Milestone reflections

Recently, I have been down a rabbit hole reading about the theory and strongly-held belief in some quarters that time is a social construct and has no meaning whatsoever. The theory goes that we collectively create the meaning of time - it has no predetermined meaning until we give it meaning. To say that something, like time, is a social construction is not to say that it doesn't exist or it is merely an illusion, but instead that humans have created systems of meaning that creates the concept of time.

I have to say, it's half fascinating, half bonkers and half sensible. It also has plenty of useful applications. ‘Excuse me, Mr Westgarth. Why are you three hours late for a meeting?' ‘Time is a social construct I do not believe in therefore there is no such thing as late'. See? Perfect. Just don't quote me on it.

For all of that bluster, I often find it's useful, cathartic and interesting to look back and see where things were/I was at certain points in life. What was I doing ten years ago, five years ago. This begs the question, what was BDJ In Practice doing five years ago?

Firstly, it took me time to find out, for January 2019's edition was one of the final ones on the old ‘digital zmag' platform. Wild times indeed. We led with a letter from MDDUS responding to a previous article that the author described as a ‘historic indemnity crisis in Australia' while drawing comparisons with what was happening in the UK at the time. How the indemnity landscape has changed.

Features included assessments of the Advancing Dental Care (ADC) project, clawback in Wales, regulation (or self-regulation) in the world of aesthetics, the orthodontic tendering process and how one practitioner made UDAs work for his practice.

Why does this matter, I hear you ask? Well, isn't it important to know where you've come from to see where you're going? How is the ADC project helping the workforce five years on? How is the issue of clawback being resolved? How are UDAs working for practitioners? How is the orthodontic tendering process? Have any of these tangibly improved? Have they got worse? Has anything been done about them at all? I shall leave you to decide on those answers.

Five years on from that issue, what does January 2024's iteration have in store? We look at the practice sales market, loneliness in the profession, withdrawing from a patient's treatment, and BDA analysis of the workforce, to name but a few. I have picked these out as they're all linked - tenuously or otherwise - to the threads of content from five years ago and show just how the profession has changed - or otherwise. How did the ADC project help to improve the workforce we see today, and what effect does that have on whether they remain an NHS practice, a mixed one or fully private? How do these things impact on whether principal dentists and practice owners sell up, especially if there are orthodontic courses of treatment involved? Does one person's view on how the UDAs worked for their practice impact on the mental health of practitioners who cannot or have not been able/willing to make it work and find themselves in a lonely and isolated place?

Perhaps the concept of time does not apply to this profession; maybe the articles and blogs I read were by practitioners who stare into the abyss and embrace the void. Meryl Streep's character in The Devil Wears Prada, Miranda Priestly, said to her assistant: ‘By all means move at a glacial pace. You know how that thrills me'. Again, I will leave you to decide whether change in this profession is moving at a glacial pace or not, but you do have to wonder what the year will have in store. Will we see a greater migration from NHS to private? How will artificial intelligence in dentistry look in 12 months' time? How will education and the assimilation of CPD look - webinars, for example, were a large construct of the pandemic. Will they flourish? What will leadership in dentistry look like? Will we see a different kind of leader emerging, will our current leaders deliver, who will our current leaders be?

Perhaps in five years' time, we'll have the answers. Perhaps we won't. Perhaps time will have fully been debunked as a social construct and there will be total anarchy. There is one final question, pertinent to all areas of our profession: can we really afford to wait much longer to find out? ◆