I often have discussions in life about doers, overthinkers and those who fall in the sweet spot of Goldilocks' porridge in the middle. Recently I was involved in a fairly lively and enlightening discussion about leaders, mainly pertaining to the evolution of football club captains, but it got me thinking about the leaders of today.
Once upon a time football club leaders were, more often than not, those who 'set the tone', were loud, screaming types. Their leadership style was more about being the leader and you follow me - leading by example, eliciting connotations with leading tribes and teams into battle.
These days leaders are thinkers, those with the eye to spot potential and bringing it out in others. They aren't the 'old school' dressing down yelling types - on an increasing basis they're quiet, reserved characters whose words and thoughts illuminate the way you want to take, empowering you, the individual, to make the right decisions, all while this is the exact path the leader wanted you to take, needed you to take.
Sustainability is one of these topics that will require leadership in some form. Will screaming from the rooftops about the climate emergency bring results? Will protestors disrupting sporting events have the desired effect? Or, will the best leaders lead you there without you even knowing?
Take the recent British Society of Paediatric Dentistry Conference I attended, for example. Sustainability in dentistry was a prominent topic with some engaging presentations from colleagues across the healthcare sector outside of dentistry revealing problems they've identified, solutions they've put in place and key performance indicators of how they will measure the success of their projects. One presenter finished by suggesting we be advocates for sustainability, which is highly commendable, but it led me to ask myself a question: how sustainable is sustainability?
I asked a number of attendees throughout the day whether they thought sustainability in dentistry was both possible and practical, whether net zero by 2030 (TBC, given recent political announcements) was feasible in dentistry and finally whether the commendable aim for many NHS trusts to only use net zero suppliers was feasible. Some were unequivocal - no, not at all, and others were sceptical - it could only happen in addition to policy decisions on a national level - not without.
How far can dentistry safely and practically go in its quest to be sustainable? The BSPD's meat-free menu for the Friday was a great idea, but was it offset by the travel carbon footprint of those in attendance? Paper cups for tea and coffee - yes, plastic cups for water? No. Train travel from London yes, car journeys from Scotland - no.
We're all asked as individuals at home and collectively as part of the organisations we work for and represent to 'do our bit'. I recycle at home and use the appropriate bins when I'm in the office and I choose reusable ahead of single use where available. I'm sure many of you reading also do. These are basics, the belief that a million people doing one thing is just as effective as one person doing a million things. Do you encourage patients to find public transport to your practice? Are their bibs reusable? Are their cups reusable? Of course they aren't, because they cannot be. There is a glass ceiling. Well all know the pandemic sent sustainability back to something approaching square one. It would be naïve to think otherwise. Now we're out of that, we are back to face-to-face and in person meetings, back to commuting, back to higher patient levels.
Without the right kind of leadership, sustainability in dentistry will never be able to smash through that glass ceiling. The discussions will not be sustainable - there will come a point where ideas creep close to patient safety warning signs, and that is not palatable, no matter how much we care about the environment.
Take the collection across the BDJ portfolio on sustainable dentistry, for example, with the Eco Focus issue in 2022 lead by the excellent Brett Duane still as valuable a resource as ever. In his editorial he said that while there is a lot the dental team can do to reduce the environmental impact of the dentistry we perform, he added that what we really need is wider system change and a 'pivotal shift in how we deliver sustainable health care'.1
Who do we look to for that change? Where is the leadership going to come from? Will it have to be a case of leading a horse to water and making it drink, or will smart leaders make us walk that path voluntarily anyway? More to the point, can dentistry really be sustainable and make the difference we all talk about? ◆
Duane B. Sustainability in dentistry gathers momentum. Br Dent J 2022; 233: 241.
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Westgarth, D. The sustainability of sustainability. BDJ In Pract 36, 4 (2023). https://doi.org/10.1038/s41404-023-2156-x