The business end of dentistry

Following a lengthy break, last month saw the VDPs return to St James in Dublin for a day release seminar, where Dr Garry Heavey spoke to us on the topic of Dentistry – the business end.

During our undergraduate training we were educated in many aspects of dentistry but somehow the fact that working as a dentist meant running a practice, in essence being a business owner, was never even alluded to.

Dentistry as a profession, particularly if you are running a single-handed practice, is not just a service from a healthcare perspective – it is a business, the virtual bread and butter of the proprietor. Yet where in any undergraduate course is a business management module?

Running a single-handed practice means you are the HR department, the stock controller, the bookkeeper, the employer, the auditor and the negotiator, and somewhere amidst all this you have to find time to be the dentist!

The tips provided by Dr Heavey were most invaluable for those of us who are ‘new to the business’, such as the importance of keeping separate accounts and credit cards for business and personal finances. You need a bookkeeper and accountant to manage your finances, for which you should have at least a quarterly profit and loss account, as well as an end of year balance sheet. Reams of receipts should not be handed over in boxes at the end of each financial year – it is inexcusable ignorance not to have at least a rough idea as to how these things work.

Dr Heavey also pointed out that it is not possible for the dentist to take charge of everything personally and this is where the process of delegation and possibly the need for a practice manager come into play, for example to check stock against invoices for quantity and prices, as sometimes some companies can inadvertently overcharge.

As the sole dentist working in and owning the practice, it is also your responsibility to hire and, unfortunately, sometimes to fire staff. You need to be able to ask appropriate questions during the interview processes and put together contracts that incorporate points on issues such as annual leave, sick pay, pensions, parental leave, disciplinary procedures and a period of probation.

Dr Heavey also spoke about the importance of having systems in place such as those for dealing with the emergency care patient, who should be dealt with by an appropriately trained member of staff who answers the telephone. Such a staff member should be aware of the right questions to ask the emergency care patient to elicit the necessary answers, and then book them into a slot with the appropriate time for the required treatment, be it 10 minutes to re-cement a crown or 45 minutes for primary endodontics – and not vice versa! Another point Dr Heavey made was that an emergency care patient is one that will see any dentist at any time, and for the added stress of trying to accommodate such a patient a reasonable emergency fee is more than acceptable.

For all VDPs our income is taxed at source, as are our PRSI and pension contributions, hence it removes the worry of taxes at the end of the financial year. A lot of practitioners end up having to borrow money for their taxes, as they have underestimated what is to be paid. Helpful tips were provided for those of us who intend to work as an associate once our contracts are finished, including saving for taxes and lab fees, fees associated with credit card and Laser card payments, as well as highlighting the importance of obtaining a payslip at the end of each month.

Dr Heavey is currently establishing a company called TotalDentalCare; its aim is to assist dentists in running and eventually buying their own dental practice, while enabling those of us new to the game to avoid as many rookie mistakes as we can.

To date it has been one of the most practical seminars focused on dentistry as a business, and as a result I will hopefully avoid many sharks in the proverbial deep waters!

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