- Email: [email protected]
Attitudes of dentists and consumers toward advertising
jm
a
BRIEF REPORTS
Attitudes of dentists and consumers toward advertising Robert F. Majewski, D D S , Irw in A. Shapiro, P h D
MS
A -L * . su rv e y c o n d u c te d in 1981 o f s tu d e n ts a n d f a c u lty a t T u fts U n iv e r s ity S c h o o l o f D e n ta l M e d ic in e 1 r e p o r te d g e n e ra lly stro n g n e g a tiv e a ttitu d e s to w a rd a d v e rtis e m e n ts fo r d e n ta l se rv ic e s. T h e su rv e y p re s e n te d h e re w a s u n d e r ta k e n to a s c e rta in a n d c o m p a re a ttitu d e s to w a rd th e a d v e rtis in g of d e n ta l se rv ic e s h e ld b y in d i v id u a l s o n b o th s id e s o f th e m a r k e tp la c e — p ro v id e rs a n d c o n s u m e rs — in th e sa m e c o m m u n ity . T h is s t u d y w a s c o n d u c te d in m e tro p o lita n L o w e ll, M ass, in 1982, fiv e y e a rs a fte r th e U S S u p re m e C o u rt d e c is io n 2 th a t s tru c k d o w n e th ic a l re s tric tio n s o n p ro fe s s io n a l a d v e rtis in g . S h o rtly b efo re th e S u p re m e C o u rt d e c i s io n , M e s k in 3 c o n d u c te d a p a ra lle l su rv e y o f b o th d e n tis ts a n d c o n s u m e rs . H e fo u n d th a t re c e n t g ra d u a te s of th e U n iv e rs ity of M i n n e s o ta ’s S c h o o l o f D e n tis tr y w e re c o n s id e ra b ly m o re n e g a tiv e th a n a s a m p le of M in n e s o ta c o n s u m e rs in th e ir p e r c e p tio n s o f th e p o te n tia l c o n s e q u e n c e s of a d v e rtis in g fo r d e n ta l se rv ic e s. M e sk in s u g g e s t e d t h a t a f o l lo w - u p s t u d y b e u n d e r ta k e n to se e w h e th e r th e o p in io n s w o u ld s h ift a fte r th e m a rk e t e x p e rie n c e d th e effects of u n re s tra in e d a d v e rtis in g .
Methods Q uestionnaires for this study were sent to 307 households in the Lowell, Mass, m etropolitan area, selected on a systematic random basis from the Lowell area telephone directory, and to all 197 dentists listed in the classified d i rectory. The two survey groups received iden tical questionnaires except for some classifica tio n data. Some 34% of the households and 63% of the dentists returned anonym ous mail ballot responses. A lthough n o n resp o n d en t bias cannot be m easured, the age distribution of household respondents closely parallels the 1980 census data for the area. There was, however, a signifi
cantly low er proportion of responses among households w ith incom es less than $25,000 and a h igher proportion of responses from households w ith incom es $25,000 and over w hen com pared w ith the population at large. Among the responding dentists, the ratio of general dentists to specialists w as virtually identical to the proportion in the directory. Four patient-seeking advertisem ents,1 rep resenting different levels of persuasion, w ith and w ithout fee listings, were used. Figure 1 show s a sim ple inform ational announcem ent; Figure 2 uses persuasive language; Figure 3 is a basic dental fee schedule; and Figure 4 com bines leader pricing w ith persuasive patronage enticem ents. Five attitude statem ents concern ing economic and social effects of den tists’ ad vertising w ere adapted from th e Tufts Univer sity study and a final conclusive statem ent, “I favor the use of advertising by dentists seeking to attract new patients,” was added. F iv e -p o in t L ik ert scales, ra n g in g from “strongly approve” to “strongly disapprove” fo r th e sam p le a d v e rtise m e n ts a n d from “ strongly agree” to “strongly disagree” for the attitude statem ents, m easured direction and
strength of attitudes. Comm ents about the is sues of the survey w ere elicited from respon dents.
Results Response to advertisem ents Table 1 sum m arizes the attitudes of respon dents tow ard the four advertisem ents. In every instance, consum ers as a group show ed a pat tern of significantly h igher approval of adver tising messages th an dentists. Figure 1, in te n d e d to be sim ila r to p ro fe ssio n a l a n nouncem ents perm itted before th e rem oval of ethical restrictions, w as the only advertise m ent to w hich dentists aw arded a m ajority of responses in th e ap proved categories. Just more than half of the dentists and 85% of con sum er respondents expressed som e degree of approval for this advertisem ent. The most decisive contrast of opinion be tw een dentists and consum ers was in response to the advertisem ent in Figure 3, a sim ple list ing of a den tist’s basic services and fees. Some 87% of the consum ers approved this message,
Table 1 ■ Approval of advertisem ents (percent of responses). Strongly approve
Approve
A nnouncem ent (Fig 1) Consumers* 58 D entistst 29 (X2 = 34.0624, P = .0000) Persuasion (Fig 2) Consumers 10 Dentists 8 (X2 = 17.5454, P = .0020) Fee listing (Fig 3) Consumers 63 Dentists 4 (X2 = 150.9790, P = .0000) Price prom otion (Fig 4) Consumers 16 Dentists 2 (X2 = 97.3972, P = .0000)
Strongly Neutral Disapprove disapprove
27 27
14 22
1 17
0 6
17 7
19 13
29 22
24 50
24 3
5 8
2 15
6 69
20 2
18 2
23 6
22 87
*Total number of consumers = 103. tTotal number of dentists = 124.
JADA, Vol. 108, M arch 1984 ■ 345
B R IE F
REPORTS
Table 2 ■ A greement w ith attitude statem ents (percent of responses). Strongly agree
Agree Neutral
Strongly disagree
Disagree
1. A dvertising by dentists will increase the public's dem and for den tal services. Consumers* 11 37 17 25 10 D entistst 5 24 13 28 30 (X2 = 17.0337, P = .0024) 2. A dvertising by dentists w ill increase the quality of dental treat ment. Consumers 11 16 21 27 26 Dentists 0 0 8 22 71 (X2 = 62.1306, P = .0000) 3. A dvertising by dentists will increase th e cost of dental care to pa tients. Consumers 11 19 17 35 19 Dentists 15 28 28 17 13 (X2 = 13.6457, P = .0090) 4. A dvertising by dentists will im prove the image (prestige) of the profession. Consumers 9 17 30 29 16 Dentists 0 3 7 17 73 (X2 = 79.7782, P = .0000) 5. Advertising by dentists w ill perm it patients to make intelligent choices. Consum ers 30 39 13 14 5 Dentists 0 5 8 19 69 (X2 = 1 2 6 .8 6 6 , P = .0 000) 6. I favor the use of advertising by dentists seeking to attract new pa tients. Consum ers 34 49 9 4 5 Dentists 7 15 19 23 37 (X2 = 84.1061, P = .0000)__________________________________ *Total number of consumers = 101 (two respondents did not answer this part of the questionnaire). tTotal number of dentists = 124.
including 63% expressing strongly approve, w hereas 84% of the dentists disapproved of the fee listing, including 69% strongly disapprove. The persuasive language and promotional slant of the advertisem ents in Figures 2 and 4 drew the low est favorability ratings from con sum ers, 27% and 36%, respectively. Dentists
were alm ost unanim ous in their strong rejec tion of the pricing enticem ents in Figure 4, rat ing it even lower than Figure 3.
A greem ent with attitude statem ents Consumers as a group were more favorable to-
Fig 1 ■ Announcement.
JO H N A . D O E , D .D .S . a n n o u n c e s th e a v a ila b ility o f E V E N IN G A N D S A T U R D A Y A P P O IN T M E N T S i n a d d i t i o n to r e g u l a r a p p o i n t m e n t s f o r F A M IL Y D E N T A L C A R E 1 2 3 M a in S tr e e t
T e l. 5 5 5 -1 2 1 2
A n y to w n , M a s s .
fo r a p p o in tm e n t
Fig 2 ■ Persuasion.
A R E Y O U A F R A ID T O S M IL E ? A r e y o u e m b a r r a s s e d to s h o w y o u r te e th ? L et m e h e lp re b u ild a n i m p o r t a n t p a r t o f y o u r im a g e . . . “ Y O U R S M IL E ” JO H N A . D O E , D .D .S . 1 23 M a in S tr e e t A n y to w n , M a s s . T e l. 5 5 5 -1 2 1 2 n o w . . . f o r y o u r fu tu re !
346 ■ JADA, Vol. 108, M arch 1984
ward advertising for dental services in every instance w hen responding to the statem ents, as sum m arized in Table 2. Responses to the first attitude statem ent, “Advertising by dentists w ill increase the public’s dem and for dental services,” w ere not strongly polarized w ithin either group, although dentists were less in clined than consum ers to believe that advertis ing w ould increase aggregate dem and for den tal services. The second statement, “Advertising by den tists w ill increase the quality of dental ser vices,” did not receive a single affirmative re sponse from dentists, some of whom expressed the belief that competitive price advertising w ould lower the quality (and price) of services offered. About a fourth of the consum er re spondents indicated some degree of agreem ent w ith the statement. The third statem ent asked for opinions on the effect of advertising on the cost of dental care to patients. As w ith the first statem ent, there was no strong consensus w ithin either survey group, although more responding den tists than consum ers believed that advertising costs w ould bring about higher fees. Dentists overwhelm ingly, and consum ers to a lesser extent, rejected the fourth statem ent, “Advertising w ill improve the image (prestige) of the profession.” A m ong th e six a ttitu d e statem en ts, the sharpest division of opinion betw een the two survey groups came in response to the fifth statem ent, “Advertising by dentists w ill per m it patients to make in tellig en t ch o ices.” Some 69% of consum ers agreed w ith this statem ent, whereas 88% of dentists disagreed. Consumers com m unicated a strong desire for product and price information so that they could compare before visiting a dentist’s of fice. Dentists, on the other hand, believed that advertising cannot com m unicate the technical complexity and varying types of treatm ents and services offered. In a final direct query, 83% of the consum ers responded positively to “I favor the use of ad vertising by dentists seeking to attract new pa tients.” Only 22% of the dentists agreed, but another 19% w ere neutral or undecided on the issue.
R espondent classifications No substantial differences in responses were found among the dentists w hen the group was separated into general dentists and specialists, nor w hen su bdivided into in d iv id u al and group practices. Only five of 35 group practice respondents reported that they w ere in large groups of five or more dentists that w ould typify the size of a dental clinic. However, w hen dentist respondents were apportioned according to num ber of years in practice and age, a close correlation, signifi cantly greater anti-advertising responses were found among dentists who were older and in practice for longer periods. Responding to the attitude statem ent “I favor the use of advertis ing by dentists seeking to attract new p a tients,” 81% of the dentists w ho reported being in practice for more than 20 years responded negatively compared w ith 65% of those in practice between ten and 20 years and 42% w ith less than ten years of experience. When these results are compared w ith data from the survey of graduating dental students at Tufts
B R IE F
University, the trend of younger dentists w ho appear to be more favorable tow ard advertising is extended. Only 34% of these graduating den tists about to em bark on th e ir careers re sponded negatively w hen asked if they plan to advertise on entering private practice. A plu r ality, 38%, w ere undecided but the rem aining 28% indicated positive intentions to advertise, although no determ ination of type or extent of advertising was elicited.1 A further com pari son w ith the Tufts U niversity results found highly sim ilar attitudes betw een the surveyed dental school faculty members and the Lowell area dentists. No s ig n ific a n t d iffe re n c e s w ere fo u n d among consum er respondents w hen grouped according to age categories or by th e ir re sponses to the question “Have you personally been to a dentist in the last two years?” w hich was intended to identify consum ers w ho ap parently are not receiving regular dental care and m ight be prim e targets of cam paigns to stim ulate prim ary dem and. Respondents w ith lower incom es were som ewhat more receptive to dental services advertising. This was consis ten t w ith M eskin’s findings.3
Fig 3 ■ Fee listing.
JO H N A . D O E , D .D .S . F A M IL Y D E N T IS T E x a m in a ti o n $ 5 C le a n in g a n d X r a y s $ 2 0 E x tr a c tio n s $ 2 0 F illin g s $ 1 0 p e r s u r f a c e O t h e r f e e s e x p l a in e d u p o n r e q u e s t 1 2 3 M a in S tr e e t
A n y to w n , M a s s .
T e l. 5 5 5 -1 2 1 2 f o r a p p o i n t m e n t Fig 4 ■ Price promotion.
C U S T O M F IT T E D D E N T U R E S --------- $ 9 9 a n d u p ! A ll o t h e r d e n t a l s e r v ic e s a t IN F L A T IO N F IG H T IN G F E E S ! C r e d i t c a r d s a n d tim e p a y m e n ts C a ll n o w ! JO H N A . D O E , D .D .S .
Conclusions
1 2 3 M a in S tr e e t
C o m p a re d w ith M e s k in ’s r e s u lts , th i s s tu d y d o e s n o t s h o w a le s s e n in g o f n e g a tiv e a ttitu d e s to w a rd a d v e rtis in g a m o n g th e s u rv e y e d g ro u p o f d e n tis ts . C o n c u r r e n t m e a s u re m e n t o f th e a ttitu d e s o f a s a m p le o f c o n s u m e rs , w h o a re th e p re s e n t a n d p ro s p e c tiv e p a tie n ts o f th e su rv e y e d d e n tis ts in th e c o m m u n ity , u n d e rs c o re s a c o n tin u in g w id e d is p a rity o f v ie w s a b o u t p ro fe s s io n a l a d v e rtis in g h e ld b y th e tw o s id e s o f th e m a rk e tp la c e . A lth o u g h so m e d e n tis ts w h o r e s p o n d e d e x p re s s e d a n u n d e r s ta n d in g of th e d iffic u lt m a rk e t re a lity fa c in g m a n y d e n tis ts as th e y se e k to b u ild th e ir p r a c tic e s , a stro n g m e ssa g e fro m th e p ro fe s s io n w a rn s of th e ir c o n v ic tio n th a t d e n ta l tr e a tm e n t is a h e te ro g e n e o u s s e rv ic e th a t s h o u ld n o t b e p ro m o te d in th e m a n n e r o f a p a c k a g e d c o n s u m e r p ro d u c t. T h e y fu r th e r a d m o n is h th a t c o m p e titiv e a d v e r tis in g m a y d o m o re h a rm th a n g o o d to th e p a tie n t w h o d o e s n o t c o m p r e h e n d th e
REPORTS
5 5 5 -1 2 1 2 A n y to w n , M a s s .
1 0 % D IS C O U N T W IT H T H IS AD!
c o m p l e x it y o f th e tr e a tm e n t p ro c e s s . N e v e rth e le s s , c o n s u m e rs h a v e e x p re s s e d a n o v e r w h e lm in g d e s i r e fo r s t r a i g h t fo rw a rd in fo rm a tio n a b o u t th e d e n ta l care o f f e r in g s — a n d p r i c e s — o f i n d i v i d u a l p ra c tic e s . T h e re a lity of th e b u s y n e s s p ro b le m fo r m a n y d e n tis ts is lik e ly to h e ig h te n an a w a re n e s s a n d in te re s t in m a rk e tin g a c tiv itie s , e v e n a m o n g d e n tis ts w h o a b h o r p ro fe s s io n a l a d v e rtis in g . T h e A m e ric a n D e n ta l A s s o c ia tio n ’s n e w m a rk e tin g s e r v ic e s p ro g ra m is a p o s itiv e r e s p o n s e to p e rc e iv e d n e e d s o f in d iv id u a l p ra c tic e s a n d d e n ta l so c ie tie s fo r m a rk e tin g a s s is ta n c e .4 T h e a p p ro p r ia te s c o p e a n d n a tu r e o f p r o f e s s i o n a l s e r v ic e s a d v e r t i s i n g , w ith in th e b ro a d e r m a rk e tin g fra m e w o rk ,
c le a rly re q u ire fu r th e r d e v e lo p m e n t a n d e v a lu a tio n .
1 ). T h e te c h n iq u e is sim p le a n d r a p id a n d , th e re fo re , in e x p e n s iv e . T h e ID b a n d is p a r t o f a r o u tin e p ro c e d u r e fo r m a rk in g d e n tu r e s th a t fu lfills th e re c o m m e n d a tio n o f th e F e d e ra tio n D e n ta ire In te rn a tio n a l of 1 9 7 8 , w h ic h p ro p o s e d th a t m e m b e r c o u n tr ie s in tro d u c e a s y s te m of d e n tu r e m a rk in g . D e n tu re m a rk in g se rv e s tw o p u rp o s e s :
it fa c ilita te s th e re c o v e ry a n d r e t u r n of lo s t o r a c c id e n ta lly s w itc h e d d e n tu r e s (F ig 2); a n d i t fa c ilita te s th e p o s tm o rte m id e n tif ic a tio n o f u n id e n t if ie d d e c e a s e d p e o p le w h o w o re d e n tu r e s . T h e im p o r ta n c e o f m a r k in g d e n tu r e s is s h o w n b y th e fa c t th a t 20 % to 25% o f th e a d u lt p o p u la tio n o f th e W e ste rn w o rld o ld e r th a n 35 w e a r d e n tu r e s .
Dr. Majewski is pedodontic resident, C hildren’s Hospital, Buffalo, NY. Dr. Shapiro is associate profes sor, marketing, College of M anagem ent Science, Uni versity of Lowell, Lowell, Mass 01854. A ddress re quests for reprints to Dr. Shapiro. 1. Shapiro, I.A., and Majewski, R.F. A ttitudes of dental students and faculty tow ard advertising. JADA 105(3):468-470, 1982. 2. Bates, and O’Steen, vs State Bar of Arizona, 433 US 350, 1977. 3. Meskin, L.H. A dvertising of dental services: a consum er and dentist attitude survey. J Am Coll Dent 45(4):247-253, 1978. 4. D ental m arketing: ADA’s program to assist m e m b e rs w ith p r a c t ic e d e v e lo p m e n t. JADA 106(2):160-166, 1983.
Denture marking G unnar Johanson, D D S , Bjorn Ekman, D D S
PhD
J e n tu r e s c a n b e m a r k e d w ith th e ir o w n e r ’s id e n tity n u m b e r o r n a m e w ith a n o rd in a ry ty p e w rite r a n d a n ID b a n d (Fig
Johanson-E km an : DENTURE MARKING ■ 347
a
BRIEF REPORTS
Attitudes of dentists and consumers toward advertising Robert F. Majewski, D D S , Irw in A. Shapiro, P h D
MS
A -L * . su rv e y c o n d u c te d in 1981 o f s tu d e n ts a n d f a c u lty a t T u fts U n iv e r s ity S c h o o l o f D e n ta l M e d ic in e 1 r e p o r te d g e n e ra lly stro n g n e g a tiv e a ttitu d e s to w a rd a d v e rtis e m e n ts fo r d e n ta l se rv ic e s. T h e su rv e y p re s e n te d h e re w a s u n d e r ta k e n to a s c e rta in a n d c o m p a re a ttitu d e s to w a rd th e a d v e rtis in g of d e n ta l se rv ic e s h e ld b y in d i v id u a l s o n b o th s id e s o f th e m a r k e tp la c e — p ro v id e rs a n d c o n s u m e rs — in th e sa m e c o m m u n ity . T h is s t u d y w a s c o n d u c te d in m e tro p o lita n L o w e ll, M ass, in 1982, fiv e y e a rs a fte r th e U S S u p re m e C o u rt d e c is io n 2 th a t s tru c k d o w n e th ic a l re s tric tio n s o n p ro fe s s io n a l a d v e rtis in g . S h o rtly b efo re th e S u p re m e C o u rt d e c i s io n , M e s k in 3 c o n d u c te d a p a ra lle l su rv e y o f b o th d e n tis ts a n d c o n s u m e rs . H e fo u n d th a t re c e n t g ra d u a te s of th e U n iv e rs ity of M i n n e s o ta ’s S c h o o l o f D e n tis tr y w e re c o n s id e ra b ly m o re n e g a tiv e th a n a s a m p le of M in n e s o ta c o n s u m e rs in th e ir p e r c e p tio n s o f th e p o te n tia l c o n s e q u e n c e s of a d v e rtis in g fo r d e n ta l se rv ic e s. M e sk in s u g g e s t e d t h a t a f o l lo w - u p s t u d y b e u n d e r ta k e n to se e w h e th e r th e o p in io n s w o u ld s h ift a fte r th e m a rk e t e x p e rie n c e d th e effects of u n re s tra in e d a d v e rtis in g .
Methods Q uestionnaires for this study were sent to 307 households in the Lowell, Mass, m etropolitan area, selected on a systematic random basis from the Lowell area telephone directory, and to all 197 dentists listed in the classified d i rectory. The two survey groups received iden tical questionnaires except for some classifica tio n data. Some 34% of the households and 63% of the dentists returned anonym ous mail ballot responses. A lthough n o n resp o n d en t bias cannot be m easured, the age distribution of household respondents closely parallels the 1980 census data for the area. There was, however, a signifi
cantly low er proportion of responses among households w ith incom es less than $25,000 and a h igher proportion of responses from households w ith incom es $25,000 and over w hen com pared w ith the population at large. Among the responding dentists, the ratio of general dentists to specialists w as virtually identical to the proportion in the directory. Four patient-seeking advertisem ents,1 rep resenting different levels of persuasion, w ith and w ithout fee listings, were used. Figure 1 show s a sim ple inform ational announcem ent; Figure 2 uses persuasive language; Figure 3 is a basic dental fee schedule; and Figure 4 com bines leader pricing w ith persuasive patronage enticem ents. Five attitude statem ents concern ing economic and social effects of den tists’ ad vertising w ere adapted from th e Tufts Univer sity study and a final conclusive statem ent, “I favor the use of advertising by dentists seeking to attract new patients,” was added. F iv e -p o in t L ik ert scales, ra n g in g from “strongly approve” to “strongly disapprove” fo r th e sam p le a d v e rtise m e n ts a n d from “ strongly agree” to “strongly disagree” for the attitude statem ents, m easured direction and
strength of attitudes. Comm ents about the is sues of the survey w ere elicited from respon dents.
Results Response to advertisem ents Table 1 sum m arizes the attitudes of respon dents tow ard the four advertisem ents. In every instance, consum ers as a group show ed a pat tern of significantly h igher approval of adver tising messages th an dentists. Figure 1, in te n d e d to be sim ila r to p ro fe ssio n a l a n nouncem ents perm itted before th e rem oval of ethical restrictions, w as the only advertise m ent to w hich dentists aw arded a m ajority of responses in th e ap proved categories. Just more than half of the dentists and 85% of con sum er respondents expressed som e degree of approval for this advertisem ent. The most decisive contrast of opinion be tw een dentists and consum ers was in response to the advertisem ent in Figure 3, a sim ple list ing of a den tist’s basic services and fees. Some 87% of the consum ers approved this message,
Table 1 ■ Approval of advertisem ents (percent of responses). Strongly approve
Approve
A nnouncem ent (Fig 1) Consumers* 58 D entistst 29 (X2 = 34.0624, P = .0000) Persuasion (Fig 2) Consumers 10 Dentists 8 (X2 = 17.5454, P = .0020) Fee listing (Fig 3) Consumers 63 Dentists 4 (X2 = 150.9790, P = .0000) Price prom otion (Fig 4) Consumers 16 Dentists 2 (X2 = 97.3972, P = .0000)
Strongly Neutral Disapprove disapprove
27 27
14 22
1 17
0 6
17 7
19 13
29 22
24 50
24 3
5 8
2 15
6 69
20 2
18 2
23 6
22 87
*Total number of consumers = 103. tTotal number of dentists = 124.
JADA, Vol. 108, M arch 1984 ■ 345
B R IE F
REPORTS
Table 2 ■ A greement w ith attitude statem ents (percent of responses). Strongly agree
Agree Neutral
Strongly disagree
Disagree
1. A dvertising by dentists will increase the public's dem and for den tal services. Consumers* 11 37 17 25 10 D entistst 5 24 13 28 30 (X2 = 17.0337, P = .0024) 2. A dvertising by dentists w ill increase the quality of dental treat ment. Consumers 11 16 21 27 26 Dentists 0 0 8 22 71 (X2 = 62.1306, P = .0000) 3. A dvertising by dentists will increase th e cost of dental care to pa tients. Consumers 11 19 17 35 19 Dentists 15 28 28 17 13 (X2 = 13.6457, P = .0090) 4. A dvertising by dentists will im prove the image (prestige) of the profession. Consumers 9 17 30 29 16 Dentists 0 3 7 17 73 (X2 = 79.7782, P = .0000) 5. Advertising by dentists w ill perm it patients to make intelligent choices. Consum ers 30 39 13 14 5 Dentists 0 5 8 19 69 (X2 = 1 2 6 .8 6 6 , P = .0 000) 6. I favor the use of advertising by dentists seeking to attract new pa tients. Consum ers 34 49 9 4 5 Dentists 7 15 19 23 37 (X2 = 84.1061, P = .0000)__________________________________ *Total number of consumers = 101 (two respondents did not answer this part of the questionnaire). tTotal number of dentists = 124.
including 63% expressing strongly approve, w hereas 84% of the dentists disapproved of the fee listing, including 69% strongly disapprove. The persuasive language and promotional slant of the advertisem ents in Figures 2 and 4 drew the low est favorability ratings from con sum ers, 27% and 36%, respectively. Dentists
were alm ost unanim ous in their strong rejec tion of the pricing enticem ents in Figure 4, rat ing it even lower than Figure 3.
A greem ent with attitude statem ents Consumers as a group were more favorable to-
Fig 1 ■ Announcement.
JO H N A . D O E , D .D .S . a n n o u n c e s th e a v a ila b ility o f E V E N IN G A N D S A T U R D A Y A P P O IN T M E N T S i n a d d i t i o n to r e g u l a r a p p o i n t m e n t s f o r F A M IL Y D E N T A L C A R E 1 2 3 M a in S tr e e t
T e l. 5 5 5 -1 2 1 2
A n y to w n , M a s s .
fo r a p p o in tm e n t
Fig 2 ■ Persuasion.
A R E Y O U A F R A ID T O S M IL E ? A r e y o u e m b a r r a s s e d to s h o w y o u r te e th ? L et m e h e lp re b u ild a n i m p o r t a n t p a r t o f y o u r im a g e . . . “ Y O U R S M IL E ” JO H N A . D O E , D .D .S . 1 23 M a in S tr e e t A n y to w n , M a s s . T e l. 5 5 5 -1 2 1 2 n o w . . . f o r y o u r fu tu re !
346 ■ JADA, Vol. 108, M arch 1984
ward advertising for dental services in every instance w hen responding to the statem ents, as sum m arized in Table 2. Responses to the first attitude statem ent, “Advertising by dentists w ill increase the public’s dem and for dental services,” w ere not strongly polarized w ithin either group, although dentists were less in clined than consum ers to believe that advertis ing w ould increase aggregate dem and for den tal services. The second statement, “Advertising by den tists w ill increase the quality of dental ser vices,” did not receive a single affirmative re sponse from dentists, some of whom expressed the belief that competitive price advertising w ould lower the quality (and price) of services offered. About a fourth of the consum er re spondents indicated some degree of agreem ent w ith the statement. The third statem ent asked for opinions on the effect of advertising on the cost of dental care to patients. As w ith the first statem ent, there was no strong consensus w ithin either survey group, although more responding den tists than consum ers believed that advertising costs w ould bring about higher fees. Dentists overwhelm ingly, and consum ers to a lesser extent, rejected the fourth statem ent, “Advertising w ill improve the image (prestige) of the profession.” A m ong th e six a ttitu d e statem en ts, the sharpest division of opinion betw een the two survey groups came in response to the fifth statem ent, “Advertising by dentists w ill per m it patients to make in tellig en t ch o ices.” Some 69% of consum ers agreed w ith this statem ent, whereas 88% of dentists disagreed. Consumers com m unicated a strong desire for product and price information so that they could compare before visiting a dentist’s of fice. Dentists, on the other hand, believed that advertising cannot com m unicate the technical complexity and varying types of treatm ents and services offered. In a final direct query, 83% of the consum ers responded positively to “I favor the use of ad vertising by dentists seeking to attract new pa tients.” Only 22% of the dentists agreed, but another 19% w ere neutral or undecided on the issue.
R espondent classifications No substantial differences in responses were found among the dentists w hen the group was separated into general dentists and specialists, nor w hen su bdivided into in d iv id u al and group practices. Only five of 35 group practice respondents reported that they w ere in large groups of five or more dentists that w ould typify the size of a dental clinic. However, w hen dentist respondents were apportioned according to num ber of years in practice and age, a close correlation, signifi cantly greater anti-advertising responses were found among dentists who were older and in practice for longer periods. Responding to the attitude statem ent “I favor the use of advertis ing by dentists seeking to attract new p a tients,” 81% of the dentists w ho reported being in practice for more than 20 years responded negatively compared w ith 65% of those in practice between ten and 20 years and 42% w ith less than ten years of experience. When these results are compared w ith data from the survey of graduating dental students at Tufts
B R IE F
University, the trend of younger dentists w ho appear to be more favorable tow ard advertising is extended. Only 34% of these graduating den tists about to em bark on th e ir careers re sponded negatively w hen asked if they plan to advertise on entering private practice. A plu r ality, 38%, w ere undecided but the rem aining 28% indicated positive intentions to advertise, although no determ ination of type or extent of advertising was elicited.1 A further com pari son w ith the Tufts U niversity results found highly sim ilar attitudes betw een the surveyed dental school faculty members and the Lowell area dentists. No s ig n ific a n t d iffe re n c e s w ere fo u n d among consum er respondents w hen grouped according to age categories or by th e ir re sponses to the question “Have you personally been to a dentist in the last two years?” w hich was intended to identify consum ers w ho ap parently are not receiving regular dental care and m ight be prim e targets of cam paigns to stim ulate prim ary dem and. Respondents w ith lower incom es were som ewhat more receptive to dental services advertising. This was consis ten t w ith M eskin’s findings.3
Fig 3 ■ Fee listing.
JO H N A . D O E , D .D .S . F A M IL Y D E N T IS T E x a m in a ti o n $ 5 C le a n in g a n d X r a y s $ 2 0 E x tr a c tio n s $ 2 0 F illin g s $ 1 0 p e r s u r f a c e O t h e r f e e s e x p l a in e d u p o n r e q u e s t 1 2 3 M a in S tr e e t
A n y to w n , M a s s .
T e l. 5 5 5 -1 2 1 2 f o r a p p o i n t m e n t Fig 4 ■ Price promotion.
C U S T O M F IT T E D D E N T U R E S --------- $ 9 9 a n d u p ! A ll o t h e r d e n t a l s e r v ic e s a t IN F L A T IO N F IG H T IN G F E E S ! C r e d i t c a r d s a n d tim e p a y m e n ts C a ll n o w ! JO H N A . D O E , D .D .S .
Conclusions
1 2 3 M a in S tr e e t
C o m p a re d w ith M e s k in ’s r e s u lts , th i s s tu d y d o e s n o t s h o w a le s s e n in g o f n e g a tiv e a ttitu d e s to w a rd a d v e rtis in g a m o n g th e s u rv e y e d g ro u p o f d e n tis ts . C o n c u r r e n t m e a s u re m e n t o f th e a ttitu d e s o f a s a m p le o f c o n s u m e rs , w h o a re th e p re s e n t a n d p ro s p e c tiv e p a tie n ts o f th e su rv e y e d d e n tis ts in th e c o m m u n ity , u n d e rs c o re s a c o n tin u in g w id e d is p a rity o f v ie w s a b o u t p ro fe s s io n a l a d v e rtis in g h e ld b y th e tw o s id e s o f th e m a rk e tp la c e . A lth o u g h so m e d e n tis ts w h o r e s p o n d e d e x p re s s e d a n u n d e r s ta n d in g of th e d iffic u lt m a rk e t re a lity fa c in g m a n y d e n tis ts as th e y se e k to b u ild th e ir p r a c tic e s , a stro n g m e ssa g e fro m th e p ro fe s s io n w a rn s of th e ir c o n v ic tio n th a t d e n ta l tr e a tm e n t is a h e te ro g e n e o u s s e rv ic e th a t s h o u ld n o t b e p ro m o te d in th e m a n n e r o f a p a c k a g e d c o n s u m e r p ro d u c t. T h e y fu r th e r a d m o n is h th a t c o m p e titiv e a d v e r tis in g m a y d o m o re h a rm th a n g o o d to th e p a tie n t w h o d o e s n o t c o m p r e h e n d th e
REPORTS
5 5 5 -1 2 1 2 A n y to w n , M a s s .
1 0 % D IS C O U N T W IT H T H IS AD!
c o m p l e x it y o f th e tr e a tm e n t p ro c e s s . N e v e rth e le s s , c o n s u m e rs h a v e e x p re s s e d a n o v e r w h e lm in g d e s i r e fo r s t r a i g h t fo rw a rd in fo rm a tio n a b o u t th e d e n ta l care o f f e r in g s — a n d p r i c e s — o f i n d i v i d u a l p ra c tic e s . T h e re a lity of th e b u s y n e s s p ro b le m fo r m a n y d e n tis ts is lik e ly to h e ig h te n an a w a re n e s s a n d in te re s t in m a rk e tin g a c tiv itie s , e v e n a m o n g d e n tis ts w h o a b h o r p ro fe s s io n a l a d v e rtis in g . T h e A m e ric a n D e n ta l A s s o c ia tio n ’s n e w m a rk e tin g s e r v ic e s p ro g ra m is a p o s itiv e r e s p o n s e to p e rc e iv e d n e e d s o f in d iv id u a l p ra c tic e s a n d d e n ta l so c ie tie s fo r m a rk e tin g a s s is ta n c e .4 T h e a p p ro p r ia te s c o p e a n d n a tu r e o f p r o f e s s i o n a l s e r v ic e s a d v e r t i s i n g , w ith in th e b ro a d e r m a rk e tin g fra m e w o rk ,
c le a rly re q u ire fu r th e r d e v e lo p m e n t a n d e v a lu a tio n .
1 ). T h e te c h n iq u e is sim p le a n d r a p id a n d , th e re fo re , in e x p e n s iv e . T h e ID b a n d is p a r t o f a r o u tin e p ro c e d u r e fo r m a rk in g d e n tu r e s th a t fu lfills th e re c o m m e n d a tio n o f th e F e d e ra tio n D e n ta ire In te rn a tio n a l of 1 9 7 8 , w h ic h p ro p o s e d th a t m e m b e r c o u n tr ie s in tro d u c e a s y s te m of d e n tu r e m a rk in g . D e n tu re m a rk in g se rv e s tw o p u rp o s e s :
it fa c ilita te s th e re c o v e ry a n d r e t u r n of lo s t o r a c c id e n ta lly s w itc h e d d e n tu r e s (F ig 2); a n d i t fa c ilita te s th e p o s tm o rte m id e n tif ic a tio n o f u n id e n t if ie d d e c e a s e d p e o p le w h o w o re d e n tu r e s . T h e im p o r ta n c e o f m a r k in g d e n tu r e s is s h o w n b y th e fa c t th a t 20 % to 25% o f th e a d u lt p o p u la tio n o f th e W e ste rn w o rld o ld e r th a n 35 w e a r d e n tu r e s .
Dr. Majewski is pedodontic resident, C hildren’s Hospital, Buffalo, NY. Dr. Shapiro is associate profes sor, marketing, College of M anagem ent Science, Uni versity of Lowell, Lowell, Mass 01854. A ddress re quests for reprints to Dr. Shapiro. 1. Shapiro, I.A., and Majewski, R.F. A ttitudes of dental students and faculty tow ard advertising. JADA 105(3):468-470, 1982. 2. Bates, and O’Steen, vs State Bar of Arizona, 433 US 350, 1977. 3. Meskin, L.H. A dvertising of dental services: a consum er and dentist attitude survey. J Am Coll Dent 45(4):247-253, 1978. 4. D ental m arketing: ADA’s program to assist m e m b e rs w ith p r a c t ic e d e v e lo p m e n t. JADA 106(2):160-166, 1983.
Denture marking G unnar Johanson, D D S , Bjorn Ekman, D D S
PhD
J e n tu r e s c a n b e m a r k e d w ith th e ir o w n e r ’s id e n tity n u m b e r o r n a m e w ith a n o rd in a ry ty p e w rite r a n d a n ID b a n d (Fig
Johanson-E km an : DENTURE MARKING ■ 347