Akkaloori Anitha

Gadde Praveen

Gadigi Jayaprakash

Shakeel Anjum

Uddarraju Shivajiraju

Zabirunnisa Begum

Iranian Journal of Public Health

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     Iranian J Publ Health, Vol. 43, No.4, Apr 2014, pp. 532-533                                                                               Letter to the Editor 532                                                                                                       Available at:    http://ijph.tums.ac.ir   An Eagle’s Eye on the Remuneration for Dentists Working in Primary and Community Health Centers in India   *Gadde PRAVEEN 1, Shakeel ANJUM 2, Akkaloori ANITHA 3, Zabirunnisa BEGUM 1, Uddarraju SHIVAJIRAJU 4 , Gadigi JAYAPRAKASH 5  1. Dept. of Public Health Dentistry, Vishnu Dental College, Bhimavaram, India 2. Dept. of Public Health Dentistry, Sri Sai College of Dental Surgery, Vikarabad, India 3. Dept. of Public Health Dentistry, Mamata Dental College, Khammam, India 4. Dept. of Oral & Maxillofacial Surgery, Vishnu Dental College, Bhimavaram, India 5. Dept. of Periodontics, Vishnu Dental College, Bhimavaram, India  *Corresponding Author: Email: gaddephd6@gmail.com  (Received 10 Jan 2014; accepted 25 Jan 2014)  Dear Editor-in-Chief  Remuneration is a significant feature of human re-source management, and these resources are the most crucial factor in the delivery of a good num-ber of public health services (1). Mukesh Chawla et al. in 1997 revised different remuneration systems for health care personnel; fixed salary provides in-centives for shirking, performance related pay (PRP) for concentrating on those aspects of the job that are measured, and misrepresenting output (2). A major problem with salary-based remuneration systems in India is that there are no incentives for dentists to perform over and above the minimum that is required of them in order to keep their jobs, do not contribute the optimal or desired level of effort, not giving any particular attention to qual-ity of care or patient satisfaction and to build or foster a close relationship with their patients, and access to care may be somewhat limited by the limited time that the dentist may allocate to his duties since their compensation is not likely to be affected in any way. A cornerstone of the theory in personnel econom-ics is that workers respond to incentives. Specifi-cally, it is a given that paying on the basis of out-put will induce workers to supply more output (3). This led us to discuss a new model called “pay for item of service” i.e. dentists were paid a “piece-rate” for each individual treatment they carried out, with specified fees for each type of treatment (fillings, extractions, crowns, bridges, dentures, etc.). The government of UK is getting fruitful results with this type of remuneration system for their NHS dentists. However, the “pay per item” system in dentistry came to be criticized for giving a potential incentive to “over-treatment” (encourag-ing dentists to err on the side of “drilling and filling”, going against trends in clinical best practice); leading to an emphasis on the speed of treatment rather than quality; and failing to encourage a preventive approach (since dentists were not paid to spend time with patients explaining how they could maintain their dental health) (4). Against this background, with proper monitoring and evaluation methods, one can overweight the disadvantages associated with this remuneration system. The preference of remuneration depends on a host of factors, such as the preparedness of the health management system, availability of institu-tional support, development and availability of management and information systems, other re-Praveen et al.: An Eagle’s Eye on the Remuneration … Available at:    http://ijph.tums.ac.ir                                                                                                     533    forms in the health sector, other reforms else-where in the economy, and overall short and long term objectives of the government in the health sector (1). Finally it is not what you pay, it is the way that you pay it and that's what gets results.  Acknowledgements  The authors declare that there is no conflict of interests.      References  1. Birgit Abelson (2011). Pay scheme preferences and health policy objectives. Health Economics, Policy and Law, 6 (2):157-173.  2. http://www.hsph.harvard.edu/ihsg/publications/pdf/No-70.PDF, accessed on 12th June 2013. 3. Edward P. Lazear (2000). Performance Pay and Productivity. American Economic Review, 90 (2): 1346-1361. 4. http://www.keepournhspublic.com/pdf/Dentistrybri-efing20081014.pdf, accessed on 14th April 2013.          

An Eagle's Eye on the Remuneration for Dentists Working in Primary and Community Health Centers in India.

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An Eagle's Eye on the Remuneration for Dentists Working in Primary and Community Health Centers in India.

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