7 Predictions for 2015

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The BDIA conference this year was an excellent opportunity, as always, to take the temperature of UK and Irish Dentistry.

Much of the debate in the profession in recent months has centred around the GDC and ARF as well as FtP (ah, we love our three letter acronyms don’t we? LOL). Thanks to the work of individuals, publishers and organisations, it seems that the tide has at least been slowed, if not turned back, and outsiders are taking a look at the GDC’s own FtP as well as the rationale for the increased cost of regulation.

I remain convinced that dentistry will follow the pathway of Financial Services regulation and become more expensive and draconian – and that the only sensible planning is to embrace change.

At the same time, it seems that the one purpose the GDC has inadvertently served is to temporarily unite members of a historically fragmented group into one common voice.

It remains to be seen who, if anyone, will take that opportunity forward.

The BDA have a once in a generation opportunity to step into the melee and make a name for themselves as a representative body with bark and bite. Have they?

Or is Tony Kilcoyne the only person who has emerged as a champion for the cause who can unite the profession and engage with the media in a way that leaves us all better off?

If Tony stands for office at the next General Election I may be tempted to break the habit of a lifetime and cast a vote (although ridding the world of the Farrage virus may prove equally compelling).

Moving past that debate (and leaving the stage to those far more eloquent and qualified than I), where is the profession going next, especially from my field of experience- the business end of things?

Here, based on my last 12 months at work and my 3 days at BDIA, are 7 of my predictions:

1. Aliens versus Predators

IDH and Oasis continue to battle it out for market share.

There is an economy of scale that has focused the larger corporates on bigger purchases historically – sometimes less than £1m in sales just wasn’t worth the hassle, paperwork, due diligence, professional fees and prevarication of the owners. That may change as the supply of larger practices dries up and both corporates start to scrape the barrel.

However, a more likely approach is that they look for the bigger mid-range corporates (over 100 practices) and so we may see some of the historically owner-managed mid-range corporates finally swallowed up as the price and timing coincide.

The historical emphasis on NHS contract purchases may also force a course change and generate more private sales (at a lower goodwill value) to hedge portfolios.

For all of that, the corporates don’t usually pay stupid money – but if they do its because they know how to get the money back through economies (a euphemism, of course) .

Prediction: more mail shots on your doormat announcing that you have been “specially chosen” to discuss a sale (note to self – you haven’t)

2. What am I bid?

In the meantime, the practice purchase agents continue to promote goodwill values that defy commercial logic and simply reflect the supply/demand curve.

There’s nothing wrong with a free market economy but when I see a tired 2-chair practice in NW London with £350,000 of UDAs and £120,000 of FPI private treatment on the market for £775,000 goodwill, I begin to wonder when pigs will start to glide past my window in V-formation?

The more worrying fact is that the prospectus for this place was sent to me by a smart dentist asking if I thought it would be a good deal?

As long as the corporates continue their land-grab and young dentists feel peer pressure to go into ownership, fuelled by family money – then caveat emptor.

Sadly, these young dentists are lawful prey and I’m seeing too many of them either buy supervised neglect at inflated prices or open private squats with insufficient funding for marketing (try £50,000 per annum for each of the first three years) and then struggle to make any living with a monster child hanging around their necks.

Prediction: more of the same until the bubble bursts.

3. Doing a Reggie Perrin

Whilst all this is going on, even the most sociopathic Principal cannot fail to notice the Klondike goodwill values and the race of dental prospectors to pan for gold in “them thar hills”.

So, we are seeing an acceleration of distress sales whilst the madness continues.

Distress?

I can’t take any more of this because:

  • I have had a GDC complaint
  • My Practice Manager is moving out of the area
  • 3 of my nurses have announced their synchronised pregnancies
  • My associate has set up on her own down the road and taken staff and patients
  • I only used to have to be a dentist – now I have to be an MBA graduate and CEO
  • I can’t be bothered learning all of this new dentistry
  • My new patients have dried up and my existing patients are as old as I am
  • I haven’t the energy for all this marketing mumbo-jumbo
  • The place needs a face-lift and I’m too close to retirement to bear the capital expense
  • My properties have increased in value so I don’t have to do all this crap any more
  • I’d rather be an associate in my own practice and let someone else deal with all this
  • My hands and eyes are starting to go
  • I need to pay for my divorce
  • I need to pay my tax

Prediction: much more of the same

4. Give us a job mister, any job?

I recently published on social media an internal email from a dentist (via Linkedin) offering 10,000 UDAs at £10.00 each to anyone who wanted them.

Dentists now emerge (if they are lucky) from FD1/2 with the prospect of bashing the NHS for low pay (35%?) in poor surroundings with exhausted staff, unappreciative patients, area managers clobbering them over the head every month on target, target, target, little or no clinical mentoring and in the knowledge that DCP’s are going to gradually eat away at their living.

Sexy career choice eh?

At the top end, highly skilled peripatetic “specialists” are wandering the country like extras in The Walking Dead, looking for “days” here and there, unable to feed themselves (some having been escorted to the door of the corporates and shown the post-apocalyptic wilderness in which they must now roam).

At the lower end, graduates and interns are fearful of the factory dentistry in which they may have to serve time.

Prediction: the smart private owner-manager will offer salaried apprenticeships to younger dentists, complete with benefits package, security of income and clinical mentoring, in return for loyalty, an open mind and a willingness to learn about the business of dentistry.

This opens the opportunity of creating “stakeholder associates” who begin to buy into your practice if they make the grade as associates. In this way, the landscape for practice sale and purchase changes over the next 20 years.

5. The limping boy and marketing

As the Pied Piper of Hamelin led the children of the town into the mountain, the limping boy struggled to make the mouth of the cave in time and was left behind, to play alone.

As the cost of digital marketing via Google and Facebook increases to reflect market demand, the small business owner is left behind in the race to spend more and more cash to attract potential new patients.

A few years ago your web folks asked you to give them a few hundred pounds a month to finance SEO and PPC.

First, we probably all know that the game has changed and that “meta-tags” and “key words” have been replaced by social influence.

Second, perhaps not everyone is quite as aware that the suggested level of investment in digital marketing to “make an impression” has increased to around £2,000 per month plus agency fees (15-20%) and plus VAT.

Less than that and its highly likely that you are not getting the correct bang for your buck (sorry, Return on Marketing Investment – ROMI).

Third, the action is on Facebook, not Google.

I’m hearing from Champions League dental marketers who are telling me that significant numbers of new patients are arriving via Facebook marketing, across a variety of demographics and socioeconomic groups.

The similarity to chiding the X-Factor and then watching it at weekends are telling.

We know its bad for us but we are fascinated.

It is now estimated that we have an average of 338 Facebook friends and that means you can multiply 1000 Facebook “likes” into 338,000 lottery chances that someone might just notice your promotion on a day that they experience a “trigger” event in their own lives and need a new smile.

It is simply a numbers game, no different from a newspaper advert, radio commercial or stand at a wedding fayre.

Facebook digital marketing requires time, significant money and people who know what they are doing

Prediction:

  • aggregation of spend – digital marketing financed by groups of dentists forming producer groups
  • re-direction of spend – into activities that are more suited to the needs of smaller business owners and their target clients/patients (cue Lifecycle Marketing – that’s why its hot to trot in UK dentistry right now)

6. Do you have an email address please?

The Post Office deliver junk and bills.

UPS deliver presents that we have bought for ourselves.

Most of my mail goes straight into the shredder or the recycle bin – doesn’t yours?

We don’t write letters any more.

We type emails and comments, we post photographs.

Our communication has become digital.

We vote contestants off with our iPads or by text.

So how antiquated and bureaucratic does it look when we get a recall letter from our dental practice or, for that matter, marketing material by mail?

OK – many practices now confirm appointments by text message but even that is becoming tired.

The future of marketing in the small business sector is storytelling (see below) by branded, personalised and content-rich email.

Collecting patients’ and prospects’ email addresses and permission to keep them posted in the short and long term is now MISSION CRITICAL to your success as a small dental practice owner.

Prediction: the end of pay-per-view digital marketing in the independent sector and the emergence of Lifecycle Marketing construction and management, content creation and content curation as key support services to the sector.

7. Jackanory

As I said in a blog earlier this week, product placement is advertising and does not EVOKE.

Storytelling is marketing.

Stories about people whose lives are being changed for the better by what you do.

People whose lives get better because they buy from you, because they work for you and because they supply you.

Your marketing has to feature endless patent testimonials.

Happy patients and team members talking about:

  • How they found you
  • Why they came
  • What difference you made to their lives
  • How they felt whilst they were with you
  • What legacy your work has left in their lives

When you do that you EVOKE and when you EVOKE you make sales and also create lifetime members of your tribe and advocates.

Prediction:

The winners in the smaller business sector will be the most skilful and dedicated storytellers.

Those who can weave a tale, who can distribute that tale across multiple digital distribution channels and can create attraction and capture systems that will draw an audience.

A bonus.

8. Where do I plug this in?

Digital print.

Digital smile design.

Digital dentistry.

Digital accounting.

Digital marketing.

Digital appointment booking.

Digital treatment planning.

Digital recall systems.

Digital recruitment.

Digital HR systems.

Digital compliance systems.

Digital practice management.

Digital analytics.

Prediction:

We are buggered if the power goes out.

I’m really looking forward to 2015 – are you?

Headhunting

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Here’s a business tip that will upset some people.

When you hear on the grapevine that a local practice has been sold………

…..make a list of all the team and clinical members (they will be on the web site) and pick the best of them to headhunt.

Outrageous?

Well, lets think about that.

Dentist A might describe that as “poaching” and indicate this as yet another aspect of how the profession has become less professional over the years.

Dentist B might acknowledge that “headhunting” has been a standard practice in business for centuries and that some agencies exist for no other purpose.

It is not for me to decide who is right or wrong – that is a personal choice – but I see nothing in governance or compliance that would prohibit a fair approach.

Unfair approach:

“I hear you have been bought out by X – the word on the street is that they are the dental equivalent of the Death Star so if you need an escape route before they brainwash you, give me a call.”

Fair approach:

“I hear the practice has changed ownership – it is quite normal in those circumstances to review your career pathway and if you would be interested in a without prejudice conversation, we would love to hear from you.”

The key issue here is not to bad-mouth anyone – that just makes the originator or the comments appear weak and untrustworthy.

But business is business and an ethical approach to head-hunting is normal business practice.

So keep your eyes and ears open – there is a lot of acquisition going on at the moment – and that creates an opportunity for those who intend to remain independent.

Letters from a Perfect Imperfectionist – The only real sales people are people like Stevie Ritchie

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Image Source: http://www.itv.com/xfactor/stevi-ritchie

A lot of people will tell you that they are in sales.

In reality they are just in account management.

The only real sales people are those whose income depends on making sales.

Affordable, appropriate and approved, ethical sales.

Self-employed, commission-only.

They are the real sales people.

I’ve seen some people go commission-only and then break the rules to make a sale.

I’ve seen them tell lies, falsify paperwork, make undeliverable promises, encourage prospects to overspend on products that are inappropriate for their circumstances and do not solve their problem.

Simply to hit target and generate a cheque.

People like that are just the scum that accumulates at the bottom of the sales kettle – every now and then you have to take a Brillo pad and clean them out – that’s what regulators are supposed to do.

Happily, for every bottom feeder – there are many more who do the job ethically and superbly.

There are those who are industrious and talented and simply shine – people who find sales and sales talk very natural – they have a patois that is lyrical and a blarney that captivates.

I have found them to be in the minority.

The majority are those who start with limited skills but are prepared to work through the “school of transactions” and take their first 200 rejections to learn how to take rejection.

Those who are prepared to invest 10,000 hours in becoming sales geniuses, even though they don’t have a natural talent.

Rather like Stevie Ritchie in this year’s X-Factor, people who work ridiculously hard and have limited talent but a belief that they can make it.

He isn’t going to win (is he?) and he isn’t naturally talented – but by God he is having a go.

If you could inject some of Stevie Ritchie’s ATTITUDE into your people – your business would fly.

“These “letters” are the personal observations of me, Chris Barrow and are not intended to reflect the views of 7connections and its team members, they just give me permission to publish here on the basis that they can keep an eye on me, a bit like a mad relative at a wedding reception. I’m likely to upset the sensitive and outrage the sensible – if you fall into either of those camps then read at your peril.”

Letters from a perfect imperfectionist – Busy?

Very busy business

I have spent most of my adult life, defining my success and my self-worth by measuring how busy I am.

Rushing around the country.

Posting on social media from hotels, airports, stations, practices.

Getting up early and finishing late.

Pushing body, mind and spirit to the limits.

Developing a super-human reputation:

“I don’t know how you keep it up?”

This year I have changed (maybe because of that Island).

I’ve taken time off in each of the last three weeks to meet up with old friends just to catch up on news.

I’m slowing down.

In future…..

I’m going to define myself going forward by measuring how less busy I am than previous years.

The work will still get done.

But my primary motivation right now is to listen to the advice given to me by my genius personal coach Michael Myerscough:

“Is what I’m about to do going to increase or decrease the level of confusion and complexity in my life?”

“These “letters” are the personal observations of me, Chris Barrow and are not intended to reflect the views of 7connections and its team members, they just give me permission to publish here on the basis that they can keep an eye on me, a bit like a mad relative at a wedding reception. I’m likely to upset the sensitive and outrage the sensible – if you fall into either of those camps then read at your peril.”

7 essential sets of numbers that you need to know every month

3d shiny golden number 7I’ve been going on about this for as long as I’ve been listening to dentists (20 years).

If I were to ask a client for their MI (management information) on a monthly basis, what would I mean?

1. previous month’s profit & loss & year to date profit & loss
2. 12-month cash flow forecast with the budget figures for the previous month updated to show the actual numbers for that month
3. product mix – how much of each main class of product was sold?
4. average daily production – what was the average daily production of each of the fee earners for the last month and year to date?
5. associate profitability calculator updated based on the previous month’s figures and year to date
6. TCO conversion stats – enquiries to consult, consults to treatment and average treatment value by patient and by product
7. ROMI – what has been my return on marketing investment for each of the marketing activities we engaged in last month and year to date

If you give us these numbers, at 7connections we can transform your business.

Why, then, is it so hard to extract that information from new contacts and (sometimes) even from the clients who invest in our services?

Abdication – “I just work as hard as I can, look at the bank account on a Friday afternoon and if the balance is OK, we are OK.”

Delegation – “I leave it to my manager to keep an eye on all of that.”

False sense of security – “We are making plenty, so I don’t need to keep that close an eye on things.”

Laziness – “I just can’t be arsed with all those spreadsheets.”

Amazing – even after all these years – and in a business that becomes more complex and risky as each year passes.

There is enough accountancy software (Sage/Quickbooks/Xero) to make this happen and enough people around who can dance with a spreadsheet (if your managers are scared of spreadsheets they need to be trained or put out to grass).

How many of the 7 reports I have outlined above appear on your desk every month?

How much time do you invest in studying the reports and making course corrections?

I promise you – get a handle on this MI and you can grow your practice at a steady 20% per annum = double in size and profits every 3.6 years, then sell it and retire happy.

Ask yourself – How can I get £2,000 to invest in coaching?

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Letters from a perfect imperfectionist – Notifications

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Before I start……

I know that there is an “on/off” switch – just the same as the one on my TV.

But aren’t notifications one of the more irritating inventions in the recent years of the internet?

Mind you, it was always thus.

Notifications is just a new word for interruptions.

Many years ago I recall sacking my then accountant, great guy, multi-talented, because he just kept on answering his mobile phone all the way through our meetings:

Ring, ring – “oh, sorry Chris, could you just hold on a minute while I take this?”

Once because your granny is marooned at the top of a burning building – maybe.

But every 5 minutes, all the way through the meeting?

No thanks – I hired a less dynamic accountant who listens empathetically and has looked after me faithfully for many years.

Similarly, I recall sitting at the desk of a CEO, whose eye contact could never last more then 60 seconds, as he twitched backwards and forwards between me and the messages appearing from the far-flung corners of his empire on his PC screen.

Another great guy – made a fortune (I haven’t) – but I always felt just a bit like I was being interviewed by Ernst Blofeld.

“We’ve been counting your UDA’s Mr Bond.”

So now, I’m sat at my desk in The Bunker, at my Macbook Air in Pret, looking at my phone on the train – and these annoying boxes and bars appear without warning, either quoting the opening line of an email or how lucky I am that someone I don’t know has taken an interest in me…..

“Dear Chris, Just to let you know that all hell has broken loose at…………..”

“Stanislav Heironymous Popodopolus has liked your………..”

“Betty Lifecoach wants to you to play PogoPonyCrushCityBollocksCrystals……….”

“Dave in Karachi wants to optimise your web site.”

It’s my own fault – I have to remember every morning to go to the DND button on my desktop and switch that off.

Then train myself to do the same on my other devices.

Otherwise I’m going to be interrupted all day, in every way, on every platform.I acknowledge my own responsibility here – that I have nobody to blame but myself.

But there is a deeper question that puzzles me?

Who decided, where, when and for what reason – that I needed to have all of these notifications in order to chart my path through life?Was there a meeting of attention-deficit disordered moguls who voted for us all to have our peace and solitude stripped away as an automatic right, should we choose to have a web presence?

Could somebody pop-up and let me know please?

p.s. ever wondered what it feels like at your front desk when your receptionist interrupts our conversation to answer the phone?

“These “letters” are the personal observations of me, Chris Barrow and are not intended to reflect the views of 7connections and its team members, they just give me permission to publish here on the basis that they can keep an eye on me, a bit like a mad relative at a wedding reception. I’m likely to upset the sensitive and outrage the sensible – if you fall into either of those camps then read at your peril.”

Chit Chat versus Conversation

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It all started with a chance remark from an associate at a client’s practice:

“One of my problems is that I never leave enough time in appointments to do the chit chat.”

This was a very experienced and highly skilled clinician, a positive team member and a profit-centre within the business.

A real keeper.

But still, he recognised the need to engage more with the patients at this Champions League specialist referral practice.

I paused to think about the difference between “chit chat” and “conversation”.

For me, “chit chat” is what folks do with a taxi driver on the way to the station or airport in the morning:

  • what did you think about the Scottish referendum
  • what do you think about United’s start to the season?
  • what do you think about the weather?

It is a skin deep conversation, calculated to pass the time before we get to our destination and simply polite.

I use Trafford Cars to get me to Wilmslow Station and Manchester Airport a lot.

I know some of the drivers by sight now – but I also know a little about each of them, because I have the habit of asking.

“Conversation” is what happens when I dig a little deeper and empathetically listen to their responses.

  • do you have a family?
  • have you been away on holiday this summer?
  • how’s the taxi business right now?

I know the driver who lives on his own in a flat and has NEVER been abroad on holiday.

I know about the driver who flies back to India 4 times a year to visit his mother in a village 300 miles from the nearest airport.

I have one driver who recently bought a boat on the River Trent with a best friend.

Dreams of weekends of cruising, fishing and entertaining children.

They bought a pup – the engine blew up soon after delivery and it has cost much more than the price of the boat to buy a new engine and get it fitted.

It has taken all summer to turn a disaster into a victory.

The adventures of my driver and his buddy are a central theme of our conversations every time he picks me up:

CB – “how are things with the boat?”

Cabby – “been on any more Islands recently?”

OK – we might not be spending Christmas together – but there is a level of connection – and that means I’m unlikely to change taxi firms.

Patients will return, refer and buy again and again if you engage them in conversation, if you keep notes of their personal circumstances and refer back to those stories at future visits.

If they know how much you care, they don’t care how much you know.