A summary of: Apelian, N., Vergnes, J-N., Bedos, C. Is the dental profession ready for person-centred care? British Dental Journal. 2020. https://doi.org/10.1038/s41415-020-1650-3
Over the past decades, healthcare professions have been urged to move towards delivering person-centred care (PCC). Dentistry has seemingly not adopted this change and decision making is still heavily biomedically grounded. The aim of this research was to collect qualitative data to further recognise clinicians’ attitudes to PCC and the perceived challenges with it.
A sample group of 11 dentists with varying levels of experience in Quebec, Canada were presented with 2 role play scenarios during short interviews.
It was found that dentists didn’t have a clear idea of what PCC entailed, and were unwilling to share decision making with patients- especially when treatment was deemed to be more challenging. Further findings were broken down into 2 main sections:
Understanding Patients
- Dentists were not keen to understand patients’ viewpoints or how illness affects the patient holistically (with exceptions in the cases of litigation protection and when a patient’s views may prevent their planned treatment taking place.)
- Dentists felt unprepared to engage with patients, particularly when they expressed strong emotions or were in a position of conflict about treatment.
- Dentists assumed that getting to know patients better would result in longer appointments and therefore have a financial and organisational impact on their work.
Shared decision making
- Dentists were open to involving patients in their diagnosis and treatment plan as long as their beliefs didn’t oppose the clinician’s professional standards.
- Dentists were restricted in their ability to compromise with patients by social and legal constraints.
The study suggests that dentists may not be ready to adopt person-centred approaches, as they are more focused on the clinical, rather than the emotional, aspect of a consultation.
It is thought that these behaviours amongst dentists are attributed to the deep-rooted idea that dentistry is seen as an art form and compromising on treatment quality contradicts this.
Barriers to providing PCC arise if the profession is seen as business and dentists act as entrepreneurs, due to having inadequate time in appointments to explore patients’ thoughts and feelings.
Going forwards, dental professionals are called to identify patient cues, recognise their emotions and respond in an empathetic way. There is also a need to move away from the notion that professionals alone decide what is best for the patient. We should reflect on PCC to maintain integrity within the profession and keep up with an ever-evolving society.
Rashmini Arnold BDS2