Career crossroads

02 October 2012
Volume 28 · Issue 9

Chris Barrow evaluates the possible impact of management groups in dentistry.

Crossroads, sometimes unexpected, crop up at infrequent intervals in every dentist's career. Whilst personal or family choices often make themselves, picking the right business or professional direction, with long term financial implications often hanging on the outcome as well as the individual's job satisfaction, always demands careful thought.

The days have long past when practice principals could comfortably devote almost their entire energies to the delivery of high quality patient care. Today's dental practice, whether NHS or private, is unashamedly a business operating in an increasingly competitive market environment which is hedged on all sides by regulations. No independent principal will need reminding of the impact of recent changes to infection control requirements, for example.

Very few dentists graduate with the primary intention of becoming business managers, and yet more and more practising principals are spending more and more of their time on administration, organising personnel, regulatory compliance, equipment sourcing and financing, and basic logistics. It is no surprise that in many cases not only is their time with their patients compromised, but also their enthusiasm for actually performing dentistry is tempered by the pressures of ensuring their practice continues to function, expand and remain viable.

Although dentistry is a diverse profession and 'one size' will never fit the circumstances of every practice, engaging in a partnership with an established dental management group offers an alternative way forward to the hard-pressed independent practitioner who would rather spend his or her time in the surgery instead of in the office.

Partnership with a management group delivers substantial immediate, and longer term benefits, with perhaps the first being the lifting of much of the responsibility for mundane, trivial but essential day-to-day management matters, perhaps typified by the famous 'who counts the paperclips?' question. At the same time, the major risks and problems associated with ownership are also assumed by the management group partner, with even the matter of eventual sale on retirement already resolved. One of the first benefits remarked upon by many of the principals who have taken this step is the significant improvement in their quality of life in terms of leisure time and confidence in the future.

A partnership with the right management group offers clinicians a failsafe route to return to their core activity and principal raison d'être – meeting and advising patients and the hands-on delivery of dentistry. At the same time, their future income as an associate is assured and will reflect their own productivity, along with a share of the profits of the business as it expands.

While it would be entirely consistent for a principal who has dedicated their career to building a practice to be reluctant to share the rewards and responsibilities of ownership, it is precisely in this scenario, as the practice expands and becomes more successful, that the business management aspects become necessarily more engrossing and the benefits of engaging with the right management group partner become more attractive.

The role of the management group partner is often misunderstood or its value underestimated. In general terms, after acquiring what is usually a 51 per cent stake in the business, the management group partner assumes 50 per cent of the profits and also charges a management fee.

From the principal's point of view, the management group partner becomes responsible for managing the personnel and all the administration and business aspects of the practice, including regulatory compliance, while at the same time offering the principal enhanced career prospects, both clinical and hierarchical, within a vibrant and growing professional organisation.

For principals who are beginning to feel frustrated at their lack of time in the surgery or for advancing their clinical skills, choosing the right management group partner is an obvious way forward.

A broad raft of further advantages impacts both the patients and staff as well improving the practice's profit potential. Regular purchases benefit from economies of scale, and access to finance for major equipment upgrades, or capital for refurbishing, is simplified and expedited. Many management groups have their own partnership arrangements with manufacturers, suppliers and laboratories to ensure the most advantageous terms, thus raising profitability without compromising standards.

Dental management groups operate state-of-the-art IT systems, improving efficiency, and the practice becomes a member of a management group 'family' and enjoys support from and access to the services and attributes of its fellow group members. For example, referral practices will operate within the group, and clinicians convene for non-competitive collegiate sessions, all helping to raise the standards of patient care. Many industry specialists regard management group partnerships as the logical way forward for independent dental practices, and responsible principals with an eye to the future owe it to themselves, their staff and their patients to investigate the potential benefits for their own practice.