The Demolition of the Principles of Good Clinical Practice

I was fortunate enough to have studied at Leeds University Dental Institute. For me, the most important lessons were in the ethics and principles of clinical practice. These foundations exist to protect the public and ensure that they can trust us to provide any necessary care.

So what in particular did I learn and what would have prevented me from being allowed to qualify and have a licence to practice?

I had to study physiology, anatomy and pathology in great detail and be continually tested on these subjects before moving on to practical surgical and technical skills. One of the key considerations I had to have in mind when making the transition from theory and applying this to practice was to understand that not all specifically diagnosed cases are the same and that the health status of a patient is never fixed. It can be ever-changing and dynamic, so a clinician needs to be reactive to this.

We were also taught about perspective when assessing a patient. I was once pulled up by the Professor in Radiology for dwelling too long on one particular area of a radiograph in my determination to reach a diagnosis. The valuable lesson was that by doing this, I risked finding artefacts and missing the bigger picture. When it comes to safety, airline pilots, sea vessel captains and motorists should know the perils of focusing too much in one area, especially in an emergency. For Covid the bigger picture includes the latest data that shows  99.9987% of the under 20s and 97.1% of the elderly survive Covid.

Examination questions were very often designed to see how well we could accommodate these variables in order to tailor-make individual treatment plans. The complete antithesis of providing safe, effective healthcare would have been to rush in and provide a blanket ‘one-size-fits-all’ treatment plan for every patient.

Not understanding and applying these principles would likely prevent you from qualifying as a dentist or a doctor. 

Apart from individualising treatment and monitoring for beneficial and adverse effects, further prescribing principles focused on the following: patient safety, identifying the most vulnerable, informed consent and prescribing within the limitations of your knowledge, skill and experience.

So, in the context of Covid, how well – how correctly and ethically – have we applied these basic principles in tackling the disease?