Efficient or Extraordinary?

One red umbrella in a group of grey umbrellas. Uniqueness concept.

Surprise is potent.

A client or patient will smile or sing about the delightfully unexpected.

They will simmer or roar at the disappointingly unexpected.

The consequences are disproportionate.

There is no leverage any more in being efficient.

We expect our transport to be on time, our room to be ready, our appointment to be fulfilled.

We will respond with irritation if you keep us waiting or if you fail to appreciate our uniqueness.

You won’t get a sale, a review or a recommendation for simply being efficient.

It is only when you take us on a journey beyond the obvious that we are motivated to buy, to vote, to share.

Google and Trip Advisor aren’t full of “5 out of 10” reviews.

It’s the 1’s and the 10’s that get the mentions.

You can choose to be at either end (to delight or disappoint) but you cannot survive being a 5.

5 is invisible.

The car wash


Back in the 1980’s I was the pension advisor for a client who owned and ran a petrol station in Blackpool.

As we inspected his accounts he taught me that the difference between winning and losing in his business was a car wash.

The profit margins on the petrol were controlled by the big oil companies and were so slim that the business couldn’t be sustained at the pumps.

He had to persuade the drivers to have their cars automatically cleaned – and hopefully buy some chocolate whilst they were waiting.

There are few family-owned stations now and the survivors have turned into mini-supermarkets.

Part of the same process that has corporatised (is that a word?) pharmacists, opticians, vets and, now, dentists.

At the risk of banging a very old drum – the difference in healthcare is that you are messing around with what makes people work properly – and that requires a higher degree of responsibility that selling commodities.

The VW emissions scandal is a predictable response to shareholder pressure for return on investment (although it would have been fascinating to be at the meeting where someone raised their hand and said “I’ve got an idea – why don’t we just lie?”). That same pressure on healthcare providers is scary.

The profit margins in day to day dentistry are going to get squeezed further and, ultimately, only the corporates and micro-corporates will have the economies of scale to survive.

It’s the occasional dentistry that will provide a living for the smaller independent and you had better be good at it.

Or open a car wash inside your practice.

I know I’m going to get vilified for this – but – a well managed hygiene-therapy department would achieve the same result.

(ducks to avoid rotten vegetables)


A large green recycling bin

Pauline works behind the bar at the Best Western Hotel, Calcot, near Reading.

Pauline clearly doesn’t like her job much.

When you approach the bar, Pauline doesn’t smile or make eye contact.

I know her name because Best Western make her wear a name badge.

If you attempt to make small talk with Pauline, she looks at you as if you have just crawled out of a recycling bin.

When you ask Pauline to pour you a drink – she pours you a drink.

When you ask Pauline if it would be OK to charge your drink to your room, she answers:

“yes – if you have your card or key” but she doesn’t look at you when she says it.

When you say “thank you”, Pauline says “you’re welcome” – but she doesn’t mean it.

Pauline is going through the motions.

When there are no customers at the bar she stares at the irritating game shows playing on the TV across the room.

I have no idea what is going on in Pauline’s life, nor do I care.

That’s not what I’m paying for.

I’m paying for her to play her part in a performance called “The Best Western Hotel, Calcot”, for which I bought a ticket.

That’s an entertainment in which I arrive at a hotel after 2 days of business travel, I walk to the bar to buy a diet coke before sitting down to catch up on emails and Pauline engages me in a bit of banter about my day, what I do for a living, the weather, the news – in fact, anything that takes my mind off work for a minute and makes me think that 4 days living in a suitcase isn’t so bad after all – and that Best Western may be a bit cheap and cheerful but at least they hire nice people.

Pauline is in the wrong job – she is more suited to:

  • traffic warden
  • HMRC or VAT offices
  • lighthouse keeper

The responsibility is with Best Western – they don’t train people to be happy when they are on stage.

It’s showbiz – and the show must go on.

Print this post and distribute to all your team.

No matter how much money you invest in marketing, equipment, training, fixtures and fittings – all it takes is one Pauline to bring it crashing down.

p.s. Pauline needs to be transferred on to the morning shift and asked to shadow Teresa – Teresa “gets it” and was a pleasure to chat with as I checked in for breakfast.


The Bridge2Aid Strategy Day


A real pleasure to be invited along to yesterday’s meeting of Trustees, Management Team and friends, listen to progress reports from key players and hear CEO Mark Topley outline plans for the next decade.

It was around 10 years ago that Annie B first introduced me to Mark after she had met him whilst fund-raising by trekking on the Great Wall of China – we quickly formed a lasting friendship with Mark & Jo Topley and founders Ian and Andie Wilson.

In 2008 came the first of a number of opportunities we have had to visit Mwanza and meet the team at Hope Dental Centre.

Bridge2Aid has occupied a place in our hearts at home since then (many of you know that Annie B regularly assists on the B2A stand at dental trade shows) and the opportunity to engage 7connections as Corporate Friends to the charity has been a recent privilege.

For Annie and I one of our highlights was to be part of the 2011 Kilimanjaro fund-raising team and to summit along with over 20 UK volunteers who have become life-long friends.

As I travel around the dental landscape, I know that many hundreds of generous individuals, businesses and dental practices in UK dentistry have had their own lives enhanced by volunteering, sponsoring, fund-raising, taking part in challenges and offering their talents and time in support of this great cause.

B2A have created sustainable dental pain relief in Tanzania by training over 350 Clinical Officers and, as well as changing one life at a time, have contributed to the development of the healthcare infrastructure for hundreds of thousands.

At the same time, they have succeeded in maintaining a family atmosphere at every level – a real sense of belonging for all those involved. You will see evidence of that at the Bridge2Aid Bash on 23rd October, during the BDIA (Showcase) and I urge you to come along and join the fun if you are staying around the NEC that evening.

The choice to support any charity is a very personal decision and the dental community are enormously generous when it comes to aid of any sort.

Perhaps a message that we can all carry to our patients, friends and family in our social media posts, newsletters and 1:1 conversations.

Today (Wednesday) we begin our second day, brainstorming ideas on how to do even more.

In another context, I recently defined a true friend as someone who makes you feel better about yourself.

I’m excited about the next 10 years supporting our friends at Bridge2Aid.

The Positive Focus

Focus On The Positive Concept

Yesterday was day 28 of 28 of my Positive Focus campaign.

I’ve been posting every day to my Facebook profile.

The rules are simple:

  1. take some time each day to write down the most positive things that happened – whatever the day was like
  2. keep a permanent record so that you can look back over your achievements

The theory is that the mind takes 28 days to acquire a new habit – and that if that habit is to focus on the positive then you will achieve more CONFIDENCE.

Which is the real point of the whole exercise.

If we approach life with a CONFIDENT mind-set, then we can overcome whatever barriers are placed in our way and celebrate our “wins”.

I’ve had some dark days in the last 28.

I emerge with a refreshed level of CONFIDENCE about my own abilities and about the future.

Every day I talk to people who are facing personal and professional challenges.

We all do – there is no escape – in the late 90’s, talked about life being a series of mountains, valleys and missiles.

The mountains are the moments when you feel on top of the world.

The valleys are filled with the darkness of which I spoke earlier.

The missiles are the unexpected nasty surprises.

Over the years I have also described life variously as a roller coaster, a game of snakes and ladders.

Money doesn’t make any difference (someone said money allows you to enjoy your misery in nicer places).

Power and prestige don’t help.

Recognition and celebrity are short-lived and shallow (although the applause is a wonderful drug).

At the end of days it will be your health and the amount of love you can GIVE that will determine your ultimate well-being.

If I could offer you one little bit of advice this morning, it would be to start your own 28-day Positive Focus.

See what happens.

Lifecycle Marketing in Dentistry – the movie



I’m pleased with the response to my presentation on Lifecycle Marketing in Dentistry, given at the Practice Plan Practice Management Conference.

For those of you who are members of Dentinal Tubules – the Manchester presentation was filmed by those clever folks at JSP Media Group (get your web site video created by them!) and has been nicely edited to cover me and my Keynote slides.

Here’s everything we know in September 2015, condensed into one hour. A valuable resource for team training.

I was delighted to read this review by Mandar Joglekar from India this morning:

Just watched the Lifecycle marketing lecture by Chris Barrow on dentinal tubules for the third time. Sharing the thoughts for my dentist friends.

Lifecycle marketing is a school of thought or a philosophy in marketing which involves seven basic steps of marketing. All these seven steps look simple, logical and easy at start. But as he deconstructs each step, it gets interestingly complex and exciting.

He applies the principles of lifecycle marketing to dental practices and creates a beautiful workflow which covers each and every aspect of dental marketing we should know. He divides the processes into – ‘to be done by actual persons’ and ‘to be done by machines’.

Chris emphasises that marketing is storytelling. People are less interested in the new gadgets you have but they are more interested in stories which tell about how you brought change in the life of a certain patient. Stories connect people.

He discusses in detail about attracting people to your website, get their e-mail and get permission to keep them posted, nurture the relation, convert patient, deliver great service, bring them back for further treatment and ask for referrals. Sounds easy but it involves many small steps and communication skills, soft skills of the whole team.

Here I must share the example Chris gives about a long term nurture to a potential client through email communication and how that customer contacted after 17 years. Great story.

Before listening to this lecture, there was a doubt in my mind about the need and effective use of these marketing principles in a small city in India where I practice dentistry for last 17 years. Many questions I had– Is it really for me ? Are these concepts only for the developed western world? As I watched, I found most of these things are possible in my practice with minor changes.

The speed at which digital world is changing is tremendous and the marketing of dental practice involves many processes which require web communication options, social media, smartphones, emails and telephonic communications skills. No one can afford not to market their practice in the digital world.

Please don’t miss this lecture on Dentinal Tubules. You won’t know how quickly those 65 minutes will pass. He is excellent communicator, funny (Listen to him as a nasty receptionist on phone) and motivates to implement these concepts.

Thanks Dhru Shah for making this lecture available on tubules. If one hour lecture video motivates me like this, I can’t imagine what will happen when I attend two full days course of Chris Barrow at my city Pune during DCUK India accelerator program in early 2016. Thanks Manish Chitnis for bringing Chris here. Looking forward to meeting and learning from Chris Barrow himself.
Cheers .

Protect your Profit Margin – the solutions


Yesterday we looked at how easy it is to erode your profit margin by careless pricing, discounting, finance and special offers.

So how do you “protect your profit”?

Frequently the answer I hear is “pay my associate less”.

It is for that reason that associate remuneration in NHS dentistry has been heading downhill for 10 years and many are on the equivalent of a 35% contract (albeit hidden in UDA values South of the Border).

The same pressure is bearing down on associates in private practice.

I’ve been one of the leading commentators on this subject (for over 10 years now), arguing that after FD1 & 2, apprentice dentists should be paid a fixed salary and then moved onto a sliding scale contract (if they make the grade) of between 35% and 55% depending on gross. I have three clients recruiting on this basis now and they are not having any trouble filling places.

However, associate-bashing (or “restoring their differentials” as Arthur Scargill might have said) is a blunt instrument that in the absence of other prudent measures can cause a lack of goodwill and low morale, as well as some untimely exits – tread with caution. It is simply easier to recruit new associates at the right rate than reduce perceived earnings potential for existing team members.

There is a more comprehensive answer to the problem of careless pricing.

By pricing from the bottom line upwards.

You begin the internal conversation by asking:

what is the minimum level of profitability that I am prepared to accept on this procedure?

If we return to yesterday’s Cerec crown , you will recall that, with a 50% associate contract in place, the original profit on the procedure was calculated as follows:

Price charged to patient £500.

“Lab bill” (i.e. the cost of milling) £135

Payment to associate (500-135) x 50% = £182.50

Operating cost per surgery per day = £250/7 hours = £35.71 (assume 1 hour for the appointment)

Pre-tax profit (500 – 135 – 182.50 – 35.71) = £146.79

Profit margin (146.79/500) = 29.35%

But we also saw yesterday that the addition of a membership plan discount, 0% finance and a higher operating cost per surgery per day could quickly reduce your profit well below minimum viable levels.

So as the owner of the business you could establish a golden rule – that you always want to make £146.79 profit on any Cerec delivered by an associate, under any circumstances.

So, assuming the lower OCPSPD, let’s bring back in the membership plan discount and 0% finance. Then reverse the calculation as follows:

Target profit = £146.79

OCPSPD (one hour appointment) = £35.71

Total gross profit required (146.79 + 35.71) = £182.50

Lab bill = £135.00

Total so far = £317.50

Payment to associate (bear with me on this for a minute) = £182.50 (as before)

Total nominal price to patient (before associate calculation) (146.79 + 35.71 + 135.00 + 182.50) = £500.00

Back to square one – but where are we going to fit the membership plan discount and the finance charge?

This is where we come to a bit of vintage Coach Barrow.

Somebody has to pay – the choice is simply yours:

  • You and Your Family
  • Your Non-Clinical Team
  • Your Clinical Team
  • Your Suppliers
  • Your Patients

There is no escape from this crushing logic.

If you and your family are prepared to pay – please go back to yesterday’s blog post and calculate your reduced profit margin.

If your non-clinical team are to pay – then announce a pay cut for them all – or draw straws this lunchtime and sack the person with the short straw (make sure the well poisoner gets that straw).

If your clinical team are to pay you have to reduce their percentage and/or ask them to share 50% of the membership plan discount AND 50% of the finance charge (remember that in the calculation above, I only paid the associate 50% of the original price).

If your suppliers are to pay – start calling them and asking for a price reduction – at least you will give them a good laugh to end the week.

If your patients are to pay – then you have to increase your RRP to absorb the membership plan discount and/or the finance charge.

Price of a Cerec crown to protect profit = £500.00

Add 20% membership plan discount (500/0.8) = £625.00 for non-members.

Add 7% zero finance charge (625/.93) = £672.04 for non-members with finance.

Or (500/.93) = £537.63 for members with finance.

That’s the right price to protect your profit (and the associate gets paid on a £500 nominal value).

“nobody in my post code will pay that much for a crown”

“when my competition get wind of that I’ll sink”

” you can’t penalise people who want credit”

“my associates will never accept that”

I’ve heard it all and more besides.

Anyone in serious business will tell you that protecting your margin is more important than setting your price.

So the only options you have are to either increase prices, reduce somebodies earnings or stop making those offers.

Let me leave you with a Golden Question:

If I make this decision, how will it affect my profit margin?

Protect your profit margin


Inevitably I get a lot of questions about pricing, usually in connection with:

  • what should I charge my patient?
  • what should I pay my associate?
  • should I offer 0% finance?
  • what discount should I offer for those who join my plan?

Without exception, the conversation begins at the wrong end – with the price.

Dare I suggest that in most cases, the dentist’s solution to setting prices is:

  • I’ll ask around a few mates
  • I’ll take a look at what the practice down the road is charging

The top-down approach to pricing is a minefield.

I recently analysed the price of a Cerec crown with a client:

Price charged to patient £500.

“Lab bill” (i.e. the cost of milling) £135

Payment to associate (500-135) x 50% = £182.50

Operating cost per surgery per day = £250/7 hours = £35.71 (assume 1 hour for the appointment)

Pre-tax profit (500 – 135 – 182.50 – 35.71) = £146.79

Profit margin (146.79/500) = 29.35%

That sounds like good business. It IS good business.

The crucial figure here is actually operating cost per surgery per day (OCPSPD).

That is calculated by looking at the fixed costs of running the business (overheads) and dividing by the number of surgery days available in the year.

Keeping your OCPSPD low is mission critical and yet most Principals don’t even know what their number is.

If you start building the shag-pile and chandelier practice, this can increase very rapidly.

In the above calculation I was dealing with a mainly NHS practice who are slowly developing their private sales.

The OCPSPD  at £250 is comparatively low.

If this creeps up – the numbers change – lets look at a practice where the OCPSPD is £450 (or £64.28 per hour).

Pre-tax profit (500 – 135 – 182.50 – 64.28) = £118.22

Profit margin (118.22/500) = 23.64%

That’s an “ouch” but not the end of the world.

Now we get to the really damaging bit.

Option 1 – the patient joins the membership plan and so you offer a 20% discount on the crown.

Option 2 – the patient is offered 0% finance with a 7% internal finance charge.

Even on the £250 per day OCPSPD the difference is dramatic:

Price to patient £400

“Lab bill” (i.e. the cost of milling) £135

Payment to associate (400-135) x 50% = £132.50

Finance charge @ 7% £28.00

Operating cost per surgery per day = £250/7 hours = £35.71 (assume 1 hour for the appointment)

Pre-tax profit (400 – 135 – 132.50 – 28.00 – 35.71) = £68.79

Profit margin (68.79/500) (note here I am using the original price of £500) = 13.75%

You cannot sustain an independent practice doing work for a 13.75% profit.

If your OCPSPD is £450

Pre-tax profit (400 – 135 – 132.50 – 28 – 64.28) = £40.22

Profit margin (40.22/500) = 8.0%

You may as well sell your practice and build a buy to let portfolio – it’s a better return and no GDC.

To summarise – if you:

  • invest in the practice so that your OCPSPD goes up
  • pay your associates 50%
  • offer membership discounts and
  • offer 0% finance

You can quickly ruin your business.

So that’s the problem.

Tomorrow I’ll talk about the solution.



The death of the web site


Chatting with one of my oldest friends yesterday, Alan Rae, a Glaswegian now living in the USA and running a fascinating business called Sportolutions, providing e-commerce solutions for leading sports clubs across three continents.

To quote their own web site:

Cloud based solutions enabling sports teams and venues to connect with, engage and create new revenue from fans online, on mobile, in stadiums and on the street.

The most interesting aspect of our conversation was in connection with a new American football league that is being launched to cover the months that the NFL is in recess.

The FXFL (Fall Experimental Football League) will provide a developmental platform for budding NFL players. Would that some UK sports could take a tip from this.

The financial backing in place is significant, including a lucrative TV deal with ESPN that, predictably, will provide a lion’s share of the funding.

Alan’s company are going to be playing their part in building the e-commerce side of the League.

Here’s the extract from our conversation that had me thinking long after we had parted:

we recently sold 38,000 tickets for a football game on-line. 59% of them were purchased on a smartphone, 9% on a tablet – a total of 68% that didn’t require a PC or a traditional web site – we have realised that our future business will be mobile based.

They have already developed elaborate applications that facilitate social engagement, membership and merchandise, as well as ticket sales.

One platform, multiple new revenue streams

No setup or ongoing costs. Clubs enjoy new revenue from memberships, social, games, competitions, peer-to-peer challenges & partner activation.

TEAMS for ticketing
Stadium level membership, season, reselling and direct ticket platform.

TOUCH for loyalty & payments
Cashless payment, loyalty reward and partner activation platform.

PULSE for social & fan engagement
Comprehensive fan outreach, games and competition platform.

TEAMS Stage for music & arts
No customer redirection to third party providers. Whether general access or fully seated, ticket sales are transacted on venues’ own websites with all the advanced features of TEAMS.

Alan’s belief is that the traditional web site will become extinct, replaced by a new form of responsive mobile site, assuming that the majority of customers will connect via a watch, smartphone or tablet.

Given the emergence of the Apple Watch, ever bigger iPhones, Android phones and iPads it begs the question whether the traditional laptop and PC will become the preserve of out-dated corporations (like the utility companies, local authorities and Government departments to whom I cannot send an email).


Whether in fact, the public will communicate with each other and with the world via hand-held and (eventually) wearable technology.

How long, I wonder, before we have to reinvent everything we know, including digital marketing.


Annoyingly (for me), he quotes Manchester City FC as one of the most innovative in the English League and Manchester United as one of the most backward. City want to learn and United think they must know it all.

Sounds familiar in UK dentistry – the biggest and longest established are the most difficult to modernise.


Get Your Year In Gear 2016 – we are good to go!



Thumbs Up With The Year

Last week I asked for your help in making a decision..

I was considering running a 3-month super-fast and dynamic personal and business coaching programme from 1st October to 24th December 2015.

I wanted to know if there was any interest – and some of you replied “YES!”


It was also lovely to hear from some old friends:

Hi Chris,

I attended your programme in the early 2000’s and I have to say it was the best coaching I have ever had – it really did change my practice.
I sold out to a corporate last year but you should promote your programme as it will really benefit those who join up to it.
I have 10 people who have confirmed their interest in 12 weeks of Coach Barrow immersion – and I’m running this request again to see if we can double those numbers before Monday next week – then I can launch the boat.
Here’s what another former client said last week:
Well I’m still living the effects of taking part in your GYYIG back in 2013 so at the moment doing it again isn’t necessary – I still re-read some of the stuff I sent you when I need a kick up the rear to get focused again!
Here’s a summary of this year’s GYYIG:

12 weeks

  • 12 weeks to get ready to create a flying start to 2016.
  • 12 exclusive one-hour recorded webinars from The Bunker on the subject of business planning so that you can download and watch at a time that suits you.
  • 12 printed interviews with me on the subject of personal planning that you can download and read whenever you are ready.
  • 12 self-assessment exercises that you can take whenever you like to measure your current well-being and where to go next.
  • 12 weeks membership of a private Facebook Group for all participants to share wins and ask questions.
  • 12 weeks of on-demand coaching by me via email or on-line call.
  • 12 weekly check-ins with me by email to monitor your progress.

Your Content

  1. Where do you want to go? Creating your vision for 2016;
  2. How are you going to get there? Setting goals for 2016;
  3. How will you know you are on course? Establishing measurement systems;
  4. How will you have time to do this? Managing time;
  5. How will you keep everyone on track? Planning your progress;
  6. Where is the money going to come from? Understanding your finances;
  7. What happens if I make changes? Playing “what-if’s”;
  8. Where do I keep count? The Mother of all Spreadsheets;
  9. How will I get my people onside? Building your team;
  10. How can I clear my desk and my task list? Delegating effectively
  11. How do I get more of what I like best and less of what I like least? Tolerations
  12. How will I keep this up? Habits

Your Investment

£300 pcm (inc VAT) for 3 months. Total £900 (inc VAT).

Your Outcome

A crash course in personal and business development with Chris Barrow – guaranteed to challenge, to entertain and to inspire.


Some of you are bothered!

So here is a second and final chance to join us.

Please email coachbarrow@me.com with the subject “GYYIG 2016” and I’ll assume that means you are interested in hearing more.

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