Best Practice? A Qualitative Comparative Analysis of Corporate and Dentist-owned Dental Practices in New Zealand

Abstract

Dental care for adults in New Zealand is part of the private healthcare system. Consequently, there is a reduced role of government regulation and responsibility for how dental practices are owned and managed. Public dentistry is unattainable for most New Zealand adults and they pay out-of-pocket fees decided by the dentist and influenced by the practice owner. If the owner is profit driven, the fees could leave dentistry out of reach for adults. If not managed with patient centred values, quality of care can be compromised and the working environment could become stressful. There is a lack of research into private dental practices and management of them; and with the emergence of corporate owned dental practices in New Zealand, dentists should be aware of how the business structures they work under affect them and their patients.

Ownership models of private dental practices in New Zealand have been defined and compared to dental practice ownership and provision of services in the UK, USA, Canada and Australia, and to private practice ownership in optometry and public hospitals in New Zealand. The aim was to explore a range of dentists’ perceptions of working and providing services under the current models of private dental practice ownership in New Zealand to determine the strengths and weaknesses of these models from a the dentists point of view. Qualitative methods were used to collect the dentists’ perspectives. Seven dentists from corporate practices and seven dentists from dentist owned practices participated in face-to-face semi-structured interviews. All 14 dentists had been working for five years or more and had current practicing registrations. Questions were asked about the structure of the practice, advantages and disadvantages, incentives, values, ethics and relationships with colleagues. A thematic analysis of interviews was aided by qualitative data analysis software. The results showed that different ownership structures affected service provision. The dentists’ perspectives illustrated the benefits and disadvantages between corporate ownership and dentist owned practices, and provide insight into services offered to the public. The results are not generalizable to all dental practices, but indicate corporate practices have a clear market in New Zealand although some dentists are sceptical due to their perception of the ethics around providing profit for shareholders.