An internal report obtained by CBC News describes the Canadian Forces dental unit as an understaffed and overstressed group of health care providers frustrated with their managers.
The workplace assessment was completed last year by Y2 Consulting Psychologists and paid for by the military. CBC News applied for it under Access to Information legislation. Parts of the document were withheld.
The report looks at ways to improve efficiency and the overall work climate.
"Some staff and management believe that 1 Dental Unit has seen an increasing amount of administrative responsibilities related to managing aspects of the dental health plans of military members for outsourced services," the report says.
"There are concerns that such tasks and responsibilities will increase while direct patient care becomes increasingly outsourced or provided by contractors."
About one-third of dental technicians and assistants spend 30 per cent or less of their time providing direct patient care, according to the report.
"Some staff and management believe that 1 Dental Unit has seen an increasing amount of administrative responsibilities related to managing aspects of the dental health plans of military members for outsourced services." - Y2 Consulting Psychologists
The report said some issues are longstanding and part of the organizational culture. It also suggests a hiring freeze and budget restrictions have led to staffing shortages.
The report said, "67.1 per cent of the respondents reported being regularly understaffed within their detachment and over 55 per cent of respondents don’t believe staffing processes to be fair and transparent."
The consultants found absenteeism to be a significant issue at eight locations. "It is noteworthy that research suggests that about 50 per cent of absenteeism is related to employee well-being and work dissatisfaction," the report said.
It suggests reassigning staff from some work locations such as 14 Wing Greenwood to areas with a greater need, including Kingston, Ottawa and Winnipeg.
The consultants said staff feel managers are slow to help them with job demands and the impacts on their well-being.
"It was interesting to note such dissatisfaction especially given that over 88 per cent of managers reported that they were able to identify and support staff who seemed stressed/distressed."
On a positive note, the report said respondents rank patient care and satisfaction as one of the most satisfying parts of their jobs. It also says that remains a key priority for 1 Dental Unit.
Future of the unit
The commanding officer of the unit, Col. Kevin Goheen, calls the report "a work-life pulse analysis."
"Keep in mind this about people in the dental clinics themselves telling me how they’re feeling and what they’re doing," he said in an interview this month.
"It wasn’t an external evaluation of somebody looking at us as a system, so you’re always going to get some people for whatever reason are unhappy or disgruntled just simply because they have a venue to be able to do it. Many of it is credible so you want to hear about it."
The report also raises fundamental questions about the future of the unit as more dental work is completed by civilian dentists who are contracted or referred through Blue Cross.
"Will dental hygienists, dental techs/assistants and dentists/dentists-specialists eventually become administrators of dental health plans? While this scenario is not likely in the near future, it is on the minds of staff and managers," the report said.
"Remaining passive about the direction of the organization... is not an effective or viable solution."
The report suggests the unit is at a crossroads and senior management have a decision to make.
"For instance, this may mean that 1 Dental Unit will become a much smaller organization in the long run with key personnel that will mostly be used for deployment purposes and the rest of the services that will be completely outsourced," it said.
"On the contrary, it may mean that 1 Dental Unit will grow in size (or increase the number of full-time, indeterminate staff or members) and reduce outsourcing."