Mike Gow: Black Box Dentistry by Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine

by Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine

Have you read Matthew Syed’s Black Box Thinking yet? It was written a few years ago for people with an interest in business and personal development, but I believe it’s essential reading for anyone working in health care.

I was reminded about it recently after DentaltownUK honorary editor Dr. Shameek Popat had attended Syed’s presentation at the annual Kois Center Symposium in the USA. (NB for anyone who doesn’t know, Dr?John C. Kois is presenting at the BACD in November!).

In his book, Syed cites health care as an example of how attitudes about failure need to change. He explains how in aviation, if there is a failure due to error or fault, pilots receive no reprimand so long as they make a full report within a set timeframe.

The aviation authorities then look at how the system could be improved, or how pilot training could be improved to prevent the same failure recurring in the future. In health care, the same candid honesty is expected but the aftermath is often quite different.

The culture in health care is to blame and reprimand any individual deemed to be responsible for the failure. This can lead to self-protection and cognitive dissonance. Cognitive dissonance is when, despite hindsight and evidence, we have the tendency to remain entrenched in a viewpoint or belief, rather than admit that we were wrong.

The internet is awash with examples of ‘perfect dentistry’. The bar of expectation is set high by both patients and our peers. In my recent interview with Dr?Barry Glassman featured in the last edition, it was refreshing and somewhat surprising to hear him give the advice to young dentists that ‘I don’t know how to tell you this, but you’re not perfect’.

In dentistry, I think we set up an expectation for perfection. While it is obviously important to set high standards and always aim to achieve the best results possible, it just simply isn’t the way it will always be.

Syed explains how the attitude in health care creates an environment where it is very difficult to be candid about this and to then learn from failure.

Some dental treatment fails, and when it does there are excellent opportunities to learn. Yet how many of us see it in that light when a patient complains, rather than panicking?

There is very little opportunity for dentists to report and discuss ‘dental failures’. When you consider that 10 percent of cases at the GDC come from referrals from our own colleagues, you can understand why this is the case.

Imagine just for a moment a place where you could discuss failures or concerns in a safe, supportive and far-reaching environment, remaining anonymous if you choose. Imagine the opportunity for mass learning and innovation for the profession. Imagine a place where we could have ‘Black Box Dentistry’. That exists now! Visit the Dentaltown forums.

I am delighted to announce that the DentaltownUK honorary editorial board has been strengthened with the recent addition of Dr Mohammed Almuzian.

Almuzian is a specialist orthodontist and founder of The Glasgow Orthodontic Academy, which offers a diploma in orthodontics. I recently interviewed Mohammed about his life and work.

Part of this fascinating short interview was conducted on the back of his trike! Anyone who remembers Billy Connolly’s World Tour Of ... series where he explored different countries on his trike will appreciate the choice of credit music in this interview!

Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine