Raise a glass to the President
Working alongside pioneering surgeons and dedicated nurses has shaped Roz McMullan’s approach to her life’s work
[ Writer: Will Peakin]
A bottle of Bushmills 12-Year-Old Single Malt Distillery Reserve sits on a shelf in Roz McMullan’s flat in London; a reminder of the moment when she found out that she had been made President of the British Dental Association (BDA).
After a 40-year career, Roz had been reconciled to retirement; enjoying her family and tending her garden, though still dedicating some time to the Probing Stress in Dentistry project she had championed as chair of the NI Council of the BDA.
“The branch had put my name forward; I thought that was a great honour, but aside from filling out the form I had not thought much about it,” Roz recalled. On the day the BDA’s Principal Executive Committee met to ratify the nominations for future honours and awards, she happened to be hosting some visitors from Australia. It was raining, and where better to take guests on a wet day than the Old Bushmills Distillery.
“Because of the ‘angels’ share’ and the risk from a spark, mobile phones have to be turned off – so I had been uncontactable,” said Roz. “At the end of the tour, traditionally you have a wee nip. It was then I noticed that I had a missed a call, so I said to my guests: ‘Enjoy your nip, I’ll go outside and see who’s looking for me.’ Well, on hearing the news I turned a whiter shade of pale. I went back, but my hands were shaking, and I couldn’t even raise the glass to my lips.”
Roz told her guests and went outside again to call her brother and tell him
the news. Looking on, the distillery staff had thought something was wrong – but the guests let them know, and a second nip was placed on the bar. When Roz returned after a short while, she was also greeted by members of staff with the bottle of 12-year-old bearing a label customised to celebrate her appointment.
“It was a whirlwind moment,” she said, adding with a laugh, “one day I’ll crack it open!”
Roz McMullan owes an early childhood habit of sucking her fingers for her distinguished career in dentistry; a deep commitment to the profession which continues formally into 2020 with the year-long BDA Presidency. At the age of five, she had been enrolled in one of two UK growth studies in Belfast (the other was in London). Each year, for the next decade, the craniofacial development of hundreds of children was tracked with radiographs, impressions, and photographs.
“Today’s ethics committees would not allow yearly radiographs to be taken, let alone in a child from five to 15 years,” commented Roz. “These growth studies are invaluable and will never be repeated.”
Professor C Philip Adams was leading the Belfast study and, realising that Roz’s mother was anxious about her daughter’s increasingly prominent front teeth, assured her that when the time was right clinically, he would oversee their straightening.
“We should measure success not by activity, but by outcomes; by what we achieve”Roz McMullan
As a teenager, maths was Roz’s favourite subject, but the culture of the time meant that women were not considered for a career in financial services. “I remember telling my orthodontist how terrible this was. He was a lovely man and he listened patiently. Then he said: ‘Why don’t you become a dentist?’ And he walked me round the dental school, and it just such a transformative moment. It was the interaction with the patient, the multidisciplinary nature of the job, the sense of being able to make a difference in people’s lives.”
Roz went on to graduate from Queen’s University Belfast and spent a year in general practice in Edinburgh, at two practices – in Stockbridge and West Calder – which illustrated the stark contrast in fortunes that can exist between communities in close proximity.
“I learned a lot about real life and the importance of caring for individual patients,” she said.
Back at dental school in Belfast, Roz trained as an orthodontist and was planning to become a senior registrar. At the time, a pivotal and revered figure in orthodontics in Northern Ireland was a Scot, Professor Andrew Richardson, who one day called Roz into his office and offered her the opportunity to work with the pioneer of corrective cleft palate surgery, Professor Olav Bergland, in Oslo.
“When I returned to Northern Ireland, I said: ‘We really need to develop alveolar bone grafting here’. Colleagues, including Professor Gunvor Semb and another Scot, Professor Bill Shaw, were incredibly supportive; we were only the second unit in the UK, after Great Ormond Street, to routinely offer the procedure.”
Roz completed her senior registrar training and in 1991 was appointed consultant orthodontist in the Western Health and Services Board (later the Western Trust) where she stayed until her retirement in 2016. “I was enthused by this wonderful training – and then, suddenly, you are out their ‘on your own’,” said Roz of her first months in the role.
“But the Trust was tremendously supportive of innovation. I wanted to de-medicalise the care that we gave to some of our babies, and so we developed the cleft liaison nurse role. I’m a clinician; I make diagnostic decisions. Working with nurses and midwives exposed me to a completely new skillset; developing care pathways and working with people in an empathetic way.”
Throughout her career, Roz has been involved in supporting dentists and dental teams in difficulty. In 2016, she worked with NIMDTA, the Northern Ireland Medical and Dental Training Agency, and Northern Ireland’s Public Health Agency to establish ‘Probing Stress in Dentistry’, which works to raise the awareness of mental wellbeing in the dental workforce, and to establish a network of mental health first-aiders to support and signpost dentists, dental students, and dental teams who are experiencing difficulty.
It’s clearly sensitive work and, in itself, counselling people who are feeling overwhelmed can in turn create mental pressures on the counsellors themselves, hence the creation of a ‘buddy’ system to maintain a mutual awareness of their own wellbeing. As I interviewed Roz, she presaged her comments with a question to me about whether I had direct experience of the issue. It was a telling insight into how discussion of suicide is best approached, whatever the context. In her presidential address, Roz said this: “These are certainly difficult times in the profession with a massive reduction in practice income and increase in expenses that most small businesses would struggle to cope with. Associate contracts have come under similar pressures over the last 10 years. Young dentists are coming out of university with large debts. Our community, hospital and academic colleagues are also affected by funding pressures, trying to maintain high standards of care, teaching and research, with reducing budgets alongside demanding performance targets and often concerned they are not valued by the organisation they work for.
“This, in addition to the burden of regulation and fear of complaints, has produced a profession that is anxious and constantly looking over its shoulder. For some, the stress can be overwhelming.”
During her presidency, Roz is determined to take the lessons from the Probing Stress in Dentistry project, and others such as Stress in the Dental Workplace Working Group in Scotland, and make them UK-wide. Public Health England has expressed a strong interest. Roz’s goal is to bring the experience and expertise of people in all nations and regions together, to create a template that can be easily adapted depending on geography and profession.
“We should measure success not by activity, but by outcomes; by what we achieve,” she said.
Confidence is a key issue
“The General Dental Council must regain trust by championing the profession of dentistry and acting wisely and proportionately when dealing with complaints. They must demonstrate to the profession that they accumulate and use our money frugally.
“All those who commission and regulate dentistry must not ignore the systemic failures, rather than taking the easy route of focusing blame on the individual practitioner.
“We must be confident that our government understands and values dentistry and recognises that prevention of dental disease is key, ensuring oral health remains integral to the population’s overall wellbeing.
“We must be able to trust the dental leaders in all four nations to deliver a system of NHS dental care that is respected, valued, properly funded, and supports dentists, no matter in what area they work, to aim for good dental health from cradle to grave.
“We can be confident that the BDA will put dentists at the heart of everything we do, no matter what stage they are in their career or where they work. The BDA is run by dentists for dentists and has the expertise to deliver practical and timely support and effectively represent you in all your diversity.
“Above all, we must have confidence in ourselves, celebrate our successes and learn from our mistakes.”
An extract from Roz McMullan’s Presidential Address.