The University of Sydney School of Dentistry, Westmead, NSW, Australia.
The University of Otago Faculty of Dentistry, Dunedin, New Zealand.
JDR Clin Trans Res. 2022 Jan;7(1):29-40. doi: 10.1177/2380084420975700. Epub 2020 Dec 7.
Dentistry is predominantly provided in a commercial context in Australia. Despite this, little is known about how dentists navigate potential tensions that may arise between commercial and professional obligations in private dental practice. This analysis uses a qualitative approach to explore dentists' perceptions and attitudes toward the commercialized nature of private dental practice and how these affect their professional role in providing care.
Participants were recruited by advertising on social media, as well as through a professional association and a corporate dental group's graduate training program. Data were collected from participants through interviews and written reflections. The data were subjected to thematic analysis to reveal deeper meanings and linkages between different emergent themes.
Twenty dentists who worked in private practice environments were recruited to take part. The analysis revealed the following themes within the data: dentistry devalued, commercial influences on professional behavior, the effect of advertising and competition on dentistry, ethical selling, and the impacts of commercialism on consumers of dentistry.
Consumers of dentistry may only be superficially empowered by the commercialized context of private dental practice. Empowerment to decide which services to access and from whom does not address the inherent disparities that exist within the dentist-patient clinical relationship. Advertising and the active "selling" of oral health services are all designed to create dental consumers, not to empower them. While advertising might assist patients to understand available treatments, the primary objective of marketing is not health education. Increasing competition and consumer choice within dentistry may help to empower consumers of dental services but only if the dentist-patient relationship remains founded in altruistic intent, with the doctrine of "caveat emptor" (buyer beware) having no place within dentistry.
This research provides novel insights into how dentists experience the commercial context of private dental practice and how this is perceived to be both beneficial and detrimental to the consumers of dental services. This work will help to guide policy development to address the commercial determinants of oral health generated by the nature of commercialized dental practice environments.
在澳大利亚，牙科主要是在商业环境中提供的。尽管如此，人们对私人牙科实践中商业和专业义务之间可能出现的潜在紧张关系，以及牙医如何应对这些紧张关系知之甚少。本分析采用定性方法探讨了牙医对私人牙科实践商业化性质的看法和态度，以及这些看法和态度如何影响他们在提供护理方面的专业角色。
通过在社交媒体上做广告，以及通过专业协会和一家企业牙科集团的研究生培训计划，招募参与者。通过访谈和书面反思从参与者那里收集数据。对数据进行主题分析，以揭示不同主题之间更深层次的意义和联系。
共招募了 20 名在私人执业环境中工作的牙医参加。分析揭示了数据中的以下主题：牙科贬值、商业对专业行为的影响、广告和竞争对牙科的影响、道德销售以及商业化对牙科消费者的影响。
牙科消费者可能只是在私人牙科实践的商业化背景下表面上被赋予权力。决定接受哪些服务和从谁那里接受服务的权力，并不能解决牙医-患者临床关系中存在的固有差距。广告和口腔健康服务的积极“销售”旨在创造牙科消费者，而不是赋予他们权力。虽然广告可以帮助患者了解可用的治疗方法，但营销的主要目的不是健康教育。在牙科领域增加竞争和消费者选择可能有助于赋予牙科服务消费者权力，但前提是牙医-患者关系仍然建立在利他主义的基础上，“买者当心”（caveat emptor）的原则在牙科中没有立足之地。
本研究提供了关于牙医如何体验私人牙科实践的商业环境的新见解，以及这种体验如何被认为对牙科服务消费者既有益又有弊。这项工作将有助于指导政策制定，以解决商业化牙科实践环境所产生的口腔健康的商业决定因素。
