Dentist-patient interactions in treatment decision-making: a qualitative study

The growing involvement of patients, third party payers, and government in the financing, planning, and delivery of health services has heightened the demand for knowledge about the process of rendering care. This study used a qualitative methodology to examine dentist-patient interactions in treatment decision-making. A series of focus groups was conducted with dentists and patients participating in an ongoing investigation of dental treatment planning conducted at the University of North Carolina. Study findings indicate that dentist-patient interactions play an important role in treatment decision-making and that both are predicated on a variety of non-clinical factors. Dentists' intuition and judgment seem to be used not only to select desired health outcomes and the means for achieving them, but also to depart from the ideal and/or to modify treatment plan presentation on a patient-to-patient basis. Patients' impressions of dentists' examination styles, personalities, and ability to relate to them as individuals seem to mediate both treatment acceptance and willingness to participate in the decision-making process. Results of this investigation suggest that any effort aimed at improving dental treatment decision-making needs to acknowledge the interplay of clinical and psychosocial factors.