This raised many alarm bells within the profession and Peter Ward, chief executive of the British Dental Association, responded by criticising the comments in a comment piece of the BDJ. Peter wrote: “Dentists don’t sell things or even services, they sell a part of themselves – they sell
their capability, their consistency, their compassion. Seeking to oversimplify this by comparing patient care to the price of baked beans and sun-dried tomatoes completely misses the point.”
Playing Devil’s Advocate for a second, surely whether it is a dental practice, garage, coffee shop, restaurant, or even just a convenience store - the owner of any small business will be putting a part of themselves into it, won’t they? Placing their reputation on the line, investing their time and money and caring about their customers, so in that sense is dentistry unique? Maybe the dental profession and patients would answer that question differently.
If you take your car to a garage, which one do you choose? The closest mechanic, the cheapest, the one with the best reputation, or the one you have been to before, trust, and have a personal relationship with? If you want to take the family out for a meal do you go to the local eatery, the cheapest place, one with a reputation, or one where the waiters are people you know and have a relationship with? There will probably be a number of factors which affect your decision – it won’t simply be a question of price. The same too applies with shopping for beans – to reduce the metaphor to a price comparison is to misrepresent (or dare I say it - over simplify and miss) the point, the whole shopping experience needs to be taken into consideration. People do not just necessarily go for the cheapest product, if they did then the more expensive stores would have no customers – everyone would be at Lidl. The fact that so many people do shop at Waitrose means perhaps we should give more credit to the maturity of customers’ decision making, and perhaps we shouldn’t be so afraid of patients’ ability to make choices regarding their dental treatment. Budget and premium (affordable and expensive) dental practices could both exist in the market - so those that desire the ongoing relationship and reassurance can choose the practice that best suits them, and those for whom money is a key factor will also have an option for treatment.
The immediate concern of consumerism and market forces in dentistry is, quite rightly, patient safety. But is it right to suggest patient safety is put at risk with this suggested market model? Motor mechanics, restaurants, airlines… they all have budget and premium sectors and yet can insist on minimum safety requirements (ones that if not adhered to could have a serious, even fatal, impact on customers). So does the criticism of Moyes’
position come from a lack of faith in the GDC’s ability to be able to regulate quality and protect patient safety or from a protectionist fear of change in the dental market? Maybe the profession and patients would answer that question differently too.
What do you think? Can dentistry be compared to other markets? If patient safety is ensured are there other concerns? Email your views to emackenzie@georgewarman.co.uk