Question 1

Who benefits most from skill mix- practice owner, the wider dental team or the patient?

Accepted Answer

Ultimately I am going to say the patient, because they will benefit from seeing clinicians who have expertise in their particular fields of practice. However, all parties are likely to benefit in some way. Practice owners will be available for complex treatments instead of treating thing that can be referred to an appropriate clinician and the wider team will benefit by receiving a good workflow and being busy doing what they love.

Question 2

Why have some practices not seen the benefit in adopting this approach?

Accepted Answer

Unfortunately I think that this could be down to an ‘old school’ way of thinking. I think the modern day dentist can see the benefit of skill mix within a team as it is starts to be a more accepted way to run a dental practice. But practices that have run a particular way may struggle to implement the changes they’d have to incur, such as reducing surgery time to make way for other clinicians or expand their practice to allow for more clinicians that way.

Question 3

Some critics have suggested it is about money. Is it?

Accepted Answer

I won’t deny it possibly is, but in the cases where a practice is small and that to implement a change such as this may require practice changes at a high cost to the owner, for example if the practice requires building changes or surgery space. However, not deploying skill mix may be seen as inefficient as utilising this concept may free up the time of principle dentists to do the more technical high value treatments.

Question 4

How readily do you think the profession embraces change?

Accepted Answer

I think in previous years change may not have been embraced as readily as it seems to be now, or rather, needs to be now. In this technological age it is crucial dental practices keep up with the pace of change as we see it happening in available technology, equipment and even marketing strategies. We have seen practices go digital, albeit reluctantly in some cases and advances in technology with things like artificial intelligence within the dental industry has seen practices become hi tech places. It’s not so much keeping up with the jones’ as it is embrace the change or fall behind business wise.

Question 5

How does skill mix work for you?

Accepted Answer

There is a great relationship between all clinicians here and there is a mutual respect for all roles within the practice. With it being a fully private practice I suppose it is easier to implement skill mix here. The owners and associate dentists all perform high quality cosmetic dentistry and have an appreciation for what the hygienists offer their patients and treatments, both before and after it is completed. There is an understanding between all dentists that their high end work is best maintained with the help of the hygienist team that support them and all patients must see a hygienist as part of their treatment plan so as to maintain the work they have done, or stabalise issues before any work is started. With dentists offering their own expertise in different areas of dentistry, there is an element of ensuring the patients are seen by the most appropriate clinician for their needs at all points in their treatment plan.

Question 6

What is the alternative for providing frontline preventative treatment to patients?

Accepted Answer

Utilising hygienists and therapists to their full potential and scope of practice means that patients can receive front line care more readily and from a preventative point of view, more frequent access to their services means that screening for oral cancer, periodontal disease and caries risk are carried out more frequently and addressed and treated easily. Direct access allows patients to see hygienists and therapists without seeing the dentist first and working within our scope of practice we can carry out clinical examinations, periodontal examinations, prescribe radiographs as well as take, process and interpret films, plan the delivery of care for patients giving appropriate advice, diagnose and treatment plan, recognise abnormalities and refer patients to other healthcare providers as needed. The rest of our scope of practice means we can effectively treat periodontal issues with or without LA, antimicrobial therapy as needed, give smoking cessation advice, provide whitening treatments and cosmetic dental hygiene, while therapists can also carry out restorations on primary and secondary dentition, extract and carry out pulpotomies on primary teeth. This means we can provide great frontline care to patients.

Question 7

What flexibility does it offer practice and patients?

Accepted Answer

It allows the principle and associate dentists to be free for more technical treatments within their skill set and not be doing treatments that can be carried out by a colleague with the appropriate scope of practice. In an NHS setting it means that the dentist is free for high value treatments and in a private setting, well I guess it’s the same. It allows highly skilled practitioners to do what they are good at, allowing the patients to have treatments with clinicians who are experts in their field. It can only be a good thing for patients and it seems more efficient for the practice to run this way.

Question 8

Is it a workable model?

Accepted Answer

What is difficult is an NHS setting whereby a hygienist doesn’t have a performer number. However, therapists have and if implemented correctly it is certainly a workable model. As far as it goes here as the Yorkshire Dental Suite (YDS), it works very well. Our patients receive the best care from the relevant clinician who is highly skilled in their field of practice and all clinicians spend their clinical time doing what they are best at. The practice runs like clock work this way.

I love working closely with all dentists here at YDS and I love the strong relationship we have in our workplace, the mission statement we all work by, the YDS ‘fam’ we all feel part of and the mutual respect we all have for each other- from dental nurse to dentist and all those in between. To demonstrate how well it can work, there may actually be some future projects lined up with one of the cosmetic dentists here at YDS and myself that showcase the ability of a cosmetic dentist to work in partnership with a hygienist for best practice. Watch this space!

Question 9

What would you say to skill mix sceptics?

Accepted Answer

It makes no sense to us that you wouldn’t want your patients to see the clinician best suited for their needs. Why wouldn’t you want a hygienist or therapist who has trained for years at University to be highly skilled in their job role to benefit the practice. Working alongside each other is a move in the right direction for the profession. We are seeing it being implemented to great effect in other healthcare sectors and it’s time to embrace it within dentistry.

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Questions and answers

Skill mix