It's not 2020!

07 January 2021

Thank God it isn’t 2020! That was, I am sure, the feeling of most of us as January began. Last year saw us battle with a global pandemic, restrictions on basic freedoms, a looming economic depression and the end to the Brexit transition period.

Thank God it isn’t 2020! That was, I am sure, the feeling of most of us as January began. Last year saw us battle with a global pandemic, restrictions on basic freedoms, a looming economic depression and the end to the Brexit transition period.

But as we enter 2021 it seems that there are, possibly, some reasons to be positive. A covid vaccination programme is being rolled out which should enable a return to normality both socially and economically, and with the negotiations over Brexit finalised it means that there is some certainty politically. (Or at least that is the expectation at the time of writing; given so many previous deadlines have been ignored there is no guarantee!)

Looking more globally, many people are pointing to the inauguration of a new president in the US as a turn around in the world’s fortunes, following the chaos of Trump’s time in office. (Again, this is only an expectation at the time of writing, the legal challenges continue!)

The fact that Trump and his supporters have questioned the legitimacy of the election has been heavily criticised in the media – however, given many of these same reporters and journalists were themselves questioning the validity of Trump’s victory in 2016 (#NotMyPresident) one has to wonder if they genuinely believe the democratic process is immune to corruption and should not be criticised, or if this is simply an argument which happens to currently be expedient. Only the journalists themselves can know – and it is possible that many of them are not consciously aware of the answer. After all, it is far easier to be more accepting of information and arguments that fit in with the way we already view the world, and to be more sceptical or dismissive about that with which we disagree. This is because we interpret information through a particular lens of understanding and, potentially, bias.

This was brought to mind recently following reaction to an Op-Ed piece in the Wall Street Journal regarding Jill Biden’s use of the title ‘Dr’. Mrs Biden has a doctorate in education. The author of the article, Joseph Epstein, makes a case against her use of the title raising arguments which are both common and age old. The debate over titles is one dental professionals know well, as it is one they themselves have fought, albeit from a slightly different angle. Where one stands on this issue will largely depend on the interpretation of the word and its usage. Is a doctor someone with a medical degree or anyone with a ‘doctorate’? And what about honorary ones? The issue is a complex one, and the author’s position rests upon the idea that something can be both literally true, and at the same time misleading. Perception and reality are not always perfectly aligned.

Many of those reacting to the piece did not engage with the arguments put forward though, instead they just discounted the views as sexist, claiming that such a case would not be made against a man. It is hard to tell if this criticism is simply an easy way to shut down opposition by tarring them as bigoted or whether people genuinely feel the piece is singling out Mrs Biden because she is a woman. Only they can know. The arguments made by Epstein certainly apply regardless of sex, but of course even if the reasoning used is not bigoted in itself, that does not mean that those criticising it don’t believe that it is.

The distinction between perception and reality is an interesting one – particularly when it comes to issues such as bigotry. The British Dental Association, along with the Faculty of General Dental Practice UK and College of General Dentistry, recently launched a survey on discrimination. It asks respondents to detail experiences they have had being “treated unfairly” within dentistry.

The survey results will be used to, “take forward evidence-based actions to address the underlying issues, and to promote greater understanding in the profession of the experiences and concerns of their fellow dentists”. For more information on the news story turn to page 6. The aim of the initiative is, of course, laudable; where discrimination exists it should be stamped out immediately. However, it should be remembered that the survey will not itself show discrimination or unfairness, only respondents’ feelings that something was discriminatory or unfair. Those two things are different and to not recognise the distinction could do considerable damage. Due process and the presumption of innocence are fundamental to justice.

As many dentists will be aware from experience with unhappy patients, just because someone feels hard done by, it doesn’t mean they have been. Practitioners often go above and beyond what might be considered reasonable with a disgruntled patient only to find them still unhappy. Unfortunately, if a patient enters a practice with little trust either in the clinician as an individual or dentistry as a whole, then they are likely to view everything that happens through that lens and bias, this could then lead them to misinterpret things and potentially even issue a complaint.

This is why the old adage that you should ‘never treat a stranger’ is as important today as it ever has been. Building a positive relationship with a patient will help ensure that your care is felt to be as good as it actually is. Without a good rapport and a sense of trust you are relying solely on a patient’s perception, and this, unfortunately, may not be 20/20!