As Practice Plan turns 25, Seb Evans speaks to Nigel Jones about the secret behind Practice Plan’s success and longevity.
1. Can you please give us the story behind Practice Plan, who started it and what was the vision?
John and Jan Tinsley started Practice Plan back in 1995. John worked with dentists and had a number of clients who used another payment provider.
Through the interactions with those dentists, he had a number of concerns about the nature of the capitation, the full care plans, which were on offer at the time.
So, John thought he’d move away and set up a company that addresses his concerns.
I think the vision was to have a membership plan structure that had all of the benefits dentists were experiencing, but more flexibility, a greater fairness for patients and dentists, was practice branded – about cementing the loyalty of patients to the dental practice brand rather than a third party.
Also, I think part of his role as an IFA made him appreciate some of the practice management challenges for dentists.
2. Why do you think Practice Plan has achieved such longevity?
We’ve taken that basic premise and expanded the range of support.
In that 25-year period, it’s become a far more complex environment in which to run a dental practice.
The regulatory environment has changed enormously, the competitive environment has changed. Dentistry has changed. We have much more diversity, in terms of the mix of NHS and private practices.
What we always try to do is keep up with the times and make sure we’re meeting an itch.
3. Can practices who aren’t Practice Plan members access the business support?
A lot of it they can, yes. We deliberately set out to help the profession.
For me, the answer to longevity – it’s because we put the dental practice at the forefront of everything. We need the dental practice to be successful. And therefore, we have to help them be successful.
If we help them, the plan and finance side will just go along with it.
4. This probably hasn’t been the 25th anniversary year you were expecting. How has 2020 been for Practice Plan and your members?
I’ve actually been in dentistry longer than Practice Plan. I cannot remember anything that remotely approaches the challenges that the last four or five months have. It really is unprecedented.
We set ourselves out to help practices to be successful. To have all of our practices we support having similar needs at exactly the same time created a workload that was just like nothing I’ve ever seen.
In any normal year, a proportion of your practices have specific needs you’re helping them address. But to have all of them with the same needs at the same time was just really tough. But in a way, incredibly rewarding.
We’re very customer centric. We’re always thinking and empathising with practices and owners who we deal with.
The thing I’m so proud of in the wider Practice Plan Group, is how we just immediately clicked into supporting practices with information and online resources as quickly as possible. We actually had them up and running the day lockdown was announced.
We quickly realised we couldn’t hold normal face to face in-person events. Instead, we held face to face virtual events. We got a webinar programme up and running in next to no time. The whole of the field team had to work from home, but they were constantly on the phone, email, WhatsApp, and in regular contact with all clients.
It was an amazing collective effort to just do what was right for practices.
On top of that, we were able to go to Wesleyan, our parent company, and say our practices are going to have a cashflow problem now. Their private fee per item income has fallen off a cliff. They’re going to be under a huge amount of financial pressure. What we want to do is halve what we would normally deduct in our fees for two months. That way we can frontload financial benefits to practices at the time they’ll most need it, while they’re trying to get other sources of financial aid in place. And Wesleyan went with it.
It’s that level of empathy. We’re close enough to our clients to understand things like the cashflow problem is going to be most acute now.
I’m really proud of what we did.
5. Why is Practice Plan doing this and no other payment plan providers?
I think it starts with the understanding of what our purpose is. Our purpose is to make the practices with which we work successful. That’s what we’re setting out to do. A plan is a means for that.
You know you’re there to make practices as successful as possible. When adversity hits them, you just know you have to do the right thing for them. You aren’t really thinking in terms of what’s the right thing for dental plans. You’re thinking what’s the right thing for practices.
We have a structure that allows us to be quite agile. Wesleyan gives us a lot of freedom to run the business the way we think is the right way for our clients and teams.
6. Can you give us some positive stories you’ve heard from practices during this time?
The most positive thing has been just how loyal patients have been to their practices.
When lockdown hit, we did some financial forecasts about how many patients would cancel or suspend their plans as a result of not being able to access their dentist.
It was hardly any. It’s remarkable how few people have cancelled.
Of course, I’ll attribute that in part to people who value the plans. But I think what it really means is they value their dentist.
One of the things we encourage practices to do, which they fully embrace, is to reach out to plan patients and keep them informed
The stories that I heard from practices where they’d done that were incredibly motivating. Patients were really very pleasantly surprised that their dental practice had reached out to them in that way.
So there are lots of positive stories about patient and practice interaction that just show how strong that bond is between patients and their clinicians.
Sometimes that was taken further and you hear about practices delivering prescriptions. Some were even delivering food to patients who were shielding and on their own.
I cannot remember a time when the goalposts have moved so frequently in such a short period of time. To be able to adapt and cope with that, it’s not been without a huge amount of stress.
Practices have done really well, I think.
7. Has this pandemic highlighted the value of payment plans?
Yes, I would say so.
That’s borne out by the level of enquiries we’re getting at the moment. I have this pleasant problem, which is how to handle the amount of demand from dentists we’re getting at the moment.
The reason is, the thing that saved a lot of practices has been the cash flow coming from plan patients. Without that, they’d have been really struggling.
The other thing that’s been interesting is whilst in England the NHS has continued to provide funding, I think that the level of communication around all that served to highlight to a lot of people how out of control they are with the NHS.
If it only represents 5-10% of your income, it’s an irritation. If it represents 100% of your income, you’re left feeling really exposed.
Part of the demand we have at the moment is from NHS dentists thinking I do not want to put myself in an exposed position again when I’m hanging off the CDO’s every word. I want to be much more in control of my own destiny.
Obviously, you can’t be in control of a pandemic or the recession we’re going into at the moment. But you can be in control of how you respond to both of those things.
Don’t get me wrong, having that guaranteed income is undeniably a good thing. But that loss of control, I think will unnerve an awful lot of people.
What’s going to be fascinating with this is to see what kind of model of NHS dentistry emerges from the pandemic and is considered to be sustainable going forward. If the current level of patient numbers going through practices carries on for any length of time, the current contractual measures just aren’t fit for purpose.
A big change to NHS dentistry has to come further down the line as a result of the COVID crisis. That’s going to be an interesting thing to see unfold.
8. What have been some of the highlights of your time with Practice Plan?
I’ve got a naff answer and a corporate answer.
The corporate answer is when Medenta joined the group. Medenta has been a fantastic addition to what we do. When DPAS became part of the group. That was a major highlight. The whole evolution of the Practice Plan Group concept, and those three companies, that has given us such a presence in the market. I think that’s been brilliant.
There’s some practical stuff. I’ve loved all the work we’ve done around the Confidence Monitor surveys. The amount of debate we were able to stimulate through that.
The naff answer is still when I get a dentist that tells me we’ve saved his or her career. Or we’ve saved his or her marriage.
That’s really the bit that has kept me doing what I do. You interact with dentists that are absolutely at the end of their tether. They are under so much pressure, they feel it so intensely, particularly under the NHS. Private dentists aren’t immune to that pressure but it’s far less pronounced.
You take a stressed up to the eyeballs NHS dentist and you take them to a different place. It’s hard to explain how rewarding it is.
9. What are you and what is Practice Plan doing in recognition of the 25th anniversary?
Specifically, 25 years is on the 10 August. We’re going to be doing various things.
We’ve got people doing 25 miles in five days for Bridge2aid. They’re running, walking, horse riding, swimming. I’m also hoping to kayak. Les (Jones, our creative director) could well be back on his bike.
We’re going to have lots of stuff on social media surrounding this. Also, Bridge2aid becomes a beneficiary of that.
10. Finally, what does the future hold for dentistry and where does Practice Plan fit into that?
I think that dentistry is in for a pretty tough few months.
For private practices, the challenges are going to be how do they generate enough income to compensate for what would be increasing costs and less patient throughput.
But, if you’re looking one to four years ahead, I think the future is extremely bright for private dentistry. The short term for NHS dentists will be fine. But I think there will be a sting in the tail further along.
There will be some fundamental changes that have to happen to NHS dentistry. But it will actually drive demand for private dentistry. We’re already seeing it.
The drive in demand for private dentistry will allow practices to identify their particular niche. Do they want to be a particularly high-end practice? One of our practices has taken the COVID crisis as a chance to become a much more exclusive private practice, seeing five or six patients per day, per dentist. Other practices have taken the opportunity to expand working hours and weekends, and adopt new patterns of working.
We’ll see lots of different business models emerge over the next few years that will create opportunities for lots of people with lots of different preferences.
Additionally, I think the demand for cosmetic dentistry is just going to go up and up. We’re seeing with Medenta, a massive increase in the loan applications for adult orthodontics.
I think people will prioritise both their health and also the cosmetic aspects of their oral health going forward. People have been thinking about their health in a much broader sense during the course of the crisis.
So for Practice Plan I think our focus has been supporting private practices, or those with a private element. There’s going to be a big expansion in private dentistry, that can only be good. The challenge for us is to make sure we continually evolve our support to make sure our practices make the most of that opportunity.
