Whatever size the operation, it’s easy to see why mobile dentistry as a business model makes such good economic sense. By Kathy Graham
Last year the company behind the Smiles Onsite mobile clinics was convicted of X-raying thousands of children without radiation licenses or any training. There were also accusations by multiple former employees of billing Medicare for procedures that weren’t performed or weren’t necessary.
Did the operators possibly feel the need to resort to these practices to make the business model work? And if so, maybe this wasn’t an isolated incident but typical in that those in the business of mobile dentistry have to over-service to cover costs.
The Australian Dental Association has nothing to say about the financial viability or otherwise of the model, long touted as a solution to the lack of dental services for hard-to-reach groups, but plenty of others do—and it’s positive.
Consider, for example, Future Care Mobile Dental Services, Australia’s largest mobile dental service provider. The company has been running since only 2015, having started out as just a one-chair mobile van, and a couple of portable chair/units. It now operates a growing fleet of seven vans, plus as many portable units throughout Victoria and NSW visiting schools, retirement villages and community housing.
Dr Oliver Colman has been with Future Care since June last year. His area of specialty is pre-school, primary and secondary school patients in outer metropolitan Sydney and up and down the coast.
In his role as a senior clinical consultant, Dr Colman accompanies mobile staff on location, where he supervises patient treatments and provides clinical advice.
“Business expenses and costs depend on economies of scale and how the practice is run.”
Dr Oliver Colman, Future Care Mobile Dental Services
The administration of patient co-ordination, sterilisation and stock management is facilitated at a centralised base in Sydney—Melbourne has one too—with its own team of dental practitioners and administration staff who liaise with parents, teachers and schools.
“For our demographic the advantages are obvious,” Dr Colman says. “We are able to educate and set the young on the right path early on. Visiting the school dentist becomes part of the curriculum in the school day which helps to normalise visiting the dentist. Patients with limited access to a dentist will avail themselves of a well-advertised service that comes to them.”
Dr Colman has no doubt that many of these kids wouldn’t see a dentist if it weren’t for operations like Future Care that have been able to grow thanks to such demand. “Scale of operation and technology have been the biggest changes together with implementation of protocols such as infection control standards,” he says, adding that until fairly recently manpower was a limiting factor, however, in the past three years, the company has hired dental therapists, hygienists and oral health therapists as well as dentists.“Business expenses and costs depend on economies of scale and how the practice is run.”
A major selling point of an outfit like Future Care is that it offers the same range of care as a fixed-site clinic excluding orthodontics and complex surgeries. “Convenience is what makes the mobile dentist so effective—whoever the target patients are.”
Dr Colman says that when considering whether to set up a mobile practice, there are many variables and that it really depends on the business model. “A mobile dental practice can be as simple as a van with a single chair and dental unit, costing in the vicinity of $80,000, right up to two- and three-chair models in large trucks complete with leading-edge technology, structured back-up and administration services, incorporating mobile technology and secure remote cloud-based computer access which would see hundreds of thousands of dollars invested,” he says.
“Business expenses and costs depend on economies of scale and how the practice is run. Equipment costs are essentially the same for fixed and mobile sites; the difference in operating costs is dependent on whether it is a one-van operation, or a fleet of them.”
Small is beautiful
Dr Mark Wotherspoon is a general practitioner who delivers a domiciliary service out of Best St Dental in Wagga Wagga—“that’s where my portable equipment is stored and sterilised and where the front office team collect patient details including a comprehensive medical history plus consent when required”. He says big or small, the main thing is “the numbers really have to add up”.
“There is actually an extra revenue stream you can add to your practice via accessing this as yet untapped group of patients.”
Dr Mark Wotherspoon, Best St Dental
He doesn’t have a van but rather a portable dental unit that he transports in the back of his car and operates half a day a fortnight, visiting the frail elderly, bedridden or cognitively-impaired patients in aged-care facilities, private residences and group homes in Wagga Wagga and surrounding towns who otherwise would probably not be seen.
“Patients who have been longstanding members of the practice get to a certain age and then just drop off the treatment cliff if they’ve got a health problem, or they’re bedridden or suffering with dementia. A trip to the dentist just seems to be one of those things that becomes too difficult. There is actually an extra revenue stream you can add to your practice via accessing this as yet untapped group of patients. So, if you’re careful with your finances and your financial model, then it does absolutely add a revenue stream to your business.
“When people over-extend themselves financially, it just doesn’t make any financial sense,” Dr Wotherspoon continues. “It’s why I went for the relatively small capital outlay model [ $20-25,000] which still allows me to do 85 per cent of the work: the examinations, preventive care and simple restorations. I treat patients in their own bed or favourite chair using the latest [lightweight] portable equipment and digital technology.”
His goal is to share his own experience and to demonstrate that it is “so easy and cost-effective for the dentist to be able to provide an affordable service for the family and the patient. As the aged care sector continues to expand, every private practice in a fixed surgery will need to develop and provide some level of mobile or portable dental service, and actually add a nice, neat little extra revenue stream for the business. I see the near future as a combination of many little players like myself providing a basic service, but who then refer the more complex cases to larger mobile surgeries [mobile vans] or when the patient numbers dictate.”
Dr Oliver Coleman wholeheartedly agrees, stating, “Mobile dentistry is an idea whose time has come, and there is no force greater than an idea whose time has come.”