August 2024 Newsletter

Message from the President

Welcome to the August edition of the Council newsletter and with this, almost an end to winter. 

There does seem to have been a lot of sickness around this year and this leads well into the subject of my message this month, practitioner health.

As dental practitioners, we pride ourselves on ensuring that we provide the best care for our patients.  But when it comes to our own health, do we follow this same mantra?

At times, life can be stressful whether it is in our professional life, personal life or both.  Sometimes we can just stretch ourselves a bit too thin, fail to prioritise our own health or self-impose unnecessary pressures.  Illness can affect us all and the importance of self-care and peer support cannot be overestimated. We are not immune to physical or mental conditions, disabilities, or disorders. 

Failure to address personal health issues does have the potential to compromise patient safety and as part of the Council’s role, we manage a small number of practitioners in our health program.  From the Council’s perspective, and we hope to think from the individual practitioner’s perspective, involvement in the health program is not viewed negatively or punitively.

The aim of the health program is to support practitioners to continue to practise safely.  This generally means that a supportive environment is in place that ensures patient safety, as well as the continued management of the practitioner’s individual health needs.

Under the National Law, “impairment” has a very specific definition. Impairment means that a practitioner has a health issue which is likely to affect or does affect the safe practice of their profession. A health issue can be a physical or mental condition, disability, or disorder, and this may include substance abuse or dependence.  If you have a health issue, and this is well managed by medical, professional and personal support, the Council may find that you do not have an impairment under the National Law (NSW).

If a practitioner is found to have an impairment, in the majority of cases they are requested to consent to conditions being placed on their registration, that allow them to continue to practise.  If the Council places health-related conditions on registration, these generally do not appear on the public register, and confidentiality is therefore maintained.

In a very small number of cases, the Council may determine that, on the basis of the practitioner’s specific impairment, it is not possible for them to practise safely, even with specific conditions.  In these circumstances practitioners may be requested to consent to not practising, until such time as the Council is confident that they are able to practise safely.

Depending on the health issue, involvement in the health program may be short-term, but it could also be longer-term.  Regular reviews occur through Council Directed Health Assessments and these assessments are undertaken by independent practitioners with expertise in the specific health issue of concern.

Impaired Registrants Panels (IRP) are also held to regularly review the practitioner’s health status and assess any ongoing level of impairment.  When the Council is confident that the practitioner does not have an impairment, they will exit the health program.  This decision will be based on independent health assessments and recommendations made by the IRP.

Occasionally, as noted above, some practitioners may have a longer-term impairment that requires ongoing support and monitoring, and they may therefore remain in the health program for a longer period of time. With this additional support, practitioners can continue to work and to provide safe care to their patients, while also ensuring that their health is maintained.

Further information regarding the health program, health assessment and IRPs can be viewed in the Council’s fact sheets.

The increase in support for colleagues with health issues is to be applauded. As an example, the Dental Board of Australia has funded an independent and confidential health and wellbeing support service for dental practitioners - dpsupport.org.au.  This service provides extra support to practitioners on a wide range of health and wellbeing related issues and more information about this service appears further on in this newsletter.

Kind regards

Deb

Adjunct Professor Deborah Cockrell AM

President

NSW Registration Fees for FY2024/25

Each year dental practitioners in NSW pay a registration fee to the Dental Board of Australia (DBA) /Ahpra to remain registered in Australia. This fee includes a complaints fee component for NSW practitioners as the DBA/Ahpra does not manage complaints in NSW.

The Council has determined that the fee for NSW practitioners for FY2024/25 will be the same as the fee paid by their counterparts in other states/territories throughout Australia.

As you will be aware, the Council’s primary role is to protect public health and safety in NSW.  It does this through the management of complaints about the conduct, health and performance of practitioners and students in NSW.  The Council’s regulatory work is funded solely from practitioner registration fees. 

Due to an increase in the regulatory work of the Council in recent years, NSW practitioners have been paying an increased registration fee, compared to their interstate colleagues, to cover this increased cost of regulation in NSW.

More recently, and as noted in previous newsletters and annual reports, it is pleasing to report that we have seen a decrease in regulatory action being taken by the Council in relation to individual practitioners, following its assessment of complaints.

Each year the Council is required to set the complaints component of the registration fee. In determining this fee, consideration is given to the overall costs associated with the Council’s regulatory work, while also ensuring that the Council has sufficient resources to act as an effective regulator to protect the public and maintain trust and confidence in the profession.

Consideration is also given to ensuring that appropriate investment in information technology, to support the work of the Council, is made. In FY2024/25, substantial investment is occurring, including replacing the Health Professional Councils Authority’s (HPCA) and Councils’ primary business system, the complaints and monitoring database, and designing and implementing a new system.

The current system was developed in the late 1990’s and has a limited ability to meet current and future service demand. A new system is necessary to better enable the HPCA to address a sustained growth in complaints, improve customer experience, enhance stakeholder access to information, and provide data management/analysis capabilities to support regulatory decision making to assist the Council in keeping the public safe.

All Councils have approved the investment in the new business system. A vendor has been engaged and the project commenced in April 2024 with support for all Councils on a shared basis, to ensure value for money for Councils.

As noted above, annual registration for dental practitioners is managed through Ahpra. More information on 2024/25 registration fees for dental practitioners will be made available on the Dental Board of Australia’s website in due course. Importantly, dental practitioners in NSW will pay the same registration fees as their interstate colleagues.

Further information relating to the work of the Council, including the costs associated with the regulation of the dental practitioners in NSW, can be found in the Council’s Annual Reports.  Please note that the 2023/24 Annual Report will be released towards the end of 2024.

Accessing superannuation to fund dental care

In its May 2024 Newsletter, the Dental Board of Australia highlighted its concerns regarding growing reports of dental practitioners encouraging patients to access superannuation to fund dental care.

The Council echoes these concerns.  The Council has seen a very small number of complaints regarding this issue, however this appears to be an emerging issue and one that we believe is necessary to highlight to practitioners, in an attempt to reduce the number of potential complaints in future.

The Board’s Code of Conduct stipulates that, as registered dental practitioners, we must be ethical and trustworthy.  Our patients put their trust in us as they believe that, in addition to being competent, we will not take advantage of them. It is also important that as professionals, we do not allow ourselves to be put into a position that feels wrong. We are ‘allowed’ to decline to treat patients and interestingly, it is often the patients who make demands who have the highest expectations.

We must consider the balance of potential benefit and harm in all clinical management decisions and must provide treatment options that are based on the best available information and not influenced by financial gain or incentives.

We encourage you to revisit the advice provided by the Board in relation to this matter.

Handover and/or referrals … the importance of getting it right.

We are all human and, from time to time, mistakes can happen.  However, in the world of dentistry, these mistakes can impact our patients.  For example, where a referral results in an incorrect tooth being extracted.

In past newsletters, we have highlighted the importance of maintaining clear and accurate health records, and how this is essential for the continuing good care of patients.  This can also be said for when we are delegating, referring or handing over a patient to another practitioner.

We need to ensure that we are communicating effectively and that the information that we provide is clear, correct and leaves no room for confusion or doubt.  And if you are the practitioner being referred to, you also have an obligation to ensure a clear understanding of the patient’s clinical needs and associated treatment.  If in doubt, double check … and do so before commencing the treatment!

The Board’s Code of Conduct states as follows:

Good practice includes that you:
a. take reasonable steps to ensure that any person to whom you delegate, refer or hand over to has the qualifications and/or experience and/or knowledge and/or skills to provide the care needed
b. understand that, although as delegating practitioner you will not be accountable for the decisions and actions of those to whom you delegate, you remain responsible for the overall management of the patient and for the decision to delegate
c. always communicate sufficient, timely information about the patient and the treatment needed to enable the continuing safe care of the patient.

Spotlight on new Council Members

Dr Stephen Harlamb – Practitioner Member

Stephen was in general private practice for 7 years before specialising in Endodontics in 1996 and has been in specialist endodontic practice in the inner west of Sydney since.  In 2012 he completed a Masters in Health Law from the University of Sydney and is currently completing a Juris Doctor at Macquarie University.

Stephen is Editor-in-Chief of the Australian Endodontic Journal, Past President of the Australian Society of Endodontology (NSW) and has published articles in Dental Traumatology, the Australian Dental Journal and Archives of Oral Biology. He was Chair of the Scientific Committee for the World Congress of Dental Traumatology held in Brisbane in August 2016.

He has previously acted as a Peer Advisor for the Dental Defence Advisory Service of the ADA (NSW), mentoring and assisting dentists and subsequently served as Council Member. He has also acted as Professional Officer for the Dental Council of NSW.

Stephen is committed to providing continuing education and, throughout his career, has delivered lectures to dentists and dental students at the Universities of Sydney, Queensland and Melbourne as well as national congresses. He is an examiner for the Royal Australasian College of Dental Surgeons and has been awarded honorary fellowships to the International College of Dentistry and the Pierre Fauchard Academy in recognition for his services to dentistry.

Dr Yong Kho – Practitioner Member

Dr Yong Kho is an experienced general dentist, and general medical practitioner, currently practising in Wollongong, and Sydney. He graduated dentistry from The University of Adelaide, where he was awarded the Dental School Medal. He is also a medical graduate of The University of Newcastle, and masters graduate of The University of Sydney.

Yong has experience in all aspects of the profession, including clinical practice, teaching, research, clinical governance, and now regulation. He has worked in public and private practice, urban and rural practice, across primary to tertiary levels of care, and military environments. Throughout his career, Yong has worked directly with almost every dental specialty, giving him an appreciation of how different craft groups within dentistry practise. He has a record of leadership, advocacy, and outreach work. Yong has been a member of various boards and committees, including the Australian Dental Association.

Yong has significant experience in education in both dentistry and medicine, with current roles as Examiner for the Royal Australasian College of Dental Surgeons, and Clinical Educator for The University of Sydney.

Yong is active in supporting and mentoring practitioners. As a Council member, he looks forward to working in a collaborative, fair, and ethical manner – to progress its mission to protect the health and safety of the public, and to support the dental profession in the process.

Dr Angela Pierce – Practitioner member

Dr Angela Pierce is a graduate of the University of Adelaide where she later studied for an MDS in Oral Pathology which she followed up with a PhD from the Karolinska Institute in Sweden. Following a period spent in academia where Angela was Associate Dean of the Adelaide Dental School and Deputy Convenor of the University of Adelaide Academic Board, Angela returned to full-time private practice and studied for a law degree.

Angela spent several years as a professional member of the SA Health Practitioners Tribunal (now SACAT). She also spent over a decade as a Councillor of the ADA SA Branch where she was Branch President for 2 years and served as federal Councillor between 2014-21. In 2021, she was awarded a Distinguished Service Award by the federal ADA and Honorary Life membership by the ADA SA Branch. 

Angela is also a Deputy Director of the Commonwealth Professional Services Review and has served on panels investigating appropriate use of Medicare services for over a decade.

In 2022, Angela relocated to Sydney and currently divides her time between general dental practice and law.

Angela is a self-confessed nerd. She enjoys playing with new technology and spending time with her 2 sons.

Postponement of call for applications for Council Education and Research Grants in September

As you will be aware, in March and September of each year the Council calls for applications for education and research grants.

The Council is currently reviewing its guidelines for applicants and therefore a call for end of year funding grants will not be made in September 2024.

It is anticipated that the revised guidelines will be finalised by the end of the year and a call for applications will be made in the first quarter of 2025.

Health and Wellbeing Support Service for Dental Practitioners

As we all know, maintaining our own health and wellbeing is of utmost importance.  We also appreciate that individual personal and/or professional circumstances may result in us requiring extra support at certain times in our lives.

This may include when a complaint has been made about you.  We acknowledge that this can be a very stressful time, regardless of whether you feel you have done anything wrong. 

The Dental Board of Australia has funded a nationwide health and wellbeing support service for dental practitioners.

Dental Practitioner Support is the first national 24/7 telephone and online service for all dental practitioners. The service also offers support to dental students, educators, employers, Australian Dental Council exam candidates and concerned family members.

An experienced team of counsellors will provide confidential and immediate support, advice and referral on a wide range of health and wellbeing related issues. The service runs independently of the Board.  Anyone calling the service does not have to give their name.

Access Dental Practitioner Support:

• 1800 377 700
• dpsupport.org.au

If you are experiencing difficulties, the Council strongly recommends you access this free and anonymous service.