Do You Really Need To Pay £xxx's for Dental Work?
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Undervalued wrote: »So why do you work in it then? (Serious question)
In another thread you mention that you have additional training and qualifications in specialised root canal work. Presumably you therefore also have the additional expensive equipment?
You also say in the other thread that, in effect, the NHS doesn't pay at all for root canal treatment although it should be provided if the dentist feels it is within their competence?
I'm lost....
Why do I work in it? I ask myself that a lot. Firstly, contrary to popular belief there is no easy way out. I do not own a practice and can not unilaterally convert patients over. In Wales, particularly south, private dentistry is not as wide spread as you may think. I would have to leave my practice and find someone prepared to take me on to run a private list.
That being said, my work profile has changed dramatically in the last 2 or so years years. Since I gained additional skills in root canal treatment I have started to take referrals. That is building nicely. The NHS do not commission people with my skill set so therefore there is no possibility of doing this on the NHS so I have to work privately. This has meant that my NHS workload has dropped by 50% and we have taken a new dentist on to see the patients I no longer can see.
YEs I do have the necessary equipment and I have had this for the last 6 years. I bought this entirely at my own expense to enable me to train and practice to the necessary levels. I got not additional funding or support from the NHS. In fact the benefitted from me as I no longer had to refer my complex treatments to their tertiary referral centres meaning less demand on the services they DO provide.
Regarding your last comment I am not sure what you are lost on. There is no fee for root canal treatment.
Technically it falls in to a band 2 course. However you can not JUST do a root filling. You have to place at least a filling or a crown/onlay after doing the root filling. The filling would be a band 2 on its own and the crown, band 3. Therefore there is no actual funding for root canal treatment even though the costs of provision are very high, often more than the band 2 fee is in the first place.
BUT if the dentist feels competent to do the treatment they are obliged to do it. So someone like me, treating my own patients, would be obliged to do pretty much all complexities because I am able to do it. Someone without my skills can say they wont do it because they dont feel able to do it then offer extraction. What they cant do is offer it privately with them ... but they can legitmately refer to me as an independent practitioner on a private basis.
My way out of the NHS is to upskill and provide an alternative service. My patients are not disadvantaged as we still have a dentist for them to see it just isnt me as much . I can legitimately and honestly say that there is no NHS provision for the level of work I do in practice. IF a patient of mine has a simple root filling then one of my colleagues is able to do it and my own time is then still being used in more complex work which is good for the practice. If it is too complex for the colleague then I woudl do it.0 -
86% of dentists do not own a practice , and working in NHS are unlikely ever to be able to.
The average dentist comes out of university owing £70,000. If , like welshdent they take further courses like , say, a msc in endodontics this is likely to cost them in tuition etc £30,000 plus the cost of the equipment. This is because someone who does not own a practice cannot suddenly go private that decision is a practice owners , they either need to find a private job , few and far between, or find a skill that is marketable privately. Or , like many of my colleagues , get out of dentistry.0 -
Why do I work in it? I ask myself that a lot. Firstly, contrary to popular belief there is no easy way out. I do not own a practice and can not unilaterally convert patients over. In Wales, particularly south, private dentistry is not as wide spread as you may think. I would have to leave my practice and find someone prepared to take me on to run a private list.
That being said, my work profile has changed dramatically in the last 2 or so years years. Since I gained additional skills in root canal treatment I have started to take referrals. That is building nicely. The NHS do not commission people with my skill set so therefore there is no possibility of doing this on the NHS so I have to work privately. This has meant that my NHS workload has dropped by 50% and we have taken a new dentist on to see the patients I no longer can see.
YEs I do have the necessary equipment and I have had this for the last 6 years. I bought this entirely at my own expense to enable me to train and practice to the necessary levels. I got not additional funding or support from the NHS. In fact the benefitted from me as I no longer had to refer my complex treatments to their tertiary referral centres meaning less demand on the services they DO provide.
Regarding your last comment I am not sure what you are lost on. There is no fee for root canal treatment.
Technically it falls in to a band 2 course. However you can not JUST do a root filling. You have to place at least a filling or a crown/onlay after doing the root filling. The filling would be a band 2 on its own and the crown, band 3. Therefore there is no actual funding for root canal treatment even though the costs of provision are very high, often more than the band 2 fee is in the first place.
BUT if the dentist feels competent to do the treatment they are obliged to do it. So someone like me, treating my own patients, would be obliged to do pretty much all complexities because I am able to do it. Someone without my skills can say they wont do it because they dont feel able to do it then offer extraction. What they cant do is offer it privately with them ... but they can legitmately refer to me as an independent practitioner on a private basis.
My way out of the NHS is to upskill and provide an alternative service. My patients are not disadvantaged as we still have a dentist for them to see it just isnt me as much . I can legitimately and honestly say that there is no NHS provision for the level of work I do in practice. IF a patient of mine has a simple root filling then one of my colleagues is able to do it and my own time is then still being used in more complex work which is good for the practice. If it is too complex for the colleague then I woudl do it.
Thanks for that detailed explanation. Much appreciated.0 -
brook2jack wrote: »86% of dentists do not own a practice , and working in NHS are unlikely ever to be able to.
The average dentist comes out of university owing £70,000. If , like welshdent they take further courses like , say, a msc in endodontics this is likely to cost them in tuition etc £30,000 plus the cost of the equipment. This is because someone who does not own a practice cannot suddenly go private that decision is a practice owners , they either need to find a private job , few and far between, or find a skill that is marketable privately. Or , like many of my colleagues , get out of dentistry.
And thanks for your contributions too.
It really is a crazy situation......0 -
brook2jack wrote: »86% of dentists do not own a practice , and working in NHS are unlikely ever to be able to.
The average dentist comes out of university owing £70,000. If , like welshdent they take further courses like , say, a msc in endodontics this is likely to cost them in tuition etc £30,000 plus the cost of the equipment. This is because someone who does not own a practice cannot suddenly go private that decision is a practice owners , they either need to find a private job , few and far between, or find a skill that is marketable privately. Or , like many of my colleagues , get out of dentistry.
Or emigrate.The word "dilemma" comes from Greek where "di" means two and "lemma" means premise. Refers usually to difficult choice between two undesirable options.
Often people seem to use this word mistakenly where "quandary" would fit better.0 -
My cohort of graduates recently celebrated a big anniversary since graduating. Out of those who qualified at the same time 20,% are working abroad, a couple have passed away , several have gone bankrupt, around 25% are not doing dentistry mostly due to health problems and most are counting the years until they can retire which will not be due for a very long time yet.
We are the generation that expected to work in the NHS all our working lives, the majority who could left the NHS in 2006 when the new contract came in, after a couple of decades in dentistry. It is noticeable the majority of ill health retirements ,bankruptcies are in those whose majority commitment is to the NHS.
Not one would recommend dentistry as a career to their children.0 -
Yet there is a stampede of applicants for dental schools.
Curious - don't those bankrupt ones work in dentistry ? As financial management side of one's life is a bit different topic to one's working life - they might be still working as associates.
I found it difficult to come up with ideas what else a dentist can do - I have come across statements that they have transferable skills but struggle to come up with examples - apart from becoming dentolegal experts of course.The word "dilemma" comes from Greek where "di" means two and "lemma" means premise. Refers usually to difficult choice between two undesirable options.
Often people seem to use this word mistakenly where "quandary" would fit better.0 -
My private dentist would be a good comedian.0
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My private dentist would be a good comedian.
Doubt you have private dentist - your dislike of dentists and resentment of their fees indicates you do not see the value in what they do and do not use their services.The word "dilemma" comes from Greek where "di" means two and "lemma" means premise. Refers usually to difficult choice between two undesirable options.
Often people seem to use this word mistakenly where "quandary" would fit better.0
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