Does competition affect the clinical decision‐making of dentists? A geospatial analysis

OBJECTIVES: To investigate the association between dentists' geographic density and perceptions of market competition with clinical decision-making among a representative sample of dentists in Ontario, Canada's most populated province. METHODS: Competition was quantified using dentist density, defined as the number of dental clinics lying within a one kilometre radius around the respondents' clinic address and by self-reported perceived pressure from other dental clinics. The outcome (clinical decision-making or treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative. Associations were assessed using bivariate analysis and logistic and linear regression. RESULTS: Dentists who perceived large competitive pressure from other dentists (OR = 1.63, 95% CI: 1.07-2.49) were relatively more aggressive in their treatment choices. Interestingly, dentists located in very low dentist density areas (OR = 1.31, 95% CI: 1.03-1.68) were also relatively more aggressive in their treatment choices. CONCLUSION: This study is the first to explore the impact of competition on the clinical decision-making of dentists in a Canadian context. It presents a valuable addition to the competition literature and helps to understand current dynamics in the Canadian dental care market.