Employer control and the work environment: a study of the Swedish Public Dental Service

The Public Dental Service in Sweden has a system of surveillance and supervision based on time studies, piecework wages for dentists, and detailed time reporting. This control system and its development are described in this article. The focus is on the effects of the system on the staff. A representative group of Swedish dentists (n = 896) and dental nurses (n = 600) was asked to participate in a questionnaire study exploring the work environment in the Public Dental Service. The response rate was 87 percent. The dentists reported that they felt constantly supervised and evaluated. Their work tempo was related to surveillance, competition, and demands of the employer. There was no correlation between work tempo and piecework results. A high percentage of the staff mentioned weaknesses in the charging and piecework system that they thought could result in an undesirable influence on dentists' work. A majority would have preferred fixed salaries. The results are discussed in terms of gender, motivation, proletarianization, and management style.