Good work for dentists : ideal and reality for female unpromoted general practice dentists in a region of Sweden

Sammanfattning: Female unpromoted general practice dentists (GPDs) in the Public Dental Health Service (PDHS) constitute about one fourth of all working dentists in Sweden. Unpromoted means that the position is without managerial functions. According to many reports, they have a problematic psychosocial work situation. This thesis aimed to: - Describe the perceived health for these GPDs, in comparison with others with a similar work situation. - Analyse their sense of support in comparison with others. - Describe how they perceived "good work", i.e. both the healthy and socially responsible work, and whether there was a difference between their ideal and their reality. - Analyse patterns in two aspects - the moral and the career aspects - of "good work" for dentists. In 2000, questionnaires were sent to all female unpromoted GPDs in the PDHS in a region of Sweden. The response rate was 94%. Results: - The dentists felt unwell, worse than other compared groups. - There was little support from the management. - There was little inter-colleague contact. - There was no cross-sectional association between collegial networks and support, but the qualitative investigation showed that collegial networks were perceived as positive. - There was a great difference between ideal and reality concerning good work. The dentists felt a lack of influence, and this was the greatest difference of all. - Three components of good work - "moral values and skill discretion", "career development" and "work environment" - were found. The dentists emphasized the moral basis of their work, confirming the character of dentistry as primarily human service work. In conclusion: There were serious work environmental problems among these dentists. The dentists felt unwell and felt a great lack of influence on important decisions. There was little inter-colleague contact, but collegial networks were perceived as positive. There was little support from the management, indicating a clear weakness in the relations between employers and female unpromoted GPDs in the PDHS. Three components of good work were found, where the moral component was the most important but it also showed the greatest difference between ideal and reality. Thus, the dentists emphasized the moral basis of their work, confirming the character of dentistry as primarily human service work and not industrial work. The dentists with the highest level of commitment perceived the largest differences. The PDHS organization has therefore failed to convince or engage those whom it ought to engage, i.e. those with the greatest commitment. The way to improve the female unpromoted GPDs' work situation would be through increased influence and support, bridging the gap between ideal and reality.