Rural public dental practice in Australia: Perspectives of Tasmanian government-employed dentists

Objective: This study sought to describe the perspectives of dentists providing public dental care in the Australian rural state of Tasmania. It sought information on a range of subjects, such as interactions with patients, as a component of baseline studies to improve models of public dental clinical services. It was conducted through a unique partnership between the University of Tasmania (Department of Rural Health) and the State government. Design: Semistructured face-to-face interviews. Qualitative methods guided collection and analysis with the application of grounded theory as a basis for developing explanatory thematic frameworks. Setting: Four regional public dental centres in Tasmania. Participants: Government-employed dentists. Results: Three main themes emerged. (i) Wanting autonomy in clinical decisions, although this was often difficult to achieve in the existing circumstances; (ii) social interactive aspects of care, which were related to the dentists' perceptions of the patients' level of interest in oral health; and (iii) the level of demand for urgent episodic care, which was very difficult to manage in the light of the workforce shortage and was seen to impact on continuity of care, efficiency and integration with other health services. Conclusions: There are strong indications that expanding the capacity and the flexibility of the workforce will contribute to improved interactions with patients and improve access to a broader range of dental care within public-sector clinical services.