The Smell of the Place….

I was searching around for inspiration for an upcoming presentation where I want to talk about the culture of a business; I came across this address by Professor Sumantra Ghoshal at the World Economic Forum.

He talks about the “smell of a place” and individuals working within the context of a business. His opening statement blows away all sorts of cobwebs of preconception.

Excellent stuff and well worth investing 8 minutes plus the thinking time to follow.

The Weekend Read – The Behaviour Gap by Carl Richards

Some of the things that I tell my clients when I start working with them:

  • I am not a solicitor although I have a working knowledge of the law as it affects dentists and their practices. I do know good solicitors and I am able to help them choose one.
  • I am not an accountant although I know enough to be able to interpret figures from most dental businesses and make vaguely relevant comments and suggestions, but they need someone who they trust and understands their business.
  • I am most definitely NOT a Financial Adviser or Planner. Again they need an independent who understands them, takes time to listen to their needs and wants and will be there for the long term.


I regularly come across dentists and other individuals who will issue statements about what to do with your spare money, where the next ‘big thing’ is coming from and the strategies they have used. When I ask them why if they’re so hot how come they’re still having to work (as opposed to choosing to) I’m usually told that they caught a cold on “Peruvian Shellac futures” or something equally esoteric.

Often I wonder if the time they spend poring over the Daily Telegraph on Saturdays and with their noses in the Investors’ Chronicle wouldn’t be better spent doing something with more relaxation and less worry about the choices you have made. I’m always curious about these apparently savvy people who spend small fortunes on cars in order to park them on their driveways or car parks for 99% of the time; but that’s a tangent.

So back to the book. Carl Richards is an American financial planner and New York Times columnist with a refreshing attitude to money. Some years ago, in order to explain points to his clients he started drawing simple diagrams on napkins; these are the book’s illustrations. He defines The Behavio(u)r Gap as the distance between what we should do and what we actually do. From the opening chapter, ‘We don’t beat the market the market beats us’ through ‘Financial Life Planning’ and ending with, ‘simple, not easy’ he shines light on important questions.

To quote Seth Godin on the sleeve notes, “smart, tactical and practical advice for anyone who has done dumb things with their money.”

Hands up if you’re not one of those – worth a read then!

Available from Amazon here

The Greatest Breakthrough Since Lunchtine #20 – Lasers ‘could prevent’ need for root canal treatment

In the second book of the semi-autobiographical series describing the progress of an Edinburgh medical graduate, Colin Douglas describes his hero, David Campbell’s, involvement with medical research. The book’s title is The Greatest Breakthrough Since Lunchtime and the cynic in me always remembers it when I read headlines like this one from BBC Health.

Lasers ‘could prevent’ need for root canal treatment

From BBC Health

Lasers have been used to regenerate parts of damaged teeth and could one day be used to prevent root canal treatments, claim US researchers.
The laser beam triggered a series of changes that led to the formation of new dentin, the layer below the enamel, in animal tests.
The results, in Science Translational Medicine, showed stem cells in the dental pulp were activated.
Experts said it was intriguing, but a long way from the dentist’s chair.
The team at Harvard University used a drill to remove part of a tooth in mice and rats.
One dose of laser therapy on the damaged tooth led to the production of a partial layer of dentin 12 weeks later.

New tissue
It was not a perfect match for natural dentin, but the researchers argue it would be easier to achieve with human teeth, which would be larger, and by refining the laser.
The scientists could not produce a new layer of the hard enamel that protects the tooth from wear and tear.
However, Dr Praveen Arany said his research could have a role in preventing root canal treatment – the dreaded and painful procedure involving the removal of a tooth’s nerve and blood vessels.
Dental cement is currently used to trigger new dentin formation, but it is not always successful.
Dr Arany told the BBC that lasers may be a better option: “The laser tool and the mechanism we have outlined would ideally be used in pulp capping that would prevent root canal treatment and hopefully preserve the tooth without the need for it to be eventually extracted.
“But once you reach the pulp and the pulp is necrotic, the cells you have to work with are no longer there so this would not work in those cases.”

Prof Ian Needleman, the director of the International Centre for Evidence-Based Oral Health at University College London, said full tooth repair was still a distant prospect.
“What wouldn’t come out of this is that a whole tooth could be regenerated. One tooth tissue could show some signs of regeneration or repair, but that’s a million miles from regenerating a tooth.
“It is interesting as a model of whether laser light can play a part in regenerative medicine, but in terms of dentistry it’s not offering an innovation at the moment.”

Stem cells
The source of the new dentin was traced back to stem cells in the dental pulp.
Experiments showed energy from the laser light was creating highly reactive oxygen inside the dental tissues.
It in turn activated growth chemicals that stimulated the stem cells to produce a new layer of dentin.
Chris Mason, a professor of regenerative medicine at UCL, said: “I was intrigued that shining a little bit of light triggered stem cells to differentiate.
“It’s incredibly low-cost and would be patient-friendly so it seems to have a lot going for it, but they can’t grow the enamel.
“The tooth is like a house, the dentin is the inner walls, but it still needs a roof and outside walls.”

The Monday Morning Quote #267

“Someone once asked Somerset Maugham if he wrote on a schedule or only when struck by inspiration.


“I write only when inspiration strikes,” he replied.

“Fortunately it strikes every morning at nine o’clock sharp.””

Steven Pressfield


Is there a race to be the biggest dental chain?

Oasis completes acquisition of Apex

Full article from Yorkshire Post here

OASIS HEALTHCARE has announced the acquisition of Apex Dental Care, following closely on the heels of its takeover of Smiles Dental last month.

The deal was completed for an undisclosed sum, the company said.

The acquisitions mean the company’s turnover will increase by 40 per cent from £160m to more than £225m. Now it will be providing dental care to more than three million patients on the NHS and privately, as well as specialist dental work.

As a result, too, of the acquisitions the network of practices has risen from 204 to 310 in just six weeks. Of these, xx (sic) are in Yorkshire.

Apex was founded seven years ago and had 31 practices across England, offering a variety of care options to patients. Its focus had been to deliver clinical excellence, both privately and on the NHS.

Oasis says it is already committed to working with the Department of Health to ensure better access to decent dental services. A number of NHS pilots are already being trialled within its existing practices.

Justin Ash, chief executive at Oasis Healthcare Group, said: “We are delighted to welcome the Apex to Oasis. Both companies share the same commitment to providing high quality, easily accessible dental care and have developed a patient-led culture.”

Mr Ash said adding both Apex and Smiles to the company’s portfolio rapidly transforms its size and scope. “It underlines the rapid progress we are making in building a strong, trusted and customer focused dental brand in a fragmented market. Our ambitions for growth do not stop here and we have a strong pipeline of acquisitions and new builds.”

Last September, Sir Stuart Rose was appointed as chairman of the Oasis board as part of its vision to create a consumer-focused chain of dental practices.

Apex Dental’s CEO, Ben Chaing, said he was pleased.

“Following initial discussions with the Oasis team, it soon became apparent that we shared the same vision for how the dental market should evolve,” he said. “By combining Apex’s dental practices with Oasis the group will be well placed to continue improving the breadth and quality of our service to patients with the benefit of an expanded network and an even stronger clinical support team.”

Doctors suicides investigated. Now it’s time for someone to take dentists’ deaths seriously too.

A recent article on the BadMed blog site by ‘Dr No’ made me think –

The piece opened with, “It emerged last year that doctors facing General Medical Council Fitness to Practice hearings have a remarkably high death rate. Over the last decade, these doctors have been dying at between fifteen and thirty times the expected rate, depending on the comparator group used to do the calculations. Some of these deaths are known to be suicides, with others suspected but not so recorded.”

The full article is available here: better-read-dead.html

So a good thing is happening in the wake of the concerns shown – whether the results will ever be fully available is another matter, of course.

I’d like to talk about the problems that are facing dentists. There have been several suicides in dental practitioners that were without doubt related to the heavy handed manner in which the CQC was imposed on the profession. There is no doubt that its introduction was wrong; it was untried, inappropriate (it examines many of the wrong things), the inspectors were poorly trained, badly briefed and from my experience were less than objective when dealing with dentistry. Most of the concerns shown by dentists’ representatives before April 2011 have been proved correct. There is still no procedure to examine quality of clinical care in practices. The financing of yet another bit of unnecessary bureaucracy has been passed to the practices by “the unaccountables”.

To return to the original article by Dr No, the numbers of complaints with which the General Dental Council (GDC) is dealing has sky rocketed in recent years. The UK has gone from a culture renowned for its stoicism to one where, in healthcare at any rate, patients are encouraged to complain. The GDC is close to overwhelm with fitness to practice hearings that are, of course, being funded by the fees of every other registered professional.

In my 12961 days on the GDC register I was fortunate enough to have only one complaint made against me (it was rejected at the first hurdle I would add). Were I qualifying today I know that I would not be so lucky and I could expect several more letters from Wimpole Street. From the notification that there had been a complaint to the final “no case to answer” letter took a couple of months. There wasn’t a single day that passed without my thinking and wondering about the “case” several times – I knew I had done nothing wrong and if the circumstances arose again I would have done the same thing.

What it must be like for individuals that have to climb the ladder of escalation I can not guess. The letters asking for more and more information, the requests for further sets of notes so that evidence of other misdemeanours can be found which drag out the process thereby putting greater and greater stress on an individual whose livelihood and personal life can be ruined.

So two points really to be made.

Firstly. Isn’t it time to introduce the excellent ‘Dental Complaints Service’ , which at the moment only deals with private complaints, across the board. I know that prevention is best and it is every practitioners’ job to ensure that complaints are minimised and the GDC tries to take a lead in that. However in these years of dentists adopting a minimal intervention philosophy shouldn’t the regulator do the same?

Second. Is there any evidence, anecdotal or otherwise, into the pressure that the ‘accused’ dentist or DCP endures and the damage caused whether that be suicide or mental illness? Is there any organised assistance in place to help them?

The Monday Morning Quote #266

“Don’t let people steal your time with petty requests.
People want to get into your space.
Only you decide who gets into your space.”
Sir Alex Ferguson

The Weekend Read – Thinking Fast and Slow by Daniel Kahneman

I read this book after reading John Seymour’s review. John is an NLP trainer with his feet firmly on the ground who taught my wife during her NLP Practitioner Training, I have been fortunate to spend some time in his company and value his knowledge, experience and wisdom. Instead of reinventing the wheel I though I would share John’s review – it’s spot on.

You can buy the book through Amazon here.


“I’m reading Daniel Kahneman’s ‘Thinking, Fast and Slow’. The man is a Nobel Prize winner and the book has had accolades showered on it. More importantly, I heard him speak on the radio and was well impressed – this doesn’t happen often. It’s been on my list to get since it first came out, a couple of years ago. I bought it on a flying visit to Waterstones back in the summer. It has sat on the current book pile until last week, when I dipped in. It is very good, with much practical wisdom. I suspect some of his gems will show up in this year’s courses.

The central idea of this book is that our minds have evolved to have two different modes of functioning. This theory has been around a while in psychology, but Kahneman brings it alive by pulling together key bits of research that have practically useful applications.

The two modes of operation are:

System 1 – fast thinking – in plain English you can call this the intuitive mind
System 2 – slow thinking – in plain English, this is the rational mind

System 1, fast thinking, operates automatically and quickly, with little or no effort, or sense of voluntary control.

Typical System 1 activities might include:

  • Noticing that one object is more distant than another
  • Driving a car on an empty road
  • Noticing hostility in someone’s voice tones
  • Understanding a simple sentence
  • Having an immediate opinion about something you know little about

All these mental activities we perform quickly and automatically, with little or no conscious effort. There is a significant amount of unconscious activity going on which makes use of many learned associations (e.g. what is the capital of France?) and skills (you are reading this automatically).

In contrast, System 2, slow thinking, allocates attention to the effortful mental activities that demand it, including complex calculations. The operations of System 2 are often associated with the subjective experience of concentration, agency and choice. They are disrupted if attention is distracted.

Typical System 2 activities might include:

  • Focusing on the voice of one person in a noisy and crowded room
  • Walking much faster than your normal speed
  • Monitoring the appropriateness of your behaviour in a social setting
  • Counting the number of times the letter ‘a’ occurs in this paragraph
  • Checking the validity of a complex logical argument.

These mental activities take time to do, they need our conscious attention and they require mental effort. There is a significant amount of conscious activity going on.

That is the brief summary of these two different modes of thinking, the intuitive mind and the rational mind. I’ll stick to these names from now on – it makes for easier reading.

When we think of ourselves we identify with our rational mind, the conscious reasoning self, that has beliefs, makes choices, and decides what to think about and do. Although we think our rational mind is where the action is, in many ways, the automatic intuitive mind is the hero of the piece and actually doing much more of the action.

It is the intuitive mind that effortlessly surfaces from the unconscious the impressions and feelings that are the grist to the mill of the conscious mind. The unconsciously competent operations of the intuitive mind generate surprisingly complex and appropriate patterns of ideas. However, only the slower conscious operations of the rational mind can construct thoughts in an orderly series of steps.

How do these two modes work together?

Both of them are active when you are awake. Your intuitive mind runs automatically and your rational mind is usually in low effort mode. Your intuitive mind feeds impressions, thoughts, intuitions, feelings, impulses and intentions to your rational mind. If it adopts these, then impressions, thoughts and intuitions turn into beliefs, while impulses and intentions turn into actions.

Most of the time, your rational mind goes along with your intuitive mind. When all is going smoothly, which is usually the case, you generally believe your impressions and act on your impulses. When your intuitive mind runs into difficulties, it calls on your rational mind to do some detailed specific thinking about the problem. For example if you hear a sudden unexpected noise, or try to divide your income by the number of hours you work, you will typically experience a surge of conscious attention and effort. This affects your body. Your muscles tend to tense, your heart rate and blood pressure increase, and your pupils visibly dilate. You could say that your rational mind and your body are activated and put on alert when your intuitive mind’s model of the world is violated.

In summary, most of what you think and do originates in your intuitive mind. However your rational mind takes over when things get difficult, and it normally has the last word. Normally this is a highly efficient division of labour. Each of your mind modes has different strengths, weaknesses, and functions. However they do not always work well together.

See if you can spot when your two minds do not work so well from the following examples:

  • Do you tend to identify more with one of these mind modes more than the other? And does this make you inclined to not switch to the other mode when it is more appropriate? How do you know when it is time to switch modes?
  • Intuitions work well when you have good skill base in the field involved, but not when you don’t. I would trust my intuitions in NLP training, but not in golf (I don’t play golf). When can you rely on your intuitions, and when can’t you? Do you sometimes get this wrong?
  • The intuitive mind has little understanding of logic, statistics and complex systems. Do you rely on it when these are involved? For example, with finances and investments? Be careful…
  • The rational mind can be very slow. If fast decisions are called for, you may keep missing the opportunities.
  • The rational mind can stay stuck in its thinking processes and nothing happens – analysis paralysis.
  • The rational mind often monitors the impulses of the intuitive mind in social situations. Failure to do so can be embarrassing, or damage relationships, whilst over-monitoring can become undue people pleasing. How do you fare on this one?

As your rational mind becomes more aware of how your two minds work together over the days ahead, notice any adjustments you want to make and simply imagine them happening, and practice these adjustments. The more you do this, the more your intuitive mind will take note and this will tend to bring about the adjustments.

May your minds become more harmonious.”

Practice Management Conference 2014 – a great offer for you.

Practice Plan are well known for providing quality meetings and conferences and this year’s Practice Management Conference is no exception.

Featuring 4 accomplished speakers Sheila, Scott, Krishan Joshi, Nigel Jones and Kevin Lewis this is a day that should not be missed.

Whether you attend in Bolton on June 6th or Reading on June 27th your time will be well spent.

Practice Plan have offered my network contacts a discount on the ticket for day so your investment will be just £100 for Practice Plan members and £120 for non-members – so book now and tell them I sent you.

Here’s the full information:

Events page header_PEGA-9HCJTV

Our expert speakers will be covering a range of topics from people management to online marketing. Learn from the best on how to take control of your business and lead with confidence, whilst ensuring your business is protected from litigation.

Here’s what your practice management team will take away from the day:

  • A clearer understanding of how to take control of your business
  • Business measurement skills and an understanding of how these can be used to make decisions with confidence
  • A blueprint for creating an emotional website, that will convert enquiries into bookings
  • An understanding of Google and how to improve your ratings
  • A new communications framework for management
  • An understanding of how to avoid conflict in everyday situations
  • The ability to confidently ask others to change and improve their behaviour for the better
  • A deeper knowledge of how to protect your business in a changing industry.

More about the speakers:

Sheila Scott
Winning friends and influencing people – how to change someone’s behaviour
As a fully fledged psychologist, Sheila Scott knows how to get into your head. A leading industry consultant, Sheila has helped 1000s of practices succeed.

Sheila will explain how to use a powerful and useful framework for giving constructive motivational feedback to team members and how to approach asking for change. Learn how you can manage people more effectively and create a motivated team.

Krishan Joshi
A blueprint for creating emotional websites
Krishan Joshi is the master of dental web design. He founded Dental Focus to create websites and provide online marketing support that will truly empower practices. He is also the co-founder of the Mouth Cancer Foundation.

Krishan’s presentation will see him introduce several new strategies to boost your dental practice’s online presence. Be prepared for an action-packed, interactive lecture with new perspectives on theming your dental website to convert more of your website visitors into phone calls, email enquiries and live online bookings.

Nigel Jones
Measure for measure. A guide to achieving business success through improved decision making
As Practice Plan’s Sales Director, Nigel Jones is at the cutting edge of the industry and will help you take control of your business with confidence. Knowledge is the key.

The ability to measure the success of your business is becoming increasingly important and is an integral part of the decision-making process. Nigel will explain the merits of business measurement and how it can help to put you in control. Discover how to engage the whole team and make a measurement culture a way of life.

Kevin Lewis
Ensuring your business is protected: safeguarding you and your practice from litigation
Industry heavyweight Kevin Lewis is the Dental Director of Dental Protection and knows everything there is to know about protecting you and your practice from legal action.

Kevin will be drawing on years of dento-legal knowledge to give you a clearer understanding of how you can protect your business in an ever-changing industry.

Bolton – Bolton Whites Hotel – 6th June 2014 – Book here

Reading – Crown Plaza Hotel – 27th June 2014 – Book here

Carlyle Tests Appetite For £1bn Dental Chain

£1 billion = £1 million x 1000. Divide that by 570 and the average practice would be worth £1.754 million. Now I realise that there is no such thing as the average practice but that seems a lot of money to me.  Could the anticipated change in dental contract influence this move? Interesting times indeed.

Carlyle Tests Appetite For £1bn Dental Chain

From Sky News

Britain’s biggest privately-owned dental chain is heading for a sale or stock market flotation that could value it at a mouth-watering £1bn.

Sky News has learnt that the owner of Integrated Dental Holdings (IDH) has asked investment banks to pitch for a role advising it on a deal later this year.

IDH, which has a network of 570 dental practices in England, Scotland and Wales, is majority-owned by The Carlyle Group, one of the world’s biggest private equity investors.

IDH calls itself the biggest dental corporate organisation in Europe, focusing primarily on NHS patients but with private and specialist practices as an increasingly important revenue stream.

According to bondholder filings for the final three months of 2013, earnings before interest, tax, depreciation and amortisation for the financial year to date rose by 21% to £48.7m.

The company was founded in 1996 by Luke Johnson, the entrepreneur who previously owned Pizza Express and who is floating Patisserie Valerie on the London Stock Exchange.

Mr Johnson and his partners sold IDH in 2006 for just over £100m, with the private equity arm of Merrill Lynch among its subsequent owners.

The company was created in its current form from the amalgamation of IDH and Associated Dental Practices in 2011, and now treats millions of patients each year.

IDH’s biggest rival, Oasis Dental Care, is also owned by private equity funds having been bought by Bridgepoint last year in a deal worth £185m.

Carlyle is examining exits for a number of its investments, including the RAC breakdown recovery service, as Sky News reported earlier this month.

The buyout firm declined to comment.

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