Growing Your Practice with New Fee-Earners

Somebody once said to me that, ‘if you think your business is staying the same size, it’s probably getting smaller.’

A lot of dental practice owners I meet are not growing their business in terms of; the number of patients they/their practice look’s after or, in terms of the number of fee earners they employ to look after their patients.

Often, they are temporarily growing their turnover and profit by increasing their fees or introducing new, higher price services. However, ultimately, there has to be a glass ceiling to this strategy, which will lead to stasis.

Dental business owners continue to face a relentless rise in their business fixed costs, with more increases to come in terms of HTM01/05, CQC Compliance and Revalidation. In the near future, they will find it difficult to maintain their annual profits and even employing the tried and tested strategy of running faster, they may find their profits are standing still.

One of The Breathe Services we host is an Entrepreneurs Business Club and this small group of dentists are passionate about really growing their practices (their turnover and their profits) year on year. Therefore, many of the fundamental conversations we have are about creating strategies to make this happen.

In particular, how to:

• Attract more new patients (Marketing)
• Diagnose, treatment plan and sell the new patients more of what they want.
• Keep their associates busy
• Keep their hygienists busy
• Move patients from the principal(s) to the associate(s)
• Introduce new fee earners and get them busy

Here’s the difficult bit…

True practice growth requires an effective, ongoing process of introducing new fee earners and getting them busy.

The accepted way of doing this has been to create a demand for the principal (or existing associate) so that their patient list grows to a point where their diaries are booked for weeks ahead. Then bring in a new dentist in order to transfer some of their patients to them. At this point, they hope/cross fingers that the new dentist can grow and build their list into a full time post.

And then, if there is room, they start the process over again.

The Principal has shown that he/she can grow a patient list, now they are looking for an associate who can do the same. But, is this the right model? It has been a reasonably effective strategy in the days when dentists working under the NHS provided virtually all high street dentistry; however, it rarely ever works in a private pay as you go practice for two very good reasons.

1. Private practices are all about the quality of the relationship and patients are reluctant to transfer their relationship to a new provider.
2. Principals are often very good at the skills they need to grow a patient list including:
   • Great interpersonal skills including being extrovert and charismatic.
   • Great selling skills.
   • Great patient retention skills.

The new associate may not have enough of the above skills and so they are not able to grow the patient list quickly (or at all). Progress in growing the list can be very slow, everyone gets fed up and blames each other and things grind to a halt when the associate resigns because their, ’book is too gappy’. Many practices end up staying the same size because of this situation.

So, if you are truly interested in growing your practice, you will either have to choose your new fee earners really, really carefully or find another, less stressful way of making it grow.

Here are some ideas for you to consider.

1. Change the patient journey so that you or somebody with your treatment planning and selling skills triages all the new patients and then allocates the work to your team of clinicians.
2. Once the new patient is dentally fit, ask them to join a Membership Scheme (in order to ensure their loyalty), and gently transfer their maintenance care to an associate and a hygienist who will take care of them going forwards.
3. Introduce hygiene – led examinations, that is re-examinations that are hosted by the hygienist and overseen by the maintenance dentists.
4. Give the Capitation list to the associate(s)
5. Give all the principal’s patients to the Associate and let the principal build a new list, then give it to another (new) Associate!
6. Pay an associate a retainer to be in the practice whilst their list is building

If you would like to know more about how Breathe can help you develop your practice, then please contact Ernie on 0845 299 7209 orernie@nowbreathe.co.uk