
Neil Carmichael explores the diverse facets of private dentistry to challenge negative perceptions from the public and profession.
In the current climate, private dentistry is often portrayed as the villain, both for the public, and arguably within the profession. It is often given as part of the reason that access to NHS dental care is difficult to attain, due to dentists ‘going private’ and leaving the NHS. Policy makers and some politicians struggle to fully understand the dental sector and the part private dentistry plays in providing care to the public, augmenting the NHS.
At a recent summit of Association of Dental Groups (ADG) members the diverse nature of the private sector was described early in proceedings by the attendees. Private care can be an NHS add-on, or generalist, or specialist, cosmetic and even community dentistry.
Payment models
Fundamentally though, almost all dentists in practice in this country are independent contractors – in other words private. They then chose the payment mechanism by which they receive their dues. This is not an easy concept for government to understand as we do not fit with most of the rest of healthcare.
Private treatment can also be funded in many ways. Some patients will decide to pay themselves, but there are growing markets in alternate funding. This might include payment plans, insurance – either their own or through an employer – and finance options, offered by the practice or other external financiers.
For many years the NHS budget for dentistry has been less than half the amount spent on private dentistry playing an important adjunct role. If clarity is provided around options and costs, private dentistry gives patients the autonomy to make decisions about their treatment choices, some of which may not be available on the NHS.
There is little data to show how private income is split, although it now far exceeds the NHS budget for dentistry, the clarity of the income for the different areas of private dentistry is poorly defined. From the experience of the group, it was felt that much of the budget and thus the care given to patients, is focused on ‘general dentistry’.
More than just cosmetic dentistry
The media attention that only suggests private dentistry is only cosmetic dentistry is damaging. Coupled with this is the reporting that dentists move to private provision for the money. All the figures provided by the main accountancy groups in dentistry suggest otherwise. Dentists move for work/life balance, taking back control of their practising lives and the ability to spend more time with their patients.
The revenue that private dentistry creates allows practices to invest in their business, providing the opportunity for innovation in patient care models, and in some case subsidise their NHS practice!
Yet with this comes certain patient expectations. The summit felt that patients paying privately wish to see the same dentist and members of the dental team every time they come. That important relationship with their care providers means that retention of both dentists and dental team members is a real focus in private practice.
Of course, with the problems of recruitment, we know this is important to all practices, but the difference was felt to be the patient expectation.
The negative effect of these media myths is that it creates unease, both to the public and also the profession. These need to be dispelled. With most private practice focusing on prevention and care for generations of the same family, and consideration of how to help patients afford to pay for private treatment, private practice provides a significant part in maintaining the oral health, and wider general health of the UK.
For more information about the Association of Dental Groups, visit www.theadg.co.uk.
This article is sponsored by the Association of Dental Groups.