Perceived professional roles and implications for clinical decision‐making

Abstract

Objectives This study aims to (a) investigate the relationship between dentists' perceived professional role (PPR), defined as the belief that they are health care professionals versus business people, and treatment intensity, determined by the aggressiveness of clinical approaches, such as in number or scope, and (b) identify the demographic and practice characteristics that have a relationship to PPR. Methods A 46‐item survey with questions on dentists' demographic and professional characteristics was mailed to a random sample of 3,201 general dentists in Ontario, Canada. PPR was measured by visual analog scale and by Likert‐type scale questions, which have been validated in the literature in terms of their ability to measure PPR. Treatment intensity was measured by a set of case scenarios. Univariate, bivariate, and multivariable analyses were performed. Results One‐thousand and seventy‐five dentists returned usable surveys (33.6% response rate). When using the two methods to measure PPR, visual analog scale and Likert‐type scale questions, dentists who identified as business people tended to have a higher treatment intensity compared to those who identified as health care professionals (p < 0.1 and p < 0.05, respectively). In multivariable logistic regression, years of practice, number of technologies used in a practice, and perceiving other dentists as competitors rather than colleagues were significant predictors of identifying as a business person. Conclusions Dentists' PPRs had a significant relationship to the aggressiveness of treatment decisions. Demographic and practice characteristics also had significant relationships to PPR. These findings may have implications for public trust and dentistry's status as a health care profession.

General Dentists’ Perceptions About Their Relationship With Specialists

“…Due to the absence of studies that assessed the general dentist–specialist relationship directly, factors shown in the literature to play a role in influencing referrals and clinical decisions were included. 9 , 10 , 11 , 16 , 17 The survey also queried demographic information, the dental practitioner's professional and clinical characteristics, as well as perceptions of competition and confidence in specialists. The survey was pilot-tested amongst a group of 12 general dentists and specialists across Canada for face validity and ease of completion.…”

What non-clinical factors influence the general dentist–specialist relationship in Canada?

“…1 ) that, through a literature review, identified different factors (environmental, patient-, dentist-, and practice-related) that may affect, or are hypothesized to affect, the general dentist–specialist relationship [ 21 ]. In the absence of studies that explored this interprofessional relationship directly, we included factors shown in the literature to influence dentists’ referrals and clinical decisions [ 14 , 15 , 17 – 19 ]. The survey collected dentists’ socio-demographic information, professional characteristics, and their perceptions of confidence in, and competition with, specialists.…”

“…The survey asked the question, “ Do you perceive specialists as colleagues or competitors? ” [ 14 , 15 ]. A visual analogue scale (VAS) was used, where general dentists indicated their perceived relationship by marking an ‘X’ on a line ranging from 0 (completely collegial) to 100 (completely competitive) [ 14 , 21 ].…”

“…” [ 14 , 15 ]. A visual analogue scale (VAS) was used, where general dentists indicated their perceived relationship by marking an ‘X’ on a line ranging from 0 (completely collegial) to 100 (completely competitive) [ 14 , 21 ]. During coding and analysis, the scale was converted into five categories: ‘completely collegial,’ ‘somewhat collegial,’ ‘neutral,’ ‘somewhat competitive,’ and ‘completely competitive’ [ 21 ].…”

“…While previous studies [ 14 , 15 , 17 – 19 ] have explored various clinical and non-clinical factors that influence referrals and other clinical decisions, the dynamics of what influences the general dentist–specialist relationship remains unexplored. The aim of this study is thus to explore practitioner- and practice-related factors that may be associated with general dentists’ perceptions of their relationship with dental specialists in Canada.…”