patient's complaint and I'll

492
00:27:49,459 --> 00:27:51,739
think, goodness me, this is awful.

493
00:27:51,829 --> 00:27:54,079
The patient's been really
badly treated here.

494
00:27:54,379 --> 00:27:59,629
And then I'll read the, the dentist or the
dental professional's comments and all of

495
00:27:59,629 --> 00:28:04,284
a sudden, the mist clears and you think,
ah, actually there was a reason why they

496
00:28:04,284 --> 00:28:09,264
did that, or, okay, there's some context
here that actually changes my perception.

497
00:28:09,624 --> 00:28:12,397
If I could put it like this, that I
think a lot of complaints raised by

498
00:28:12,517 --> 00:28:17,167
colleagues against another colleague
are often given li very little

499
00:28:17,167 --> 00:28:22,417
thought and often very hotheaded in
the way they're, they're sent off.

500
00:28:22,417 --> 00:28:25,357
And it is back to the point I was
saying about how easy it is to raise a

501
00:28:25,357 --> 00:28:27,877
complaint on the gd, uh, GDC website.

502
00:28:28,534 --> 00:28:32,974
And my advice is really simple to any
anybody that's thinking of raising

503
00:28:32,974 --> 00:28:38,224
concerns, it is extremely rare that
you will come across an issue that

504
00:28:38,224 --> 00:28:40,534
has to be raised there and then.

505
00:28:40,834 --> 00:28:47,579
Very often the vast majority of cases
can wait for 24 hours with zero impact.

506
00:28:47,879 --> 00:28:53,699
And so drafting an email and letting
that email sit in your drafts rather than

507
00:28:53,699 --> 00:28:57,929
clicking the Send button and then going
to bed and sleeping on it and coming to

508
00:28:57,929 --> 00:29:02,472
it with a fresh, you know, pair of eyes
the following morning, can be invaluable.

509
00:29:02,802 --> 00:29:06,162
And the number of times I have in
my professional life written an

510
00:29:06,162 --> 00:29:09,372
email, and by the way, you feel
a lot better just for writing it.

511
00:29:09,372 --> 00:29:12,972
It's not the sending necessarily, and
then just sitting it, you know, letting

512
00:29:12,977 --> 00:29:14,562
it sit there, come to it the next day.

513
00:29:14,862 --> 00:29:18,912
And I would say, you know, more than
50% of occasions, I then press the

514
00:29:18,912 --> 00:29:20,772
Delete button and I think better of it.

515
00:29:20,922 --> 00:29:24,612
And I, you know, have a bit more
perspective and I've calmed down a little.

516
00:29:24,612 --> 00:29:29,077
So, you know, as you know, a very simple
bit of advice from me would be, yeah,

517
00:29:29,077 --> 00:29:32,317
if you, if you want to raise concerns
about a colleague and you're not sure how

518
00:29:32,317 --> 00:29:33,787
to do it, put your thoughts in writing.

519
00:29:33,967 --> 00:29:36,757
Don't press the Send button
and then review it the next

520
00:29:36,757 --> 00:29:37,837
day and see how you feel.

521
00:29:37,987 --> 00:29:39,397
The power of the pause, right?

522
00:29:39,397 --> 00:29:41,437
When you're in that sympathetic
zone, you're amygdala's going

523
00:29:41,767 --> 00:29:42,937
Oh, you gotta do something here.

524
00:29:42,937 --> 00:29:45,097
That's the time when you
absolutely shouldn't do it.

525
00:29:45,097 --> 00:29:45,847
Yeah, absolutely.

526
00:29:45,847 --> 00:29:49,237
The amount of emails I haven't
sent, and I've been so pleased.

527
00:29:49,537 --> 00:29:52,027
So then you wait 24 hours and
you think, well actually, you

528
00:29:52,027 --> 00:29:55,387
know, I do need to either send
the email or have a conversation.

529
00:29:55,387 --> 00:29:59,677
I, I'm thinking a conversation would be
far better than an email, if possible.

530
00:29:59,887 --> 00:30:00,397
Is that right?

531
00:30:00,697 --> 00:30:06,607
I think it's because I think, um, a
lot of tone gets lost in email and

532
00:30:06,607 --> 00:30:12,771
communication is only small parts,
what we say, and a large part of body

533
00:30:12,861 --> 00:30:15,351
posture, gestures, facial expressions.

534
00:30:15,651 --> 00:30:19,401
And I think, you know, when you are
communicating something like that,

535
00:30:19,611 --> 00:30:23,451
having those additional cues to support
the communication are so important.

536
00:30:23,751 --> 00:30:25,378
But having said that.

537
00:30:25,584 --> 00:30:30,444
If you then do not feel that your
concerns have been properly listened to

538
00:30:30,744 --> 00:30:35,424
or acted upon, then having it in writing
is really helpful, because if you are

539
00:30:35,424 --> 00:30:39,658
later criticized for not dealing with
it appropriately, having that record,

540
00:30:39,658 --> 00:30:45,028
that audit trail of what you said, uh,
is, is is also of great importance.

541
00:30:45,381 --> 00:30:50,391
And the way I would advise kind of ticking
both of those boxes is it doesn't hurt

542
00:30:50,391 --> 00:30:54,581
to have the conversation and then to just
gently say at the end of the conversation,

543
00:30:54,581 --> 00:30:58,496
so, perhaps it'd be easy for both of
us, you know, to help both of us out.

544
00:30:58,496 --> 00:31:01,886
If I just summarize what we've agreed
and I'll pop it in an email to you.

545
00:31:02,186 --> 00:31:05,936
Um, it's a nice way of kind of tying
someone's hands to an action, but

546
00:31:05,936 --> 00:31:07,496
also providing that audit trail.

547
00:31:07,870 --> 00:31:11,530
Would you advise giving them a
bit of a warning shot, like saying

548
00:31:11,530 --> 00:31:14,170
in an email, um, can I pop over?

549
00:31:14,260 --> 00:31:19,450
I've got just some concerns about this
patient, or someone came to see me and I

550
00:31:19,450 --> 00:31:22,250
just wanna understand a bit more, or would
you just leave that til you see them?

551
00:31:22,387 --> 00:31:23,587
That's a really good question.

552
00:31:23,797 --> 00:31:28,147
Now, my personal view, I hate
emails that say, can I have a word?

553
00:31:28,177 --> 00:31:28,507
Yeah.

554
00:31:29,467 --> 00:31:29,887
You worry

555
00:31:29,887 --> 00:31:32,197
you just think, oh, what is it?

556
00:31:32,197 --> 00:31:32,617
Yeah.

557
00:31:32,797 --> 00:31:37,357
So I, my personal, if I'm the recipient,
I would just rather you rip the plaster

558
00:31:37,357 --> 00:31:40,417
off, walk in my room and say, I need
to talk to you about this and this.

559
00:31:40,657 --> 00:31:44,227
I think if you are gonna give someone
a, a warning, a advance notice in an

560
00:31:44,227 --> 00:31:45,817
email, because that can be helpful.

561
00:31:45,817 --> 00:31:48,397
It can give, you know, if you wanna
to talk about something specific.

562
00:31:48,397 --> 00:31:52,747
So let's say you wanna talk about a
particular patient, I think absolutely

563
00:31:52,747 --> 00:31:57,547
can be helpful to give them the notice
so they can go and review those records.

564
00:31:57,547 --> 00:32:00,157
They can remind themselves of
the patient and you can have a

565
00:32:00,157 --> 00:32:01,447
more constructive discussion.

566
00:32:01,747 --> 00:32:04,537
Because otherwise what you are gonna
get when you knock on their door is,

567
00:32:04,777 --> 00:32:08,017
look, I can't remember the detail,
give me some time to read the records.

568
00:32:08,017 --> 00:32:11,017
And you're just kicking the can down
the road when you've gone to that

569
00:32:11,017 --> 00:32:14,347
room, having built up the courage
to have that difficult conversation.

570
00:32:14,647 --> 00:32:17,977
But what I would say, just,
just to be kinder is give

571
00:32:17,977 --> 00:32:19,627
enough information in the email.

572
00:32:19,792 --> 00:32:22,867
You know, you, you can say, look,
I've saw, I saw Mr. Smith this

573
00:32:22,867 --> 00:32:27,007
morning, had some concerns around his
appointment with you last Tuesday.

574
00:32:27,277 --> 00:32:29,587
Have you got some time later
on today to discuss it?

575
00:32:29,887 --> 00:32:33,247
So there's no, there's none of that kind
of cloak and daggers, you know, I want

576
00:32:33,247 --> 00:32:36,217
to have a word about something serious
and you don't tell them what it is.

577
00:32:36,217 --> 00:32:39,007
I just, I juts think it’s,
uh, my personal view is.

578
00:32:39,007 --> 00:32:40,787
It's just a kind way
of dealing with people.

579
00:32:40,966 --> 00:32:43,696
It's interesting though, I think people
avoid having these conversations,

580
00:32:43,696 --> 00:32:45,736
and you've already mentioned that
when you, when you're talking to

581
00:32:45,736 --> 00:32:48,556
another colleague going, oh, you
know, how should we feed this back?

582
00:32:48,556 --> 00:32:50,326
Oh no, they'll take it
really badly or whatever.

583
00:32:50,326 --> 00:32:55,246
Well, we often really assume that that
person is gonna be defensive, they're

584
00:32:55,246 --> 00:32:59,076
gonna take it badly, they'll be a real
arsehole when, when we feed back to them.

585
00:32:59,076 --> 00:33:04,716
But, uh, my colleague Sarah always
quotes that we overestimate the negative

586
00:33:04,716 --> 00:33:08,406
impact of having a conversation and
we underestimate the negative impact

587
00:33:08,406 --> 00:33:10,176
of not having that conversation.

588
00:33:10,326 --> 00:33:13,916
I think that's absolutely right and I
think, you know, clinicians in general

589
00:33:14,012 --> 00:33:17,984
are really invested in their own
abilities and their own performance,

590
00:33:18,074 --> 00:33:23,024
and they are keen to know when they
are, you know, not doing something.

591
00:33:23,354 --> 00:33:28,469
Now, a lot of this conversation
has naturally kind of drawn towards

592
00:33:28,469 --> 00:33:30,479
the, the sinister motive side.

593
00:33:30,479 --> 00:33:33,119
You know, we've got someone, you
know, some really bad and we've gotta

594
00:33:33,119 --> 00:33:34,529
have a really difficult conversation.

595
00:33:34,829 --> 00:33:39,059
But actually, if it is something,
let, let me think of an example.

596
00:33:39,059 --> 00:33:43,559
Let's say receptionists has noticed
that all the patients coming out of,

597
00:33:43,889 --> 00:33:49,169
uh, my surgery are saying that they
feel like I didn't take the time

598
00:33:49,169 --> 00:33:50,789
to welcome them into the surgery.

599
00:33:51,149 --> 00:33:54,485
Now, to somebody that might be a
difficult conversation to go and speak.

600
00:33:54,635 --> 00:33:58,085
'cause I might be quite a bullish
character, I might be quite dismissive.

601
00:33:58,285 --> 00:34:01,142
But equally, I might be
totally oblivious to this.

602
00:34:01,142 --> 00:34:03,812
And if somebody says to me, actually,
George, you, we've had a couple of

603
00:34:03,812 --> 00:34:07,385
patients that just happened to mention
that they quite like the way that the

604
00:34:07,385 --> 00:34:12,125
previous dentist, uh, used to welcome
into the surgery and offer, you know,

605
00:34:12,155 --> 00:34:15,545
to take their coat or I, I dunno,
ask them how their day's going or

606
00:34:15,545 --> 00:34:16,985
how their holiday was or something.

607
00:34:17,359 --> 00:34:19,879
And that might give me the
opportunity to say, oh, yeah,

608
00:34:19,939 --> 00:34:21,139
no, I hadn't thought of that.

609
00:34:21,139 --> 00:34:25,339
I, my my impression was that patients
want to be in and out as quickly as

610
00:34:25,339 --> 00:34:27,559
possible, and that's why I'm rushing.

611
00:34:27,559 --> 00:34:30,319
It's not because I'm rushing, it's because
I think that's what the patient wants.

612
00:34:30,649 --> 00:34:33,349
I'm really pleased you brought this to
my attention and I'll do that in future.

613
00:34:33,619 --> 00:34:36,979
So it's, it's probably not the best
example, but you, you know, it, I

614
00:34:36,979 --> 00:34:40,729
think it's fair to say that, you know,
the vast majority of clinicians are

615
00:34:40,759 --> 00:34:44,299
insightful, are keen to develop and
would prefer to have these kind of

616
00:34:44,299 --> 00:34:45,829
blind spots brought to their attention.

617
00:34:45,979 --> 00:34:46,092
Yeah.

618
00:34:46,097 --> 00:34:48,192
And I always think that feedback.

619
00:34:48,507 --> 00:34:51,387
It's a total gift and we
don't get enough feedback.

620
00:34:51,387 --> 00:34:53,697
And this is one of my real
bug bears at the moment.

621
00:34:53,817 --> 00:34:59,099
Um, we teach a model of difficult
conversation having framework

622
00:34:59,099 --> 00:35:01,319
for difficult conversations
called the High Five model.

623
00:35:01,737 --> 00:35:05,397
And the High in the High Five
model stands for highest intent.

624
00:35:05,697 --> 00:35:09,297
And you were talking about the fact
that, you know, we have been assuming

625
00:35:09,382 --> 00:35:13,227
a, a a lot of the conversations we've
had that you know, that the person's

626
00:35:13,227 --> 00:35:18,217
bad or they've got some malicious,
either intent by complaining or the

627
00:35:18,217 --> 00:35:22,267
doctor or dentist being complained about
is lazy or, or something like that.

628
00:35:22,267 --> 00:35:25,237
And that is just hardly
ever the case, isn't it?

629
00:35:25,237 --> 00:35:30,627
You know, there are some bad eggs
in the basket, but mostly people are

630
00:35:30,867 --> 00:35:33,837
overwhelmed, they're stressed, they're,
you know, struggling with work.

631
00:35:33,837 --> 00:35:37,017
And we had, um, Dr. Chris Turner
on the podcast recently talking

632
00:35:37,017 --> 00:35:39,687
about, you know, what to do when
you are the difficult person.

633
00:35:39,687 --> 00:35:42,057
And he said he does a lot of appraisals.

634
00:35:42,057 --> 00:35:44,817
He's the founder of Civility
Saves Lives movement.

635
00:35:45,147 --> 00:35:46,107
Does a lot of appraisals.

636
00:35:46,107 --> 00:35:49,917
And he sort of gets given the people that
are, have been complained about or, or,

637
00:35:49,922 --> 00:35:53,637
or seem to be difficult characters or, or
lazy people have thought they're lazier,

638
00:35:53,667 --> 00:35:54,807
not really doing their job properly.

639
00:35:54,807 --> 00:35:57,597
And he said, you know, in all
his time of seeing these people

640
00:35:57,597 --> 00:35:59,277
that not one of them is lazy.

641
00:35:59,714 --> 00:36:02,294
It's other, there's other factors at work.

642
00:36:02,294 --> 00:36:04,066
They're getting to be burnt out.

643
00:36:04,066 --> 00:36:06,256
There's just too much going on,
there's difficult interpersonal

644
00:36:06,256 --> 00:36:07,306
relationships, all that.

645
00:36:07,306 --> 00:36:10,936
And so most of us go to work
to do a good job, don't we?

646
00:36:10,936 --> 00:36:15,016
And most of us, when we are raising
complaints about other people or

647
00:36:15,016 --> 00:36:18,886
notice that something wrong are
doing it because genuinely we are

648
00:36:18,886 --> 00:36:21,586
worried and concerned about the
treatment that patients have had.

649
00:36:21,586 --> 00:36:26,086
So if both of you think about your
highest intents in that conversation,

650
00:36:26,086 --> 00:36:31,546
so why am I having this conversation
if it is vexatious and malicious 'cause

651
00:36:31,551 --> 00:36:35,656
their, their competition for me in my
practice, well, a, I won't be thinking

652
00:36:35,656 --> 00:36:38,536
about what highest intent anyway,
i'll just be doing despicable things.

653
00:36:38,536 --> 00:36:40,546
So let's exclude that Lot of people.

654
00:36:40,896 --> 00:36:43,476
They'll be thinking, well, what
do I want out this conversation?

655
00:36:43,476 --> 00:36:45,666
I just want some feedback
so they don't do it again.

656
00:36:45,666 --> 00:36:50,006
Or feedback so that they're aware
or just understand more, then that

657
00:36:50,006 --> 00:36:53,096
has got to be quite a good way of,
of going into the conversation.

658
00:36:53,096 --> 00:36:55,646
And, and even would you advise stating it?

659
00:36:55,646 --> 00:36:58,196
So just saying that I just wanted
to, to check something out.

660
00:36:58,196 --> 00:37:00,656
'cause something, something
happened, I've noticed something

661
00:37:00,656 --> 00:37:01,616
and I was just a bit worried.

662
00:37:01,616 --> 00:37:05,246
I just want to flag it up in case
you hadn't seen it and just check

663
00:37:05,246 --> 00:37:08,066
in with you about what was going on
and just understand what happened?

664
00:37:08,366 --> 00:37:12,096
just so that I'm clear that we are
both working to the best of our

665
00:37:12,096 --> 00:37:13,536
ability or, or something like that.

666
00:37:13,605 --> 00:37:13,935
Yeah.

667
00:37:13,935 --> 00:37:19,635
And what I would say is that I think
these so-called difficult conversations,

668
00:37:19,635 --> 00:37:23,145
and they, and they are, I'm, I'm
not, I'm not minimizing that, but.

669
00:37:23,445 --> 00:37:24,435
It does get easier.

670
00:37:24,735 --> 00:37:29,415
And I think the more that you have
those difficult discussions with

671
00:37:29,415 --> 00:37:34,275
your colleagues, the more it will
become almost a, a casual, you

672
00:37:34,275 --> 00:37:35,925
know, chat over the water cooler.

673
00:37:35,985 --> 00:37:41,475
So it, it's, it becomes, uh, for
both parties, uh, a conversation

674
00:37:41,475 --> 00:37:43,605
of much less significance.

675
00:37:43,935 --> 00:37:49,545
I don't mean by that, that it gets dealt
with any less, uh, seriously, it is just

676
00:37:49,545 --> 00:37:53,985
that it's in the rear view mirror of
both parties a lot quicker and you're not

677
00:37:53,985 --> 00:37:55,605
dwelling on it for the rest of the day.

678
00:37:55,605 --> 00:37:57,195
Did I say the right thing?

679
00:37:57,195 --> 00:38:01,727
How's it been received or the recipient's
thinking you know, I feel totally outraged

680
00:38:01,727 --> 00:38:03,077
that they've come to me with this.

681
00:38:03,427 --> 00:38:08,257
And I think what can really help that is
it's, it's part of a broader culture piece

682
00:38:08,567 --> 00:38:15,361
and that involves offering the positive as
well as the negative feedback, and I think

683
00:38:15,361 --> 00:38:21,662
that is something that in clinical dental
practice, we are particularly poor at.

684
00:38:22,014 --> 00:38:27,204
If a patient goes to see someone
and let's say that the usual dentist

685
00:38:27,204 --> 00:38:30,714
is on holiday and they say, uh, you
know, I normally see George, and by

686
00:38:30,714 --> 00:38:34,194
the way, George is lovely, you know,
he was, he always puts me at ease.

687
00:38:34,314 --> 00:38:37,134
I've always struggled with going
to the dentist, but I finally found

688
00:38:37,134 --> 00:38:38,694
someone I feel comfortable with.

689
00:38:38,994 --> 00:38:42,745
Then I would say, make a
note of that really quickly.

690
00:38:43,045 --> 00:38:47,035
And then when George gets back from
holiday, go and knock on his door

691
00:38:47,035 --> 00:38:48,685
and say, have we got two minutes?

692
00:38:48,715 --> 00:38:50,215
I saw Mrs. Smith last week.

693
00:38:50,455 --> 00:38:51,475
She said You were lovely.

694
00:38:51,805 --> 00:38:55,585
Um, she said, you've really put her at
ease and you know, she feels much more

695
00:38:55,585 --> 00:38:56,935
comfortable coming to the dentist now.

696
00:38:57,235 --> 00:38:59,215
And you'll make that person's day.

697
00:38:59,395 --> 00:39:00,925
You will feel better for it.

698
00:39:01,225 --> 00:39:03,895
And it then means that when you need to
go and have the difficult conversation,

699
00:39:03,895 --> 00:39:07,705
you've got a much better relationship
of, uh, exchange of feedback with them.

700
00:39:07,765 --> 00:39:12,025
Because, you know, in a sense, positive
feedback is, uh, also a difficult

701
00:39:12,025 --> 00:39:16,135
conversation because you are still having
to use all of those communication tools,

702
00:39:16,465 --> 00:39:20,695
um, learn to go and interact with your
peers, sometimes senior colleagues.

703
00:39:20,995 --> 00:39:24,355
Uh, so I think it's all good in
terms of building up that skill base.

704
00:39:24,392 --> 00:39:26,762
Yeah, and sometimes we don't
have those positive conversations

705
00:39:26,762 --> 00:39:27,632
'cause it feels awkward.

706
00:39:27,632 --> 00:39:28,082
You are right.

707
00:39:28,082 --> 00:39:29,672
They are still challenging conversations.

708
00:39:29,672 --> 00:39:33,002
Like, oh, does it feel a bit icky
to tell George that his patient

709
00:39:33,002 --> 00:39:34,532
thought he was really good?

710
00:39:34,532 --> 00:39:38,642
But I think we just start, need to
start thinking of feedback as data.

711
00:39:38,972 --> 00:39:39,752
This is some data.

712
00:39:39,752 --> 00:39:41,252
George, we've got some data for you.

713
00:39:41,252 --> 00:39:42,842
The patients like it when you do this.

714
00:39:43,127 --> 00:39:43,727
Yes.

715
00:39:43,817 --> 00:39:44,117
Yeah.

716
00:39:44,372 --> 00:39:46,952
I've also got some data for you that
they don't like it when you do that.

717
00:39:47,525 --> 00:39:47,931
Yes.

718
00:39:47,961 --> 00:39:48,201
Yeah.

719
00:39:48,441 --> 00:39:51,081
And then it's up to the recipient,
what they do with that data.

720
00:39:51,381 --> 00:39:54,921
Um, and I think that's the really
important piece because, you know, it,

721
00:39:54,921 --> 00:39:59,661
it in the context of raising concerns
to another clinician, you know,

722
00:39:59,661 --> 00:40:01,101
there's, there's two phases to it.

723
00:40:01,101 --> 00:40:05,181
One is imparting the information and
there are certain situations where it's

724
00:40:05,181 --> 00:40:10,311
then over to them and, and you, I suppose
to a point, your, uh, responsibility

725
00:40:10,311 --> 00:40:14,033
is discharged at that point of
parting, you know, handing that over.

726
00:40:14,345 --> 00:40:18,661
An example might be the one I gave
about not welcoming to the surgery.

727
00:40:18,871 --> 00:40:21,991
Now that's not something that you can,
again, knock on the GDC's door with.

728
00:40:22,291 --> 00:40:25,231
It's not something that in necessarily
you're gonna lose any sleepover.

729
00:40:25,501 --> 00:40:27,421
It's just good negative feedback.

730
00:40:27,451 --> 00:40:30,541
It's just, here's a heads up, here's
something you could do that's gonna

731
00:40:30,541 --> 00:40:35,101
cost you nothing, take no time, but
will apparently have an impact on

732
00:40:35,101 --> 00:40:36,721
your patients and how perceive you.

733
00:40:37,021 --> 00:40:37,771
Over to you.

734
00:40:38,101 --> 00:40:42,001
Now, you may choose not to start welcoming
your patients in the way that's been

735
00:40:42,001 --> 00:40:46,081
suggested, or you may choose to totally
overhaul how you are interacting with

736
00:40:46,081 --> 00:40:47,701
your patients when they walk in the door.

737
00:40:48,001 --> 00:40:48,931
That's a matter for you.

738
00:40:49,171 --> 00:40:53,011
And that is, uh, well that's why I
love the data point, because feedback

739
00:40:53,011 --> 00:40:54,931
is just an exchange of information.

740
00:40:55,231 --> 00:40:59,131
And then how it's acted upon is, is
a, a totally separate se uh, level.

741
00:40:59,341 --> 00:41:03,571
Now, there will be occasions just to kind
of go back to the, the more serious side

742
00:41:03,571 --> 00:41:07,501
of the spectrum where actually you are,
you are invested in that data and how

743
00:41:07,501 --> 00:41:09,871
it's used, and you have to follow it up.

744
00:41:10,111 --> 00:41:13,771
It isn't enough to say, we've had
reports from a couple of patients

745
00:41:13,771 --> 00:41:16,801
that you're not putting gloves on
before you clinically examine them.

746
00:41:17,101 --> 00:41:18,391
And then that's it.

747
00:41:18,391 --> 00:41:19,441
I'm not gonna do anything.

748
00:41:19,711 --> 00:41:23,342
You then, of course, need to make
sure the, the feedback's been acted

749
00:41:23,342 --> 00:41:26,552
upon and, and something's been
put in place, uh, to, to make sure

750
00:41:26,552 --> 00:41:27,692
that's been properly addressed.

751
00:41:27,692 --> 00:41:30,752
And if it hasn't, that's the point
at which you might wanna be picking

752
00:41:30,752 --> 00:41:33,992
up the phone to us and taking advice
on how you escalate those concerns.

753
00:41:34,142 --> 00:41:35,362
Yes, I was gonna ask that.

754
00:41:35,542 --> 00:41:36,077
So what.

755
00:41:36,107 --> 00:41:40,847
Happens if you know someone continues
doing that thing, you, you fed back to

756
00:41:40,847 --> 00:41:42,497
them about you've had that conversation.

757
00:41:42,497 --> 00:41:46,307
I heard a phrase the other day that a
mistake made more than once is a decision.

758
00:41:46,307 --> 00:41:48,077
I thought, oh, that's interesting.

759
00:41:48,077 --> 00:41:50,357
Although, I must say I made
mistakes more than once all the

760
00:41:50,357 --> 00:41:51,917
time, you know, unknowingly.

761
00:41:51,917 --> 00:41:56,211
But yeah, if, if you've had that behavior
fed back to you and you've decided to keep

762
00:41:56,211 --> 00:41:58,971
doing it, then you do have to escalate.

763
00:41:58,971 --> 00:42:02,721
So what advice would you be giving
if I phoned you up and said, right.

764
00:42:03,021 --> 00:42:04,131
I've had the conversation.

765
00:42:04,131 --> 00:42:05,811
They weren't particularly receptive.

766
00:42:05,811 --> 00:42:08,511
They were a bit defensive about
it, and, and it's happened again.

767
00:42:08,746 --> 00:42:14,969
Well, let's take it as a given that, uh,
everyone listening has done the first

768
00:42:14,969 --> 00:42:18,419
stage, which is to make sure you've got
an effective process in place, okay?

769
00:42:18,419 --> 00:42:22,319
So if you don't have that in place,
then it makes this bit very difficult

770
00:42:22,619 --> 00:42:26,069
because following on from the
difficult conversation and putting

771
00:42:26,069 --> 00:42:31,439
it in writing, as I've uh, suggested
previously, is to escalate it in-house.

772
00:42:31,709 --> 00:42:35,669
So that might be clinical director,
it might be practice manager,

773
00:42:35,999 --> 00:42:37,379
might be practice principal.

774
00:42:37,709 --> 00:42:42,329
But whatever setting you are working in,
there will be a hierarchy to some extent.

775
00:42:42,509 --> 00:42:46,229
There'll be someone with whom
the buck stops, and you can

776
00:42:46,229 --> 00:42:47,729
escalate your concerns to them.

777
00:42:48,029 --> 00:42:50,879
My suggestion at that
point is put it in writing.

778
00:42:50,969 --> 00:42:52,439
You want an audit trail.

779
00:42:52,439 --> 00:42:56,879
You want to be able to evidence that
you have executed your professional

780
00:42:56,879 --> 00:42:58,655
responsibility appropriately.

781
00:42:59,329 --> 00:43:00,510
Thereafter.

782
00:43:00,625 --> 00:43:02,035
it's helpful to monitor it.

783
00:43:02,035 --> 00:43:05,845
You, you know, of course there will be
situations where you are not entitled to

784
00:43:05,845 --> 00:43:09,835
know how things are dealt with and it,
nor would it be appropriate and, and the

785
00:43:09,835 --> 00:43:11,815
conversation ends at you escalating it.

786
00:43:12,115 --> 00:43:15,535
But there will be circumstances
where if you think patients are

787
00:43:15,535 --> 00:43:19,765
being put at risk, you do want to
monitor how that's being dealt with.

788
00:43:20,065 --> 00:43:24,535
And if after escalating in a local
setting as far as you can, you find

789
00:43:24,535 --> 00:43:28,405
that nothing is being done, then it is
at that point that you definitely do

790
00:43:28,405 --> 00:43:32,965
need to start to consider escalating
your concerns to the regulator.

791
00:43:33,455 --> 00:43:35,795
But I, I would say three
things before you do that.

792
00:43:35,795 --> 00:43:40,265
First off, you would be really well
advised to speak to your indemnify,

793
00:43:40,265 --> 00:43:43,415
and as I've, as I've already said in
dental protection, medical protection,

794
00:43:43,715 --> 00:43:47,315
um, we would be more than happy to
have that conversation just to sense

795
00:43:47,315 --> 00:43:51,125
check and, and often actually, rather
than sense checking what we're doing is

796
00:43:51,125 --> 00:43:53,015
just exploring with you other options.

797
00:43:53,315 --> 00:43:56,195
Um, not necessarily saying which one
to take, we're just giving you the

798
00:43:56,195 --> 00:43:58,115
menu so that you can make your choice.

799
00:43:58,602 --> 00:44:02,412
Uh, and then I would say
really read the guidance.

800
00:44:02,622 --> 00:44:07,572
The GDC and the GMC all have,
both have their own guidance

801
00:44:07,572 --> 00:44:09,642
on escalating concerns to them.

802
00:44:09,872 --> 00:44:13,708
The types of things they deal with,
um, and the types of things they don't.

803
00:44:14,008 --> 00:44:18,328
And then the third one, uh, which again
I've alluded to is just take a breath.

804
00:44:18,478 --> 00:44:23,818
There's, there's very little that you need
to deal with absolutely there and then.

805
00:44:24,118 --> 00:44:28,678
Even pretty serious stuff, you can go and
have a cup of tea and sit down for half

806
00:44:28,678 --> 00:44:30,748
an hour just to compose your thoughts.

807
00:44:30,948 --> 00:44:35,808
And then, you know, if, if you are
left with the conclusion that it's

808
00:44:35,808 --> 00:44:40,638
appropriate to raise it to the GDC,
then you have to, of course, act as you

809
00:44:40,638 --> 00:44:42,198
think is professionally appropriate.

810
00:44:42,498 --> 00:44:45,078
It's then a matter for you how you
deal with it, with the individual.

811
00:44:45,078 --> 00:44:46,818
I, I've seen it happen both ways.

812
00:44:46,818 --> 00:44:51,288
I've seen individuals get, uh, complained
about where the first they knew about

813
00:44:51,288 --> 00:44:53,238
it was a letter from the regulator.

814
00:44:53,708 --> 00:44:57,798
and I've had a case very recently
where actually the directors of the

815
00:44:57,798 --> 00:45:01,903
practice wrote to the individual
and said, just a heads up that we

816
00:45:02,028 --> 00:45:04,458
have had to refer this to the GDC.

817
00:45:04,758 --> 00:45:06,318
This is the information we've given them.

818
00:45:06,588 --> 00:45:09,318
We're very sorry that we've had to do
this, but hope you'll appreciate the

819
00:45:09,318 --> 00:45:10,968
difficult position that we were placed.

820
00:45:11,268 --> 00:45:14,358
Um, it, it's then a matter
for you, the individual, how

821
00:45:14,358 --> 00:45:15,438
you choose to approach that.

822
00:45:15,438 --> 00:45:16,428
There's no right or wrong.

823
00:45:16,428 --> 00:45:18,708
I think it depends on the
relationship that you have.

824
00:45:19,058 --> 00:45:23,948
But, but really I would say in a practice
setting where, unfortunately because of

825
00:45:23,948 --> 00:45:28,028
the management structures, invariably
the person that you are complaining

826
00:45:28,028 --> 00:45:32,798
about, you know them personally,
you're very close to them by, by kind

827
00:45:32,798 --> 00:45:37,298
of nature of, of, of the proximity,
you work with them in the practice.

828
00:45:37,598 --> 00:45:40,328
And so, you know, you can
be the good and the bad guy.

829
00:45:40,418 --> 00:45:42,638
You can say, look, we've
had some really difficult

830
00:45:42,638 --> 00:45:44,888
conversations, nothing's changing.

831
00:45:45,218 --> 00:45:48,585
We have a professional obligation,
we've had to raise this to regulator,

832
00:45:49,005 --> 00:45:53,325
but second part to that, appreciate
that's really difficult and we want

833
00:45:53,325 --> 00:45:54,705
to support you through the process.

834
00:45:54,705 --> 00:45:57,345
And here's some signposting to support.

835
00:45:57,345 --> 00:45:59,955
And you know, I know that
could be seen as disingenuous.

836
00:45:59,955 --> 00:46:03,705
I know that could be, uh, not
particularly well received by, uh,

837
00:46:03,735 --> 00:46:08,295
the individual, but if you are raising
concerns for the right reasons at the

838
00:46:08,295 --> 00:46:13,965
right times for the right things, then
I don't see it as totally unreasonable

839
00:46:13,965 --> 00:46:15,615
for those two to go hand in hand.

840
00:46:15,615 --> 00:46:17,205
Then you can be good and bad copying one.

841
00:46:17,772 --> 00:46:18,808
Yeah, I totally agree.

842
00:46:18,988 --> 00:46:23,683
But the problem I'm thinking about is
that obviously a lot of our listeners

843
00:46:23,683 --> 00:46:26,983
are gps and they're dealing with patients
that have been seen by secondary.

844
00:46:26,983 --> 00:46:27,283
care.

845
00:46:27,283 --> 00:46:30,793
And so they are spotting issues that have
happened in secondary care or secondary

846
00:46:30,793 --> 00:46:34,303
care spotting issues that's happened in
general practice, and it's much, much

847
00:46:34,303 --> 00:46:38,233
harder these days to pick up the phone
and have a conversation with that person.

848
00:46:38,233 --> 00:46:41,473
So, although it's not impossible,
would you still be saying, look,

849
00:46:41,533 --> 00:46:44,173
just see what you can do to
actually speak to that person?

850
00:46:44,221 --> 00:46:47,881
Yeah, I, I would, to be perfectly
honest with you, um, I, I absolutely

851
00:46:47,881 --> 00:46:51,511
take your point about primary
secondary care, proximity challenges.

852
00:46:51,571 --> 00:46:55,321
Um, and we see that a lot as
well in, uh, dental practice, for

853
00:46:55,321 --> 00:46:59,581
instance, between general dentist and
specialists, perhaps an orthodontist.

854
00:46:59,881 --> 00:47:02,731
A really good example is where
a dentist has taken the wrong

855
00:47:02,731 --> 00:47:05,311
tooth out and they're blaming the
orthodontist 'cause it was written

856
00:47:05,311 --> 00:47:07,321
wrong on the referral and vice versa.

857
00:47:07,819 --> 00:47:11,869
And actually, based on my experience
over the last 10 years of dealing

858
00:47:11,869 --> 00:47:16,639
with these cases, the ones that are
dealt with much more efficiently, much

859
00:47:16,639 --> 00:47:20,029
more effectively for the patient, the
patient gets the best outcome, the

860
00:47:20,029 --> 00:47:23,959
clinicians get the best outcome are
the cases where the two.pick the phone

861
00:47:23,959 --> 00:47:25,449
up to each-other and talk it out.

862
00:47:25,879 --> 00:47:30,782
Now, the caveat to that is that you can
only go so far with that, can't you?

863
00:47:30,782 --> 00:47:34,742
And you, you know, busy practices
and sometimes difficult to get

864
00:47:34,742 --> 00:47:38,462
contact details and you want to
maintain professional boundaries.

865
00:47:38,762 --> 00:47:42,212
So yeah, I get there are all sorts
of challenges to that approach,

866
00:47:42,482 --> 00:47:46,232
but wherever possible, I'm a huge
advocate for just, um, sitting

867
00:47:46,232 --> 00:47:49,352
two people in one room and bashing
their heads together to sort it out.

868
00:47:49,397 --> 00:47:51,247
And 9 times out of 10 you can do that.

869
00:47:51,247 --> 00:47:54,002
Yeah, and I always think, well, what
would I want if I was that person?

870
00:47:54,002 --> 00:47:58,562
So, you know, if I was that, um, surgeon
secondary care, the GP's noticed a

871
00:47:58,562 --> 00:48:01,802
mistake or something with bedside
manner and you know, it, it really needs

872
00:48:01,802 --> 00:48:06,152
addressing, I would much rather have a
phone call and say, look, I just can, I

873
00:48:06,302 --> 00:48:07,532
just wanted to talk to you about this.

874
00:48:07,532 --> 00:48:11,492
I thought it might be useful feedback
for you, whatever, then, then hear

875
00:48:11,492 --> 00:48:12,932
about it the first time through.

876
00:48:13,232 --> 00:48:16,952
Either the regulator or through
the hospital official liaison

877
00:48:16,952 --> 00:48:18,692
complaint, complaint process.

878
00:48:18,692 --> 00:48:21,842
But it's hard, and it may be that
I need to talk to colleagues about

879
00:48:21,842 --> 00:48:24,722
that and approach it together and
discuss with, you know, the colleagues

880
00:48:24,722 --> 00:48:26,312
about how, how best to do that.

881
00:48:26,946 --> 00:48:32,196
You know, I think with the best one in
the world, even if someone has really,

882
00:48:32,256 --> 00:48:36,186
um, explained why they're escalating
and things like that, you're, you

883
00:48:36,186 --> 00:48:40,956
still might feel quite pissed off
or you'd feel very upset about it.

884
00:48:41,256 --> 00:48:43,416
I mean, we're not talking
about the, the minor stuff.

885
00:48:43,416 --> 00:48:44,136
You have a conversation.

886
00:48:44,166 --> 00:48:44,766
Oh, yeah, okay.

887
00:48:44,766 --> 00:48:46,026
I noticed I was a bit grumpy that day.

888
00:48:46,026 --> 00:48:47,016
Yeah, I, I can change that.

889
00:48:47,016 --> 00:48:49,146
But we have made a big, a big error.

890
00:48:49,146 --> 00:48:51,486
Someone said, actually, we are
gonna need to escalate this.

891
00:48:51,486 --> 00:48:52,986
And they have complained about you.

892
00:48:53,286 --> 00:48:56,196
That is, I. Really difficult
on all sorts of levels.

893
00:48:56,196 --> 00:48:57,906
Firstly was the fact there's
a complaint going through.

894
00:48:57,906 --> 00:48:58,806
We talked about that earlier.

895
00:48:58,806 --> 00:49:02,646
But secondly, that interpersonal level,
I think I would be feeling a lot of

896
00:49:02,646 --> 00:49:06,036
shame, a lot of embarrassment, and we
know that actually when people feel

897
00:49:06,036 --> 00:49:10,086
shame and embarrassment, then that often
comes out as defensiveness and, and

898
00:49:10,086 --> 00:49:13,561
arsiness and actually I could be then
behaving quite badly towards that person.

899
00:49:13,746 --> 00:49:14,946
And I'm sure you've seen that as well.

900
00:49:14,946 --> 00:49:17,286
So what do we do when it, when it's us?

901
00:49:17,725 --> 00:49:18,265
great question.

902
00:49:18,265 --> 00:49:21,925
I think first of all, if it's
somebody knocking on your door,

903
00:49:21,925 --> 00:49:25,818
coming to speak to you, recognize
how difficult that's been for them

904
00:49:25,968 --> 00:49:26,178
Yeah.

905
00:49:26,178 --> 00:49:27,558
The courage it would've taken, right?

906
00:49:27,573 --> 00:49:28,563
Yeah, absolutely.

907
00:49:28,623 --> 00:49:33,663
And recognize that the alternative
options were up to and including

908
00:49:33,663 --> 00:49:35,043
reporting you to the regulator.

909
00:49:35,628 --> 00:49:41,478
So as far as possible, deal with it
constructively, recognizing that because

910
00:49:41,748 --> 00:49:45,048
the more you do that, the more they
will come and knock on your door the

911
00:49:45,048 --> 00:49:49,878
next time, and the more you will have
the opportunity to address these things

912
00:49:50,178 --> 00:49:55,578
at a very local level without all the
unnecessary stress of that escalation.

913
00:49:55,878 --> 00:50:01,748
But also just take time out to
reflect rather than going with the

914
00:50:01,748 --> 00:50:05,168
instinctive response because, you
know, I think dentists and doctors,

915
00:50:05,168 --> 00:50:06,761
we are naturally high achievers.

916
00:50:06,828 --> 00:50:14,071
We're so used to going through a, you
know, very rigorous educational pathway

917
00:50:14,371 --> 00:50:19,953
that has driven us to become these
almost robotic, individuals that cannot

918
00:50:20,013 --> 00:50:23,013
possibly face any challenge or criticism.

919
00:50:23,313 --> 00:50:28,998
And I, I know for one, you know, I, I used
to, um, receive feedback really badly.

920
00:50:28,998 --> 00:50:30,528
I'm, I'm probably still not great.

921
00:50:30,528 --> 00:50:34,638
I still naturally err on the very
defensive side, but I'd like to think that

922
00:50:34,638 --> 00:50:37,658
I have driven myself to get better at it.

923
00:50:38,062 --> 00:50:43,342
And my personal approach now is to
just take some time out and, and

924
00:50:43,342 --> 00:50:49,002
really force yourself to look into the
uncomfortable parts of your professional

925
00:50:49,002 --> 00:50:52,626
life and really, you know, reflect
on the feedback you've been given and

926
00:50:52,626 --> 00:50:54,186
think actually, have they got a point?

927
00:50:54,582 --> 00:50:59,202
And you don't necessarily have to agree
with feedback in order to accept it.

928
00:50:59,202 --> 00:51:02,652
Do you, if you go back to the data
point, you know, you, you can receive

929
00:51:02,652 --> 00:51:05,922
it, you can thank the individual
for it, and then you can store it

930
00:51:05,922 --> 00:51:10,032
away in a metaphorical draw and not
necessarily do anything to act upon it.

931
00:51:10,032 --> 00:51:14,202
Because some feedback will be, you
know, if we use my example earlier,

932
00:51:14,202 --> 00:51:17,252
if the patients don't like the way
you're greeting your patients, some

933
00:51:17,252 --> 00:51:20,152
patients might love that, or some
patients might come to you because

934
00:51:20,152 --> 00:51:23,422
you are a little bit less small
talk and you get on with things.

935
00:51:23,722 --> 00:51:26,002
So you might decide
actually, well that's fine.

936
00:51:26,002 --> 00:51:27,802
If they want to have that,
they can go and see you.

937
00:51:28,102 --> 00:51:30,442
You know, that's the benefit of
the fact we both work here and I'll

938
00:51:30,442 --> 00:51:31,732
stick with doing things my way.

939
00:51:32,032 --> 00:51:33,082
I've got no issue with that.

940
00:51:33,082 --> 00:51:36,232
And I think that's important
that you recognize that not all

941
00:51:36,232 --> 00:51:38,002
feedback needs to be acted upon.

942
00:51:38,656 --> 00:51:40,512
But also I think.

943
00:51:40,812 --> 00:51:47,592
Having that courage to alter your
approach and to, to think okay, yeah.

944
00:51:47,682 --> 00:51:52,362
Uh, feedback from my, uh, nurses, for
example, that I'm abrupt in how I speak

945
00:51:52,362 --> 00:51:54,602
to them, um, I've now had that feedback.

946
00:51:54,692 --> 00:52:00,112
It's on me to, from this point forward,
make a real conscious effort to fix that.

947
00:52:00,412 --> 00:52:03,876
And you mentioned earlier before
about, two mistakes being, uh,

948
00:52:04,371 --> 00:52:08,631
intentional, and that's me paraphrasing
your words, but also a lot of

949
00:52:08,631 --> 00:52:10,191
clinical practice is habitual.

950
00:52:10,491 --> 00:52:13,971
You know, if you've been in practice
for 20 years, you will be able,

951
00:52:13,971 --> 00:52:15,801
you'll have a particular patter.

952
00:52:16,111 --> 00:52:20,521
You know, I remember I used to say to
patients the same phrases we'd moan about

953
00:52:20,521 --> 00:52:23,881
the weather, my nurse would roll her
eyes because it's, God, I've hear, I've

954
00:52:23,881 --> 00:52:26,401
heard this script 30 times today already.

955
00:52:26,701 --> 00:52:29,701
So to change that, to change
that approach based on that

956
00:52:29,701 --> 00:52:31,141
feedback, is really difficult.

957
00:52:31,141 --> 00:52:33,241
So don't expect instant results either.

958
00:52:33,541 --> 00:52:36,721
Um, but be prepared to work
at developing and improving.

959
00:52:36,816 --> 00:52:40,621
And if that means, you know, an a, a
criticism of your clinical practice, be

960
00:52:40,621 --> 00:52:45,001
prepared to go and go on a course, do some
CPD, you know, address those shortcomings,

961
00:52:45,231 --> 00:52:48,655
maybe work with the person giving you the
feedback to see how they can support you.

962
00:52:48,685 --> 00:52:52,225
'cause if they are supportive enough
to knock on your door and have that

963
00:52:52,225 --> 00:52:55,375
difficult conversation, then I'd bet
some decent money, they'd be happy

964
00:52:55,375 --> 00:52:57,595
to support you to address it as well.

965
00:52:57,745 --> 00:53:00,595
I think the phrase that's coming to
me is that feedback is a total gift.

966
00:53:00,595 --> 00:53:01,285
So you're right.

967
00:53:01,285 --> 00:53:05,545
If that person is taking the time to
do that, then they've, they've stepped

968
00:53:05,545 --> 00:53:08,155
up to do it and you need to listen.

969
00:53:08,455 --> 00:53:12,255
Uh, the problem is, just like
you said, in, in medicine, it's

970
00:53:12,285 --> 00:53:14,235
all about are we perfect or not?

971
00:53:14,235 --> 00:53:16,965
And you know, the way that we've been
trained, you gotta get every single answer

972
00:53:16,965 --> 00:53:20,415
right, every single diagnosis right, and
never fail and never get anything wrong.

973
00:53:20,415 --> 00:53:24,825
And so when you are, when you get the,
the, the data that actually you have done

974
00:53:24,825 --> 00:53:29,380
something that's caused other people pain,
possibly or, or suffering or distress, a

975
00:53:29,560 --> 00:53:33,190
you feel really bad 'cause you don't wanna
ever call anyone cause anyone suffering

976
00:53:33,190 --> 00:53:35,980
or make a mistake, so there's that like,
oh no, I've done harm to somebody else.

977
00:53:35,980 --> 00:53:36,880
Or That's not worse.

978
00:53:36,910 --> 00:53:37,570
There's that.

979
00:53:37,870 --> 00:53:41,380
But then there's the shame of, gosh,
I'm not good enough, I'm not enough.

980
00:53:41,380 --> 00:53:44,665
And when you've been judged all
your life by what you produce,

981
00:53:44,665 --> 00:53:48,070
what you do, how good you are, then
that's really hard to cope with.

982
00:53:48,270 --> 00:53:52,525
And, and then the first thing we tend
to do is become very, very defensive

983
00:53:52,825 --> 00:53:55,165
and try and explain why we did it.

984
00:53:55,165 --> 00:53:58,045
And I remember when I would get
complaints, the first thing I'd just look

985
00:53:58,045 --> 00:53:59,365
back and make sure it wasn't my fault.

986
00:53:59,755 --> 00:54:01,555
Make sure I didn't do anything wrong.

987
00:54:01,765 --> 00:54:04,225
That's all well and good, but actually
what if I had done something wrong?

988
00:54:04,255 --> 00:54:08,665
I need to be able to tolerate it when I am
in the wrong because I know I can change.

989
00:54:08,665 --> 00:54:10,675
But we really struggle with that.

990
00:54:10,825 --> 00:54:11,165
We do.

991
00:54:11,170 --> 00:54:13,985
And, and I think what we need
to do is normalize mistakes and

992
00:54:13,985 --> 00:54:18,908
normalize complaints, and try
to remove some of the stigma.

993
00:54:19,248 --> 00:54:23,898
And I think the dentist that
tells you they don't get a

994
00:54:23,898 --> 00:54:26,198
complaint, it's one of two things.

995
00:54:26,198 --> 00:54:29,648
Either they're lying or they
don't have an effective process

996
00:54:29,648 --> 00:54:30,728
in place to capture them.

997
00:54:30,878 --> 00:54:33,668
One thing that I've
noticed as well is, um.

998
00:54:33,818 --> 00:54:37,028
my instinct would be if someone comes
to tell you about, gives you some

999
00:54:37,028 --> 00:54:39,788
feedback, like, okay, well let's,
let's just keep this very confidential,

1000
00:54:39,788 --> 00:54:40,748
but thank you for telling me.

1001
00:54:40,748 --> 00:54:42,338
And you know, I'll change whatever.

1002
00:54:42,638 --> 00:54:46,808
But actually when I have shared
stuff that's gone wrong, times where

1003
00:54:46,808 --> 00:54:50,498
I think I've really mucked up, when
I've had negative feedback and stuff,

1004
00:54:50,798 --> 00:54:52,478
it's made me feel so much better.

1005
00:54:52,478 --> 00:54:57,878
And I ended up, I end up now sharing it
on the podcast with thousands of people.

1006
00:54:57,878 --> 00:54:59,681
But it's so helpful.

1007
00:54:59,711 --> 00:55:02,771
Brene Brown says, shame
cannot survive being spoken.

1008
00:55:02,771 --> 00:55:06,431
So the minute you tell someone about
the mistake you've made or the feedback

1009
00:55:06,431 --> 00:55:08,591
that you've got, it just dissipates.

1010
00:55:08,591 --> 00:55:10,301
'cause everyone goes,
oh yeah, that's helpful.

1011
00:55:10,301 --> 00:55:11,051
Yeah, what you gonna do?

1012
00:55:11,051 --> 00:55:12,551
And gosh, that happened to me.

1013
00:55:12,551 --> 00:55:17,321
And interestingly, in all, all the emails
we get from people about the podcast,

1014
00:55:17,621 --> 00:55:22,031
it's mostly saying, oh, when you told
that story about when you mucked up,

1015
00:55:22,091 --> 00:55:23,891
oh, that made me feel so much better.

1016
00:55:23,968 --> 00:55:25,978
And it, it really, really does.

1017
00:55:26,008 --> 00:55:27,178
It's uncanny, isn't it?

1018
00:55:27,478 --> 00:55:30,743
It's, it is, and, and the the same is,
you know, it's absolutely true of, you

1019
00:55:30,743 --> 00:55:32,243
know, things like adverse incidents.

1020
00:55:32,243 --> 00:55:37,103
So I will often, uh, lecture, you know,
newly qualified dentists and I'll say,

1021
00:55:37,103 --> 00:55:41,783
you know, two weeks into my foundation
year, um, I was drilling a patient's tooth

1022
00:55:41,783 --> 00:55:45,653
and the bur came outta the handpiece and
disappeared down the back of their throat.

1023
00:55:45,953 --> 00:55:49,043
Um, and it was a terrifying
moment for me as a dental,

1024
00:55:49,343 --> 00:55:51,233
uh, a newly qualified dentist.

1025
00:55:51,473 --> 00:55:55,553
But instantly you can just see
that almost the relief from those

1026
00:55:55,643 --> 00:55:57,023
in the audience as they realize.

1027
00:55:57,053 --> 00:55:58,103
Oh, right, okay.

1028
00:55:58,343 --> 00:55:59,393
And you survived.

1029
00:55:59,633 --> 00:56:03,893
Um, and I think that's a really nice
point to kind of bring in is, is, you

1030
00:56:03,893 --> 00:56:09,203
know, my, my GDC experience, which
I've spoken about for me, really was to

1031
00:56:09,203 --> 00:56:11,663
springboard to a really fruitful career.

1032
00:56:11,963 --> 00:56:15,173
It opened my eyes to
the world of indemnity.

1033
00:56:15,473 --> 00:56:20,963
It opened my, uh, eyes to NPS and dental
protection and the great work that they

1034
00:56:21,263 --> 00:56:23,393
did to support me through that process.

1035
00:56:23,693 --> 00:56:27,933
Um, and ultimately I'm convinced that
it is ultimately what got me a job

1036
00:56:27,933 --> 00:56:31,503
with them doing the work that I do
now, supporting other dentists, because

1037
00:56:31,833 --> 00:56:36,153
the empathy that you get from going
through the process is invaluable.

1038
00:56:36,393 --> 00:56:40,473
And so if I was to meet the chap that
complained about me now to the GDC,

1039
00:56:40,473 --> 00:56:44,283
I'd probably buy him a drink and shake
his hand and say, thank you very much.

1040
00:56:44,283 --> 00:56:48,993
But the serious point is he
never got an apology from me.

1041
00:56:49,143 --> 00:56:53,376
He never got a refund, and he
never got an explanation of why the

1042
00:56:53,376 --> 00:56:57,816
treatment I provided was appropriate
and why, to put it bluntly, he

1043
00:56:57,816 --> 00:57:00,066
was wrong to raise his complaint.

1044
00:57:00,366 --> 00:57:02,676
It was misunderstanding, miscommunication.

1045
00:57:02,676 --> 00:57:03,816
It wasn't bad treatment.

1046
00:57:04,116 --> 00:57:08,136
Him going to the GDC
achieved absolutely nothing.

1047
00:57:08,436 --> 00:57:10,716
He had to wait nine months for an answer.

1048
00:57:10,896 --> 00:57:12,846
I had to wait nine months for an answer.

1049
00:57:13,146 --> 00:57:16,926
And if he'd come to the practice
directly, he would've got an apology.

1050
00:57:16,926 --> 00:57:20,616
He'd have got a refund because, you
know, I was, you know, very keen and

1051
00:57:20,616 --> 00:57:22,626
still am on, you know, building goodwill.

1052
00:57:22,626 --> 00:57:26,376
And if it's, if, if that's what it takes
to keep someone happy, then I, then I

1053
00:57:26,376 --> 00:57:28,046
will, even if I've done nothing wrong.

1054
00:57:28,363 --> 00:57:29,983
So he'd have got a lot out of that.

1055
00:57:29,983 --> 00:57:34,093
And instead, by going for that nuclear
option, that opportunity was missed.

1056
00:57:34,333 --> 00:57:37,603
Now, he didn't have the benefit
of being aware of all the local

1057
00:57:37,603 --> 00:57:41,648
processes that we have, but anyone
listening to the podcast, working in a

1058
00:57:41,648 --> 00:57:45,548
healthcare role, will know what those
local measures are in the processes.

1059
00:57:45,548 --> 00:57:48,398
So really it's a gift to go
through those local process.

1060
00:57:48,428 --> 00:57:52,028
You get much more out of it than going
to the regulator, because the regulator

1061
00:57:52,028 --> 00:57:56,708
is a very cold process that actually I
think even the complainant doesn't win.

1062
00:57:56,798 --> 00:57:58,988
You know, it's, it, it doesn't
really get anyone anywhere.

1063
00:57:59,228 --> 00:58:02,738
Save them, as I say, just to, to drive
that point home that there will be

1064
00:58:03,068 --> 00:58:06,908
certainly cases that that need to go
there and I'm not minimizing that.

1065
00:58:07,169 --> 00:58:10,646
The annoying thing about being
complained about is that that's

1066
00:58:10,646 --> 00:58:11,546
where you learn the most.

1067
00:58:11,546 --> 00:58:12,866
That's where you developed the most.

1068
00:58:12,866 --> 00:58:15,076
That's where, you know, I
looked through in my careers.

1069
00:58:15,076 --> 00:58:18,536
It's either where things that have
not worked or failed or negative

1070
00:58:18,536 --> 00:58:22,286
feedback that I've got where I've
actually learned and changed the most.

1071
00:58:22,286 --> 00:58:25,826
And that's a really annoying
thing about like self-awareness

1072
00:58:25,826 --> 00:58:27,056
and personal development.

1073
00:58:27,356 --> 00:58:30,086
You don't develop if everyone's
telling you how wonderful you are.

1074
00:58:30,416 --> 00:58:32,726
You do when they start telling
you, well that could have been done

1075
00:58:32,726 --> 00:58:35,726
better, or that was a bit rubbish,
or this is how it made me feel.

1076
00:58:35,726 --> 00:58:39,866
So it is a real gift, even if
the person doesn't respond like

1077
00:58:39,866 --> 00:58:41,066
it's a real gift at the time.

1078
00:58:41,266 --> 00:58:44,496
Before we finish quickly, George,
do you have any other tips for what

1079
00:58:44,496 --> 00:58:49,986
people can do themselves when they
are dealing with a complaint that's

1080
00:58:49,986 --> 00:58:53,406
either gone to the regulator or going
through sort of official channels?

1081
00:58:53,406 --> 00:58:57,936
'Cause it's such a, a difficult
and anxious and uncertain time.

1082
00:58:57,936 --> 00:59:01,686
So what would you be advising
your, your members to do as well?

1083
00:59:01,774 --> 00:59:05,224
I answer it more how I'd say, you
know, advise a friend over coffee.

1084
00:59:05,524 --> 00:59:08,074
So, if a friend of mine came
to me and said, look, George,

1085
00:59:08,074 --> 00:59:09,424
I've, I've got this going on.

1086
00:59:09,724 --> 00:59:11,524
I, I would say three things.

1087
00:59:11,824 --> 00:59:16,974
First of all, I would say take
some time out to focus on yourself.

1088
00:59:17,274 --> 00:59:19,914
It might be you take a week of leave.

1089
00:59:20,004 --> 00:59:23,694
You know, if it's as bad as you know,
a GMC or GDC complaint, you know

1090
00:59:23,724 --> 00:59:26,874
that's only gonna happen at worse
one or two times in your career.

1091
00:59:26,874 --> 00:59:28,344
So it's a really significant event.

1092
00:59:28,644 --> 00:59:30,804
Put yourself first, take some time out.

1093
00:59:31,104 --> 00:59:33,594
Secondly, speak to people about it.

1094
00:59:33,774 --> 00:59:35,934
There is absolutely no reason why.

1095
00:59:36,249 --> 00:59:37,899
We need to bottle these things up.

1096
00:59:37,989 --> 00:59:42,599
It is not the career ending calamity
that we will initially think it is.

1097
00:59:42,949 --> 00:59:47,599
And so having the opportunity
to draw on that, uh, support

1098
00:59:47,599 --> 00:59:49,069
network is really important.

1099
00:59:49,662 --> 00:59:51,552
And thirdly, I would say keep perspective.

1100
00:59:51,852 --> 00:59:58,242
So, um, my back of a napkin calculation,
if you see, uh, 30 patients a day,

1101
00:59:58,362 --> 01:00:02,922
five days a week, 48 weeks a year for
a 30 year career, you're gonna see

1102
01:00:02,922 --> 01:00:07,242
in the region of quarter of a million
patients or patient interactions.

1103
01:00:07,612 --> 01:00:12,387
Now, if you have in your career 10
serious complaints, you've still got

1104
01:00:12,567 --> 01:00:16,922
249,990 happy patient interactions.

1105
01:00:16,922 --> 01:00:20,852
So, you know, it's really important that
when you get that Christmas card or that

1106
01:00:20,972 --> 01:00:25,772
gift or the thank you notes, I say keep
them, put them on display, and then have

1107
01:00:25,772 --> 01:00:27,392
a box or a draw that you put them in.

1108
01:00:27,662 --> 01:00:31,442
So when you get to those really
low points, um, you can open the

1109
01:00:31,442 --> 01:00:35,882
drawer and just be reminded that
actually this is a single event.

1110
01:00:35,912 --> 01:00:38,582
This is not you, and how it
defines you as a clinician.

1111
01:00:38,732 --> 01:00:38,829
that.

1112
01:00:38,829 --> 01:00:42,639
So see it as a significant event
if you do get, you know, a serious

1113
01:00:42,639 --> 01:00:46,269
complaint and yeah, and, and take the
time that you need to deal with it.

1114
01:00:46,569 --> 01:00:48,399
Yeah, I love that about talking to people.

1115
01:00:48,399 --> 01:00:49,329
Get people on your side.

1116
01:00:49,359 --> 01:00:52,179
'cause if you, as soon as you share
it, it takes a sting out of it.

1117
01:00:52,179 --> 01:00:53,499
It really, it really does.

1118
01:00:53,499 --> 01:00:56,859
It might be difficult the first time,
but then, uh, you'll feel, and you

1119
01:00:56,859 --> 01:00:59,649
will find that people are really,
really supportive of you as well.

1120
01:00:59,679 --> 01:01:00,879
Generally people are, aren't they?

1121
01:01:00,879 --> 01:01:02,649
They're like, oh, thank God
that didn't happen to me.

1122
01:01:02,679 --> 01:01:03,849
What can I do to support you?

1123
01:01:04,314 --> 01:01:07,974
Yeah, I remember, I remember telling
my boss when I got my GDC letter and

1124
01:01:07,974 --> 01:01:12,654
I built up the courage to walk in,
um, at lunchtime to speak to my boss.

1125
01:01:12,654 --> 01:01:17,754
And I walked in thinking, this is just
gonna open the doors to the second

1126
01:01:17,754 --> 01:01:20,274
tranche of, you know, negativity.

1127
01:01:20,274 --> 01:01:23,724
I've had the letter and now I'm gonna
get sacked or suspended or whatever.

1128
01:01:24,361 --> 01:01:28,051
And, um, actually my boss just
gave me a hug, you know, we had a

1129
01:01:28,051 --> 01:01:31,261
very close friendship and said, I'm
really sorry that you've had that.

1130
01:01:31,561 --> 01:01:32,851
It seems really unfair.

1131
01:01:33,221 --> 01:01:35,591
And they were from that
point on right through the

1132
01:01:35,591 --> 01:01:37,421
process, incredibly supportive.

1133
01:01:37,421 --> 01:01:41,131
So the error I made was presupposing
how they would deal with it.

1134
01:01:41,431 --> 01:01:45,331
And I suppose the knock onto that, the,
the, the, the point that I, you know,

1135
01:01:45,331 --> 01:01:49,621
it'd be great to use this opportunity is
if you have a colleague that's in receipt

1136
01:01:49,621 --> 01:01:51,891
of a complaint, yes, they sound serious.

1137
01:01:51,891 --> 01:01:55,761
A complaint to the regulator is
serious, but just remember that it

1138
01:01:55,761 --> 01:01:57,441
doesn't define them as a clinician.

1139
01:01:57,741 --> 01:01:59,751
It's part of a bigger story.

1140
01:01:59,751 --> 01:02:04,491
There's always context, and first and
foremost, I think as any colleague would,

1141
01:02:04,671 --> 01:02:08,821
would want to, um, support them, you know,
leave the, the regulators to make the

1142
01:02:08,821 --> 01:02:12,657
judgements, and you just be there as a
friend and colleague to help through it.

1143
01:02:13,065 --> 01:02:16,065
we had someone on the podcast who was
talking about a, a patient who died

1144
01:02:16,065 --> 01:02:19,471
by suicide, and they felt incredibly
guilty and lots of people were very

1145
01:02:19,471 --> 01:02:22,801
supportive, but the one thing that
made the difference to them was their

1146
01:02:22,801 --> 01:02:24,361
boss saying that happened to me.

1147
01:02:24,661 --> 01:02:27,901
And they went, oh, that was the one
thing, oh gosh, it wasn't just me.

1148
01:02:27,931 --> 01:02:29,461
'Cause you feel like, oh, I'm dreadful.

1149
01:02:29,671 --> 01:02:30,301
It was just me.

1150
01:02:30,301 --> 01:02:33,031
So sharing, being vulnerable,
telling people your story

1151
01:02:33,031 --> 01:02:34,051
can all be really helpful.

1152
01:02:34,515 --> 01:02:38,925
George, that's been really helpful and
if people wanted to of contact you or

1153
01:02:38,955 --> 01:02:42,615
find out more about the work that the
Dental Protection Society or Medical

1154
01:02:42,615 --> 01:02:47,235
Protection Society does, you know, where
would you, or they want more stuff around

1155
01:02:47,235 --> 01:02:48,645
this, where would you point them towards?

1156
01:02:48,810 --> 01:02:52,480
Okay, so they can go to our website,
which is dentalprotection.org

1157
01:02:52,500 --> 01:02:54,340
or medicalprotection.org.

1158
01:02:54,680 --> 01:02:57,710
They can access that from any
country that we operate in.

1159
01:02:57,710 --> 01:02:59,660
And we have country specific sites.

1160
01:02:59,990 --> 01:03:05,300
On there, there is a wealth of information
and resource, including access to our

1161
01:03:05,360 --> 01:03:10,550
e-learning platform, which has a range
of webinars for the benefit of members.

1162
01:03:10,820 --> 01:03:14,720
So I'd encourage anyone with an
interest, uh, to have a look on there.

1163
01:03:15,020 --> 01:03:18,440
If anyone wants to get in touch with me
personally, if they've, they've enjoyed

1164
01:03:18,440 --> 01:03:22,370
hearing about my experiences, um,
then they can contact me via LinkedIn.

1165
01:03:22,370 --> 01:03:26,600
So I'm available on LinkedIn, um,
or via the Dental Proection pages.

1166
01:03:26,623 --> 01:03:26,893
Great.

1167
01:03:26,893 --> 01:03:29,983
So we'll pop all those notes in the show
notes and I think we are going to be doing

1168
01:03:29,983 --> 01:03:33,793
some, some webinars, um, in association
with the Dental Protection Society and

1169
01:03:33,793 --> 01:03:35,773
Medical Protection Society soon as well.

1170
01:03:35,833 --> 01:03:38,533
So if you remember, keep
an eye out for that.

1171
01:03:38,623 --> 01:03:43,693
Um, we'll also make a download of the
High Five conversation model available in

1172
01:03:43,693 --> 01:03:47,293
the show notes just in case anybody wants
to look further into that and explore

1173
01:03:47,293 --> 01:03:48,583
how they might be able to use that.

1174
01:03:48,583 --> 01:03:50,173
So George, thank you so much for being on.

1175
01:03:50,173 --> 01:03:51,763
It's been really, really helpful.

1176
01:03:51,823 --> 01:03:54,973
Um, and I'm, I'm certainly gonna
bear a lot of that in mind.

1177
01:03:55,063 --> 01:03:59,563
Uh, if I ever have to, you know, complain
about a doctor myself or a dentist or

1178
01:03:59,563 --> 01:04:04,453
whatever it is always, always better to
have the conversation go locally and don't

1179
01:04:04,453 --> 01:04:07,283
escalate unless you absolutely have to.

1180
01:04:07,483 --> 01:04:08,350
Yeah, absolutely.

1181
01:04:08,370 --> 01:04:09,705
Thanks for having me, Rachel.

1182
01:04:11,342 --> 01:04:12,272
Thanks for listening.

1183
01:04:12,372 --> 01:04:16,832
Don't forget, you can get extra bonus
episodes and audio courses along with

1184
01:04:16,922 --> 01:04:21,752
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1185
01:04:21,832 --> 01:04:26,292
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1186
01:04:26,292 --> 01:04:29,262
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1187
01:04:29,636 --> 01:04:33,156
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