British Film Institute film, “The Dentist” from 1993.

1993 was a big year for me, I turned 40, moved my practice away from a reliance on the NHS and our son was born. It doesn’t seem that long ago. The dentists and their practice shown in this film could be considered to be contemporary, conscientious and keen. 

I came across this film entirely by chance last week, I was searching the BFI website for something unrelated to dentistry. The “blurb” about it says:

“This film is part of a series called Profiles, the film was produced in collaboration with the Foreign and Commonwealth Office, aiming to illustrate to international audiences the (presumably) appealing lifestyles enjoyed by British professionals.

Bryan Harvey is a dentist in Essex. His career is split between his practice, working as an advisor at the British Dental Association, and working as an oral surgeon. The short programme attempts to show a rounded portrait of the man rather than focusing exclusively on his work – showing his family life and social engagements at the local rotary club.”

Bryan’s practice in Woodford continues to thrive, I know he had many successful years working at the DDU, he has clearly had a very good and active career and contributed a great deal to dentistry. 

Take 15 minutes, have a look to compare, contrast & reflect on the changes.

LINK TO THE FILM

 

Servant Leadership

I first came across the concept of Servant Leadership in Robert Greenleaf’s book.

Wikipaedia describes the concept thus, “the servant-leader shares power, puts the needs of others first and helps people develop and perform as highly as possible. Servant leadership turns the power pyramid upside down which puts the customer service associates at top of pyramid; instead of the people working to serve the leader, the leader exists to serve the people. When leaders shift their mindset and serve first, they unlock purpose and ingenuity in those around them, resulting in higher performance and engaged, fulfilled employees.”

In recent times I was impressed by Danny Meyer’s description of his use of the concept in his restaurants described in his excellent book, “Setting the Table”.

Traditional management is “top down”:

But something wonderful happens when you flip the structure:

The leader’s role is to serve and support the layer above them, no matter where or who they are.

You cannot have a dynamic organisation unless you are constantly encouraging people to improve and believing that they can do it.

Does it work? My personal experience says so and Suzanne Peterson and her colleagues showed that when CEOs are servant leaders, tech companies have significantly higher returns on assets over the next nine months, even after controlling for prior returns. HERE

Leadership is a multifaceted discipline take some time and consider this concept, you’ll be glad that you did.

 

Sam’s gone and now Cook retires.

Today (weather permitting) will see a great sportsman applauded on and off the pitch at the Oval when England face India in the fifth and final test of the series. I remember Alastair Cook being plucked from the relative obscurity of an ECB Academy tour of the West Indies in February 2006 to fly out (or around, or possibly over?) to India as a replacement for the injured Michael Vaughan & Marcus Trescothick. From his 60 in the first innings and century in the second he looked the part, he played in the second test on that tour but could not play in the the third due to illness (it was India after all), since then he has not missed a test match and his records are the stuff of legend.

You can read reports about the man and his stats elsewhere, but what I admire about him is the way he has shown dedication and concentration and brought sportsmanship to his role. He is not the most forceful, fluent or stylish of batsman but he became the very best Alastair Cook that he could be. Opening batsmen are up there with golfers and tennis players in my estimation of the hardest “jobs” in sport, whilst they have the support of the team they also feel they have let a team down if they fail (which they do with regularity). One slip, one mistake and that’s it. In most sports you can have another go, not as a batsman.

Over the past decade I have admired hugely two young men who have captained their countries with dignity, skill and diplomacy, not only captained but led by example and have rarely put a foot wrong. Both have retired from the international stage, one from the sport completely. Can you have heroes who are 30+ years younger than you? Of course you can if they are Cook and Sam Warburton. They have both used what talent they have been given, worked incredibly hard, put their bodies in harm’s way and missed out on normal life (whatever that may be) to make the most of their talents. Thank you both for your inspiration and service.

(Ironically only Cook has “Welsh” blood – his mother is from Swansea – whilst Sam’s parents are both English.)

When the time comes I hope wherever you are you will stand and applaud a true great as he takes his bow at The Oval.

I can’t think of a better excuse to play Roy Harper – enjoy.

 

 

HMRC and the evolving status of associates.

HMRC & the changing status of associates.

First published in dentistry.co.uk HERE

The BDA has emailed their members working in General Practice to tell them that HMRC are reviewing the status of associate dentists. This is no surprise to many observers but to some in the profession it will be another cause for outrage. In a career spanning nearly four decades I have observed the late adopters and laggards chant their mantra of, “They wouldn’t dare do that to us” through several new NHS contracts, compulsory VT, CPD & audit, the imposition of the CQC and the rise of the spiteful creature the GDC has become.

Their next question is, “What’s the BDA doing to stop it?” Particularly vocal are the non-BDA members. Over the past 15 years the BDA has repeatedly advised individual dentists to be wary of relying entirely on NHS income. Reading between the lines the advice is, “get out of it, the system is failing”.

The BDA can do very little if a government decides that they are going to change a policy. Especially if that policy will:

  1. give them more control over a group or profession,
  2. bring more money into the exchequer and, possibly in this case,
  3. shift the pension contribution obligations to a third party.

The advice to all parties is to ensure that you routinely work with an accountant who understands the employment status of associates NHS and private, hygienists and therapists. Be clear on the contract that you have and insist that there is documentary proof of claimed employment status.

I still visit practices where DCPs are clearly employees but treated as self-employed because of convenience. Observing work patterns of many NHS associates I struggle to justify their status as truly self-employed.

An unintended consequence of 2006, a step to control dentistry further or just evolution? Time will tell.

 

PS There’s a fact sheet from CIPD with links to a questionnaire from HMRC to determine status (you will probably have to register with CIPD to access – no worries it’s free). I suggest that you have a play with the links and make your own mind up. Link to the fact sheet HERE.

 

 

 

Time to review your associate contract?

A couple of years ago I asked a specialist dental lawyer friend of mine why her firm suggested using the BDA associate contract rather than writing one of their own, she replied that as the BDA contracts are the the mostly widely used they are regarded as the industry standard. She went on to say that the longer and more complicated the contract the more likely it was that there could be challenges and disputes both of which cost money to resolve. (Simplify, simplify)

Times change, bringing changes in the context of contracts, therefore the content needs to evolve.

The BDA has updated their template dental associate contract to reflect these changes; the amendments include clarification around:

  • Practice hours.
  • Time away from the practice.
  • Locum cover.
  • Provision of equipment.
  • Hygienist services.
  • NHS contract requirements.
  • Private fees.
  • Confidentiality and data processing.

I am still surprised by how many associates and principals do not have a formal agreement in place or, where they do, there is no regular formal review of working arrangements. When I visit a practice to carry out a Practice Business Health Check I ask about not only “if” but also “when” contracts are in place and reviewed.

With the self-employed status of associates coming under increasing scrutiny it is important for both parties their contracts are contemporary. 

BDA members can access the relevant updated contracts on the website here: New Contracts

 

The Seven Pillars of a Successful Dental Business…simplify, simplify, simplify.

There are times in your life when you have to sit down and simplify.

I did it first as a DJ by asking myself what really makes people dance and enjoy themselves and how could I cram all that fun into a short space of time.

I did it 40 years ago during my first job when the pressure of being “on” for 7 straight days threatened to turn me into a blob of jelly and bones.

And again 30 years ago as I became a practice owner, that exercise took place whilst sitting on the floor in Malaga airport enduring a 6 hour delay for a flight to Gatwick. I produced a one sheet marketing plan that proved so practical and successful I used it again when I started my second practice a year later.

I did the exercise once more when I finally changed career from clinician to coach. Here’s the back story.

The Seven Pillars of a Successful Dental Business

In 1995 whilst studying on the MBA course with the Open University I was struggling to reconcile the structure and working patterns of a dental practice with those of the businesses that we were examining. Yes, there were some things that they had in common but there were also glaring differences, so I devised what I thought fitted the business of dentistry. In the dozens of practices with which I have worked since then the definitions have been re-enforced and I have come to rely on them so they are an almost unconscious backbone to my analysis and planning.

Vision.

The cliche is, “if you don’t know where you are going then you have no idea if you are getting closer or further away.” This is at the heart of my initial work with a client and their business. They need to know what they want, so we work hard at the outset and taking the long term view, perhaps as long as a decade, to discover what direction they need to take and what growth will mean for them. This is real “what is your dream?” area. From there we chunk things down, initially to 3 years then to 12 months, then 90 days and smaller. Classic coaching protocols, not used nearly enough.

Financial Controls

If you are going to have a dream and aim towards it then you must know what your financials are going to look like. I am still amazed that many practice owners only look backwards, even in this age of online banking they wait for their bank statements and reconcile; at some point after their financial year end they wait for their accounts to be produced so that they can discover what they did maybe 20 months or more ago.

So I encourage my clients look to forward using spreadsheets or other financial software (spreadsheets are simpler) in order to see monthly general and cashflow budgets. The advantages are clear, for long term planning, for setting of fees and for the day-to-day monitoring of cashflow.

Sales

Let’s get one thing clear – we’re all in sales. Selling can and should be one of the highest form of communication that takes place. It is all about establishing and maintaining a relationship with the patient. I have no time for people who say that you should earn £X from every new patient, in my experience to push new patients before a solid relationship is in place is doomed to failure and frequently results in buyer regret.

Marketing

I take John Jantsch’s definition as the bedrock of all marketing. It’s simple and effective: “Marketing is getting people who have a specific need or problem to know, like, trust and do business with you and then to refer you others who have the same need or problem.” If your marketing doesn’t do that, at a reasonable cost, then there is little point in proceeding. No amount of money spent on external marketing will replace a good internal marketing system. The biggest crack through which business falls is the failure of the team to ask for referrals.

People

The recruitment, training and maintenance of a good team takes constant work. First rule, start as you mean to go on, ensure that the new recruit is imbued with the core values of the practice and that their formal induction lets them see and absorb the culture of the business. Next, listen to them through regular appraisals that are a two way street, and respond to the established training and development needs.

Systems

Einstein said that things should be made as simple as possible, and no simpler. Unfortunately enforced compliance has overtaken what should have come naturally, the heart of the administrative systems must be your practice manual or “how we do things here”. This should be a living document, constantly being adapted, adopted and improved as the demands on the practice evolve.

Environment

Is the practice a place you would want to visit? How does it look, smell and sound? How does it feel? Regularly revisit the physical environment so that you can see things from your patients’ points of view.

How’s your practice doing? Does it need a Health Check?

www.dentalbusinesscoach.co.uk

The Monday Morning Quote #498

“Don’t wait until all the conditions are perfect for you to begin.

Beginning makes the conditions perfect.”

Alan Cohen,

Crises share two things..

Writing in the Weekend FT Gillian Tett looks at (financial) crises old and new and what they share.

First, the pre-crisis period is marked by hubris, greed, opacity and tunnel vision…that makes it impossible to assess risks.

Second, when the crisis hits, there is a sudden loss of trust, among investors, governments, institutions or all three.

Remember that that the roots of the word “credit” comes from the Latin, “credere”, meaning to believe; finance does not work without faith.

The irony is that too much trust creates bubbles that (almost) inevitably burst.

Wise words indeed.

 

The Monday Morning Quote #497

“If you spend too much time looking at what you have achieved, you’ll fall behind.”

Paul O’Donovan

Source: Southern Star

The Monday Morning Quote #496

“Boredom is the feeling that everything is a waste of time;

serenity is the feeling that nothing is.”

Thomas Szasz

via John Naughton