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a blog by Chris Barrow

The new cure for supervised neglect

Many is the time that I've been contacted by a dentist who has just bought a practice from an older Principal and who wants advice on how to deal with the supervised neglect that they have inherited.

Before I offer you the solution, I'd like to point out the frequency with which I find myself asking if they looked at the accounts before the purchase, with specific reference to the lab bills as a percentage of sales?

In mixed practice, anything below 10% is a warning signal that not enough dentistry is being done - an indicator of check ups delivered quickly and treatment deferred indefinitely, largely because the owner nearing a sale may have lost their enthusiasm (especially so if there are nice juicy plan premiums dropping in to the bank account every month).

Most of the time the numbers haven't been scrutinised (I still don't quite understand why people would buy a business for hundreds of thousands of pounds and not look under the bonnet? At the very least, ask your accountant and/or business coach to take a look and give you some pointers).

So new owner arrives and is caught between a rock and hard place:

  1. Old owner leaves - new owner inherits supervised neglect;

  2. Old owner stays - continues to supervise neglect (ticking bomb) and still trousers associate fees (rubbish ROI for new owner).

As an aside, unless you are a micro-corporate, old owner SHOULD ALWAYS GO - then I wouldn't have to spend countless hours listening to new owner tell me how old owner is sabotaging every change and undermining every strategic and tactical decision.

If old owner does go (always the better idea), then the new owner has inherited that supervised neglect - so what next?

From the perspective of the patients, this can be a dangerous situation for the new owner:

  • Old former owner never used to hurt me, seldom advised treatment and kept my costs low;

  • New owner is telling me that I have problems and need solutions that are going to cost money;

  • Is new owner looking to me to pay for his practice purchase (or new car?)

In previous years I have advised new owners to wait, to build trust first (perhaps over a couple of recall cycles) and then slowly to re-educate the patients - but only when the patients have had time to get to like you.

It's a slow fix, frustrating and potentially dangerous if the patient's oral health suddenly deteriorates.

Now we have a much faster fix.

I should have spotted this earlier - it was staring me in the face but I hadn't made the connection.

The new cure for supervised neglect is....

The intraoral scanner!

A couple of weeks ago and during a team training day in a 5-star practice (that has experienced sudden and considerable staff turnover), I asked for a show of hands on how many of the team had seen the IOS in operation.

Enough hadn't that we decided to set up a lunchtime demo.

So the receptionist became the mystery patient and the therapist showed the rest of the team:

  • how to take the scan and

  • how to explain what she was seeing to the patient

Before we began, the receptionist shared with us that she was aware of some recession but, otherwise, was very happy with her teeth and gums.

Within 10 minutes of the therapist showing her the scan, the patient was agreeable to a significant course of treatment to improve the obvious problems that were visible on the screen.

That was when the penny dropped for me:

  • Patients take their time to trust a person;

  • Patients trust what they can see with their own eyes, if it is explained to them in simple terms.

Bingo - supervised neglect cured.

It's not about the new dentist wanting to share "her opinion" that the patient's mouth is in a mess.

It's about what the patient can clearly see on the scan of THEIR TEETH AND GUMS.

So next time a prospective owner asks me for advice on a practice that has 5% lab bills my advice will be much simpler:

"By all means buy if the price is right, encourage the former owner to leave straight away - and then buy a scanner and make sure you use it on every patient."

I was already aware that IOS is a game-changer - and here is yet another reason why.

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