- Team DentalReach
Abstract
Randomly formed working groups or incompatibility between team members causes easy team disintegration. But even in a successfully developed group, managers may not not use its commercial potential, not promote it as a special service, as an advantage of the clinic, or derive additional material and psychological benefits from the fact of its formation. In both the cases, the dental dream team formed is a pseudo or false dream team.
An uncomfortable question - who should be the team head?
In a team setup, who handles the OPD maybe arbitrary, usually dictated by the:
- plan for the upcoming treatment
- someone from the necessary narrow specialists works in that shift,
- someone found free time from an appointment,
- someone was interested in the patient's clinical situation.
In clinical practice, there are often cases when a patient is diagnosed with several relatively simple disorders and their elimination requires the intervention of different specialists, not necessarily of the highest qualifications.
Improving the oral cavity includes a whole range of necessary measures for surgery, therapy and probably orthodontics and prosthodontics, but this is performed by individual specialists who repeatedly conduct examinations, and based on the symptoms, narrow specialists make their own diagnosis and carry out their treatment plan. So it turns out that every narrow specialist does not treat the disease, but only removes the symptoms of the disease - it's good if the positive effect lasts for a long time.
There is however, a more thoughtful way out of the situation. The head of the team should be a dentist of the highest category, trained in general dentistry. He/she is assigned the duties of the "head center": he receives primary patients, examines, diagnoses, directs the patient to the doctors who are actual performers of the treatment process, distributes assignments, and after the completion of treatment controls the work of each member of the team and bears responsibility for it as a whole.
Before treatment, the patient is presented with this experienced doctor (in some literary sources he is called a ‘treatment planner’). He knows the possibilities of the doctors of the clinic and "sorts" the patients: it is better to refer this to dentist A, he will cope with this clinical case; and this - to dentist B, he is more likely to solve such a problem. Of course, this is a step forward compared to traditional "impersonality" and some protection against possible low treatment results, but this is not a guarantee of a creative, comprehensive approach to patient treatment.
As you can see, specialists continue to work in isolation, interacting indirectly, through the head. However, to not fall into the trap of a pseudo team, certain questions require honest attention:
- Is the workload for the foreman manageable if OPD is heavy?
- Can we assume that any doctor of the highest category, trained in general dentistry, will adequately cope with the mission entrusted to him?
- What will happen if such a “treatment planner” is mediocre, if he doesn’t know modern technologies in different areas of dentistry, but does something to suit his bosses?
- What impression will the patient make of him if he is a bad communicator or an emotionally burnt-out person?
If this head only allots patients to specialists like a treatment co-ordinator, then how to pay him, because he does not directly earn money?
It seems that such an association of professionals will not work as a whole: it paralyzes the creative potential of doctors, collegial professional experience and intelligence, it is not capable of causing a synergistic effect.
Other options for team head:
Leading the group is usually the responsibility of a person of authority. Good options for a team head include:
- senior in rank (for example, chief physician, senior specialist), or
- a doctor who has the most responsible area of work with a given patient or
- more active doctor-communicator, or
- the members of the group choose the leader by mutual agreement, taking into account the clinical situation and the contribution of the specialist to its solution.
Types of pseudo teams - The brigade type & the Henry Ford conveyor belt type
1. The brigade type
Sometimes specialists with different professional credo and mentality are forced to work together, with different communication and creative abilities, characters and properties of the nervous system. This is the brigade type of pseudo team - uniting narrow specialists in an inadequate form of providing services in complex clinical situations that require the use of the latest technologies.
This pseudo-team includes specialists who differ significantly in the level of professional skill and ethical qualities.
The formation of a good dental team is especially important in small clinics, where the professional level and mentality of specialists differ significantly. It is even more difficult to form a team when a financial plan hangs over each doctor, when the manager and director demand that the doctor surrender at least a specified amount per shift. In clinics that have declared a fight for the average check, there can be no team, here greed reigns supreme.
Case Example 1There are clinics where dentists who are incompatible in their professional level and ethical principles - for example, an implant surgeon and a prosthodontist - are on the “team” at the behest of their superiors or by accident. It happens that the surgeon acts on the principle of "placing more implants and making more money", without thinking about what difficulties it creates for the prosthodontist and dental technician. At the same time, the prosthodontist may not be skilful enough to handle tricky full arch cases, but only simple ones which further complicates the case. A responsible surgeon cannot guarantee the patient the overall quality of work, as the final prosthesis is handled by the prosthodontist, who also cannot give a guarantee because prognosis heavily depends on correct implant placement - unless both work in synergy with each other.
The overall favorable outcome of treatment depends on the level of qualifications of each narrow specialist, the consistency of their actions, the unity of approaches to the clinical picture and understanding of the ways to achieve the desired results.
2. Henry Ford conveyor belt type
In the Henry Ford conveyor belt type of pseudo team, there is a "capture" of someone else's territory or simply put- ‘case stealing’ - a narrow specialist does something instead of a colleague who was actually supposed to. This happens for various reasons:
- the doctor has mastered a related specialty and tries to realize the acquired skills as much as possible
- brings the narrowness of the clinical thinking of an individual colleague
- the doctor's desire to make more money on each patient
- a thoughtless desire to show originality in solving a problem
- a desire to curry favor with the authorities who like smart colleagues who bring big incomes.
Each specialist, having waited for his turn, performs his own scope of treatment regardless of diagnosis and opinions of other colleagues regarding the general treatment plan, without thinking too much about the logic and intentions of the specialist who acted before him or will join the patient's treatment after.
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