Patients' perceptions of general dental practitioners: The influence of ethnicity and sex of dentist

Social Behavior and Personality, 2001 by Newton, J Timothy, Davenport-Jones, Lucy, Idle, Matthew, Patel, Mina, Et al

A total of 126 participants were asked to select, from a series of photographs, the dentist which they perceived as: most caring, most competent, and which they would wish to have as their own dentist. White European male dentists were most likely to be chosen as the respondents' general dental practitioner. Men were generally perceived as more competent than women. Women were more likely to be chosen as the most caring dentists. It is concluded that, in the absence of other information, sex and ethnicity of the dentist exert an influence on patients' perceptions of general dental practitioners.

Research examining the factors which influence patients' choice of general dental practitioner has been limited. However, it would appear that such choices are not random, Garfunkel (1980) reported that only 1 percent of patients chose their GDP from a telephone book, the remainder had sought some information about the practice, most notably from friends and relatives. When asked what characteristics of their dentist would influence their choice, the general public tend to focus on the dentist's manner (Bulman, Richard & Slack 1996). Similarly, when asked about the characteristics of their "ideal" dentist, members of the general public place great emphasis upon communication skill (Lahti, Verkasalo, Hansen & Tuuti 1996). However, to date no study has addressed the influence of ethnicity and gender on patients' choice of a dentist. In part this may be due to methodological difficulties. Respondents are unlikely to report a socially undesirable preference for a dentist of a specific sex or ethnicity, and questionnaire studies have not directly asked about such preferences. In order to address this question a forced choice methodology is necessary (Ahmad, Kernohan & Baker 1992). These authors conclude that patients feel that it is important that their doctor understands their culture and language. The present study seeks to examine the influence of sex and ethnicity on patients' expressed choice of dentist and their perceptions of the dentist's competence and caring.

METHOD

The design chosen for the survey was a forced choice task in which participants were asked to examine 8 photographs depicting individuals from four broad ethnic groups: White European, Black African, Asian Indian and Chinese/Japanese Asian.

PHOTOGRAPHS

Given the likely confounding influence of age and attractiveness on individuals' ratings of competence and caring (Eagley, Ashmore, Makhijani & Longon 1991), it was important that the photographs showed individuals who were similar in these characteristics. By choosing dental students from a single year of study (and excluding mature students) it was possible to standardise for age. The researchers then rated all the students for attractiveness and selected those who were given similar ratings within the four broad ethnic groups. The researchers included individuals from different ethnic backgrounds to control for variations in perceptions of attractiveness across cultural groups. Individuals selected to act as "dentists" in the study were approached and asked to take part. All individuals who were photographed gave their written consent to participation. Photographs were taken in standard conditions, with a blank background, and cut to show only the head and shoulders. The photographs were attached to card in random order and numbered.

PROCEDURE

Participants were selected at random in shopping centers and asked to participate in a study examining people's perceptions of dentists. It was felt that the true purpose of the study could not be explained fully since it might bias responses. The participants were shown the photographs, asked to look at them and to answer the following questions:

Which of these people would you choose as your own dentist ?

* Who do you think is the most caring as a dentist ?

* Who do you think is the most competent as a dentist ?

Participants were then asked to give their sex and age, and to indicate from a list how they would describe their own ethnicity.

RESULTS

Responses were received from 126 individuals. Of these, 68 (54.0%) were female and 58 (46.0%) male. The age range of the sample was 15 to 81, the average age being 35.24 years (sd=14.94). The ethnic distribution of the sample was as follows: White European, 90 respondents (71%); Black African, 20 respondents (16%); Asian Indian, 7 respondents (6%); Chinese/Japanese Asian, 7 respondents (6%); Other ethnicity, 1 respondent (

1.1 Whom would the general public choose as their dentist?

The most popular choice overall was the White European male. Table 1 shows the number of choices made according to the ethnicity and gender of the person shown in the photograph. Photographs of the White European dentists were chosen more often than any other group. More male dentists were chosen than female dentists.

There was a significant association between respondents' ethnicity and their choice of a dentist from the same, or a different, ethnicity (Table 2, Chit=10.21, p