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Supporting dentists' health and wellbeing - a qualitative study of coping strategies in 'normal times'

Abstract

Background Research has highlighted multiple determinants of dentists' health and wellbeing, and has raised concerns over workforce morale and retention. Limited research has been undertaken on possible solutions. Thus, the aim was to explore the coping strategies used or advocated by dentists to protect and support their health and wellbeing.

Methods This qualitative study involved a purposive sample of dentists working in England taking account of age, gender, career stage, work sector, geographical area, position and route of entry to registration. Dentists were approached via gatekeepers across England to participate in semi-structured interviews. A topic guide, informed by past research, was used to guide the discourse. Informants' views were audio-recorded and field notes were made. Data were transcribed and analysed using an interpretative phenomenological approach to generate theory with the support of the framework methodology.

Results Twenty dentists were interviewed from a range of backgrounds. Self-reported coping strategies included a range of strategies for 'taking control', including 'embracing self-care' and 'seeking professional support', while drawing on 'supportive personal and social networks'. Managing professional careers included diversifying through greater 'mixing' of NHS with private work, privatising, specialising, or combining dentistry with another role. Strengthening job security and facilitating diversity of experience remain important for supporting the health and wellbeing of dentists. Selling practices or, in the extreme, completely leaving the profession were considered practical options. At organisational level, building sustainable teams and transforming culture were advocated as important; while at systems level, reforming the NHS and bridging the gap between the profession and regulatory body were considered vital. Additionally, the need for strong professional leadership and wider societal debate was advocated as part of a whole systems approach to enable job satisfaction in delivering high-quality, patient-centred, evidence-based care in future.

Conclusion While dentists demonstrated a range of coping mechanisms, multi-level action was advocated to enhance the health, wellbeing and retention of dentists. Systems reform at macro- and meso-levels is urgently advocated to enable fulfilling careers within dentistry, particularly for those at the front line of primary dental care in the public sector. Personal resilience alone will not suffice and recommendations for action are explored to avert a public health catastrophe. This is a time for reflection, debate and action.

Key points

  • Conducted before the outbreak of COVID-19, this research highlights the urgent need for multi-level action to improve the workplace environment, the dental system and regulation of dentistry in support of professional fulfilment and career retention for dentists to enhance health and wellbeing.

  • Dentists' coping strategies, both emotional and practical, are required where significant meso- and macro-level challenges exist; this may involve drastic action, particularly among early-career dentists and those working in the NHS.

  • Building personal resilience alone is insufficient to raise morale and enhance the wellbeing of early-career dentists; however, there is a place to support active healthy coping mechanisms in those entering the profession.

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Acknowledgements

The authors would like to thank Public Health England for funding this project, key gatekeepers for their support in the recruitment process, and all dentists who participated in this study for taking time to share their views and experiences. Finally, Sukriti KC who helped during its revision.

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Correspondence to Jennifer E. Gallagher.

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SW and JEG work for Public Health England and FCS for the National Audit Office. The views expressed do not represent the views of the above organisations.

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Gallagher, J., Colonio-Salazar, F. & White, S. Supporting dentists' health and wellbeing - a qualitative study of coping strategies in 'normal times'. Br Dent J (2021). https://doi.org/10.1038/s41415-021-3205-7

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