A way out for the GDC

The first thing one needs to say is that there are glaring factual inaccuracies in the Standards Committee's report. It is stated that when dentists were first registered as a separate profession they wanted to be recognised alongside surgeons rather than general practitioners and so did not use the title 'Dr'. The truth is that, at that time, dentists were considered little more than licensed tooth-wrights and not worthy of the title.
Secondly the report states quite erroneously that until 1999 the Council took action against dentists using the title 'Dr'. This was never the case. In fact in November 1995 the Council had to admit that, due to the fact that so many dentists were using the title in defiance of its guidance, it had little choice but to remove the prohibition.

The Standards Committee relied heavily on opinion polls when producing its recommendations. We all know it is possible to conduct an opinion poll to produce the result desired:

The Committee used an opinion poll  which seems to me to be a perfect example of where a predetermined result has been decided and a poll to produce that result conducted.

An example of a question posed:


"The use of the title doctor is in fact a courtesy title and they are not necessarily qualified medical doctors. Do you think it is OK for them (dentists) to use the title doctor?"

- now if that isn't a leading question I don't know what is. There is a clear implication in the question that dentists using the title 'Dr' are somehow implying they are medically qualified. In fact later on the report states "....only 17% of people understood what a courtesy title meant." - and of course it appears it was never pointed out that medical practitioners use the title as a 'courtesy' as well.

The Focus groups who conducted the poll  stated that  ".....it is important to note that dentists' use of the term 'doctor' was not a 'top of the mind' issue amongst respondents " - and a shift from indifference to objection apparently occurred only after detailed, facilitated discussion. In other words if the respondents were initially indifferent on the issue, it seems they were in essence provoked to give the response required.

I think it is clearly the case that the data used in the report is so flawed as to make that whole section invalid and the GDC should have no hesitation in rejecting the Standards Committee's recommendations on use of the title 'doctor'.

Monday morning is homeopathic dentistry.........

Click on image to enlarge

The other cartoons including this one can be found by following this link

The GDC's dilemma

As a result of one complaint to the Advertising Standards Authority that a dentist was using the title 'Dr' in a way that was misleading, the GDC asked its Standards Committee to consider the use of the title 'doctor' by dentists as part of its investigation into the Principles of Ethical Advertising. In doing so the GDC appears to have unwittingly put itself in a dilemma that it has hitherto be unable to resolve, in that included in its recommendations on ethical advertising, the Standards Committee concluded that dentists in the UK should no longer be permitted to use the title 'Dr'.

The GDC needs to issue guidance on ethical advertising but realises that it is in danger of inflicting immense damage on itself, over an issue which is entirely of its own making, if it votes to implement a ban it will be unable to enforce. Consequently it needs to find a way of accepting the recommendations of the Standards Committee on advertising, whilst rejecting its recommendations on use of the title 'Dr'.

In the next posting I will outline serious flaws in the data the Committee relied on in reaching its conclusions such as to make that part of its recommendations invalid.

An open letter to the GDC

Evlynne Gilvary
Chief Executive and Registrar
General Dental Council
37 Wimpole Street,
London, W1M 8DQ.


06/09/2011

Dear Ms. Gilvarry,

Use of courtesy Title "Doctor"

I am writing to let you know that I have been using the courtesy title 'Dr.' for almost 20 years and intend to continue to do so. I have been contacted by a large number of predominantly younger dentists who have been using the title since qualifying and the general consensus of opinion is that they have no intention of ceasing to use the title, whatever the Council might decide. I believe the overwhelming majority of practitioners feel the same on this issue and are similarly resolved.

I am aware that the Council is awaiting an impact analysis of the proposals in the ethical advertising paper before considering the matter on 22nd. September.

I believe there are two important issues for the Council to consider when deciding on how to vote on this matter. One being the impact a decision to implement a ban would have on the status of the profession, as dentists try to explain to their patients why they should no longer be called 'Doctor'; the second, the impact on the credibility of the Council if they implement a ban which they may find themselves unable to enforce

Yours sincerely,

Dr. Michael Wilson.

Making ourselves heard

It needs to be borne in mind that the GDC can only carry out its role as governing body of the profession with the assent and co-operation of the profession in general - the vast majority of whom are GDPs.

Many practitioners have contacted me to say they are very concerned about the impact a decision to implement a ban would have on the status of the profession, as they try to explain to their patients why they should no longer be called Doctor. The other important point that has been raised repeatedly is the cost to the profession should they feel the need to change practice stationery, signage, web-sites etc. - at a time when they are having to cope with the additional financial burden of CQC registration and implementation of HTM01-05.

The overwhelming response I have received is that dentists have no intention of ceasing to use the title 'Dr.' Consequently the GDC is in danger of inflicting immense damage on itself, over an issue which is entirely of its own making, if it votes to implement a ban it will be unable to enforce.

I would suggest we write or e-mail the GDC so they are made aware of the strength of feeling in the profession on this issue and so they are in no doubt as to the potential consequences to the credibility of the Council, should they put themselves in a position so out of step with the profession at large.

The way forward

We can learn a lesson from history here. The situation in 1995 was that a large number of dentists were openly using the title 'Dr.' in defiance of the GDC's guidelines and indeed many had written to the GDC stating that they were using the title 'Doctor' in their practices. The Council realised that if they did not vote to remove the prohibition, it would have to take legal action against the dentists who were in breach of its guidelines, which would be both impractical and financially prohibitive.

The situation now is somewhat different in that a very large proportion of dentists are now legally using the title. I have spoken with a large number of younger dentists who have been using the title since qualifying and the general consensus of opinion seems to be that they have no intention of ceasing to use the title, whatever the Council might decide.

We need to make it abundantly clear to the GDC that if they do vote to implement a ban, dentists will ignore it and continue in their use of the title 'Doctor'. The Council would then find themselves in the embarassing position of being practically and financially unable to act against those dentists openly flouting it's guidelines.

Oh No! I've just remembered........

Click on image to enlarge

All the other cartoons including this one can be found by following this link

Where we are now

In order to allow sufficient time for the full impact analysis of the proposals to be undertaken, The GDC has decided that the issue will now be considered by the Council at its meeting on 22nd. September.

Consequently we still have time to express our feelings on this matter to the Council and if we are complacent and do nothing we may wake up on 23rd. September to find we have lost our right to use of the title 'Doctor'.

There are two important issues for the Council to consider when deciding on how to vote on this matter. One being the impact a decision to implement a ban would have on the status of the profession, as dentists try to explain to their patients why they should no longer be called 'Doctor'. The second, the impact on the credibility of the Council if they implement a ban which they may find themselves unable to enforce.

The genie is out of the bottle

It is amazing that, after all these years, the GDC is still smarting from being persuaded to amend their guidance to allow dentists to use the courtesy title 'Doctor' back in 1995.

The Council's position then was that use of the title 'Doctor' would confuse patients and it appears to be unchanged. Rather than confuse patients, I would maintain that use of the title 'Dr.' helps patients understand the dentist's role as leader of a team of Dental Care Professionals. With around 50% of dentists graduating being women, their use of the title 'Dr.' helps patients distinguish them from the hygienists, therapists and dental nurses who are also involved in their dental care. It also helps patients understand the depth of knowledge and understanding that a dentist has acquired during their years of training.

A whole generation of dentists will have been using the title 'Dr.' since they qualified and will be somewhat bemused by the fact that the GDC is still of the view that they should revert to being 'Miss', 'Ms', or 'Mr' so as not to confuse their patients!

I think it highly unlikely that dentists using the title 'Dr.' will cease to do so no matter what the GDC might decide at the completion of its consultation. Once the genie is out of the bottle it is difficult to persuade it to return!

History of the issue

The decision by the GDC in November 1995 to allow dentists to use the courtesy title 'Doctor' was the culmination of a well organised campaign run by Dr. Douglas Pike, himself a member of the GDC at the time. Dentists who wished to do so were encouraged to use the title 'Dr.' in relation to their practices and increasing numbers were doing so - even though at that time the GDC regarded the use of the courtesy title 'Doctor' by dentists a matter of serious professional misconduct.

When the issue was debated by the GDC in May 1995 it was defeated by the narrowest of margings. The GDC was fully aware of the rising open useage of the title 'Doctor' within the profession and had to either remove the prohibition or act against those dentists flouting its guidelines.

The matter was once again debated by the GDC in November 1995, by which time a large number - I believe it was in the region of 3000 dentists had written to the GDC stating that they were using the title 'Doctor' in their practices. Indeed this was pointed out by the then President of the Council Margaret Seward before the vote, when she said that if the Council did not vote to remove the prohibition it would be placed in the embarassing position of being out of step with a groundswell of opinion within the profession and that it would be practically and financially impossible to act against dentists openly using the title.

The notification sent to all dentists by the then Registrar of the GDC following the vote removing the ban on use of the title 'Doctor'

The purpose of this blog is to raise awareness amongst dentists in the UK that they are currently under threat of losing their right to use of the title 'Doctor'.

I am not really sure why this has re-emerged at this time - but it appears that, in considering revised guidelines on ethical advertising, the General Dental Council (GDC) were aware of two complaints that use of the courtesy title 'Doctor' was somehow confusing to patients in the UK. As a result the GDC gave its Standards Committee the task of investigating this, which resulted in a recommendation that the Council vote to implement a ban on dentists using the title.

The GDC debated the use of the courtesy title 'Doctor' by dentists at its meeting on 24th. February 2011 in the context of revised guidelines on ethical advertising. The GDC decided at that time not to vote on the issue but to ask for an impact assessment to take place and be presented to a future meeting. Originally it was thought that it would be considered and voted on during the meeting on 20th. May - but it appears that, in order to allow sufficient time for the impact analysis to be undertaken and presented, this has been postponed until the meeting on 22nd. September when the Council will once again consider the matter.
Consequently there is still time to influence the Council's decision and I would urge colleagues who wish to retain their right to legally continue using the title 'Doctor' to write or e-mail the GDC to show the strength of feeling amongst the profession.

Over the next months I will be adding to and expanding this blog so please feel free to post any comments.