A fresh perspective

PEC UK candidate Lauren Harrhy talks to Julie Bissett about the changes she wishes to see in dentistry

A 33-year-old mother of three, Lauren qualified from Cardiff in 2009 and, two years ago, bought what is now called Sparkle Dental Centre, a mixed practice where she was previously an associate when it operated under its former name, MJ Dental Services. Lauren has since undertaken a complete rebranding ‘as quickly as finances allow’.

With a passion to create better working conditions for dentists – ‘I want to improve the climate in which we all work’, she is also hoping to offer a ‘fresh perspective’ on representing dentists and is standing for the BDA’s Principal Executive Committee (PEC) UK seat.

And much of this change, she feels, needs to be focused on how a stressful working environment is negatively impacting on the dental community.

According to a study published in January in the British Dental Journal – a survey of stress, burnout and wellbeing in UK dentists – ‘dentists working in the UK exhibit high levels of stress and burnout, and low wellbeing. General dental practitioners seem to be particularly affected. Issues relating to regulation and fear of litigation were deemed to be the most stressful aspects of being a dentist’.

Lauren knows the impact only too well. Her practice is located in a high needs area, which creates huge challenges for her and her team.

She explains: ‘We have three main issues. Firstly, it can take hours of clinical time to achieve three UDAs. Secondly, patients place very low value on their dental health, so often FTA appointments are then upset when they are no longer offered NHS appointments. And, thirdly, largely due to the first two issues, it’s difficult to recruit dentists to work in the area.

‘The associate I have currently is amazing and an absolute find, but it has taken nearly two years to get a suitable person in place who fits with the practice and is able to work for more than one day.’

Mental Dental

Lauren plans to apply to be an FD trainer later in the year, but, in the meantime, the usual problems within dentistry have inevitably meant that managing staffing issues and very tight finances is difficult.

She says: ‘The small private section of the business subsidises the NHS side and these constant obstacles risk impacting on maintaining good clinical standards.’

A few years ago, Lauren’s juggling reached crisis point and she suffered burnout. Triggered largely by postnatal depression, she took a month off and, despite still having attacks of anxiety from time to time, now has much better coping mechanisms.

She says: ‘I wouldn’t hesitate to ask for help now if I felt my mental health declining.’

Her experience led to the creation of an online outlet for fellow sufferers – a closed Facebook group called Mental Dental, for dentists in crisis. It offers a ‘safe place’ for dentists to discuss common issues and challenges, as well as just have a general moan about the profession.

Lauren says: ‘There is a pervasive fear of rigorous regulation, high litigation and moral injury due to working under a NHS contract that is not fit for purpose. It forces all of us to compromise the care we provide our patients, for nearly 40% less remuneration in real terms. So, we are more afraid, working harder, for lower income, paying out more for various bodies to regulate us and protect us from litigation.

‘Some dentists might never admit they are stressed – to themselves or anyone else. Many are self-aware, but perhaps feel they do not have the time, do not need or don’t know how to find the help they require.’

Mental Dental, therefore, is designed to be a ‘first port of call’ for stressed dentists.

Lauren explains: ‘It can be used as a place to gather thoughts prior to being signposted to an organisation that can assist you with your particular issues. For some dentists, just the act of writing a post, or having some sympathy from peers who understand, is enough to make them feel better.’

Redressing balance

Ironically, although she views the digital world as positively encouraging a ‘community spirit in many that has been missing for some time’, she also sees the online world as a threat to professional confidence and patient satisfaction.

She explains: ‘Social media is not only harming patients, as they strive for physical perfection, which is either unattainable or will cost them thousands to try to achieve, it is also hurting the wellbeing of dentists, as we see others who may seem to be surpassing us clinically or in life.

‘There are some closed social media groups that allow those who are achieving financial and clinical success to showcase their purchases and cases. These may be viewed as aspirational or inspiring. What we must realise is that clinical ability and financial success exist on a spectrum and that achieving one does not necessarily mean that you have achieved the other.’

Mental Dental was also born from a desire to redress this balance. She says: ‘I was fed up of seeing how downtrodden and anxiety-filled some of the posts were on the popular platforms. I felt that it would be great to have a safe space to air our feelings and see that, very often, others are having similar issues.’

As well as Mental Dental, Lauren has also been involved with setting up Confidental – a helpline for dentists in emotional crisis. The helpline is designed to offer ‘emotional first aid’ to dentists who are struggling emotionally and/or mentally and may be feeling overwhelmed.

Lauren says: ‘Sometimes a friendly and open, but confidential, ear gives us the opportunity to give voice to all the doubts and fears and shameful thoughts that gnaw away at us and leave us feeling weak.

‘Chatting to a colleague can put a situation into perspective and give us the tools to use our own inner strength and resources to make the decisions or seek further help to solve our own problems. Additionally, we are fully indemnified by Wesleyan to listen and signpost.’

For more long-term support, she suggests the Dentists’ Health Support Programme or recommends dentists join a local branch of the BDA or LDC ‘so you can meet local dentists who may understand the issues that are particular to your area or patient population’.

As to the numerous key moments in a career that can pile on the pressures, Lauren is unequivocal.

‘The profession is rife with flashpoints. When a dentist finishes their FD year, they may feel like their support network has evaporated overnight. At about five to 10 years post-qualification, we may be more confident in our skills, but the pressure mounts when we realise that much more is now dependent on those skills, as we move through lifestyle changes such as marriage, having children and owning a home.

‘Buying a practice and the few years after is also a particularly stressful period – you can no longer solely rely on clinical skills and must learn how to manage staff and ensure that your business remains financially viable with staff and patients depending on you to do so.’

She views networking as essential ‘for building relationships with colleagues so we have somewhere to turn if we need advice or help’.

‘Dentistry can be a very isolating profession, but it need not make us isolated. We can choose to forge links and friendships, which will have inestimable value to our mental resilience. I truly believe graduates are completely unprepared for what awaits them in general practice (good or bad) and often have little to no experience of business or being public facing.’

Forewarned is forearmed

Ultimately, she suggests that ‘forewarned is forearmed.’ She concludes: ‘Undergraduates and FDs should be taught how to manage their emotional wellbeing so they are able to be kinder to themselves – and, in doing so, more empathetic with patients and colleagues. We all need a safe place to address our daily battles.’

For more information about Confidental, visit www.confidental-helpline.org. The helpline number (not currently free to call) is 0333 987 51 58.

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