In December the GDC once again ducked the issue by failing to vote on whether dentists should continue to use the title 'Dr', whilst ratifying its guidance on ethical advertising. The GDC is aware that, in asking its Standards Committee to consider the use of the title 'doctor' by dentists as part of its investigation into the Principles of Ethical Advertising, it has unwittingly put itself in a dilemma that it has hitherto be unable to resolve, in that included in its recommendations, the Standards Committee concluded that dentists in the UK should no longer be permitted to use the title 'Dr'.
The GDC is now intending to consider the matter when it meets in March. It 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 a previous posting I outlined reasons why the GDC should have no difficulty in so doing.
The Council now has a new Chair in the person of Kevin O'Brien. He points out that the role of the GDC is not to represent registrants but to "take considered decisions on matters which may affect the standards of care patients receive". Let us hope he encourages the Council to realise that, in taking those decisions, it cannot act as some medieval Star Chamber and not consider 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 'Dr'.
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'.
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.
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
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.
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.
