Table 1.

Indicative statements relating to institutional logics from archival data.

Medical professionalism logic	Business-like health care logic	Commercialism logic
Providing dental care as a dental professional	Delivering dental care according to principles set by public funders	Supplying dental care as a commodity
Dentists: Do we wish to be considered as entrepreneurs in the market place – and treated accordingly? Or as a learned society serving society and accordingly looked after and rewarded by society? (Welsh Valley practitioner, 1985) Dentists: If one relies on patients who have ‘shopped around’, despite standard NHS fees, then one must expect patients who are more interested in ‘cheap’ treatment. In the words of a gentleman who called here recently ‘I would not want to go to a dentist who had to advertise’ (Crocker, 1986) Dentists: It is an indisputable fact that professional standards are absolute and therefore not negotiable. Standards are limited only by the corpus of knowledge and achievement of the age (Bosley, 1987)	Dentists: We applaud both equality and excellence, but we are not at all sure if we can have them both (Sear, 1984) Govt: The available money buys for patients, both a decent level of quantity and decent quality of care and treatment, while providing dentists with a reasonable return for their efforts (Bloomfield, 1992) Govt: Money spent on dentistry should be used effectively and efficiently to improve oral health. Need rather than demand should be the focus of the system. (Department of Health, 1994) Govt: PCTs should commission such services as are necessary to secure access to a high quality NHS dental service and to improve oral health and address inequalities (Department of Health, 2002).	Dentists:. We are going to have to market our services and persuade our patients to part with their discretionary dollars. Many say that this debases the profession – hoosh! (Eilertsen, 1986) Dentists: An increasing quantity of dentistry done in the UK has little to do with general health. … Why cannot dentistry be considered just one more consumer good? (Leader, The Probe, 1996) Dentists: No one enjoys going to the dentist and patients do not buy dentistry [oral health] as a commodity. They buy an attractive smile and the benefits of oral health in that order. ‘Need’ hangs around the profession's neck like an albatross (Gordon, 1997) Dentists: To give up your freewill and control of your business to bureaucrats and politicians would be a gross dereliction of duty to yourselves, your staff and most of your patients. (Rowe, 2006)