“Surely it is obvious we are doing the job. But what job?”

In the Editorial in the previous issue I speculated on how much more straightforward the world might be if politicians were honest about their intentions when it comes to government spending on oral health care; although the principle might also be just as well applied to other fields in medical and health funding. They are never easy decisions since they involve people's quality of life and indeed at times their lives themselves.

Last time, we pondered on the matter as the gloaming logs gently settled in the fire basket and today, the next dawn in the holiday season, we have relit the kindling and are ready to contemplate the follow-on subject. Wouldn't it be an even better Boxing Day treat if... we were honest with ourselves?

It seems to me that part of the problem is that as a profession we probably are not quite sure where we are, where we are going or indeed where we want to be. Without being clear about these aspects of our lives there is little hope that we are going to find satisfaction. Spending our waking, working hours being resentful about poor NHS contracts and fees is not a very positive way to conduct our chosen career path. At a recent forum of the great and the good in dentistry a statistic from one speaker sparkled out at me with an almost thrilling clarity. It seems that the average difference between the net income achieved by a dental practitioner in wholly NHS practice and in whole time private practice is, how much do you think? One hundred thousand pounds? Fifty thousand? Twenty? No, it is, on average a mere £5,000.

It almost begs the questions, what are we fighting for, what are we arguing about and what are waiting for? What it does not do is to paint a picture of 'greedy' dentists sloping off from the NHS for rich pickings in the private sector. Instead, the back-up details point the way to the honesty that I refer to above. The private practitioners see fewer patients, have greater decision making power and increased freedom over the type of work they do and treatment they provide. Plus, most importantly, they express far greater satisfaction at work. How often have we heard colleagues say that they have 'started enjoying dentistry again'?

So, if we are honest what do we want from dentistry? A good standard of living? A secure profession? An ability to use our skills to the advantage of others? What were the thoughts and principles that guided us when we applied for dental school, can we remember?

People well versed in motivation will always ask what one's objectives are. To those of us who just get on and do things, which as dentists is something for which we are famously renowned since it is in our nature, it is often an irritating question. Surely it is obvious we are doing the job. But what job? In a similar vein, business coaches and marketing experts ask of us what business we think we are in. Immensely frustrating for us to have to answer for surely it is obvious isn't it? Well, is it? What business are we in? What business are you in? Please answer honestly.

Infuriating as these requests are, being able to answer them does enable us to make decisions on almost all other matters so much more easily. Having specified and shared objectives in the context of the practice also ensures that the rest of the team can focus on what they do and what they don't do. Being clear is a help to everyone. Staff are clear as to what the practice can and can't, or at least has chosen not to, offer. Patients are clear about whether they wish to attend and the treatment to which they wish to consent. More is resolved, less is left uncertain.

If we can answer these questions then we may be able to find our way to being honest with ourselves as to what we want to gain from dentistry. The cosy Christmas carol tells us that Good King Wenceslas looked out on the feast of Stephen, being St. Stephen and St. Stephen's Day, or Boxing Day as we now know it. Whether the snow this year will be 'deep and crisp and even' I can only guess ahead of the occasion but whatever the weather if we can decide to answer ourselves honestly in the coming year then it will not only be a treat on Boxing Day but a fresh start for a steadily improving 2008.

Best wishes for a very Merry Christmas and a Happy, Healthy and Prosperously Honest New Year.

Stephen Hancocks OBE Editor-in-Chief