title: Providing care to people on social assistance: how dentists in Montreal, Canada, respond to organisational, biomedical, and financial challenges.
abstract: BACKGROUND
  Dentists report facing difficulties and experiencing frustrations with people on social assistance, one of the social groups with the most dental needs. Scientists ignore how they deal with these difficulties and whether they are able to overcome them. Our objective was to understand how dentists deal with critical issues encountered with people on social assistance.
  
  
  METHODS
  We conducted in-depth, semi-structured interviews with 33 dentists practicing in Montreal, Canada. The interview guides included questions on dentists' experiences with people on social assistance and potential strategies developed for this group of people. Analyses consisted of interview debriefing, transcript coding, and data interpretation.
  
  
  RESULTS
  Dentists described strategies to resolve three critical issues: missed appointments (organisational issue); difficulty in performing non-covered treatments (biomedical issue); and low government fees (financial issue). With respect to missed appointments, dentists developed strategies to maximise attendance, such as motivating their patients, and to minimise the impact of non-attendance, like booking two people at the same time. With respect to biomedical and financial issues, dentists did not find any satisfactory solutions and considered that it was the government's duty to resolve them. Overall, dentists seem reluctant to exclude people on social assistance but develop solutions that may discriminate against them.
  
  
  CONCLUSIONS
  The efforts and failures experienced by dentists with people on social assistance should encourage us to rethink how dental services are provided and financed.
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill college avenue, Montreal, Quebec H3A1G1, Canada. christophe.bedos@mcgill.ca.
authors.forename: Christophe
authors.initials: C
authors.lastname: Bedos
authors.forename: Christine
authors.initials: C
authors.lastname: Loignon
authors.forename: Anne
authors.initials: A
authors.lastname: Landry
authors.forename: Lucie
authors.initials: L
authors.lastname: Richard
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Allison
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003812:Dentist-Patient Relations; D003815:Dentists; D004468:Economics, Dental; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008483:Medical Assistance; D008875:Middle Aged; D036301:Qualitative Research; D011792:Quebec; D055815:Young Adult