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. 2013 Oct;94:63–70. doi: 10.1016/j.socscimed.2013.05.038

Table 2.

Multiple logics in the dental practice field developed from service level data.

Ownership responsibility Professionalism Population health managerialism Entrepreneurial commercialism
Composite principles
Authority and managerial responsibility for practice staff, reputation and servicing patients and community Clinical excellence, altruism, best interest of patients, patient advocacy, technical knowledge, professional responsibility and self-governance Trace and explain public expenditure; govern good practice. Trading and opportunity with a focus on sustaining and developing a profitable business



Expression
Try to sustain the business long term for the sake of staff and patients Patients are treated according to technical and ethical values Patients are treated as a unit Patients as a source of income
Feel part of the NHS
Close relationships with staff. Sub-contracting is risky Give the patients authoritative options Be accountable via hierarchical bureaucracy for what you’ve done and why Conscious of the market and consumers' wishes.
Ownership is beyond owning the enterprise - it concerns setting practice ethos Gatekeeper – police what is available on the NHS Meet targets Excite wider demand
Resources governed by need not demand
Concentrate on reputation of the practice amongst the local community Treat NHS and private patients the same See remuneration not based on balancing income and expenditure for individual patients Commercial GDPs view income as ‘swings and roundabouts’
Close relationships with patients ‘coal face’ built on family/friends Emphasis on ‘our’/’my’ patients Assert patients' best interests, charge structures second Strategic priority (public policy) orientated Range includes piece rate GDPs
Population prevention strategies
Keep abreast technically Sub contract to others Conscious of branding
Individual clinician's are responsible for deciding what is best for the patient Dispassionate, issue-based decision making Business entrepreneurship
Do not criticise other clinicians