By Simon Hocken, Lead Coach: Business, Practice & Clinical Leadership
To the untrained observer, many private dental practices appear to offer the same service at remarkably similar fees. However, in my experience, if you know what to look for, most private dental practices fall into one of two groups. I call them:
1. Just In Time Dental Practices and
2. Wellness Dental Practices
And I suspect that the pareto principle applies, that is 80% of UK Private practices are “Just In Time Dental Practices” and 20% are “Wellness Dental Practices”.
Have a look at the characteristics for each type of practice below (and given that any classification of practices is bound to be flawed), see which group your practice most likely falls into:
Characteristics of A Just In Time Dental Practice include:
- 20-30 minute new patient consultations.
- The Dentists offer “limited/edited” Treatment Plans to new patients of circa £500-£1,200.
- The Dentists offer single tooth treatment plans to returning patients of circa £100-£400.
- The Dentists provide mostly fillings and rarely offer lab based dentistry (about 5% of gross).
- The actual hourly rate grossed by the dentists’ ranges from £80-£160/hour which translates into £700- £1,100/day.
- The Hygienists spend their appointments mainly providing scale and polishes with a little oral hygiene instruction squeezed into 20 or 30 minute appointments. There is no sense of progress for the patients and little in the way of periodontal indexing.
- Most of the patients have some sort of chronic perio disease and rarely get well.
- The Hygienists gross circa £475-£550/day with 60-75% occupancy and insist on being paid £30-£40/hour regardless of whether they are seeing patients.
- These practices often offer a capitation scheme to their patients and often provide the capitation patients with more dentistry than they are paying for.
- The patients stay because the bills are manageable and they believe that they are getting comprehensive dental care.
- These practices have usually “converted” from being health service practices, continue to provide some health service provision and are effectively private, health service practices.
- Many of these practices are struggling to make a profit faced with rising costs and unsupportable demands from their associates and hygienists.
- Facilities may need sprucing up.
- Rushed patient journey.
- Potentially late running clinicians.
- Next to no marketing, unsure of it’s effectiveness.
Characteristics of A Wellness Practice include:
- 45-60 minute new patient consultations
- The Dentists offer unlimited, comprehensive Treatment Plans to new patients of circa £500-£20,000 and have sophisticated communication skills so as to enable the patients to say yes to 80% of them.
- The Dentists provide many restorations that are lab based so as to increase the longevity of their solutions (about 10-15% of gross).
- The Dentists offer reassurance to returning patients that nothing needs doing, or if it does, it is simply maintenance of their healed gums and their restored dentition.
- Returning patients are often members of a maintenance scheme that ensures their loyalty and spreads the cost of their maintenance dentistry.
- The actual hourly rate grossed by the dentists ranges from £200-£450/hour which translates into £1,500- £3,300/day.
- The charismatic evangelical Hygienists have long appointments with their patients, usually between 45 and 60 minutes. They provide comprehensive and intensive periodontal treatment to get rid of the patient’s active disease and set up a number of indexes so as to monitor their patient’s progress and make sure that their disease is not returning.
- Most of the patients have got rid of their chronic perio disease and are maintaining their healed status.
- The Hygienists gross circa £650-£900/day with 80-95% occupancy and are well paid.
- These practices have patients who pay for their treatment as the go with the exception of their membership patients.
- The patients stay because they know that they are getting comprehensive dental care with a functional preventive element which means that once they have completed their journey to ”wellness” they will simply require inexpensive maintenance dentistry. The patients are fiercely loyal and wouldn’t dream of going anywhere else.
- These practices have never been health service practices and are usually squat practices run by charismatic, visionary principals.
- Many of these practices are making a good profit and are extending their services into new areas of general wellness.
- These practices usually have state of the art facilities … with a relaxed patient journey.
- The clinicians never run late.
- Their marketing is very sophisticated and effective.
So, do you know which camp you are in?
Right, it might surprise you to know that I don’t really have an opinion about which is the best sort of practice to own, (as long as me and my family can be patients in a Wellness Practice!) And, I am not about to try and persuade you to to move your practice from one group to another. Both types of practice can serve a specific group of the population and be fun and profitable to work in or own. They’re just different!
For me, there are two good reasons for identifying which group your practice belongs to:
- Each type of practice needs its own set of business practices to make it work and
- The marketing for each practice is very different.
Let me demonstrate:
Many Just In Time Dental Practices are shrinking. This is mainly because the patients no longer feel the need to go back as regularly as they once did and the dentists are not seeing enough patients in a day to make enough gross to make the practice work properly as a business.
In order to make a Just In Time Dental Practice (JITDP) work it must:
- Be completely systemised and run like a well oiled machine in order to maintain…
- …a high patient throughput, that is 25 to 40 patients per dentist per day.
- Have Dentists who can work quickly, no faffing…
- …meaning that each dentist needs a list size of around 1,500 active patients.
- And the Hygienists only look after severe perio patients because most of the time the dentists need to provide exam, scale and polishes in 20 minute appointments.
- So, a JITDP with 3,000 Patients requires 2 FTE Dentists and a part time hygienist.
- This will create a turnover of circa £550k and a…
- …net profit of 28-35% of turnover, to be shared by the two dentists.
In order to make a Wellness Dental Practice work it must:
- Have terrific relationships with the patients and within the team.
- Have Dentists who are comfortable offering full mouth rehabilitation and are able to communicate the benefits to the patient so that they say yes to the treatment.
- Low patient throughput, that is 8 to 18 patients per dentist per day…
- …meaning that each FTE dentist needs a list size of around 700-1,000 active patients.
- And the Hygienists look after all of them! It would never occur to a dentist in this type of practice to do an “Exam, Scale and Polish”.
- A Wellness Dental Practice with 2,000 patients requires 2 FTE Dentists and 1.5 full time hygienists.
- This will create a turnover of circa £850k and a…
- …net profit of 18-28% of turnover, to be shared by the two dentists.
Marketing a Just In Time Dental Practice effectively, requires:
- A functional effective, working web site as it’s primary marketing tactic.
- Fantastic signage and “Kerb presence”.
- A clear “proposition” that states clearly what is on offer and…
- …reassurance that the fees will be affordable.
- An effective recall system.
- An effective dormant patient reactivation system.
- 10 new patients per full time dentist per month.
- Cost of acquisition of new patients, £10-70/patient.
Marketing A Wellness Practice effectively, requires:
- A functional, effective working web site as it’s primary marketing tactic.
- A clear proposition that states clearly what is on offer.
- An effective lapsed treatment reactivation system.
- A water tight patient get patient programme.
- 5 new patients per full time dentist per month.
- Cost of acquisition of new patients, £120-240/patient.
The point I am making is that these two types practice are very different businesses (both profitable) and as ever, one size business coaching doesn’t fit bothl!!!
If you would like some help with starting a “Just In Time” or a “Wellness” Dental Practice or if you are interested in taking your your practice to the next level, then email me or call me directly on:
t. 07770 430576