Are You Safe Enough?

That might sound silly, but the only times I have asked that of someone was when I suspected domestic abuse of my patient.  The only times I was asked were during my pregnancies when the midwife had to ask: ‘are you safe at home?’  Safety isn’t restricted to domestic abuse, crossing the road or wearing safety specs in the surgery.  We shouldn’t have to wait to be asked at home, work or play; we should be thinking are we safe enough?

Now before you realise this is about health and safety and switch off, bear with me.  There’s a revolution coming and it’s not about PPE, dotting i’s and crossing t’s or about more paperwork.  It’s about health!  Your health, my health, the health of your team; putting the health back in health and safety – so to speak.

I’m going to rewind a bit, I went on a health and safety course for dentists last week.  Not the sexiest CPD topic I’ve chosen, but New Zealand just had a huge overhaul of their Health and Safety Act and as the basis of my H&S knowledge is based on the UK act, it seemed it was time to brush up.

I had braced myself for a very dry day but it was not at all what I had expected.  No check lists, no you must do this… but a very interesting look at why people do stupid things and get hurt, who’s getting hurt and why some behaviours are really difficult to change.

Before I get to the direct dental implications these things surprised me:

  • 45yrs is a tipping point (I’ll come back to why)
  • In NZ 89% of work accidents involve the over 45s
  • In NZ there are currently more over 45s in the workforce than below (not predicted to change till 2036!)
  • The average reading age of the workforce in new Zealand is 9yrs old

For those of you outside NZ, generally kiwis are underprepared for retirement, there haven’t been any systems for general pension schemes outside the state pension until recently.  Many people here work beyond ‘retirement’ age, I was on a course with a dentist in his 50th yr of practice!  That’s no goal of mine, more like nightmare!

So why 45? Well, turns out it’s a biological age for cognitive changes, that is to say we have more difficulty with newer things and we start relying on the hardwired behaviours that we spent the previous 45yrs learning.  In simple speak: we spend more time on autopilot, are less likely to accept new ways of doing things and if we do want to improve old habits it gets harder to do.  Bugger!

The 45yr thing struck home in a few ways: that’ll soon be me, implications for my team (who are older then 45) and bringing in new practices, that if I want to help dentists look after themselves and their team, the good habits need teaching well before 45.

But what about the health part?  Well this has to do with how we view and manage  health risk.  For those of you rusty of your health and safety, it’s all about identifying hazards, assessing risk and then either eliminating or minimising the risk.  Most health and safety focuses on event based risk (like needle stick injuries); the shift is coming as it starts to look more at time based risks such as noise, posture/positioning and stress.

What might that look like? Who knows? but it might be about identifying that the frequency and duration of exposure to the sound of a high speed or ultrasonic does correlate to hearing loss; that repeatedly holding the same physical postures day in day out will contribute to back, neck and shoulder problems; that chronic exposure to financial, time and emotional stressors will be detrimental to optimal mental function.  That these are significant health risks and whilst we can’t go and wrap ourselves in cotton wool, we do need to talk about the elephant in the room.

Lets educate young dentists on how to manage these risks and provide resources for both preventing and managing the consequences.  I know there’s enough non-dentistry in the undergraduate curriculum and at 18 who would really take on board long term issues when short term you just want to get to be a dentist.  But post grad, hopefully before your eyesight starts to go, the aches and pains start to creep in something can be done.  There’s a missed opportunity and we’re failing to look after our own.

You always hear how much it costs to train a dentist, well who ever ends up picking up the bill, the investment becomes very dear indeed if we burn out half way through our career. The knock on from that if we are still working will increase the risks to those we work with and the patients we work on.  The health costs to put us back together could also be significant.  So, lets look out for each other, look after ourselves, whilst more education in this area would be great- we all know how to look after ourselves better maybe we just need some motivation to do it!