Patient Attitudes Toward Dentists/Oral Physicians Providing Limited Preventive Primary Care

Abstract

Objective: To determine the attitudes of ethnically-diverse patients in a multi-disciplinary public dental clinic about dentists performing medical screening procedures and inquiring about general health issues Method: A new program to train general practice dental residents (GPDRs) as oral physicians (OPs) by providing limited preventive primary care was initiated by Harvard Medical/Dental Schools and Cambridge Health Alliance (CHA). After translation into Spanish, Portuguese, and Haitian Creole, a questionnaire was distributed to approximately 1,000 patients of four GPDRs (PGPDRs) and patients of four other CHA staff dentists (PCHAs). Questions related to acceptance of dentists asking about health problems, performing medical procedures, and perception of dentists and other paramedical professionals relative to physicians/doctors.

Result: 222 patients (63 males age 45.8±14.8, 111 females age 45.6±14.9) returned questionnaires at time of treatment or by mail, separated by PGPDRs or PCHAs. There was a large significant difference between the two clinician groups in the relation of being allowed/not allowed to ask and actually being asked for PCHAs but not for PGDPRs.

Surprisingly, PCHAs increased over time in Acceptable to Ask more than the PGPDRs for 24 of 29 queries, most likely because the GPDRs began to function as OPS early in their training, which spread to other CHA staff, suggesting a Hawthorne-like effect.

Acceptability for dentists performing medical procedures varied from 18.2% for “flu shot”, 25.2% for “drawing blood”, to 67.0% for “prescribing drugs”. Influence of self-reported health issues significantly correlated with Acceptable to Ask (p≤.01).

Patient perception of dentists being a doctor/MD relative to other health professionals ranged from 91.8% for physician/surgeon, pediatricians 86.6%, dentists 78.9%, psychiatrists 77.9%, OPs 72.9%, podiatrists 64.2%, osteopaths 61.7%, hygienist 25.13%, pharmacist 18.0%, and social worker 11.0%.

Conclusion: Although somewhat confused about professional titles and responsibilities, patients did demonstrate increasing acceptability of dentists providing limited primary care.