Qualitative investigation into factors leading to ill-health retirement among dentists

BACKGROUND: Data published in 1999 from the Government Actuary on the National Health Service Pension Scheme (1989-1994) have indicated that the frequency of premature ill health retirement (IHR) is four times more prevalent among dentists at age 42 years compared with doctors.

OBJECTIVE: The aim of this project was to determine the factors that contributed to the premature retirement of general dental practitioners (GDPs).

METHOD: Semi-structured interviews were carried out during 2007. A topic list was developed, piloted and used to guide the interviewer. A purposive sampling technique was used to recruit the respondents from an insurance company database. A framework approach to data analysis was utilised.

RESULTS: Twenty-three respondents were interviewed, 19 Male and 4 Female, aged between 39-59 years. Depression, stress and anxiety were reported by many respondents to be major causes of their retirement, followed by musculo-skeletal disease and premature disability caused by trauma. This is illustrated by the following ‘…just went straight into general practice but with some regrets. Practice was so depressing (d1)' ‘I withdraw, I don't engage …. I found it more and more difficult and one morning….I collapsed in tears at the practice' (d6). Dentists reported both negative and positive comments in relation to support received from their health insurance company ‘[the insurance company] were very good for the short term conditions (d5)'. However, dentists who had retired due to depression or psychological illness found them ‘uncaring for the long term conditions. They were insulting and they didn't agree with the consultant, despite the prognosis (d7).

CONCLUSION: Respondents reported that stress and depression were reduced after IHR. However, they felt that support systems for GDP need improvement and insurance companies are not always helpful. Thanks are due to The Medical Sickness Society and COPDEND for their financial support.