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.
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
- 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.
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.
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.
8. Where do I plug this in?
Digital smile design.
Digital appointment booking.
Digital treatment planning.
Digital recall systems.
Digital HR systems.
Digital compliance systems.
Digital practice management.
We are buggered if the power goes out.
I’m really looking forward to 2015 – are you?