Perhaps you should only book exams and small fillings on your first day back?

9988524-vacation-time-concept-wall-clock-isolated-on-the-white-backgroundOr not take a holiday at all?

From The Harvard Business Review.

Find Out Whether Your Surgeon Has Been on Vacation

It’s well known that in workplaces with routine tasks, workers’ productivity falls if they take too long a hiatus from their jobs, and apparently there is a similar effect for surgeons. In a study of 188 surgeons who performed coronary bypass operations, Jason M. Hockenberry of Emory University and Lorens A. Helmchen of George Mason University found that for a given surgeon, each additional day away from the operating room subsequently raised patients’ mortality within one day of the procedure by 7.4%, perhaps because after time away from the job, surgeons are less likely to recognize and address life-threatening complications.

The nature of surgeon human capital depreciation.

David Starkey’s diary: Why don’t we celebrate the triumphs of private dentistry?

From The Spectator

To the dentist. And for an extraction. I hadn’t had a tooth out in decades. But the twinges when I bit on a nut warned me that my problem molar — much abused by a badly fitted bridge in the 1970s — had finally given way. My usual dentist confirmed as much with a poke and an X-ray. Then came the surprise. ‘I’m going to hand you over now,’ he said. Having a tooth out has ceased to be a hazard of life to be borne and grinned at. Instead it’s become dental surgery. And it requires a specialist. Mine was a man with a mission. ‘My job is to make sure you feel no pain,’ he said. And he proceeded, with skill, charm and patience, to do just that. The result was that the extraction, rather than the grinding wrench I remembered, was almost an anticlimax. But it wasn’t only the medicine that struck; it was also the efficiency and customer care: my notes (back to the faulty bridge of 1973) were to hand; I was given clear instructions about post-operative care; my specialist even rang me at the end of the working day to check there had been no complications. I was almost profuse in my gratitude.

As I put the phone down, I reflected on the gap — almost unbridgeable — between what I’d experienced and the school dentist (a kindly old soul, despite his terrifying equipment) of my childhood. Dentistry was, of course, like all other forms of medical care, part of the original NHS. But it escaped relatively quickly. Would the extraordinary progress I’d just experienced have been possible if it hadn’t? At any rate, it proves that the privatisation of an important part of healthcare isn’t the end of the world as we know it. Why, in all the endless debates about the NHS, don’t the Tories trumpet the triumphs of privatised dentistry?

But of course popular attitudes are just as important. Thanks to endless handsome, toothsome celebrities, people will pay for dentistry because they see it not as a question of health, for which they will shell out grudgingly if at all, but as one of cosmetics. Impossibly white, impossibly regular teeth have become a sign of beauty. And there is no limit to what people will pay to make themselves beautiful. Quite the opposite, in fact: as the price of perfumes, colognes and assorted snake-oil unguents demonstrates, when beauty’s at stake the rule is the more expensive the better. So now it is with teeth.

Here surely there is a lesson for our health policy, however it is funded and organised. We have got nowhere by presenting lifestyle diseases of obesity and so on as a health crisis. Health is a necessity; boring and, thanks to the NHS, someone else’s responsibility. But make it a question of beauty; work with the grain of celebrity culture and not against it; enlist people’s vanity and not their reason, and doctor’s surgeries might become as well run as my dentist’s, and the nation’s waistline will be in as good nick as its teeth.

The Monday Morning Quote #315

“False friendship, like the ivy, decays and ruins the walls it embraces;

but true friendship gives new life and animation to the object it supports.”

Richard Burton


NASDAL figures for 2013-14

An interesting analysis from the financial year 2013-14 from NASDAL via Alan Suggett and his team at UNW Business Unit. I’ll be interested to see 2014-15.

The 2014 NASDAL benchmarking survey of practice Profit & Loss information was published last month.

A report of the findings appears later in this UNW Dental Bulletin.

Each year the UNW Dental team extends the NASDAL survey results by recalculating average practice profits to include the cost of the work carried out by practice principals (ie as if they were working as associates in their practice), in order to calculate a true practice “business” profit (ie where the market rate for carrying out all dental work is offset against profits.

Historically, on this measurement basis, average NHS practice profits per principal have been far in excess of those earned in private practices.

However, the gap is closing!
Average profits per principal in an NHS practice were £29,458, and in Mixed practices £16,173.

Private dental practice profits creep ahead of NHS practices in NASDAL survey

A strong performance from private dental practices in the financial year 2013-14 has led to them record- ing higher profits than their NHS counterparts in the latest benchmarking statistics from the National Association of Specialist Dental Accountants and Lawyers (NASDAL).

It’s the first time in a decade that private practice has overtaken NHS practice although there were early positive signs of a recovery in the previous financial year. The profit differential is small with an average NHS practice making a profit of £129,000 compared to £131,000 in a private practice.

Overall the picture for dental practices is improving, Income and profits are up across the board with all types of practice seeing increased profit and relatively static costs. Fee income is up by £7k in a typical NHS practice and by £21k in a typical private practice.

Private practices suffered in the years following the 2008 slump but have gradually picked up. This is thought to be partly due to private practices having greater control over their income than NHS practices, and hence having a greater ability to recover from poor trading results in the recession. The survey shows that the average profit per principal in an NHS practice was £129k whilst in private practices it was £130k.

In 2013/14, the average fee income generated by a dentist of a private practice was £248,000 compared to £180,000 for a dentist of an NHS practice. It should be borne in mind that these are figures are dramatically reduced when costs and expenses are extracted. Meanwhile, practice expenses have remained relatively unchanged, equating to 65% of fee income for a NHS practice compared to 68% for a private practices.

Calculated annually, the statistics are gathered from a sample of practices across the UK to provide average ‘state-of-the-nation’ figures. They are used by NASDAL accountants – who work for 27% of the dental profession – to benchmark their clients’ earnings and expenditure and to help them run their practices more profitably.

A variety of key components had remained unchanged: UDA rates are almost identical as well as business structures with 58% of the profession being sole traders and the rest either partnerships or Limited companies. The number of incorporations increased by only 3%. Earnings for associates have gone up by just a small amount, with around an average £700 per individual.


The Monday Morning Quote #314

First they came…

First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out—
Because I was not a Jew.
Then they came for me—and there was no one left to speak for me.

Martin Niemöller


The Monday Morning Quote #313

1) “The harder you work the luckier you get.”

2) “We create succes or failure on the course primarily by our thoughts.”

Gary Player

See his thoughts on Rory McIlroy here


BDS (Cardiff) found to be invalid – you really couldn’t make this up.

In what I presumed to be a delayed April 1st posting UK Dental News & GDPUK have released the following story.

  • In a media release dated 10 April 2015, the General Dental Council announced that all BDS degrees awarded by Cardiff University since 2010 are invalid and announced the measures it will be taking as a result. This is due to Cardiff’s failure to apply for status as a medical authority between 2010 and 2014.
  • All Cardiff graduates since 2010 have an unregistrable BDS degree.
  • Cardiff University will issue five years’ worth of new BDS qualifications dated 1st May 2015 for the students affected.
  • Dates of initial registration and CPD cycles will not be changed but all qualifications will be recorded by the GDC as BDS Cardiff 2015.
  • All affected registrants will have to apply to be ‘restored’ to the Register by 8 May 2015.
  • Anyone who does not apply will have their name removed on 29 May 2015.
  • There will be no charge for ‘restoration’.The GDC and Cardiff University have written to the graduates concerned to explain this process.

Only one comment that I can think of and I’ll delegate that to John McEnroe.

The Monday Morning Quote #312

Something very personal today. Twenty two years ago today I woke up alone realising that the focus of my life had changed irrevocably. The day before Susan had given birth, and our son William had arrived in the world (eventually).

I came across this on the StoryPeople website some years ago, printed it and stuck it on my notice board. It used to embarrass Will but I think he has come to accept the message.

I hope you had a great birthday mate.

 “There has never been a day when I have not been proud of you, I said to my son,

though some days I’m louder about other stuff so it’s easy to miss that.”


The Weekend Read – The One-Page Financial Plan by Carl Richards

51birN1QorL._AA160_I was listening to a conversation last week at a meeting where I was presenting about the collection of trinkets that seems to afflict dentists, a form of “keeping up with the Dr Joneses” emerges at conferences and meetings with people trying to outdo each other in cars driven, holidays taken, business loans obtained and size of mortgage. The attachment to the visible trappings of success I find interesting, as someone who has little desire to own a new car and lives, mortgage free in his holiday home. This wasn’t always the case and I truly wish that I had read this book thirty years ago, it might have saved me some of the pain that I have suffered learning the lessons that I have. There is a saying in coaching that the best time to plant a tree is 30 years ago and the second best time is today – so I have read, enjoyed and learned lessons from Carl Richards’ second book.

As a business coach working with dentists and their teams I regularly have to talk money, how to earn it, keep it and make it work for the long term. I am not an accountant or an IFA, rather someone who has made the mistakes and wants to pass on the lessons to help others making those same mistakes. This is a book that I would happily share with my clients.

Carl Richards is a Certified Financial Planner and a columnist for The New York Times, he is the author of The Behaviour Gap and has a widely circulated weekly newsletter.

He is also someone who over reached himself and lost his home in 2010 so there is a certain amount of Been There Done That & now you can buy the T-shirt to help you going the same way.

What I like most about The One-Page Financial Plan is the way that the author doesn’t presume to tell you what he thinks is right for you; rather, like a good coach, he encourages you to discover your values and goals. He leads the reader through a series of straightforward steps that will help you prioritise what you really want in life and what steps you need to take to get there. He does this because his experience tells him that often the first question that Financial advisers ask is the wrong one and that they and the client need to establish the “Why?” of planning.

Refreshingly jargon free Mr Richards continues the good work that he started in The Behaviour Gap and uses the simply drawn but highly effective cartoon drawings to illustrate the points he makes. The book is split into four sections over 10 chapters, the sections are:

  • Discovery,
  • Spending & Saving,
  • Investing and
  • Strategies for Avoiding the Big Mistake.

I would say that this book is deceptively simple and like all such books will repay repeated reading and, above all, the taking of action after reading.

Available from my Amazon Page here.

Course News – Anterior and Posterior Composite course in South West.

Mastering Posterior & Anterior Composites[3] (1)I was fortunate to be one of the speakers at the recent launch of  the BDA South Western Branch, Young Dentist Group.  Making far more of an impression on the delegates was Dr Andrew Chandrapal.

Andrew is returning to the South West on May 15th and 29th to present a 2-Day Intensive Course “Mastering the Art of  Posterior and Anterior Composites.

The events are taking place in the beautiful surroundings of Woodlands Castle, Ruishton, Taunton and are organised by Black Swan Dental Spa.

Here’s what the principal of Black Swan, Dr Ahmad Nounu, says:

Its finally ready to go….after months of organisation between Black Swan Dental Spa and Hereaus we have the official 2 day Posterior and Anterior composite course by Dr Andrew Chandrapal to announce…Learn how to master both arts as a general dental practitioner to achieve stunningly beautiful results whilst also making it profitable and enjoyable for yourself.

Every one of us working in practice would like to improve the quality of our composite work so why not learn from one of the UK’s leading clinicians. Both events held in the beautiful settings of the Somerset countryside and only 20 spaces available per day…full lunch and parking provided and a special offer booking reduced price for booking both days. If you are interested then remember spaces are limited, it’s a hands on course and once the places are all gone, they are all gone! Andrew’s previous courses have all been a sell out!

Please either reply to myself by email ( or contact Black Swan Dental Spa directly on 01460 77517 or to express your interest/book. Half the places are already gone after the speaker’s appearance at the YDG conference last month.

We look forward to taking all your skills to the next level soon.

Mastering Posterior & Anterior Composites[3] (2)

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