Is dental practice now just dog eat dog?

I know you get fed up with me writing about when life was easy for a private dentist (sometime between 1992 and 2006), however, for a few years now I have been observing increasingly bad behaviour by some dentists (both practice owners and associates).

Maybe I’m part of the problem because I constantly coach dentists to be more commercial in their approach to dental practice. In fact, I frequently describe my job as having to facilitate an uneasy marriage between clinical dentistry and the needs of a business.

However, all of us have a line between acceptable commercial behaviour and dog eat dog behaviour. Maybe the folk involved in the examples below have drawn a different line in the sand to me or maybe their moral compass is simply swayed by the thought of all that money (because greed seems to be one of the common denominators in these behaviours).

My definition of a professional is somebody who puts their clients’ needs before their own, but increasingly I find that some dentists are willing to reverse this principle. It seems that sometimes the rules of decency, fair play and respect for colleagues goes out the window once the chance to make some money arises.

Here are just a few examples of poor behaviour I have come across this year:

Irritating behaviours including:

  • Refusing to sign or delaying the signing of an associate contract
  • Refusing to give sufficient notice of holidays
  • Cancelling sessions or finishing early because the session wasn’t booked densely enough
  • Associates treating friends and relatives for free (including having the practice pay a share of their lab bills)
  • A friend working in a corporate practice as a locum related an incident when the two regular dentists refused to see an emergency patient because it was their coffee break
  • Associates who insist on keeping all of the call out fee for treating emergency patients out of hours
  • Dentists texting or answering emails while their patient is in the room (or even answering their phones!)

Even more surprising bad behaviours such as:

  • A dentist selling his practice insisted on re-negotiating the contract of sale (in her favour) just days before it was due to complete
  • An associate agreeing to buy out a retiring principal at an agreed price while at the same time preparing to spend the money on opening a practice down the road and contacting the patients to ask them to come with her
  • An orthodontic associate who refused to use the practice therapists
  • An NHS orthodontic practice where the dentists see (circa) 80 patients a day, some of them having to queue on the stairs while waiting for their (late running) dentist, while the owner earns seven-figure profits
  • The NHS orthodontic practice booking five minute de-bond appointments
  • The dentist who takes to social media to castigate their patients and/or their suppliers (creating a sort of digital lynch mob)
  • Associate dentists who at interview forget to mention their GDC fitness to practice case

And then there are practice owners who:

  • Have still to invest in a computerised practice management system or even a website
  • Treat their patients privately but expect the NHS to provide out of hours emergency treatment for them

I could go on, and I don’t have an answer for all of this. (In my darker moments I fantasise about sending my list to a Daily Mail reporter…) You could argue that this is just good commercial business behaviour. Or you could argue that the veneer of professionalism that dentists rightly wear is getting mighty thin!

So does that mean that dental practice is now just another dog eat dog business where the most commercial player wins? If so, like the dragons in the den, I’m out!

I think some of the reasons for these behaviours are:

  • The high value of dental practices
  • The reducing profitability of some practices
  • Lower associate earning potential
  • Competition for associate jobs

I suppose everybody in dental practice has some sort of recognition of acceptable and unacceptable behavior. For what it’s worth, I believe all businesses should treat their clients, their staff and their suppliers with the same respect that they would wish to be treated with. Maybe the old adage that you reap what you sow applies here — I, for one, certainly hope it does.

And, lastly, some dental consultants I come across are clearly pushing their clients into this overly commercial and unprofessional behaviour. Almost a perfect storm isn’t it! Well, you don’t have to take part, you can wear your integrity on your sleeve and choose to behave like and only work with folk who share your professional values (and mine).

If you would like a chat about how I can help you, contact me on

m. 07770 430576



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