Many of you will, I imagine, be familiar with Moore's Law: the concept that computer processing power doubles roughly every two years. In 1971, about 2,000 transistor components could be fitted on a printed circuit board; by 2008 that number had increased to over 2bn.
This provides a sobering reminder about how our use of IT has intensified (and makes you wonder how the Lunar Lander ever functioned with less memory than the average pocket calculator). It's also an excellent demonstration of an 'exponential curve'.
I got to wondering whether there was an inverse curve of the same shape associated with methods of dentists' remuneration. The first 'fee per item' model lasted 42 years. The second model, registration with some continuing care and capitation, lasted about 16. The third, UDAs and local commissioning, will have managed only eight years by the time of its likely demise.
This leads me to suppose that by about 2020, there will be a new contract roughly every other week, which is why we will need the advanced computing power available to us by then to deal with it.
This assumes, of course, there is any time left to actually get paid for doing what dentists have been traditionally trained to do. The British Dental Association's Business trends survey, published in January, showed that while only 20 per cent of UK dentists had increased their patient-facing time in the past year, 60 per cent had reported an increase in time spent on administration. That was before the introduction of new regulation in the shape of the Care Quality Commission and its local variants.
The need to complete seemingly endless paperwork has been well advertised recently in the professional press, and if dentists are not to become full-time administrators, the conclusion must be they will employ more such personnel to do it on their behalf, further raising the cost of care delivery. Can this be sustainable in a time when budgets, national and personal, are shrinking?
Applications for the latest (and, if Moore's inverse law holds true, potentially shortest –lived) National Health Service contract pilots have nevertheless poured in, with at least 10 applicants for every pilot place available.
It's to be hoped the computing power available to the business services authority is significant, if these pioneering practices are not to be overwhelmed by duplicate paperwork during the trials. For, no doubt, UDAs will still need to be recorded as a baseline check, while dummy registration statistics and capitation calculations are made alongside them.
Things will be even more complex in the second and third strands of the pilots, where patient deprivation scores and details of more advanced treatment provided will need to be kept, but in all strands presumably, oral health assessments will additionally need to be recorded, updated and reviewed.
Duplication will also be the name of the game when the new NHS national commissioning board takes over the existing contract structure in 2013 following the abolition of PCTs and SHAs, only to have to immediately start work on whatever new contract arrangements are to be brought in for 2014. I do not envy them that task.
We're used to dentistry being the 'forgotten component' in the major NHS re-organisation that is about to begin, with scarcely a mention in the July 2010 white paper. But remember that in 2006, it was only the dental contract that changed: this time we're about to be plunged into a 'change within change' scenario and the scope for confusion seems even greater.
A further aspect of Moore's predicted increase in computing power seems to be, sadly, that computer crashes, bugs and glitches also proliferate, so here's hoping that we can harness the benefits without also reaping the problems.
Gloomy predictions of this nature are, of course, more likely to be found within the rather longer tradition of Old Moore, whose Almanack is 315 years old and going strong. Breakthroughs in the treatment of diabetes and autism are forecast for 2011, but nothing of dental note, I'm afraid. Now where's my crystal ball?