Hi! Today we are going to try to find a solution to the ultimate career question for every dentist in UK -- should you work as an NHS or Private dentist?
There are currently hundreds of UK dentist job opportunities. With such saturated market, it can be difficult to decide which way to take your dental career -- NHS or Private? You will inevitably have to choose one or the other at some point in your life, depending on your long-term goals. Unsurprisingly, dentists can change their job frequently, especially when hunting for a better career opportunity with more attractive contractual conditions. We are going to look at the pros and cons of being an NHS and Private dentist so you can select the most appropriate one for yourself.
The NHS of the United Kingdom was born in 1948 as a "hugely ambitious plan to bring good healthcare to all" (1). Since then, however, the NHS contract for dentists has changed numerous times.
Currently, the majority of NHS primary care dental practices still operate under the so-called UDA system where patient charges are graduated in categories called "bands of treatment" -- Band 1, Band 2 and Band 3 (2). It means that, if clinically necessary and appropriate, a patient can receive as many filling as needed and pay a single flat fee for this (e.g. Band 2 fee). If a patient, for example, needs to be seen 3 times for 5 fillings, the dentist must allocate enough time in their books to carry out all treatment. As you can imagine, this can reflect on the treatment length:pay ratio of self-employed associate dentists.
Clinical need for treatment can be seen as the cornerstone of NHS dentistry. It defines the service in a way that allows dentists to maintain the health of their patients' mouth, gums and teeth without being overly concerned about cosmetic treatment. Every NHS dentist must exercise their clinical judgement prior to presenting the options of treatment and delivering treatment itself. For example, if a patient has poor oral hygiene and demands white fillings on all teeth with cavities, you may have to consider the success of such treatment under the conditions of poor oral hygiene and/or diet. You may have to warn the patient that cosmetic white fillings on back teeth may be a private option. You can direct the patient to simpler options to stabilise their teeth, oral hygiene and diet prior to prescribing complex treatment.
Working under an NHS dental contract can be daunting for some people. There is great demand and pressure in the service which will reflect on your treatment time. The same is valid for working with NHS dental laboratories and increased turnaround. Working hours of NHS practices are usually 9 am to 5 pm, however this has been changing recently in favour of longer working hours (such as 8 am to 7 pm) to improve "patient access".
Undoubtedly, being as NHS dentist requires good time management skills and clinical efficiency to make sure every minute counts. You can read more about optimising your NHS workflow to maximise your potential.
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With private dentistry in UK you will be responsible for the delivery of cosmetic treatment and full mouth reconstructions, if this is your interest. You can also undertake cosmetic periodontal treatment, orthodontic treatment, private endodontic treatment and more.
You don't have to be on the specialist register to practice private dentistry in UK. However, private dental practices usually hire associates who have one or two special interests under their belt and are confident in delivering such care.
Why private dentistry? Well, most private dentists allow for the use of expensive materials and dental laboratories to deliver custom tailored cosmetic and restorative reconstruction. Treatment targets are more loosely defined in favour of extended dental appointments. More time is allocated per patient with more time to deliver the full stages of the treatment. Private practices work with expensive dental laboratories for a highly personalised result. Understandably, patients can have high expectations for what they are paying and can be more demanding towards the quality of care provided by the specialist.
In conclusion, NHS provides a broad spectrum of dental procedures under certain regulations and complexity. Conversely, private dentistry is more focused on delivering cosmetic treatment and extended treatment appointments to achieve this. In reality, NHS treatment predominates in mixed practices where private care may also be available. Understanding both aspects may improve your career plans depending on your long-term goals.