A University of Melbourne academic has called for an end to turf wars and internal conflicts within the dentistry professions.
Dr Melanie Hayes, Lecturer in Dental Hygiene at the Melbourne Dental School and President of the Dental Hygienists Association of Australia Ltd, says dental professions must learn to work constructively together, for the sake of health reform.
Her call is timely given the many questions and uncertainties surrounding the future of dental health reform (as covered at Croakey recently).
Melanie Hayes writes:
Within health disciplines, different professional craft groups all too often suffer from poor inter-craft relationships. Consistent with this, within dentistry, there has been a searing undercurrent of hostility between the different professional sub-groups – dentists, hygienists, therapists, prosthetists, and specialists – much of it based on historical events.
The current standoff baseline position is for presidents of representative professional associations to take a tough stance on issues that arise, and to utilise their relative power to try to achieve their specific goals.
As is occurring in much of the health sector, it seems though that it is time for a conversation to be had about shared interests, so that our professions can move forward together to ensure the public’s oral health needs are met, as well as improving professional reputations.
It is time for our leaders to take an ethical approach to leadership in the dental sector.
This may be difficult on several fronts; firstly, the leaders of all associations may not necessarily share this view; and secondly, the members of each association might perceive such an approach as ‘weak’ or ‘soft’.
Change can often be interpreted negatively, particularly when perceived to be scary, challenging, or difficult. However, change can be innovative and positive and exciting too, but all too often circumstances surrounding change lead to a loss of competency or control, which is why we feel negative.
Leading for change
To help others feel more positive about change, it would be wise for ethical leaders to ensure that members of their associations and the public are well-informed and involved in open discussions about impending change, so that they feel prepared and in control.
Ethical leaders need the ability to adapt to change. Often outside factors will drive change within an organization – for example, legislative or regulatory amendments.
While no organisation is immune to change, the way change is handled can be done ethically, by ensuring that there is core consistency within the association.
A crisis of morale and feeling of discontent with changes might be avoided if ethical leaders use clear communication strategies to ensure that members are well informed of the direction of the association during times of change.
Ethical leaders need to ensure their communication encompasses values such as empathy and patience, suggests a review of literature in the field of ethical leadership.
Good communication is more than simply relaying a message clearly; interpersonal skills such as body language, active listening, asking engaging questions, being socially aware and accountable are all valuable for ethical leaders.
Ethical leaders invest time in building a team and establishing broad based support. Active listening is important, particularly in more informal settings; it not only helps build rapport with the team, but serves to increase trust, according to a recent article in the journal, Management Dynamics. It may even highlight issues that might not otherwise come to attention. These strategies will also promote loyalty, which is integral during times of change.
It is time for such a ‘team’ to exist beyond the boundaries of different qualifications or professional associations. What the dental industry needs is strong intersectoral collaboration.
Some of the biggest issues affecting the dental sector involve ‘outsiders’ such as the health insurance providers and State and Federal Governments; if the dental industry was represented by an intersectoral collaboration representing all practitioners, with a unified message, this would certainly make it ‘easier’ for the insurance providers or government to listen to their proposals and implement recommendations.
For this to be achieved, preconceptions of other dental professions or their respective associations must be suspended. Open communication is critical; without listening or speaking up, we cannot begin to understand the issues from other organisations.
Through developing understanding, we may be able to clarify confusions and even build on shared philosophies. Demonstration of such ethical leadership would earn respect within the sector, and more importantly, in the wider community.
When there are conflicting views, a balance or compromise often needs to be struck on the spectrum.
Consider the push for Universal Dental Care, and the improbabilities of this being fulfilled. If they could find the funding, who will this negatively affect? The taxpayer? Other healthcare services? Transport or education? How will they address the workforce distribution to ensure publicly funded dental was accessible to all? This reflects on the difficulty in the ability for associations in leading change, particularly when the ethics of a number of individuals and organisations require consideration.
How can we expect the Government to listen to the dental industry on this issue when each association has different position statements or proposed strategies?
Unfortunately, leaders from all sectors often become ‘seduced’ by bureaucracy, and prevented from thinking and acting for themselves. Moral obligations should transcend bureaucratic laws; if we are to set a commendable example, we should not be afraid of seeking high ideals. Bureaucracy presents a challenge to dental associations, as it cultivates acquiescence, dependence and excuses.
Empowering and enabling people to act deliberately and decisively, and exert power over themselves rather than others will help to foster responsibility and moral example, according to an exploration of the impact of ethical leadership behavior on employee outcomes.
It is time to move beyond the turf wars and tough stands, and work together for what really matters – accessible and affordable dental care for all Australians.
Ethical leadership skills can be learned, and are often influenced by the environment we are in. Leaders within the dental professions need to consider their vices and virtues, as well as personality traits and find a balance.
Polarising behaviour is unlikely to help one lead effectively and ultimately it prevents a leader from being able to achieve their goals. Ethically, balance may not always be possible, however integration of ethical values can be explored by finding common ground.
The National Oral Health Alliance has demonstrated how this can be achieved in a broader context, among select dental and general health associations.
Urging intersectoral collaboration
Imagine what the dental industry could achieve if we changed the status quo, and embraced ethical leadership and intersectoral collaboration.
We could reflect the collegial relationships between dentists, hygienists, therapists, prosthetists and specialists that are established in dental teams and dental schools around the country.
We could dispel our reputation for ‘in-fighting’ and earn the respect of wider stakeholders, including the Government, through unified position statements and recommendations.
We could achieve positive change, change that would benefit all dental professionals and the wider community.
This appeal is not directed at a single organisation. Rather, in light of recent events and the future of dental reform, it urges the leaders of all dental professional associations to purse ethical leadership, before individual egos and agendas become immovable obstacles.
• Dr Melanie Hayes is Lecturer in Dental Hygiene at the Melbourne Dental School and President of the Dental Hygienists Association of Australia Ltd.