Dental Tribune United Kingdom Edition

(dinosaur fossils) that they produced. They later discov- ered that the peasants dug up the bones and then smashed them into many pieces, great- ly reducing their scientific value, to maximise their payment.” There are also examples to be found in the business world. In a paper published for Harvard Law school enti- tled Executive Compensation at Fannie Mae: A Case Study of Perverse Incentives, Non- performance Pay, and Camou- flage, (Bebchuk et al 2005) the authors highlighted a number of serious flaws with the pay arrangements and practices of the company. In particu- lar they discussed the per- verse incentives built within the company, the soft land- ing for failure and the issues with pay decoupled from per- formance. Whilst this was not an in depth psychological study, it does make me won- der that if the CEOs of Fan- nie Mae can overestimate its earnings by almost $9b, how realistic is it to expect peo- ple to make the right choic- es whilst working within a system with inbuilt perverse incentives? So, why do many feel that NHS dentistry is failing? Well of course, it depends on a number of factors and if you listen to the media’s quar- terly dentist bashing articles the main reason the NHS is in such a mess is probably down to greedy dentists. But in reality we all come across scores of dentists trying to do the best that they can for their patients whilst trying to stay on top of the ever bur- dening regulations imposed upon us. This leads to the question of causation. In 2009 the Con- servative party then in oppo- sition released ‘transforming NHS dentistry’ in which they summarised that the 2006 contract was “disastrous” and that “perverse incentives now force dentists to skip essen- tial preventative care to meet short term targets for cura- tive treatments”. Whilst little headway has been on their plans to “immediately intro- duce strong new incentives for preventative work”, the pilots for a new NHS contract are now truly underway. However given that the Conservative party now in coalition government has acknowledged an actively failing system, should there ever be a legal challenge from a patient which pertains to quality of care found with- in nGDS, would courts rule negligence on the part of the dentist who is providing the front line service or the cen- tral government that has set the workings of the system? I think we all know the answer. The output driven per- verse incentives found within nGDS clearly affect some in our profession more than oth- ers. Those providing front- line services seek to win or lose the most and whilst this affects everyone, in my opin- ion younger associate dentists entering our profession are in the most vulnerable category. Ever increasingly young associates are being asked to meet arbitrarily derived tar- gets, working within a system with little room for clinical flexibility. So whilst they may satisfy the business element of providing en masse dentistry, is this really in the best inter- est of patients, dentists and our profession? In my next article I will be focusing on the unfair bur- den that is being placed on younger associate dentists and whether or not the stand- ards they are being held to are realistic and fair. DT page 9DTß January 16-22, 201210 Comment United Kingdom Edition NSK United Kingdom Ltd www.nsk-uk.com Office 5 Gateway 1000 Arlington Business Park Whittle Way Stevenage Hertfordshire SG1 2FP Tel: 0800 6341909 +44 (0)1438 310670 Fax: 0800 6341910 +44 (0)1438 310671 NSK’s Endo-Mate TC2 cordless handpiece has a large LCD screen incorporated in the lightweight cordless handpiece, and a simple 5-key operation ensuring it is easy to use even during the most delicate endodontic procedures. NSK’s ENDO-MATE DT endodontic micromotor is specifically designed for use with Ni-Ti files from all major suppliers and this ultra-slim, lightweight endodontic micromotor delivers complete versatility with an advanced memory able to store up to 9 speed and torque settings. The Varios 970 Ultrasonic scaler from NSK provides a patient-friendly and efficient way to meet the challenges of endo by exchanging the tip and with a choice of over 70 alternative tips, there is always one to meet your needs. 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For more information call NSK on 0800 6341909 or visit www.nsk-uk.com As one of the world leaders in handpiece technology, NSK offer a range of endodontic handpieces, micromotors, ultrasonic scalers and apex locator. Featuring, precision control Endo-Mate TC2 Endo-Mate DT iPex Varios 970NLX Plus Varios 170 MultiPad NLX Plus MultiPad 標準 ( 印刷用 ) レーザーマーキング用 光グラデーション付 枠付 ( 印刷用 ) PANTONE 432C 1109R Varios 370 Varios 570 About the author Neel Kothari qualified as a den- tist from Bristol University Dental School in 2005, and currently works in Sawston, Cam- bridge as a princi- pal dentist at High Street Dental Prac- tice. He has completed a year-long postgraduate certificate in implantol- ogy and is currently undertaking the Diploma in Implantology at UCL’s Eastman Dental Institute.