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I took part in a conversation this morning that I would not have believed possible just a few years ago. Chatting to a former client about joining our Breathe Business Club in 2008. She (the co-owner and practice manager) said:
We would be interested in joining provided you can guarantee that we will not be sat in a room with a bunch of dentists worrying about converting from NHS to private practice. We did our conversion over 5 years ago and have no time for that debate – we don’t want to join a business club where people are asking us for ideas, we want a club where we are getting ideas.
Whilst I can understand the sentiment, the strength of expression took me by surprise. As always, I marinaded in the conversation for a few hours and then evolved my thinking – to recognise that the gap between the “have’s” and the “have not’s” in UK dentistry is getting rapidly wider. The “have’s” in this case being those that have left the Health Service forever (includng children and exempts). The “have not’s” being those that are still undecided, on the fence or one foot in both camps. And just to prove that I can be wrong – a later conversation with another client who has an extremely profitable mixed practice – his Primary Care Trust were considering offering him a fixed price UDA contract for 10 years, provided he achieved his performance targets every year. Now if that isn’t signing your life away to the devil – I don’t know what is. Dr. Mephistopheles agrees to £22 a UDA for 10 years and signs the PCT agree his targets. Somewhere along the line, they move the goalposts – and he is swinging from them by a part of his anatomy. I continue to live in a world of three types of dentist:
left the NHS behind – getting on with it;
playing dice with Rusty Charlie (see Steinbecks Cannery Row);
still quaking in their NHS funded boots and talking about how the residents of their town will not change.
How interesting this is all getting. By the way – I was able to confirm to my client that the group she is considering joining is made up of the first category – but we have clients in all three – you can choose which to join and we have ideas for them all!