EDITORIAL

At sixes and sevens

Bill Evans

Managing editor, E-mail:bill.evans@wits.ac.za

Let's take a cue from the Communique released by our Association CEO and published in the May issue of the JOURNAL :

•National Health Insurance planning staggers along, with recent decisions appearing to reverse previous policy, vide the revised role envisaged of the Medical Aid Schemes, now being wooed to work with the State in operating the NHI and in covering conditions originally reserved for NHI only

•Dental Assistants obliged to register and the Professional Board for Dental Therapy and Oral Hygiene extends the deadlines

•The Dental Technology Professions Bill introduces denturists, restricts the rights of dentists to choose their technician, limits the options of dental traders to trade feely and…

•Extends the right of technicians to claim directly from Medical Aid Schemes.. even when the dentist is not satisfied with the prosthesis.

The phrase "At sixes and sevens" may well encompass these developments. It may be defined as "a state of confusion and disorder or of disagreement between parties" (Phrase Thesaurus). It probably derived from a complicated game of dice which was called "Hazard" in which the riskiest numbers to shoot for were five and six… in French cinque et sice.. easily misinterpreted into English as "'six and seven". Wikipaedia lists many examples of the application of the phrase, right from the mid 1380's, viz Chaucer, Shakespeare, Gilbert and Sullivan amongst others. Topically it may be interesting to note that Harold Macmillan referred to "Six and Seven" when United Kingdom membership of the European Economic Community was first muted in the 1960's, and how applicable is it right now that the UK is facing Brexit!

The profession may well be entangled in a state of confusion and disorder exemplified by the developments listed by our CEO, a state of Sixes and Sevens, but not yet in chaos! At least not in the usual sense of the word which implies somewhat more than the six and seven dilemma. Nevertheless a wider inspection may lead to a consideration of whether the Theory of Chaos may actually apply. This is an intriguing thought. The Theory is a branch of mathematics which is focused "on the behaviour of dynamical systems which are highly sensitive to initial conditions" (Wikipaedia). Chaos Theory is exemplified by the butterfly wing story…the paper presented by Edward Lorenz in 1972 entitled: "Predictability: Does the flap of a butterfly's wings in Brazil set off a tornado in Texas? Ridiculous of course… until serious consideration is given to the explanations. Essentially it proposes that a small change in the initial condition of the system causes a progressive chain of events which leads to large scale phenomena. The most intriguing aspect of the theory is that it recognizes that chaotic systems are predictable in the short term but then seem to become random. In principle the behaviour of a deterministic system can be predicted… but in a chaos sequence, predictions can hold true for a limited period only. In the prediction of weather, as a convenient example, we may be reasonably accurate in our predictions over a few days forward.. but thereafter there is increasing uncertainty. The systems may be deterministic, in other words, future behaviour is determined by the initial conditions But that does not make them fully predictable.

Lorenz summarised the theory in 1963:

Chaos: When the present determines the future but the approximate present does not approximately determine the future.

Sufficiently confusing? But the ideas are clear a small change now can result in a considerable (if not huge) change later…. and now lets revert to the scenarios mentioned by our CEO and repeated above. The changes envisaged are already radical.. even at this initial stage. If there are any Chaos influences which may affect the outcome, the Association and the Profession will be facing increasingly complex situations. What precisely can we forecast as the long term effect of the professional not being able to determine which technician shall handle his or her cases? How will collusion between Medical Aid Societies and NHI impact on private dental practice? Will the new registered members of the Oral Health Care team come to enjoy greatly extended clinical options? In fact, are we contemplating a situation befuddled and all at SIXES and SEVENS?

The Association will depend upon the full participation of members in dealing with these issues.

Is it not serendipitous that in July we can bring the sixes and the sevens together in a manner which will redound to the enhanced reputation of our Association?.... Mandela Day on 18th July offers the chance for us to celebrate the 67 magical number.. he devoted 67 years of his life to the community. Can we offer our 67 minutes, can we contribute to the initiative of the Association? Positive action to minimize Chaos!