Dentists generally don’t run their businesses strategically. When they do the results are awesome — Eben Van Der Walt and his partners saw a 30% rise in turnover at Portmore Dental after embracing boardroom discipline. He kindly gave us a Hive Five interview.
How has dental business changed over the past five years and what are your predictions for the next five?
The three Cs — compliance, corporate and cosmetic dentistry — have gone from under the surface to the forefront and I expect this trend will continue exponentially. Compliance is getting more onerous and there’ll be a big shift in how that is handled, with external companies taking more of a role. That’s why corporates have grown so much, they can centralise their compliance departments for efficiency.
Elective cosmetic dentistry will become more competitive. A lot more practices started up in the past five years, yet there will be quite a shortage in primary care dentistry. NHS budgets are getting tighter and dentists themselves are realising they can’t make a living in the NHS, so the big NHS guys will get bigger while the smaller guys will fight for the carrot of cosmetic dentistry. If you look at how opticians are operating, with big corporates dominating primary care, I think dentistry is going same way.
How do you deal with the dichotomy of your clinical and business roles?
In the past year our turnover has grown from £1.8 to £2.4 partly because we have a new approach to this problem. Hive’s shadow board has helped us get better at business decisions by making us put on our board member hats and think on a different level, away from clinical concerns.
It was new for us to be put in that kind of environment. Our meetings used to be muddled up with clinical decisions and operational stuff about staff members, products etc. It feels novel that we now have dedicated time and space to make strategic decisions. Dan has been pushing this forward, he’s always physically or remotely present in the board meetings, and Ross has been there too.
Once this principle was pinned down we were able to do a lot of it on our own and report back. Every now and again they would tell us, “Listen guys, you sneaked some ops stuff in here…” It’s really having that discipline to think and act on a board level. We are all scientists, we are trained to think in a logical, scientific way, but at the board level it has to be more strategic.
It helps to get off site for board meetings. So every six or eight weeks we get out of our scrubs and go somewhere where we can think clearly. We tried to do them at the practice initially but there would be a staff member popping their head round the door with a question or a clinical emergency. Going off site means you need to delegate your ops. Even if you’re a single owner you have to give that to someone because you can’t be a good clinician and a good businessman at the same time. A good ops manager is critical.
What advice would you give to ambitious dentists who wish to acquire or grow a practice?
Probably not do what I’ve done! Before you start growing or buy, get business literate. Learn to read a balance sheet and see how numbers work before you jump. Although it’s still an easy field to grow a business in, if you don’t know these things you can easily burn your fingers. When associates ask me for advice I say take it slowly. Especially if you’re launching a squat or, even more importantly, if you’re buying an existing business — you need to be able to analyse it.
With infinite time and budget, what would you consider implementing to transform your dental practice?
Instead of our five-year plan to go completely digital I’d do it in six months. I would have done this from day one if I had the money, it’s especially valuable when it comes to big implant work. And if I had an unlimited time budget I would train staff to be able to do things better and quicker, especially dental therapists. They can lighten the load of dentists, but it takes time to train them to do good restorative work. Being able to hand associates and therapists more means I could get on with the work I really want to do.
If you could give your 21-year-old self a piece of advice, what would it be?
I’d say to myself, “Don’t become too reliant on your clinical income from day one.” This happens to many young dentists and it happened to me. You earn more and scale up your standard of living — I bought the biggest house I could afford in my 20s and the fastest car — but then when you try to grow a business you’re so reliant on the clinical income that you’re too time poor. Yet you might have to put in even more clinical hours to make a down payment on the business, so make sure you know where you want to go.
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