Doing business in the NHS: exploring dentists’ decisions to practise in the public and private sectors

Abstract

Through discussion of the findings of a national study of general dental practitioners this paper explores the beliefs, values and practices of dentists, the factors that influence their decisions to practise in the public and/or private sectors, and their experiences of making the transition towards increased private practice. In examining particularly their ideological beliefs, attitudes to business and entrepreneurial behaviour, it considers the appropriateness in sociological thinking of the division between perspectives which have perceived professional behaviour as primarily motivated by economic self-interest and occupational control, and those which have considered professional behaviour to be characterised by altruistic values and a public-spirited concern for patient welfare.

The facilitating factors and barriers influencing change in dental practice in a sample of English general dental practitioners

“…The influence of economic factors on health professionals' willingness to adopt new practices has been identified in previous research with both doctors and dentists. 15,16 A remuneration system which limits the perceived financial risks of adopting new practices is more likely to encourage the dental profession to make desired changes.…”

A qualitative investigation of the views of primary care dentists on participating in prospective studies in the North-West of England

“…35 Although clinical trials have been undertaken in primary care dentistry there has been no evaluation of recruitment strategies of dentists 7 or participants. This study shows that as in other areas of clinical practice, 36,37 dentists' ethos and that of the practice influences their involvement in research. Involvement has been associated with increased respect from patients, 38 but there is a need for appropriate recognition by the research team.…”

Evidence summary: what do dentists mean by 'prevention' when applied to what they do in their practices?

“…Studies with a main focus on other issues, such as dentists'/practices' attributes affecting patient well-being 9 or reasons for changing public/private mix of work 10 reveal other concepts relating to prevention, rather than prevention itself. Most of these studies' fi ndings are constrained by the predominantly closed, quantitative methods of data collection used.…”

“…The literature found [9][10][11][12][13][14][15][16][17] indicates a number of dimensions along which dentists' perceptions of prevention can be located (Fig. 1).…”

“…Most dentists regarded aspects of prevention to be part of their professional work, 9,12 a source of job satisfaction 13 and of value to the practice, its image 13 and a marker of quality of care. 10 However, the quantity and proportion of working time spent undertaking preventive activity varied widely, 12 and activity data sources may be unreliable. 16,17 Historically, it appears that preventive activity was mainly related to clinical use of preventive products, for example fl uoride, 13,15 although visual aids for dental health education, including posters and pamphlets, were reportedly used almost 35 years ago.…”