Knights, knaves and gnashers: Professional values and private dentistry

This article applies Le Grand's distinction between knightly and knavish mo tivations to the behaviour of dentists in choosing whether to treat patient s on the NHS or privately. Using national quantitative and discursive surve ys, it shows that dentists' notions of their own interests centre on indepe ndent small-business entrepreneurship and their professional culture define s patient interest in terms of access to clinically autonomous practice bas ed on a restorative paradigm. Government attempts to promote preventive den tistry in the context of the weakening in dentists' bargaining position as general dental health improves and the determination of the profession to p rotect high remuneration have led to conflict. Both knavish and knightly mo tives (understood from the perspective of dentists' professional culture) l ead dentists to exit from the NHS, Any analysis of 'robust' policies, desig ned to accommodate both motivations, must take into account social factors such as professional cultures which influence how practitioners understand their own interests and those of their clients.