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Rationalisation and 'McDonaldisation' in dental care: private dentists' experiences working in corporate dentistry
Alexander C L Holden1, Lee Adam2, William M Thomson2
1The University of Sydney School of Dentistry, Faculty of Medicine and Health, Australia; Sydney Dental Hospital and Oral Health Services, Sydney Local Health District, NSW, Australia. alexander.holden@sydney.edu.au.
Abstract:
Introduction This study examines how dentists experience the corporatisation of dentistry and the impacts of rationalisation. The emergence of corporate dentistry in the early twenty-first century has introduced greater competition into the dental marketplace. Ritzer's theory of 'McDonaldisation' explores the rationalisation of services through corporatisation and provides an apt framework with which to understand the qualitative insights gathered through this project.Methods Semi-structured interviews and reflective journals were used to collect insights from dentists who were working in private practice. Data were then subjected to thematic analysis.Results A total of 20 private dentist participants provided 22 separate interviews and multiple reflective accounts. Following analysis, three key themes emerged: 1) opportunities provided by corporate dentistry; 2) balance between professionalism and commercialism in corporate dentistry; and 3) competition between independent and corporate dentistry.Conclusions The participants' insights demonstrate how Ritzer's four dimensions of rationalisation - efficiency, predictability, calculability and control - have been encapsulated by corporate dentistry in Australia. Corporate interests in Australian dentistry are perceived to improve competition and offer opportunities for younger and less experienced dentists, but the findings also suggest that those leading corporate dentistry need to ensure that rationalisation does not diminish the caring relationship between dentists and patients.
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