Dental Tribune Asia Pacific Edition | 11/2018 WORLD NEWS 07 Managing a dental practice: Jimmy’s story By Dr Alun Rees Jimmy* stood shyly on my doorstop and asked, “Can we go for a pint Alun?” This wasn’t the normal way for a client to start our work together, but I had known Jimmy for the bet- ter part of 20 years and understood that he was a proud man who found it difficult to ask for help. People seek my help for a num- ber of reasons. Often, it is because they have reached a crisis in their business lives or have arrived at a crossroads and cannot decide which path to take. At other times, they realise they are stuck in the middle lane, being overtaken by other busi- nesses. Some want an outside set of eyes helping them to analyse where they could perform better. In Jimmy’s case, this was a crisis, and over a couple of pints, he started to share his problems. “I paid the Inland Revenue £40,000 a couple of weeks ago and now they’re back and want the same again,” he told me. “I was able to cash in a policy last time, but I don’t understand why I’m so broke. I thought I was making good money—the practice is full and I’ve never been busier.” My approach I was a dentist before changing career, and I work in a way that is unique but familiar to my clients. First, I take a thorough history of the client and his or her business. Next, comes a detailed examination of the practice and a number of diagnoses. In consultation with the client, we decide on priorities and a time frame for change and then formulate a de- finitive treatment plan, if you will. Frequently, as with dentistry, there is a need for triage and an urgent intervention to deal with the acute appeared fine—until it did not. It only takes one rock to sink a ship and Jimmy was sailing without charts or depth gauges. We moved Jimmy to a new firm of accountants, who liaised with HMRC. I negotiated with the bank on his behalf to temporarily increase his overdraft, and we were able to get the practice out of the emergency ward as stability was regained. As in dentistry, people who have had their acute pain removed are tempted to return to old habits, but Jimmy could see that there were other things waiting to trip him up. He was at an age where retirement was in his thoughts and I was able to show him that a profitable, well- run business would fetch a better price than one in its present state. Taking his retirement sale as our end point, we created a vision for the business and determined what would be measurable land- marks along the journey. The results By introducing financial con- trols and budgets, he was able to bring his materials, laboratory and utilities bills down by 25 per cent. At the same time, we increased his fees and subsequent turnover by 10 per cent, increasing overall profit by 20 per cent. Both he and his associate ac- cepted referrals for some treatments, but that was done on a random basis. By introducing a defined patient journey for all new and old patients that put communication at its heart, patient treatment plan acceptance almost doubled. With an average course of treatment priced in excess of £3,000, this was significant. Jimmy boasted about being a bit of a dinosaur when it came to mar- keting, with a very basic website. With the engagement of his much younger associate, the practice took some definite steps forward in its marketing, utilising targeted social media. The referring dentists were identified and supported, and again communication was improved. Re- ferrals increased by 20 per cent in the first year, and he was able to em- ploy another associate. Two years after the crisis, though, Jimmy had a health setback and needed a quadruple coronary by- pass. I insist on my clients asking themselves the what if questions regarding their planning. Having put good personal and business sys- tems into place, Jimmy was able to sell the practice as a going concern and start his retirement a couple of years earlier than he had considered. * Name has been changed. About the author: Dr Alun Rees graduated from Newcastle Uni- versity in the UK and started his career as an oral surgery resident before working as an associate in several practices and opening two of his own. He sold his dental business in 2005 and, as a Coaches Training Institute-trained coach and Kolbe consultant, now runs the Dental Business Coach, where he offers support and advice re- garding practice organisation and management in the UK, Ire- land and beyond. Dr Alun Rees runs the Dental Business Coach, where he offers support and advice regarding dental practice organisation and management. (Photograph: Alun Rees) problem. In Jimmy’s case, we needed to stop the bleeding. As a specialist clinician, Jimmy took pride in his clinical skills, and so he focused on getting the minu- tiae of every case as organised and accurate as possible. When it came to running a business, he presumed that, as everything had worked in the past, it would continue to do so in the future. His previous response to any dip in cash flow was to work harder. This time, however, it would not work. The need for financial controls Although he paid his accoun- tants a monthly retainer and annual bookkeeping fees, no accounts had been submitted to Her Majesty’s Revenue and Customs (HMRC) for the previous three years. His prac- tice manager and he rarely commu- nicated effectively and he presumed that she was “managing”, whereas she was barely administering. There were few financial controls—no bud- gets or planning. With a monthly gross of about £50,000, everything Starting Well drive encourages young children to visit dentist By DT UK LONDON, UK: It can sometimes feel like dentists are fighting a losing battle when it comes to children’s oral health, especially given that re- cent figures from NHS Digital show that the number of children admit- ted to hospital for tooth decay has risen for the second consecutive year. It comes as welcome news, then, that around 30,000 children in the London Borough of Ealing have reg- istered with a dental practice this year, thanks in part to Starting Well: A Smile4Life Initiative. The initiative, run by NHS England, is intended to reduce oral health inequalities and improve the oral health of children under 5 years of age. This is done by focus- ing on those children not currently regularly attending a dentist and by providing their parents with ad- vice regarding sugar intake and the benefits of fluoride exposure for teeth. Though it will eventually be a national programme, Starting Well: A Smile4Life Initiative was launched in 13 high priority areas in January 2018, one of which was Ealing. These areas were chosen on the basis of local trends in oral health, existing oral health improvement plans and local authorities’ experience with tooth decay. At the recent BDIA Dental Show- case, Kelly Nizzer, Regional Lead for Dental, Pharmacy and Ophthalmic Services at NHS England’s London Region Team, outlined how well the initiative had performed. “It has worked so well for us and we are giving training to the den- tists with paediatricians from the hospital and community dental services along with Health Educa- tion England,” said Nizzer. “A number of our practices in Ealing have done things like events. In one event, there’s a parade taking place. Around 40,000 people go through the whole of Ealing for a re- ligious ceremony and all those prac- tices came and had stands there and got to talk to a number of people. We had about 400 new children from 0 to 5 that have gone into the practice from that event. We provide them with various resources to help them.” Due to the initiative’s success, it is likely to soon be expanded to Starting Well: A Smile4Life Initiative is run by NHS England and aims to reduce oral health inequalities and improve the oral health of children under 5 years of age. (Photograph: Dmytro Zinkevych/ Shutterstock) other London boroughs like Strat- ford and Hammersmith. This would likely involve commissioning new dental practices and including au- ditable oral health promotion in their contracts. IMPRINT PUBLISHER/PRESIDENT/CHIEF EXECUTIVE OFFICER Torsten R. Oemus CHIEF FINANCIAL OFFICER Dan Wunderlich DIRECTOR OF CONTENT Claudia Duschek CLINICAL EDITORS Nathalie Schüller Magda Wojtkiewicz EDITOR & SOCIAL MEDIA MANAGER Monique Mehler EDITORS Brendan Day Kasper Mussche Franziska Beier ASSISTANT EDITOR & VIDEO PRODUCTION Luke Gribble COPY EDITORS Ann-Katrin Paulick Sabrina Raaff BUSINESS DEVELOPMENT & MARKETING MANAGER Alyson Buchenau DIGITAL PRODUCTION MANAGER Tom Carvalho JUNIOR DIGITAL PRODUCTION MANAGER Hannes Kuschick PROJECT MANAGER ONLINE Chao Tong IT & DEVELOPMENT Serban Veres GRAPHIC DESIGNER Maria Macedo E-LEARNING MANAGER Lars Hoffmann EVENT AND EDUCATION MANAGER Sarah Schubert PRODUCT MANAGER SURGICAL TRIBUNE & DDS.WORLD Joachim Tabler SALES & PRODUCTION SUPPORT Puja Daya Madleen Zoch ACCOUNTING Karen Hamatschek Anita Majtenyi Manuela Wachtel DATABASE MANAGEMENT & CRM Annachiara Sorbo MEDIA SALES MANAGERS Melissa Brown (International) Hélène Carpentier (Western Europe) Matthias Diessner (Key Accounts) Weridiana Mageswki (Latin America) Barbora Solarova (Eastern Europe) Peter Witteczek (Asia Pacific) EXECUTIVE PRODUCER Gernot Meyer ADVERTISING DISPOSITION Marius Mezger DENTAL TRIBUNE INTERNATIONAL GMBH Holbeinstr. 29, 04229 Leipzig, Germany Tel.: +49 341 48 474 302 Fax: +49 341 48 474 173 info@dental-tribune.com www.dental-tribune.com ©2018, Dental Tribune International GmbH. All rights reserved. Dental Tribune International makes every effort to report clinical information and manufacturer’s product news accurately, but cannot assume responsibility for the validity of product claims, or for typographical errors. The publishers also do not assume responsibility for product names, claims, o r s t a t e m e n t s m a d e b y advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune International.