The recent publication of the report The private dentistry market in the UK by the Office of Fair Trading (OFT) has received a somewhat muted reaction in the general media, perhaps because the report was not as critical as was expected. What has occurred, however, is a firm reaction within the dental press and some stirring correspondence in The Times reminding the world that dentists are not the same as retailers and thus need to be treated differently.

Dentists are indeed not retailers, although some provide an excellent retail service providing oral hygiene products for their patients. But dentists do provide a service for the public, and sometimes I feel there is confusion inside the profession between the professional responsibilities for provision of clinical care (sometimes referred to as clinical dentistry) with the responsibilities for all the general non-clinical care that envelops the clinical package. This is perhaps best summarised as the difference between patients and customers.

Along with others I have been a great proponent for good customer care in dental practice, quite often in these leaders. But I may have helped create some of the confusion myself by not clarifying exactly what I mean. This is my opportunity to do so.

Customer care in dentistry focuses on the processes and systems put in place within a dental organisation to make the non-clinical experience as easy and enjoyable for patients as possible...

To me, customer care in dentistry focuses on the processes and systems put in place within a dental organisation to make the non-clinical experience as easy and enjoyable for patients as possible. Patient care is a completely different aspect, incorporating everything involved in clinical care. Thus, to me, when the OFT or anyone else discusses customer care they are not suggesting aspects of dentistry involving clinical decisions or treatment at all. This is within the remit of the General Dental Council. They are talking about such matters as making appointments, contacting the practice by telephone, making complaints if necessary, understanding the prices, obtaining a second opinion and changing to a new dentist.

Of course some areas of overall patient care fall partly within my definition of customer care and partly within my definition of patient care, such as ensuring patients have treatment options explained clearly to them to obtain informed consent, but I suspect no-one denies the importance of this. In the main, however, people who suggest the dental profession lacks a certain expertise in the provision of customer care are not referring to clinical decisions, time spent in carrying out clinical procedures or the quality of clinical treatment.

All of this makes the OFT report both understandable and (hopefully) more welcome. When the report refers to the need for private dentists to be more consumer-orientated, it is not referring to the quality of clinical dentistry nor the time taken to carry it out but to the difficulty people have in obtaining information about treatment options and costs. When it also refers to the liberalisation of dental services (meaning less restricted access to dental care because of the lifting of restrictions on both PCDs and Bodies Corporate) it is not concerned with the clinical care itself, but the difficulty people have in accessing care and the perceived anti-competitive environment dentistry still enjoys.

All the above is summed up by the title of this leader. Our patients are both patients and customers, and while they are obviously the same people it might help to consider them as wearing two different hats when we are looking at how we are providing care for them. The patient hat refers to everything that happens related to clinical dentistry, and it is here that professional standards and ethics are so important. The customer hat refers to everything else, and to be honest we are still newcomers to many of these concepts and have a lot to learn.

The OFT has suggested that we should start by filling the 'information gap' between dental organisation and patient/customer, especially in the area of prices and quality of service. This is a sensible suggestion, but it makes the assumption that we know the answer. I am not always sure we do, as I know how difficult some people find it to explain the difference between private and NHS dentistry in a way that patients relate to. But that's another story.