The evolution of the Dental Practice Manager

A GUEST POST BY FIONA TEASDALE - PRACTICE/BUSINESS MANAGER - MYTON PARK DENTAL CENTRE

I have been in dentistry now for over 20 years. I started my journey as many of us do, as a Trainee dental nurse back in 2003. I fell into the dental world due to redundancy in the retail sector, but really when I think back, I always thought of a dental nurse as being glamorous like my dental nurse at the family practice, and I wanted to be just like her when I grew up. Little did I know it wasn't glamorous at all but very rewarding.

I took my first practice manager role in 2009. This role was to run the practice but also to help turn it around as my boss at the time had just purchased it.

There was so much to do; we had a fairly big NHS contract for the size of the practice, and it needed building up in so many ways. I loved nursing in surgery and loved the interaction with the patients and seeing the before and after results not just in cosmetic appearance but how the patients build their trust in us.

The dental nurse is such a special and very much needed cog of the patient journey. However, my thirst for my own development and training people outweighed the desire to be in surgery, and when the opportunity came to manage a practice, I knew this was where I needed to be.

I kept my registration until 2022 just in case but knew by this point, I wouldn’t be returning to the chair-side role.

The management role I took on back then was very much different to what is needed today.

Many practice managers like me came up through the ranks to manage a practice with no specific training and just we just found our way. Back then, although not all that long ago, this was acceptable, and a practice ran fine this way. The principals ran the business side, and we ran the shop floor so to speak.

We were not really given the tools or the understanding of what it took to run a practice for profitability apart from  being told “no we can’t afford that this month”. I don't think I even contemplated at the time what profit and loss (P&L) was or even that it existed.  The tide has turned now from what was deemed ok back then to what is needed now in the pursuit of a successful thriving dental practice and business.

Through all my experience I have gained over the years working between independents, small groups and a corporate, I have witnessed the evolution of what is needed to be able to successfully run a dental practice. It doesn't need to be complicated either. The role has evolved so much so that the practice manager job description from even 5 years ago is outdated.

We all know that it is hard to sustain a practice purely on an NHS contract in most places in the UK, growth of the practice is what's needed to help it run as a business. For this to happen practices need Business Managers, and this is where we say goodbye to a Practice Manager in the old sense of the title.

The manager of your practice needs to be in knee deep in the finances, planning budgeting and reporting. The practice needs someone who has oversight of all the workings so the correct decisions can be made as to what direction the practice needs to take. The principal needs someone to carry their ideas and be able to work and communicate effectively with them and the wider team.

 Since I took over my new role as a Business Manager, I have been extremely lucky with the opportunity to be able to fully get to grips with all the KPI’s and see where there was potential in the business. Without having the oversight on all the financial information I wouldn't have been able to promote the direction the business needs to take to make a profit.

Not only this, but making it a great place to work that pays good wages where we don't lose sight of patient care yet still provide the best service we can.

The road has been a slow uphill one over the last 2 years but being able to manage the practices P&L we have seen growth of over 250% in real terms without cutting costs or cutting corners.

How did I manage this...... Having a business owner who was open to new ideas, and a new updated direction was the first step. If he wasn't open to change then I would not have been able to do my job.

I had to select the right team to help achieve our goals. I have been able to up-skill them and give them autonomy of the tasks needed to make the everyday running of the practice happen.

By building a financial spreadsheet to incorporate the P&L, invoicing and weekly income was the first step to see what our income was vs the outgoings. Were we spending the money in the right places and were there areas we could improve upon? Reviewing the KPI’s and zoning the books was another way we could steer the practice in the direction we needed to.

One of the biggest improvements was also ‘Getting the right clinician for the treatment or appointment needed’ and when I say this, I mean using a hygienist for the Hygiene appointments and enabling the Therapists to use their full scope of practice.

They are now seeing patients for exams, enabling them to build treatment plans and see and treat the NHS children. Educating patients on the difference between a Hygienist and a Therapist is important as well so they know why they are seeing the different clinicians.

 Previously the practice manager would juggle everything from reception to nursing to rota, audits reviews and training. You simply cannot do it all. These are all important tasks but what I think needs to happen now is as well as having a Business manager your Senior Nurse can step up to run the clinical team.

You can appoint jobs to others to give the nurses extra responsibility to see them thrive at the opportunity. What a difference it is to see the nurses who have more responsibility taking the opportunity to grow and feel like they are part of the journey as well.

With a TCO in place, we are able to expand on our patients journey and now have the opportunity to track the inbound referrals and the new patients from first point of contact to end of their treatment.

My role now is looking each week at the productivity of the surgery as a whole and the clinicians on an individual basis. The clinical team also thrives on seeing their productivity - it's a welcome change to the mundane feeling sometimes of just being on the hamster wheel.

They can see the difference they make which they find rewarding. I work with my senior nurse on the stock budget, who finds it rewarding when she doesn't spend as much as the budget allows. I give her time so she can look for the best deal and has a way of reducing costs every week. When the team are involved, they understand, and they are on the bus with you heading in the right direction.

The only way to achieve all of this is to be forward thinking. We must evolve as a team including the business owners. We must give the people the correct titles and tools to be able to do their job to the best of their ability. If we stick to cloak and dagger like years gone by, how can the team you have employed make the practice function as a successful business.

This said, we have lost staff along the way, and sometimes this does have to happen to get the right people in the team. Their contribution was appreciated but they knew this wasn't for them and that's ok. Not everyone shares the same vision but once you get the team on board it makes the running of the practice easier.

The road to success........

Invest in the practice, invest in your team! Get the right people on board and pay for the training! If you invest in your people and they will invest in the practice and the practice will succeed.