Table 3 Case-based memo

This was quite an eye opening interview in the sense that the practice manager was very direct, practical and open. In his accounts, the bottom line is that this preventive program is not profitable; dentists will do it for giving back to the community, not to earn money from it. I am so glad we had this interview; otherwise I am not sure if someone would be so up front about it. So, my question really is, is that the reason why dentists have not adopted it in other practices? And what about other patients who come here, who are not enrolled in the research program, does the dentist-in-charge treat them all as being part of the program or it was just an impression from the interview and what I saw here during my time in the practice... or will the dentist continue doing it in the next future?

I definitely learned that dentistry in private practice is a business, at the end of the day a target has to be achieved, and the dentist is driven by it. During the dentist's interview, there was a story about new patients being referred to the practice because the way they were treating patients now; but right now I am just not sure; I really need to check that... need to go back and ask the dentist about it, were there any referrals or not? Because this would create new revenue for the practice and the practice manager would surely be happy about it. On the other hand, it is interesting that the practice manager thinks that having a hygienist who was employed few months ago is the way to adopt the preventive program; she should implement it, freeing the dentist to do more complex work. But in reality, when I interviewed the hygienist I learned that she does not want to change to adopt the program, she is really focused on what she has been doing for a while and trust her experience a lot! So I guess, the dentist in charge might be going through a new changing process, different from what happen when the MPP protocols were first tried in this practice; this is another point to check on the next interview with the dentist. I just have this feeling that somehow the new staff (hygienist) is really important for this practice to regain and maintain profit throughout the adoption of preventive protocols but there are some personality clashes happening along the way.