In the past, certainly up until 10 years ago, being a competent practitioner was enough to build a successful practice, earn a good living and be sufficiently professionally challenged to make day-to-day dentistry relatively interesting.
But rather a lot has changed in the past decade, and in retrospect I think we can pinpoint 2009 as the starting point for a number of seismic events that coincided to create a very different dental landscape from the one that existed at the turn of the century.
In January 2009 the UK slipped (officially) into recession for the first time for almost 20 years. In June 2009 Jimmy Steele’s review of NHS dental services in England was published, and finally in December 2009 HTM01-05 guidance was issued. These three events combined during a 12-month period to make UK dentistry a very different proposition from anything that had gone before.
This recession is arguably the first that has really hit the dental profession, and we have all heard anecdotal stories about increasing FTA (failure to attend) rates, reduction in recall effectiveness and gaping white spaces in appointment books.
The Steele Report laid the ground for the first phase of pilots that began in July 2011. This coming April, a further 25 practices are being added to the scheme in order to ‘fine-tune’ different aspects of the impending contract. Whether the outcome is a care pathway or a capitation solution, or a combination of both, it is the uncertainty of the ‘what’ and ‘when’ that is so disruptive for practitioners and their businesses.
Finally, the introduction of HTM01-05 made demands on practices that have required investment, not only in decontamination equipment, but also in developing processes and protocols that could demonstrate compliance. Since 2009, the burden of CQC inspections has also placed further strain on financial and personnel resources.
With constant pressures being exerted on what are in the main small businesses, the need to concentrate on commercial, as well as clinical factors, has gradually gained traction within the profession. Software of Excellence’s ‘Best Practice Check Up Survey’ provides evidence that dentists now recognise being considered good business people is equally as important as being considered good clinicians, and good business acumen plays an important role in the overall success of a practice.
For many dentists the running of their business has always been less of a priority than the clinical aspects of the practice. However, my view is that each is of equal importance in running a successful practice. Those practitioners who are unaware of their most basic performance indicators are now, I believe, in grave danger of losing focus in these important business areas.
Naturally, the quality of clinical care provided to patients is of the utmost importance and this factor is likely to increase in significance once the NHS pilots are concluded and the details of the new contract are announced. Meeting patient demands for cosmetic and aesthetic treatments, as well as maintaining learning and keeping up to date with the latest clinical techniques, are vital. But with the number of private practices continuing to increase, albeit more slowly than in previous years, the demands to run an efficient and profitable practices are more important than ever.
Being a great clinician is no longer the only skill needed to be a successful dentist. The continued squeeze on disposable incomes continues to impact on routine attendance in the private sector, and the ability to operate a slick and efficient operation is now recognised as a key factor in creating a successful and profitable practice.