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Contract care in dentistry: sense-making of the concept and in practice when multiple institutional logics are at play

Journal article
Authors Ylva Ulfsdotter Eriksson
Karin Berg
Ulla Wide Boman
Magnus Hakeberg
Published in Sociology of Health and Illness
Volume 39
Issue 7
Pages 1035-1049
ISSN 0141-9889
Publication year 2017
Published at Institute of Odontology, Section 1
Department of Sociology and Work Science
Pages 1035-1049
Language en
Links dx.doi.org/10.1111/1467-9566.12543
onlinelibrary.wiley.com/doi/10.1111...
Keywords dental care professionals; contract dental care; institutional logics; organisational and occupational professionalism
Subject categories Sociology

Abstract

In 2009 contract dental care was introduced into Sweden's Public Dental Service under a programme called Dental Care for Health (DCH). Previous research has revealed a possible dilemma whereby dental care professionals had the role of insurance agent foisted upon them, as they were assigned the task of ‘selling contracts’. Using qualitative interviews, this study explores how these professionals make sense of contract dental care today. Drawing on the concepts of occupational and organisational professionalism, in combination with the institutional logics perspective, we discern that dental care professionals are entangled in multiple rationalities when reasoning about and dealing with DCH. A professional logic comes into play over health issues and preventive care, while market and corporate logics are present in relation to selling contracts and taking responsibility for the financial aspects of DCH, all of which creates tensions in these professionals. Overall, dental care professionals in the welfare sector respond both to an organisational and an occupational professionalism.

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