Corporate dentistry

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corporatewebAre you attracted to the corporate model or do you prefer running the show yourself? Dentists on both sides of the fence tell Kerryn Ramsey the pros and cons.

“My decision to go corporate has been a bit like a holiday; it means I have plenty of time to treat my patients,” says Dr Brian Cowie who joined 1300Smiles six years ago. Dr Scott Evans, meanwhile, prefers running his own family dental surgery. “I enjoy the independence of making my own decisions, both clinically and business wise,” he says.

When it comes to choosing a business model in this profession, if you want to run your own practice, doing this independently or joining a corporation can be a real dilemma. In Australia, around 10 per cent of practices have joined forces with one of the corporate groups—the largest operator, Dental Corporation (DC), presently runs 200 practices, while 1300Smiles, Dental Partners, Pacific Smiles Group and Life Time Smiles are all growing. Here, a number of dentists explain why there are two sides to every story.

Dr Brian Cowie had been running his Kirwan practice in Townsville, north Queensland, for 36 years until he joined 1300Smiles in 2008 and relocated it to Belgian Gardens. “I was about to sell up and do something else with my wife—we had a country property and we wanted more time raising our beef cattle,” he says. “I decided to sell the practice and the equipment to 1300Smiles, although I still own the building itself. I was going to work here for 12 months but six years later I’m still here!”

The work/life balance is a real attraction when working under a corporate group. Dr Cowie works four days a week and also has a week off each month. “I got to the stage where I had enough of the hassle of running my own business, dealing with stock, staff and everything else. Now I’m really enjoying dentistry itself.”

This is a common advantage stated by dentists—the well-oiled system means that practitioners don’t need to worry about the equipment, fit-out, administration, branding and social media. Dr Greg Duguid, who runs Tugun Totally Teeth under the Dental Partners banner, concurs: “I’m free to choose my number of work days and my chair side hours, thus allowing me more flexible time for holidays, training, etc.”

According to Dr Brad Moore, who’s signed up with Pacific Smiles Group (PSG), patients see these centres as a “one-stop shop”. He explains, “The average size of PSG’s dental centres allow for equipment investments that could be challenging in smaller enterprises. The equipment is up to date, most have radiology, including cone beam CT at larger dental centres, plus many have visiting specialists.”

Dr Ron Ehrlich of Sydney Holistic Dental Centre, who joined Dental Corporation in 2007, also appreciates the independence. “It’s a tailored juxtaposition between the support we receive in financial management, HR, bulk-ordering consumables and marketing, against maintaining autonomy in business decisions and practicing,” he says.

Handing over the whole kit-and-caboodle doesn’t appeal to all dentists, however. Dr Scott Evans is a case in point. He’s the principal dentist of Evans Dental at Mermaid Beach in the Gold Coast, taking over from his dentist dad, Stanley. Even the name of the practice makes a statement. “When I branded us Evans Dental, I didn’t see it as a pitfall—I saw it as a badge of honour. I’m proud of the fact that we offer personalised dental care.

“Patients often say, ‘It’s so nice to see the same dentist every time I come here’. Quite a few patients have said that it doesn’t work like that at corporate practices. As a private practitioner, I develop a strong relationship with a patient, and that can last for many, many years.”

Dr Kim Davies, who runs the fiercely independent Bytes Dental in Ballina, NSW, also acknowledges the importance of a dentist-patient relationship. “The community sees the same faces, and we get to know the patients on an intimate level,” she says. “Some older folks love popping in on their way past just to chat about their latest medical operation, or gossip about someone. Plus, we sponsor the bowls club so there’s certainly a community feel about working in a small town as an owner dentist.”

So, are there any downsides when running a private practice? Both Drs Scott and Davies admit that the administration takes away time in surgery. “We’ve always had to be businessmen/dental operators but there’s no doubt that side of it is a lot more time-consuming than it used to be,” says Dr Scott. “Just running a practice makes a lot of demands on your time. But a good practice manager, or your wife, solves a lot of those problems.”

While a corporate dental practice undoubtedly takes away some of the drudgery, the level of independence is flexible. “Admin is still a part of the business side for me and I monitor it like it is my own practice,” says Dr Duguid. “I basically have total independence running the practice, providing standards of care are maintained and the practice is profitable. I have full control of doing what I choose to do.”

Pacific Smiles’ Dr Moore finds the PSG model is efficient and cost effective. “I practise as an independent dentist ‘leasing’ a fully serviced surgery from PSG,” he says. “I let them know my standing schedule and they make sure the staffing, instruments and consumables are available for my selected days. PSG has some clever systems in place to make sure the centres are well managed and well serviced by practitioners so patients’ needs are well met.”

Dr Duguid, meanwhile, notes another positive aspect—he doesn’t have to deal with the marketing and social media aspects. “Dental Partners provides a lot of great exposure through our extensive advertising, branding and marketing campaigns which could never be done by a single practice.”

According to Alan Clarke, director of Dental Partners, “The most positive aspect of joining Dental Partners is that you are not alone. We seek to provide a sense of community and collegiate for our clinicians, while continuing to focus on all aspects of a successful practice.”

Dr Daryl Holmes, founder and managing director of 1300Smiles, says that different practices often work together, collaborating on difficult cases and providing second opinions. “Dentists can attempt to keep on top of the latest clinical developments and techniques themselves, and be an expert in everything, but that’s very difficult for most dentists,” says Dr Holmes who currently has 25 practices on the books. “Having access to specialised skills across our network of practices is a real benefit for our dentists and their patients.”

Dr Ron Ehrlich of Dental Corp has found a similar experience—”DC provides a unique collegiate approach to dentistry, while in the past I would have seen other practices as competition and now I see as partners. It’s a collaborative group to be a part of.”

Dr Holmes also points out that there’s no need for the significant capital outlay and risk associated with opening a practice. He says there’s a real “relief from tax office scrutiny, given there is no need for dentists to maintain a complicated service trust or other structure”.

The chance to receive efficient management and clinical autonomy in a dental chain is an incentive for many dentists, but other independent practitioners are attracted to different values. Dr Davies sums it up: “I’m pretty sure the profits could be higher if I ran a strict business model—for example, by charging every eligible item to every health fund within every certain timeframe. But we tend to just charge for what is needed.

“My education from the University of Queensland was based upon strong ethical values about being a professional and doing what is best for patient health. With this foundation, we aim to serve the patients’ needs rather than gain maximum profits. If I was all about profits, I would have studied business. I am all about providing dental health first, and letting the money flow from there. Corporate practices run by non-dentists may not have the same values in the same priority.”

Undoubtedly, it’s horses for courses when it comes to running a dental practice. It comes down to your personal preference, so take time to talk to professionals—both colleagues, businesspeople and financial advisers—to get the right fit. ?

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