8 ways you’re blocking dental practice growth


Last weekend the Breathe team hosted a four-day retreat to help 12 clients master the art of leading and managing a dental practice. With the luxury of plenty of time, the coaching ranged from identifying core personal values to creating and leading a balanced team.

I am always curious about the blockers that slow a client’s progress and although this group varied from a single-handed squat to an eight-surgery West End practice, some of their blockers were surprisingly similar.

So, here are my Top Eight Blockers To Dental Practice Growth:

1. Low average patient value. This usually means the dentists are doing a little on a lot of patients. Most dentists love a big list of patients and the full diary that goes with it (despite the amount of time they have to spend doing check-ups). However, having a lot of patients means they rarely have to sell a treatment plan as most of their patients will say yes to a single unit of dentistry. In this situation, the opportunity cost is all the work that isn’t being done. If you’re interested in calculating your average patient value, divide your last 12 months gross by the number of patients who visited the practice during this period. The average patient value for Breathe Clients varies from £70-£90 for NHS practices to £180 to £400 for private practices. The number of active patients required for a full time private dentist is circa 800-1,000 adults, for an NHS dentist about twice this.

2. Low new patient numbers. New patient value will be greater than returning patient value and so a low number of new patients (less than 10 per full time dentist per month in a private practice and double that in an NHS practice) will slow the practice growth. If word of mouth together with an old website (more than three years old) are your only marketing tactics, you will likely suffer from poor new patient numbers. A well thought out marketing strategy can drive between 40 and 100 new private patients a month into your practice.

3. Bad opening hours. Patients are increasingly reluctant to fit in with your hours and practices that open seven days a week in supermarkets find that their busiest day of the week is a Sunday. (The second busiest is a Saturday). Some of our clients have more than doubled the size of their practices by opening outside of their old 35 hours a week regime.

4. Insufficient leadership and management resource. In many practices the owner has too many roles and simply too much to do, meaning that things simply don’t get done. Leadership and management during lunch breaks, evenings and weekends will slow your progress and stop you having any other sort of life! The impulse to do this tends to accompany the belief that working in your practice is more important than working on it. The result is fees get earned but the practice stays in limbo. And many practice managers simply lack enough skill (or training) in financial control, marketing, sales management and people management (particularly managing dentists) to have any hope of executing a business plan (typically spending most of their time operationally fire-fighting).

5. The wrong people. Low grossing associates, hygienists who just clean teeth, low-skill practice managers, receptionists who haven’t been trained to convert an enquiry into a new patient consultation… You get the picture.

6. Poor facilities. Bad location, poor parking, poor access. Paradoxically, I have visited some fantastic NHS clinics recently and some awful private practices. Clients are more discerning these days and they have a greater choice of practices so they can easily move to if they dislike your: wood chip walls, depressing patient lounge, blue-tacked notices telling them off, lack of air-con and wet film x-rays. Some dentists have been taking all the profit out of their practices for years and years and their practices inevitably slip behind their competition in every aspect.

7. The wrong proposition. The market is changing and it might be changing faster in your catchment – leaving your set of offerings behind.

8. A lacklustre owner. Lack of a robust and compelling growth plan, the resources to execute it and the belief that it will work…

If you recognise any of these blockers and you would like to talk about how to overcome them, email me on simon.hocken@breathebusiness.co.uk to arrange a chat.

With all good wishes,


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