Judging from the latest figures published by the National Association of Specialist Dental Accountants and Lawyers (NASDAL), the attractiveness of swapping dependency on the NHS for a life in private practice must have significantly increased for many. The figures show that the average private practice profits per principal have jumped to £140,129 in the year ended 5 April 2015, compared to an average NHS practice profit of £129,265. But is money the sole motivator for dentists to make such a change?
Dentistry.co.uk: Average private profits seem to be on the rise at the moment. Do you think this could be an attractive reason for some dentists to go private?
Josie: It would be naïve to suggest that money wasn’t a consideration. After all, the financial viability of a practice is a very important factor towards a sustainable future. But every dentist is different and each have their own reasons for considering a reduction in dependency on the NHS. The figures are looking attractive but that said, in my experience, to believe that earning more money was the sole motivator for a dentist to make such a change would be a mistake.
Jayne: I agree completely. Because of the way the NHS contract is currently structured, it is true to say there is a ceiling on a dentist’s income – in fact, in the future there is potentially only an over-delivery scope of 2%. So it is easy to generalise and assume that an increased income was and is seen as the primary benefit of a move away from the NHS when it fact it is much more. There is never one reason, but a variety, and in turn those reasons can hold a different weighting depending on the dentist and the practice situation.
Dentistry.co.uk: In what way can those reasons vary?
Jayne: By exploring a private option, they are choosing to reduce their reliance on the NHS and ultimately change their business model to address a variety of reasons. Some dentists might think to themselves: ‘I’d like a little more time to complete a filling’ or in examinations: ‘I’d like the chance to speak to the patient in more depth about health benefits or explore if they are happy with their smile’.
Some are looking to expand their clinical skills, others are looking to run their business how they see fit – potentially looking to reduce their hours or find a work-life balance that suits them. They are seeking out opportunities that their current working situation restricts, and in my experience, the justification for seeking independence from the NHS varies from dentist to dentist.
Josie: Exactly. For example, seeking a happy working environment can be a factor. Private dentistry can provide a way to reduce professional concerns without potentially compromising on the standard of patient care they wish to provide. It even reduces the worry of inadvertently breaking a rule or a contractual clause in an increasingly complex contract system. Get the balance right, it can equally have a positive impact on family, health, and personal and professional enjoyment of life.
Jayne: At the end of the day, a dental practice is a business and ultimately the dentist’s. By choosing to seek independence from the NHS they are taking the opportunity to take control of that business and make decisions unencumbered by contractual obligations.
Josie: If a dentist chooses to go private, especially with a membership plan at the foundation, it allows them to allocate their time accordingly and cost everything correctly. Which means that a patient is paying for the amount of time the dentist really needs to provide the treatment they require. Straight away the pressure is off for the dentist, which leads to other positives that Jayne has mentioned – a more relaxed dentist means a happy team and the ability to give the patient a better service.
Jayne: I agree. A move to private dentistry can free up the dentist and the team’s time, as the administration burdens are also greatly reduced. This enables them to concentrate on other areas of the business or potentially develop their skills. Another off shoot of this is the ability for a dentist to balance their working week with their life outside of the dental practice. So, to summarise a private dentist is effectively creating the space and time to deliver dentistry on their terms. Overall, the benefits are much wider than remuneration as it covers a combination of benefits, which include professional pride and personal satisfaction.
Josie: Every dentist and practice circumstance is different. NHS dentistry, for many, with its focus on performing clinically necessary treatment to achieve healthy mouths, teeth and gums, offers an excellent service. The truth is, it is very difficult to compare the two, since one is measured in time and costs, and the other in units. There are key considerations that can influence the potential success of a conversion and they all need to be fully explored so that an informed and balanced decision can be made. I suspect that a high proportion of dentists simply haven’t explored their options or sought out the right sort of support to do so.
Jayne: Whatever type of dentistry a dentist and their team want to carry out, there is a system that will work for them. Whether to stay within the NHS, opt for a mixed practice or make the move to practising private dentistry exclusively, it can all be explored and the choice is ultimately the dentist’s.
A proportion of the NHS conversions that I am supporting at the moment are principal only. This is where the principal converts and the practice redistributes the UDAs – either sharing them between existing associates, or bringing on another associate.
Whereas some dentists might be waiting on the prototypes to lead the way when it comes to a future within the NHS, as Josie has mentioned, there is no harm in exploring options. So perhaps they haven’t yet found a person who is experienced and is able to explore their specific options, chat through personal concerns and offer support on how to manage them.
Practice Plan has supported hundreds of dental practitioners to seek independence from the NHS. To find out more visit www.practiceplan.co.uk/nhs.
Josie Hutchings and Jayne Gibson have both been helping practices successfully convert from NHS to private for the last 12 and 21 years respectively. Through their experience they have an excellent understanding of the challenges and issues practices face and are well versed in solving these with the right results for the practice.