Health implications of buying a practice as a young dentist

01 July 2019 | Blog
Health implications of buying a practice as a young dentist

Owning a practice - whether with a partner, colleague or on your own, starting from scratch or buying an existing business - could be everything you have dreamed of since you sat your finals. But having your own business is never just a job; it will likely become your main focus or even your family’s livelihood and is a huge undertaking and responsibility for anyone, which could turn into the challenge of your professional life.

Introduction

Of course it can, and should, be viewed as an extremely exciting venture. After all, you get to make it truly yours; choosing everything from the members of your team, the equipment and materials you use to the branding, decor and even the colour of the walls.

However, if you’re not truly prepared for it, it can become more than you bargained for, taking up all your time, putting significant pressure on both you and your family and causing untold financial worries. That’s all before you consider potential staffing issues, patient’s clinical needs and expectations and the increasing regulatory compliance requirements you’ll need to tackle. All of this, when dentistry is already widely considered to be one of the most stressful professions, should be carefully considered before you take the plunge.1

Stressors

In the most recent survey of the stress of UK dentists published in the BDJ in January this year, the main areas of stress were cited as:2

  1. risk of making a mistake, the threat of complaints/litigation and concern about the GDC (a survey by Dental Protection last year supported this, indicating that 89% of respondents were worried about being sued by patients, and three quarters of those believed that had an impact on the way they practise, as well as their own welfare)3
  2. patients being difficult or dissatisfied
  3. red tape and bureaucracy
  4. NHS targets/work, and having to work fast to see as many patients as possible with the risk of running behind schedule.

Whilst these are all valid concerns and need to be addressed, what is evident - especially if you run your own practice - is that some of these issues are actually in your power to manage and mitigate against.1

Setting up from scratch

When Mide Ojo, a dentist in his mid-30s who is based in South West London, decided the time was right to buy a practice, he decided to go through the process of setting up a squat practice. His wife is a pharmacist and they have three small children.

Mide had begun by looking into buying an existing practice but experienced inflated prices with bidding wars well over the asking price. This wasn’t just for practices he liked but with some in less than desirable areas. He also wanted to be near his family and friends, so spent five years looking for an ideal location for his dream practice.

Mide said “As I lived in Twickenham and knew the area well and naturally found it easy to investigate suitable premises. I had been jogging around Twickenham and, looking at empty shops and buildings, identified an old Indian restaurant within 10 minutes of where I live and thought it had good visibility on a busy high street, so potentially good footfall and passing trade.”

Mide continued “The very next day I saw a ‘To Let’ sign being put up on my way to work. I made sure I was the first to view the property later that day and made an offer (subject to conditions) on the spot.”

Mide finished by saying “It was the single most stressful process I have been through. I was let down by the first contractor which meant the project overran and was over budget, and that caused me much anxiety. My single biggest worry was that I was going to jeopardise my family by the reduced finances as it taking time to have an income as a new business owner. I did have a robust business plan but I was still always worried it wouldn’t work. But my wife was my rock…I would never have got through it without her and even though there were many sleepless nights and many more with only a few hours, I would still recommend it. I’ve learnt a lot and I couldn’t have done it without the people who helped me.”5

The potential issues that could arise shouldn’t put you off having your dream. It could help to speak to peers and colleagues who have undertaken this exciting venture and try to learn from their experiences, to be as prepared as you can.

Here are some tips to help you avoid unnecessary stress, so you can get on enjoying the positives of an amazing life-changing experience.

  1. Seamless process during the purchase: Lis Hughes, MD at Frank Taylor Limited, who help dental professionals buy practices said: “In our experience, for a seamless process with the least possible stress, good financial advice is key; to make sure the buyer can afford to buy and run a business and not drive themselves into debt. Goodwill is not tangible but can cost a lot of money so buyers need to be protected. Specialist legal advice is another key factor. There are many issues around dental practices, particularly where there is an element of NHS dentistry and buyers need a specialist lawyer who can put warranties and indemnities in place to protect them. It can be the most stressful time but also the most rewarding.

Key topics any buyer needs to think about before becoming a practice owner are cashflow, business development and marketing, compliance and the CQC, leadership and management, employment and HR.”4

  1. Team/staff/management: it is important to choose the right staff for your vision or get to know make sure you are all clear on the practical elements such as transferring any existing contracts and understanding their strengths, motivation and skills. Having a practice or business manager in your team, or even just employing robust HR policies and practices, can go a long way to reducing the risk of unnecessary personnel issues later on1,6a,7 Lis continued “The buyer will be exposed to many management challenges that they have probably not had to deal with before. We encourage all of our buyers to invest in an employment and HR service, as this runs a high risk of impact on the business. Without a good team, a practice can very quickly loose its identity, which is vital.”
  2. Support to help you run the practice: whether its regulation, financial planning, marketing, payroll or just day-to-day management, using practice management software as well as having business consultants, dental specialist lawyers and accountants or dental plan providers can help you with the intricacies of running your business. It’s important, of course, to use the right people or systems that are reputable and tried and tested, recommended to you by friends and colleagues.6
  3. Purchasing equipment that won’t let you down: It might feel like a totally computerised practice, with all the latest kit, is the way to go, making things faster and more efficient, but you need to ensure it works for you. It needs to support you not cause you more stress by breaking down or being too complicated to use efficiently.

Carefully choosing a supplier who you can build a long-term relationship with can help give you the support you’ll need. Many companies offer financing, leasing and equipment repair services as part of their contracts. Sometimes this route may initially appear more expensive but in the long run prove to be better value for money, saving you and your team time where your contract includes consultancy and training on the equipment, as well as on-going repair and maintenance costs.1,6 As always, it pays to do your homework to see what suits you better.

  1. Patient expectations: whether you have taken on an existing patient list or starting from scratch, having a good relationship with your patients can make all the difference. Patients tend to complain about the same things; the perceived ‘attitude’ of certain members of staff, poor time-keeping, the risk of unnecessary treatments and a lack of clarity whether a treatment provided was NHS or private. Clear internal policies and transparent pricing, actively managing both staff and patient expectations alongside regular, unambiguous communication can go a long way to avoiding future disagreements or misunderstandings. This, as well as keeping up your CPD could protect your practice from patient complaints and the risk of negative contact from the GDC8,6
  2. A work life balance: having something to look forward to or enjoy outside of the practice, such as having friends who aren’t in the industry, can really help to leave the daily stresses behind and allow you to switch off when you’re away from work10
  3. Looking after your mental and physical health and wellbeing: this is imperative, as stress and musculoskeletal issues are all too common in dental professionals. Techniques such as yoga, mindfulness, meditation or Pilates, or simply enjoying the outdoors through exercise have been shown to reduce stress, as have making time for yourself, whether it’s as simple as having a hot bath, reading a good book or listening to your favourite music.2,9,10

Take the time to step back and decide what’s right for you and your future career path, but remember to look after yourself as you are the most important asset you have. Think about how you will combat unnecessary stress, so you can fully enjoy having a smooth-running and exciting venture that is all yours.

 

References available on request.

This article is intended for general information only, it is not designed to provide financial, health or other advice, nor is it intended to make any recommendations regarding the suitability of any plans for any particular individual. Nothing in this article constitutes an invitation, inducement or offer to subscribe for membership or additional benefits of Dentists’ Provident.

No responsibility or liability is assumed by Dentists’ Provident or any copyright owner for any injury or damage to persons or property as a consequence of the reading, use or interpretation of its published content. Whilst every effort is made to ensure accuracy, Dentists’ Provident, the authors, Editors and copyright owners cannot be held responsible for published errors.

Dentists’ Provident exercises editorial control only over material published and/or produced by it.  No responsibility or liability is assumed by Dentists’ Provident for any articles produced or reproduced in third party publications and/or websites.

The views or opinions expressed do not necessarily reflect views of Dentists’ Provident or copyright owners. Inclusion of any advertising material does not constitute a guarantee or endorsement of any products or services or the claims made by any manufacturer.

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