How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada
1 Division of Oral Health and society, Faculty of Dentistry, McGill University, 3550, rue University, Montréal, Québec H3A 2A7, Canada
2 Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Montréal, Quebec, Canada
3 Faculty of Medicine, University of Sherbrooke, 150 Place Charles Lemoyne Bureau 200, Longueuil, Québec J4K 0A8, Canada
4 Agence de la Santé et des Services Sociaux de Montréal, 1301, rue Sherbrooke Est, Montréal, Québec H2L 1M3, Canada
5 Faculté des Sciences Infirmières, C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada
BMC Health Services Research 2013, 13:464 doi:10.1186/1472-6963-13-464Published: 5 November 2013
In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance.
This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists’ offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study.
Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists’ willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement.
The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions.