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Patient satisfaction and communication as competitive levers in dentistry

Alessandra Mazzei (IULM University, Institute of Economics and Marketing, Milan, Italy)
Vincenzo Russo (IULM University, Institute of Economics and Marketing, Milan, Italy)
Alberto Crescentini (Alta Scuola Pedagogica di Locarno, Locarno, Switzerland)

The TQM Journal

ISSN: 1754-2731

Article publication date: 12 June 2009



The purpose of this paper is to ascertain the most relevant quality factors and communication activities that are suitable as competitive levers in dentistry.


The research is based on a model that highlights the reciprocal influence between patient satisfaction and dentist reputation. The model points out that experience/behaviours, explicit communication and word‐of‐mouth are antecedents of both patient satisfaction and dentist reputation. This research is based on interviews with senior dentists, focus groups with patients and a survey of dentistry patients.


The most important quality factors for patient satisfaction are the doctor‐patient relationship and the clarity of information about treatment and cost. Key communication levers are first, the implicit communication that arises from successful treatment and overall service quality; second, the explicit communication that arises from interpersonal relations with the dentist and the staff, and the referrals of previous patients.

Practical implications

In order to gain competitive advantages, dentists should achieve an average level of patient satisfaction for “given” and “secondary” factors; to pay careful attention to “strategic factors”; and to explicitly communicate “opportunity factors” since patients are usually unaware of their value. Furthermore, dentists should emphasize interpersonal, experiential and third‐party communication with patients.


The paper puts forward a model that integrates previous service quality and reputation management models, and makes suggestions for the improvement of service quality management and communication in dentistry.



Mazzei, A., Russo, V. and Crescentini, A. (2009), "Patient satisfaction and communication as competitive levers in dentistry", The TQM Journal, Vol. 21 No. 4, pp. 365-381.



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