30,000 patients and counting

_O9A5106Shaun Smith tells Sophie Bracken the remarkable story of how he and his partner, Simon Nocton, created the UK’s largest independent private practice – The Dental Surgery in London’s Corn Exchange.

Shaun Smith has built something simply unique in UK dentistry.

As trailblazer of the profession, Shaun didn’t establish a dental corporate, hasn’t franchised a series of practices under a single brand, nor did he make his fortune buying and selling dental properties. Shaun created something that UK dentistry has never seen before.

Over the last 25 years, Shaun and his partner, Simon Nocton, have been growing the largest independent private practice in the country. Boasting an incredible 14 surgeries, The Dental Surgery, located within the city of London’s Corn Exchange, is a one-of-a-kind practice in the UK.

I visited Shaun and the team at The Dental Surgery  – which was awarded Practice of the Year: South, at the Private Dentistry Awards in 2012 – to hear how this friendly, laid-back Kiwi turned shrewd businessman to create this colossal practice, while never compromising on patient care.

In the beginning

Shaun begins his story at the very beginning of his career, arriving in England from New Zealand in 1985 at the tender age of 24, with little to his name aside from a degree in dentistry and a passion for adventure.

‘I came with a six-month work visa’, Shaun tells me over coffee in the stylish meeting room situated in the middle of The Dental Surgery.

‘In those days, dentistry was desired labour. The NHS had created this huge demand for dentistry and medicine, but it didn’t have the doctors and dentists, so they were supplied by New Zealand, Australia and South Africa. Graduating dentists from those countries were always going to work in the UK, and not their home countries.’

However, after working in a few practices in London, Shaun became disillusioned with 1980s NHS dentistry.

‘I’ve got to say I hated it. The compromise of quality of care, service and product that was offered on the NHS in those days was just awful. I couldn’t do it. I hadn’t gone through five years – nor did I possess the correct morals and ethics – to work in that environment.

‘So at that point I said: “This is me and dentistry done”, and I gave up.’

Laying the foundation

Seemingly finished with dentistry, Shaun was on the verge of a complete career change. He made plans to study for a masters degree in business and was accepted to both Harvard and the London Business School, when the opportunity arose to take up a position at a practice in Moorgate. Shaun’s curiosity got the better of him. ‘I went to have a look and it was a nice little practice, with really nice patients that you had time to talk to’, explains Shaun.

He took the position, and subsequently fell in love with dentistry all over again. ‘I decided that if I was going to do this I was going to be very very good at it’.

When the owner of the Moorgate practice sold the building to a developer, Shaun took his 40 new patients with him to a run down practice in Plantation House in the city of London. This, as Shaun says, ‘was the nucleus of what we have today – 30,000 private patients in 14 surgeries. And those first 40 patients still come’.

Shaun completely refurbished the Plantation House practice, putting in a total of seven surgeries. After seven years at Plantation House, the iconic building was marked for demolition, so Shaun and his patients were on the move again.

British Land, the owner of Plantation House, suggested another building to Shaun – the Corn Exchange near Fenchurch Street station. With this move, The Dental Surgery was born. Shaun and his team designed and built a gargantuan 10-surgery practice, an unprecedented feat at the time.

‘We made some pretty big mistakes in those days, but everyone was amazed’, remembers Shaun. There was nothing like a 10-surgery practice in the UK at the time. But by 2010 we had completely outgrown the space, so in 2010/2011, in the middle of the recession, we spent over £1 million remodelling and taking 50% more space. We put another four surgeries in. That’s what you see today.’

Growing the empire

_O9A5288The Dental Surgery is astonishing – a practice of this size, scale and calibre is something that very few within the profession will ever have witnessed. It is so large that an unwitting patient left to their own devices might have trouble finding their way around. But despite being situated underground, on the lower ground level of the Corn Exchange, the practice is remarkably bright, and the décor is stylish, contemporary and consistent throughout. But in typical fashion of any growing empire, and in typical Shaun style, The Dental Surgery is already beginning to outgrow even this colossal space.

‘At the moment we’re in discussions with the landlord to take the rest of the ground floor and put in another nine or 10 surgeries’, Shaun explains. ‘We have six full-time hygienists that are booked up six to eight weeks in advance – we need more hygienists, like yesterday! Likewise our orthodontist needs a couple of surgeries ASAP.’

The Dental Surgery is already currently the largest independent private practice in the UK, and the addition of a further 10 surgeries would certainly blow any practices looking to contest that title out of the water.

Shaun believes that it’s The Dental Surgery’s constant drive to remain ahead of the curve that keeps it at the top of its game. ‘We’re certainly one of the most innovative practices in the UK’, he says. ‘We invest in a lot of cutting-edge technology. We’re on the third-generation 3shape digital impression scanner. We were the first practice in the UK to get it.’

But it’s not just in terms of technology that The Dental Surgery innovates. The practice is innovative in the way that it promotes its hygiene programme, putting prevention at the very forefront of its services. With six full-time hygienists, this is arguably one of the most innovative and comprehensive hygiene programmes in the country. But Shaun believes that the team can always do more.

‘I don’t think we’ve even scraped the surface with our hygiene programme’, he says. ‘Sarah Gilder, without a doubt, is one of the strongest hygienist in the country and we’ve been together for a long time. We could do with two or three more hygienists, but we don’t have the space!’

It’s important to remember that The Dental Surgery operates on a larger economy of scale than most practices – a fact that Shaun appreciates: ‘I know it’s tough for small businesses to spend large sums of money on new equipment and staff’, he says. ‘I have a great support team around me, particularly now. We have very good cash flow – a lot of it is out of our pocket or out of our investors’ pockets. We reinvest everything. Running a business is quite natural to me so I just get on with it, and I always plan for the worst. Our numbers are large, but we have a great financial team so we just get on with it, and think about the next project!’

Lasting relationships

Shaun also tells me that support from industry has helped The Dental Surgery tremendously in becoming the entity that it is today. ‘Industry-wise I’ve been very lucky. I have some very good friendships – with Optident in particular. I also have a great relationship with The Dental Directory, which has dealt with all of our practice refurbishments, and we have always used Belmont equipment. I have an exceptionally good relationship with Software of Excellence, and we were a beta tester of some of their products. I still talk to them about new developments. I have a nice relationship with Carestream Dental as well.’

Shaun also credits his good friend Bob Bird, a chartered surveyor, with the smooth running of taking on such a mammoth project. ‘He project manages for me. Bobby has built all of our practices. Because of our size, we need a bit more planning than your average high street dentist. But it’s the old adage, if you look after people, they will look after you. Pay it forward. That’s what I try to do’.

The philosophy of paying it forward is at the heart of The Dental Surgery, and looking through the practice’s appointment book, it’s clear to see. Shaun has grown his initial patient base of 40 patients to around 30,000 – many of them relatives of those initial 40.

‘I have two distinct types of patient: some in their early 40s through to 70s, and then a whole group of patients between 18 and 30. They are the children of those original patients. They’ve been seeing me since they were children, or they have come to me since they have finished school. It’s great because I know all about them, even though I’ve never met them before!

‘A great referral source is my two daughters, who are 24 and 22. My youngest daughter is training to be a doctor in Dublin. Her friends come all the way from Dublin to see me.’

Word of mouth

_O9A5291As the largest independent private practice in the country, one would assume that The Dental Surgery has an entire team dedicated to marketing. In fact, quite the opposite is the case. Shaun believes that when it comes to putting yourself out there, it’s best to keep the message simple.

‘We don’t have a marketing strategy as such, but Erika [Shaun’s personal assistant] is instrumental. Our strategy is that if you treat the patient well, they will treat you well.

‘Those initial 40 patients turned into this [30,000 patients], because we treat them well. It’s all been word of mouth.’

Shaun purchased the domain, www.thedentalsurgery.co.uk, back in 1996, which he believes was the UK’s first dental practice website. Shaun says he’s proud of the current design of the website – it’s as contemporary and welcoming as the practice is in real life – but he believes it could be much more. ‘It looks like an Aston Martin, but we need to keep working on the content’ he says.

‘We need to market ourselves more as dentists. People ask us, “Do you do X and Y?” and we say that not only we do, but we’re probably the best in the country. We place more implants than anyone else, and we have the best dentists and hygienists in the country. We really don’t tell enough people about that.’

Yet the practice has its very own smartphone app, enabling patients to book appointments, review services and stay up to date with the practice’s latest offers.

Paying it forward

I ask Shaun if he has any advice for ambitious dentists looking to emulate his success. ‘It’s about treating people well’. Shaun says simply. ‘If you care for people, whether they be staff, patient, colleague, supplier or financer, they will treat you well in return. That’s the key to it. Pay it forward. Try to be the very best dentist you can. Don’t compromise.

‘I have patients that have been with me since 1988. There are many fine dentists in the UK but there’s a huge gap in UK healthcare where patients need to be cared for, for life.’

Now Shaun has created his empire, does he have any plans to slow down, take stock, and survey all that is his? He’s adamant that he intends to remain as involved as ever. ‘I work all the hours God gives. I work clinically four days a week, and then on Wednesdays I meet with the accountants, have staff meetings, catch up on admin. I have no plans to slow down. I enjoy it way too much.’

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