Having graduated in South Africa, I came to practice in the UK, and I helped introduce tooth whitening, then dental veneers to the UK. We were the first practice to do veneers. We then brought out the faculty from New York University – Larry Rosenthal and his group – to teach dentists cosmetic dentistry. I brought out Omar Reed, who was one of the world’s leading practice management consultants, and that has made a huge difference to the way dentists practice.
Then I joined the Dentex group and was introduced to [Dr] Biju [Krishnan] who is, if nothing else, probably one of the most entrepreneurial dentists I’ve ever met. He introduced us to iConsentu, and all I can say is that I wish I had it 20 years ago. It would have saved me a lot of sleepless nights.
iConsentu gives the patients the opportunity to see the ups and downs of the procedures they’re going to have. It gives a kind of graphic detail of what’s going to be done. And then they can make a really informed choice, whether to go ahead with the procedure or not, instead of saying, “well, you talked me into it”. Plus, should it happen that something doesn’t work out, we can go back to iConsentu and see what was said and what was agreed to.
Has the topic of consent changed at all? Has dentistry become a more litigious industry?
Absolutely. Every time we lift up our drill and start working on a patient, there’s a thought of, ‘what’s the future of this relationship going to be?’ You never know. Things can turn and people are unpredictable. Someone I think is really sweet and kind and nice, can turn out to be voracious, demanding, self-centred, actually awful. If you don’t have the correct documentation, it can lead to a lot of anxiety.
Legal dentist claims can have a huge mental toll on dentists. Have you seen that yourself?
100%. In fact, I don’t even think we’ll do an advanced restoration like a crown or a bridge or anything without having the patient complete the iConsentu program.
Do you think people didn’t previously understand the kind of ramifications of cosmetic procedures?
Very often, and it’s difficult to describe, especially if we haven’t gone through the procedure ourselves. My dental assistants have and so it does help because they can explain to them exactly what they’re going to feel and what they’re going to go through. But it’s much better doing it in a form like iConsentu does, where it’s professional. It’s sort of been peer reviewed. It’s well done and explained, and nothing’s left to the imagination.
Before iConsentu, what was the alternative? And for dentists that aren’t currently using it, what kind of consent procedure are they looking at?
You would explain to the patient, and you’d have them just sign a piece of paper that had the procedure explained to them. Sometimes you didn’t even do that; that only came in more recent than that. There was never a signed acceptance. You just proposed the treatment to the patient and they accepted the treatment. That’s how our profession works. You know, they came to us and they would take the advice. The only time we ever needed anything signed was if a parent sent a kid in, who was under the age of about 15 or 16. We needed something to be signed saying they could have the treatment, but an adult never had to sign anything ever. Only in the last 15 years or so has this changed.
To your mind, is it the informative nature of iConsentu that sets it apart?
Having watched Biju [Krishnan] put it together, and having looked at the questions and explanations, I couldn’t have done it better myself. It’s good for the patient to not just hear it, but they can read it and keep a copy of it. It really does save a lot of worry.
The patient comes in for the appointment, and before we start the procedure, say veneers or whatever it is, we’ll sit them down with the iPad. Or, we’ll send it to their home and they can do it there. I then go through it and sometimes, if we feel they still don’t fully understand, we’ll go through it again and it only takes 10/15 minutes.
Would you say that consent is one of the biggest challenges for your profession in terms of barriers that you have to face?
Yes. You have to have consent today. Today it would be unethical to embark on a course of treatment without having consent. These procedures are not reversible. You can say that it’s reversible, but it’s not reversible. So you have to be absolutely sure. So now, I check before I embark on any course of treatment that the patient has gone through the iConsentu program.
It absolutely behoves every practitioner to use iConsentu. It’s almost malpractice not to use it today.
Is there anything exciting on the horizon in the dentistry industry? Anything that is keeping your interest piqued in the dentistry world?
Technology is changing all the time. We’re in the world of digital technology. You know, we can scan procedures if you want. You’re going to have milling machines in the practice that mean you can actually do restorations in the practice yourself. So that’s great. A lot of practices are no longer using dental laboratories. They do the work all in-house. We still use laboratories because we like the artistry that the ceramist has.