Articles, Dentistry

A shift in power

As someone who has spent much of his 24-year career immersed in the dental market, it is always with some trepidation that I reach for market reports in to the industry. Everyone is entitled to their opinion and perspective, but too often I find myself thinking that the authors have taken shortcuts in the production of their report and not bothered to properly understand the market on which they are commenting.

Such reservations do not apply to Philip Blackburn, the author of the 2014 Laing Buisson Dentistry UK Market Report that came out in April. His report is a very useful and thought-provoking analysis of the history, current state and possible future of the dental market. That’s not to say that I agree 100% with all aspects of the report but any differences are really a matter of interpretation rather than fundamental disagreements.

Take, for example, the theme of patients behaving like consumers. Such ideas are by no means new and Philip is not alone in seeing a shift in power away from dentists to patients, driven by a more competitive environment. Philip and others see such competitive pressures building within private dentistry over the next five to 10 years, leading to opportunities for providers focusing on keener pricing and convenient opening hours; providers such as retailers like Sainsbury’s or Tesco.

Lack of loyalty

Such conclusions seem fairly logical when earlier in the report you read confirmation of the pressure experienced by the private dental market during this period of economic turmoil and also the predicted oversupply of dentists. This is further reinforced by reference to the work carried out last year by Oasis that identified the apparent lack of loyalty to a particular dentist of those patients aged under 30.

It all seems difficult to argue with and yet I can’t escape the feeling that there is more to it than meets the eye.

Let’s go back to that Oasis research. One interpretation of the results is certainly that there is a new generation of dental attenders who will be forever more willing to shop around for their dentistry using a much wider range of buying criteria than has previously been the case. Another interpretation could be that, as hinted at earlier in the Laing Buisson report, those in their late 20s are only just re-engaging regularly with a dentist after the loss of parental control and instability in terms of career and home. It therefore follows that they haven’t necessarily had the time to build up the loyalty to a particular dentist that could override normal consumerist behaviour.

Following that line of reasoning on further, it potentially presents a challenge for those providers in retail settings as patients as they battle for customer loyalty. Patients may initially be attracted by the offer of benefits such as longer opening hours and easy parking. However, assuming some degree of continuity of care, they may then form robust relationships with specific clinicians who they may follow, foregoing the conveniences, if that clinician moves on to the edge of a contractual exclusion zone.

Shopping around

But hang on a minute, hasn’t there been growing evidence of patients shopping around for treatment and aren’t there lots of anecdotal stories of patients turning up at their regular dentist sporting a new set of veneers, a different shade, or even some form of adult orthodontic system? 

Yes, and while it’s tempting to suggest this may say more about the ability of practices to internally market their services, such examples do point to more consumer-like behaviour. However, even here I would tentatively put forward a theory that it’s not as simple as it appears. It seems to me that when a patient is deciding upon a dentist for their routine dentistry, the loss of control that is implicit in terms, such as non-elective, means trust in the clinician is all important.  

Therefore, it’s not surprising that for most practices, the best source of new regularly attending patients is the recommendation of others who can personally testify to the trustworthiness of a particular clinician. When it comes to elective care though, such as cosmetic dentistry, I wonder if the psychology of a feeling of greater control in the mind of the patient lends itself to more consumer-like activity.

Reading the signs

If you are starting to get the feeling that this is the kind of semantic or academic debate best reserved for a few drinks at the end of a dental event, I wouldn’t blame you. But maybe there is a practical dimension to my musings in the selection of appropriate marketing activity. After all, search engine optimisation (SEO) must have less relevance for practices seeking to grow the number of regular attenders as the majority of potential such patients will be acting on recommendation and googling the practice by name. Conversely, SEO will have huge significance for practices wishing to promote more specialist services that seem to be found by patients googling treatment type rather than practice name.

That there are already signs of patients behaving like discerning customers can be in no doubt. Whether such signs signal the complete transfer of power from patient to dentist in five to 10 years and the implicit end of loyalty to a dentist, I’m not so sure.

Nigel Jones is sales director at Practice Plan, a provider of conversion support and practice-branded dental plans. Nigel first began helping dentists convert from the NHS to private care in 1990, the middle of the last recession, continuing such support throughout the majority of his 24-year career. He has added to his understanding of the healthcare market and the Government’s NHS reform programme through his involvement with the independent sector healthcare providers such as Netcare and Virgin Healthcare.

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