7 reasons why successful dental practices decline


Between 2010 and 2014 UK dentistry grew by 27 per cent. To put that into context, GDP growth was well under two per cent for the same period.

Incredibly, dentistry will grow by another 7.5 per cent this year. It’s hard to think of a sector that shows the same trajectory of sustainable growth. Imagine if you had chosen to be an estate agent in Leeds instead of a dentist there 10 years ago. Ouch.

Assuming you did choose dentistry though, is your practice growing in line with the sector – that is, seven per cent or more a year?

The answer will depend on where you are in your practice build cycle (if you bravely set up a squat three years ago you will be growing at a far faster rate, more like 35 per cent).

If your practice is long established and in a comfort zone it may actually be declining, a shocking thought I know! But if your practice is reducing at say five per cent a year and the market is growing at seven per cent, just do the maths. You’re missing out on a lot of business.

Perhaps the more shocking part is that with few exceptions in my experience the rate of decline actually accelerates over time.

So why are so many well established practices in decline?

The reason is largely to do with the traditional dental business model which goes something like:

  • Start squat when 30
  • Grow it up into a successful practice by the time you hit 45
  • Having arrived, gently take your foot of the gas
  • Nothing bad happens, it just slowly, often imperceptibly, declines over the next 10 years
  • You sell it and retire to grow tulips

Here are my top seven reasons why established dental practices are in decline:

  1. The comfort zone kills your fight. As the waistline grows and the killer instinct fades you get a bit lazy and bored with the repetitious nature of the work. There’s no fire in the belly left and you worry more about the house extension than the business.
  2. Your hands are tied by the informal cartel. Neither you or your business rivals dare to rock the boat. There are no ‘disrupters’ – it’s quite cosy in fact (until a disrupter enters the ring).
  3. You don’t want to invest in the practice. You see very little incentive to do so. How does a new patient loo earn you more profit? The existing loo is fine, you put it in 15 years ago and have never heard a patient complain about it.
  4. Lack of effective marketing. Most practices have little understanding of the new patient acquisition process needed in 2015. Testament to this is the prevalence of generic websites that squander the vast marketing potential the web offers.
  5. Lack of a sales process. We all know the most successful clinicians are not necessarily the best clinicians. They are the ones that can communicate effectively with patients and present options in a clear way and, yes, business people call that selling. It’s a fact of life that practices that embrace a sales culture are far more successful than those that don’t.
  6. Not understanding of the performance numbers. And having no real interest in them, largely because for the last 15 years you have not had to be interested in them. You won’t have systems that deliver performance data every four weeks and you rely on year-end results which are usually 24 months old.
  7. Lack of ambition. There’s no imperative to make a plan to take the business forward.

The whole market is in steady growth, so if you’re not getting it somebody else is. There are new practices opening; large, sophisticated and well equipped NHS practices along with clinics in Sainsbury’s and the corporates – but the most likely benefactor is the switched on entrepreneurial practice owner.

If you are a mature practice owner and this article is registering with you, please call me – I can help.

Best wishes



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