A private affair

Before I talk about what I think constitutes a private patient, I have to tell you about a recent lecture I gave to a group of 60 postgraduates in the north of England, the majority of whom were principals or associates delivering NHS dentistry.

However, before I was due to speak, I spent an hour eating and chatting with my prospective audience. The conversation didn’t revolve around patients, prices, marketing or business practice – nothing new there. What surprised me was that the conversation didn’t once steer towards the subject of teeth. I found this unusual, because dentists usually tend to enjoy a good old natter about clinical issues while they tuck into a good meal.

The sole topics of conversation were golf (OK – that happens) and UDAs. It was 20% golf and 80% UDA’s – targets being negotiated and existing targets renegotiated. Then it was UDAs, UDAs, UDAs – for a whole hour. I even listened to an interesting debate about how to legitimately massage the UDA figures to keep the PCT happy while not killing yourself (and losing valuable golf time). It would appear that some training courses are appearing on the market that will show you how to manipulate those UDA’s and keep the grey-suited PCT officials happy in their ignorance. Such is progress.

Anyway – on with the show – ideas to make sure that your patients request and appreciate private dental treatment: Practices that are considering offering more private treatment options or a full conversion fall into two categories, each requiring a different approach. The first category looks at practices where the physical facilities and the team are below average. It looks at tired or scruffy premises, poor decoration and equipment and staff who are jaded by the ongoing pressure of keeping a busy NHS practice alive, tolerating poor performance and behaviour by clinicians and patients alike.

In this case, you have to smarten up your premises and your act before offering private treatment options and expecting a viable and profitable response. To do this, you will either have to invest or borrow money to improve facilities and to provide team training on customer service and communication skills. All of which assumes that you are simultaneously going to stop tolerating poor behaviour by patients.

Once you have completed that process (which will take maybe a year or more), you can join the second category of practices, those with good-quality facilities and a strong team, delivering an attractive customer service experience and great dentistry.

If you are either introducing or converting to private dentistry, there is a key phrase that must be incorporated into your team’s language: ‘In order to maintain our standards of customer service and clinical care we have decided to offer dentistry on a private basis in the future.’

This isn’t about the NHS being a poorer offer, it’s not about you having to change because of the Government’s new proposals – it’s simply a business decision that you have made, the objective of which is to keep practising customer service and clinical skill at the same level as before.

Expanding on the last point, a client recently announced at one of our dental workshops that, after a year of business coaching he had finally realised that the year had been spent converting the patients’ attitudes, not the practice. It’s about changing the expectations and the mind set of the right type of patients, allowing the rest to walk away and some of them to drift back over time.

Let’s take a look at pizzas.

• If I want to fill my stomach at half-time, I’ll ring Dominos. I’m not too bothered about what’s on the pizza; I just want it edible and delivered.

• If I want to take the kids out on a Saturday afternoon, I’ll go to Pizza Hut. Still not too bothered about the pizza and I’ll tolerate the staff and the surroundings because I just want the kids entertained.

• If I’m travelling on business, I’ll go to Pizza Express. I know that wherever I walk through the door, if it’s in Edinburgh or Bristol, I will get the same standard of customer service, the same patient journey, the same tables and cutlery, the same standard of good-quality pizza.

• If I’m out for a romantic dinner for two – it will be at a privately owned trattoria, where the owner will dance around us when we arrive, the waiters will be personalities and the food and wine will be outstanding. You get exactly what you want and exactly what you pay for.

Is dentistry any different? I don’t think so.

• Domino’s dentistry – shabby premises, tired staff, harassed dentists, dipping sheep all day.

• Pizza Hut dentistry – it’s OK but that’s all – and you are not sure whether the other people in the waiting room are your ideal companions.

• Pizza Express dentistry – efficient, clean, good customer service, good dentistry – consistency.

• Trattoria dentistry – a five-star experience with lovely premises, caring and attentive staff, great dentists/hygienists, great dentistry.

Which dental practice do you currently offer to your community – and which would you prefer to offer?

I don’t believe that you can mix and match – serving a Domino’s pizza in Pizza Express surroundings or a trattoria pizza (at trattoria prices) in a Domino practice. The buying public are going to get annoyed and confused by that mixed marketing message.

This philosophy convinces me that there is room in the market for a Pizza Express dental franchise in the UK. As I’m not a dentist, I cannot initiate such a business under current legislation but if any dentist reading this article has the interest and a best friend with a few million to invest, please give me a call – I’d love to help build that business! In the meantime, there are enough patients everywhere in the UK to support each of these business types – so just decided which one you want to own and/or work in.

I recently visited a practice in the East Midlands that was bought from a retiring dentist by a husband and wife dental couple, three years ago. They proudly showed me photographs documenting the renovation of a tired 1970s configuration into a more modern and funky establishment – lots of light oak and smoked glass – you know what I mean. I sometimes call this a ‘wine-bar’ practice – very popular and trendy at the moment.

So far so good – the team all have nice navy blue uniforms and are enjoying the new look. Then they brought out the price list and I nearly fainted – half-price dentistry in private surroundings. The cost of an initial consultation was exactly 50% of what I had seen in a rural practice down in the South West the week before. Closer examination revealed similar cheap dentistry offered across the treatment board.

The rationale? ‘We didn’t want to frighten off the patients when we bought the practice so we decided to keep close to the original price scale, in line with NHS prices, while we refurbished.’ So they have transitioned from the category one to category two practice, have completed the refurbishment and retraining, and are still too scared to put their prices up to a realistic level.

I’m talking here about moving from the equivalent of £90 per hour towards our clients’ average of £180 an hour over the next two to three years. But they haven’t even taken the first steps yet and are afraid to do so. This creates an interesting paradox – they are attracting a steady flow of new patients into the practice – but there is a high proportion of ‘messers’ among them.

This may be an interesting new breed of patient – private ‘messers’ who don’t want to mix with the riff raff at the local NHS practice (or tolerate the customer service) but don’t want to pay realistic prices – so they are taking advantage of this funky wine bar practice but messing them about at prices they can afford. Needless to say, my coaching is about raising prices and firming up on patient behaviour.

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