THINKING BUSINESS
a blog by Chris Barrow

Do you have enough or have you had enough?



My comments in yesterday's post on the demise of the NHS and the help available generated this comment from my friend Dhru Shah:


"No wonder we have a retention and recruitment challenge and we have a disengagement in dentistry.

Don't tell me how many million in sales. Tell me the level of engagement and enthusiasm and will of the teams at MyDentist? How is that measured and translated ?

Or is this a short term vision to make as much profit and disappear leaving the drained workforce to fend for themselves?

Maybe it's time the profession start looking at a different side of the story."


I reached out top Dhru yesterday and asked for permission to reproduce that comment this morning and respond - simply because it's important to me.


A few observations follow - but I want to make it clear that I'm not in any way disagreeing with Dhru - he makes a good point with passion.

  • We have a recruitment and retention challenge in teams because wages have been poor for decades and Covid has forced the issue. Most of my audiences laugh with recognition when I ask if they have heard "I could get paid just as much for stacking shelves in a supermarket." in their staff rooms. There is no funding in the NHS to pay the wages required to keep people in the profession - I've seen nurse wages rise from £12 to £15 or £17 an hour across the UK - where is the money coming from, other than the private sector?

  • We have a recruitment and retention challenge in clinical delivery because the 3,000 dentists (according to the BDA) who have elected to leave the NHS since lockdown have done so, not necessarily for more money but for better working conditions and the chance to deliver proper dentistry as opposed to discredited UDAs;

  • In all my years I have never met a client who converted from NHS to private in order to make more money - not one. Every single one of them converted in order to eliminate their distress - frustration with paperwork and bureaucracy, exasperation with lack of recognition and communication, exhaustion at running in the hamster wheel, fear of being hunted by the GDC and the Dental Law Partnership;

  • They also converted to be able to deliver customer service and clinical care at a level of which they were proud;

  • As a former employee of IDH, I travelled their landscape in 2008-2010 and discovered that the level of engagement and enthusiasm throughout the business was heroic - people doing their level best to deliver - and I have no doubt that is unchanged. I further submit that the majority of dental teams, NHS or private, are doing their level best, day in, day out. When I was at IDH, private was 15% of sales, now at MyDentist it's 50% of sales - you don't get there without enthusiasm, engagement and good dentistry;

  • It's the NHS who have consistently left a "drained workforce to fend for themselves" - the lack of communication throughout the pandemic has been a classic example of that. I refer to one of my sleepless clients with an NHS practice servicing over 10,000 patients, down from 6 to 1.5 dentists over the pandemic, the practice premises paint-bombed twice by frustrated patients and frantically reaching out for help to her LAT - no effective response to any emails or communication in three months The Practice Plan conversion has been a success but sadly only 3,500 patients can be accommodated;

  • And the client who, after nearly 3 decades of NHS support at the highest level, returned from one meeting last Autumn addressed by a junior health minister, so disillusioned that his practice has now been sold to a budding micro-corporate;

  • Even though we must be wary of short-term institutional investment into any business (especially healthcare), I believe that many of the private equity firms I'm seeing in dentistry right now are responsible investors looking to build long-term strength for the sector - comfort and security for teams, clinicians and patients. There's not so much "flip, flog or float" as there was in the first 10 years of the century.


Dhru you are so right - it can never be "about the millions" and it must always be about caring for people.


I've mentioned in this blog my dismay at the Ferraris and dolly-birds at The Dentistry Show and about the Instagram culture that suggests success is a consequence of "followers", not results.


I equally believe that anybody who independently owns a dental practice has the right to make a fair profit now, to enjoy their business journey and ultimately sell it as part of their exit plan.


The NHS dental landscape makes that more and more difficult to achieve.


In my 26 years I have never met a client who either converted or sold because they didn't have enough - they did so because they'd had enough of a broken system.



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