Angle Orthod. 2022 Jul 1;92(4):446-462. doi: 10.2319/070421-533.1.
To evaluate orthodontists' perceived impacts on their practices as a result of general practitioners (GPs) and direct-to-consumer (DTC) orthodontic care providers and the adaptational changes implemented in the past 10 years.
An electronic survey was administered to 270 orthodontists in Canada and the United States to determine demographic background, perception of perceived impact, and specific changes implemented to improve practice competitiveness.
More experienced orthodontists (P = .0001) and males (P = .027) were more likely to indicate a perceived impact from GP orthodontics. American orthodontists were significantly more likely than Canadian orthodontists to perceive an impact from DTC providers (P = .017). There was a positive association with orthodontists' years of experience and having implemented adaptational changes to their practice for a period greater than 10 years across multiple categories. Female orthodontists were more likely to have implemented adaptational changes for a period of less than 10 years across multiple categories.
The perceived impact of GPs providing orthodontic care was greater than that of DTC providers. American orthodontists were significantly more likely to perceive an impact from DTC providers. Orthodontists have experienced a reduction in referrals from GPs and an increase in referred case difficulty. Less experienced and female orthodontists have made the most adaptive changes to their practices in the past 10 years.
评估全科医生和直接面向消费者的正畸治疗提供者对正畸医生实践的影响，以及过去 10 年来实施的适应性变化。
对加拿大和美国的 270 名正畸医生进行了电子调查，以确定人口统计学背景、感知影响的感知以及为提高实践竞争力而实施的具体变化。
经验更丰富的正畸医生（P =.0001）和男性（P =.027）更有可能表示受到全科牙医正畸的影响。与加拿大正畸医生相比，美国正畸医生更有可能认为直接面向消费者的供应商有影响（P =.017）。正畸医生的从业年限与他们在多个类别中实施超过 10 年的实践适应性变化之间存在正相关关系。在多个类别中，女性正畸医生更有可能在不到 10 年的时间内实施适应性变化。
全科医生提供正畸治疗的影响大于直接面向消费者的供应商。美国正畸医生更有可能受到直接面向消费者的供应商的影响。正畸医生的转诊量从全科医生那里减少，而转诊病例的难度增加。在过去 10 年中，经验较少和女性正畸医生对他们的实践进行了最多的适应性改变。
