Dental practice management training

In his seminal book on entrepreneurship, The E-Myth, Michael Gerber famously urges owners of small enterprises to work ‘on’ the business rather than ‘in’ it. The point Gerber is making is that if any business is to have real long-term growth potential, then it is vital that the owner should focus his or her energies on understanding how the business works, what makes it successful and then doing everything possible to nurture and build on those positive foundations.

Unfortunately what usually happens, as Gerber points out, is that too many small business owners tend to put all of their efforts into being the ‘hands’ that provide the actual service or product – the plumber fixing broken taps, the baker making wedding cakes, the car mechanic fitting new brake pads – and dare I say it the dentist fixing damaged smiles.

It is pretty obvious why this should be so. In our case we have trained for five years, and often more, to be expert craftsmen in the art and science of technical dentistry. By and large, dentists enjoy the nitty-gritty of clinical dentistry, the satisfaction of a well-placed composite, a crown that fits perfectly, a well-executed extraction or root canal treatment.

The problem with this approach is that all the while we are being dentists a myriad of other things are happening (or more likely, not happening) that have a dramatic, drastic impact on the success or otherwise of the practice and business. There would be few of us these days who would not consider that modern dentistry is a business, albeit a very special one that blends professionalism with skill and, whether we like it or not, management and business acumen.

Traditionally, though, our training ingrains within us a reactive stance – patients come in with a set of problems that we diagnose and to which we then react by providing the necessary therapy and advice. Business, though, demands a fundamentally different approach, a far more proactive one. Put simply, you have to make something happen almost out of nothing, the so-called Blue Ocean Strategy described in the book of the same name by W Chan Kim and Renée Mauborgne. You have to think ahead, be constantly looking at ways of keeping up with the competition, competition that has

sharpened remarkably in recent years following deregulation of the profession in terms of more relaxed marketing regulations, corporate ownership and so on.

Initial aims

If we are honest, most of us didn’t go into dentistry to learn how to develop a business plan; how to manage, motivate, hire, fire, appraise and reward staff; how to prepare financial accounts and analyse the resulting managerial accounting information; how to develop an integrated marketing strategy; how to sell dentistry ethically; how to build a first rate service operation that consistently delivers world class customer service, did we?

Did we ever consider that we would have to see ourselves as ‘leaders’ dictating direction, values and assuming responsibility for the well-being and future prosperity of any number of employees – in the words of the world’s leading authority on leadership, Warren Bennis: ‘Not so much doing things right, more doing the right thing’.

We live in times when, for the first time ever, the public are starting to really value the product we provide, our ability to transform smiles painlessly and for the long-term. Do you have the managerial skills to ride this wave, to make the very most of it? Recently published studies have shown that a large majority of the UK public now see dentists as being able to dramatically improve an individual’s quality of life and there has been a corresponding surge in the uptake of dental care. With this has come a growing consumerism amongst the buying public.

Complaints against perceived poor quality care have increased and there is much less tendency to accept everything a healthcare provider has to say at face value. We cannot afford to be the paternalistic ‘doctor knows best’ dentists of old. Patients now demand a greater say in the delivery of their healthcare and if they don’t like what they see there are plenty of other providers willing and able to step in. Who would have thought, even a decade ago, that cheap air travel would impact on the provision of dental care in the UK and yet how often do we hear about patients travelling to the far flung corners of the earth for their cosmetic dentistry?

Address the issues

The world has changed and it is against this environmental backdrop that the modern dentist-owner must function. Given the level of competition and the serious way many operators, Gerber-style, consider and plan their businesses, it is simply not good enough to bury one’s head in the proverbial alginate powder and hope that the business side of things will take care of itself. Thought, attention and time must be given to addressing the issues that affect any small business.

The question is how does a dentist acquire the necessary managerial and leadership skills to do this? Certainly not from the dental schools and for a number of reasons. First and foremost, they do not feel it is within their remit, secondly they don’t have the skills to do so and in the current era of budgetary restraints within dental academia it is highly unlikely that either of these positions will alter.

The schools’ collective view that such things will somehow be taken care of post-graduation is unlikely to change in the foreseeable future. A considerable amount of managerial training is available to dentists from a host of gurus and experts who promise personal and business transformation and in the way such things work they attract a wide following of devoted disciples who will swear blind that ‘Guru A’ provides the true and only light.

It is not the intention of the author to denigrate such sources of training, rather to suggest that there may be another, middle, more structured way – a business qualification tailored to professional practice and specifically to dentistry, delivered by a combination of business academics, non-dental business people (including some of the aforementioned gurus) and dentists who are daily incorporating the latest business and managerial thinking successfully into their practices and reaping the benefits.

In the business world the MBA (Master of Business Administration) is seen as a valuable means of acquiring the skills necessary to run successful businesses in the 21st Century. Those who poo poo the MBA as academic and irrelevant to modern business have usually never stepped inside a business school and base their criticisms on a wide range of unfounded assumptions and prejudices.

Rightly so, the MBA is the international currency by which management training is valued. Why not a dental MBA? So much effort and money has been directed towards the study and teaching of clinical, technical dentistry and rightly this will continue, but surely the time has come to view the study and teaching of the business side of dental practice as being of equal importance.

Philip Newsome will be speaking at the Private Dentistry Event 07, Central Hall, Westminster, London, on 30 November 2007. Other speakers at the event include Kevin Lewis, Omer Reed, Lina Craven and Komal Suri. For more information, or to book your place, call 0800 371 652, email or visit

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