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a blog by Chris Barrow


In 1997 I walked into a dental practice, to be confronted by a sign that read “NHS Patients”, with an arrow pointing to the left.

Looking in that direction, I saw a traditional dental reception desk and waiting area (yes – they had a room dedicated to waiting), with the usual dog-eared magazines, kiddies toys, dental information leaflets, a fish tank and some very sheepish people who looked as if they were waiting outside the headmaster’s office at school and expecting the strap.

To the right, a room in which a Chesterfield sofa faced a fire and a coffee table whilst thick carpets and subdued lighting greeted the lucky occupier to the sound of a coffee percolator gurgling away.

I was horrified and, predictably, passed my concerns on to the owners.

They responded over the next 18 months by converting to Practice Plan and reducing patient numbers from 11,000 to 4,000 and dentists from 5 to 2.

Drastic perhaps but it did have the effect of creating a business that provided them with a good living, a happy team and delighted patients – in fact, the practice was recently sold on attractive terms.

Not everybody, however, has the luxury of solving the segregation problem by sacking their NHS patients – for many, their business is not at a critical mass where that’s possible – or they simply don’t want to because they see the provision of NHS dentistry, in spite of the challenges, as a social responsibility.


A few months ago I walked into a dental practice and joined the milling throng of patients in a large reception and waiting area (we still love waiting, don’t we?). A complimentary visit to discuss business development with the owners.

Not much different from 18 years ago, apart from no fish tank and a plasma TV showing morning soaps.

One of the receptionists asked if she could help and when I explained who I was, her eyes widened and she jumped up and quickly escorted me into the “Private Lounge” down the corridor.

The dejected occupants of the waiting room glanced across as I departed, like a rafter of turkeys arriving at a Marks & Spencer processing plant.

Once more, I was horrified and, predictably, passed my concerns on to the owners.

Does segregation feel right to you?

I asked them to consider an alternative approach.

“Here at ABC Dental we are very proud of the fact that we offer the same level of customer service and clinical care to all of our patients, irrespective of whether they choose to have their dentistry funded by the Government or they fund it themselves.”

Which feels best, the above statement or the physical segregation of people based on their purchasing choice or perceived socio-economic grouping?

It will inevitably beg the question (primarily from team members) – “so what’s the difference between NHS & private dentistry?”

(by the way, I asked that question at a recent meeting of dentists and practice managers and realised that not one of them was able to answer confidently)

“The Government regulate the quality and the quantity of dentistry that they are prepared to fund.

If you choose the private route then:

  1. we have the opportunity to recommend better quality materials for the work that we do

  2. we have the opportunity to recommend treatment options that the Government simply do not fund

  3. we have the opportunity to invest more time in creating your end result

  4. the benefit of which is that we may be able to offer solutions that will have superior aesthetics and durability”

But back to physical segregation.

Like a Trump – it just leaves a bad smell.

Can I suggest an alternative approach please?

Don’t have a Private Lounge.

Step 1 – Make sure that your commonly used Patient Lounge is one that you are proud of.

Step 2 – train your people to apply The Golden Rule.

Step 3 – Offer a Privacy Lounge – that can be used by ANY patient who would benefit from some privacy because:

  1. they are nervous

  2. they are famous

  3. they are paying for treatment

  4. they want to discuss their personal circumstances

A Private Lounge is an echo of an earlier and best forgotten age.

A Privacy Lounge is a service to your patients.

However they choose to pay.

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