Wham, Bam, thank you Mam!

 

David Houston, from David Houston and Associates in Weston-Super-Mare, talks about his experience of converting to private dentistry and why he chose to do it.

 

So, why did you want to ‘go private’?

 

There were a number of reasons why we considered conversion.  One, I think, was the satisfaction from being able to do quality work and not being constrained by NHS budgets to use certain laboratories and materials.  I can now charge an hourly rate which covers my expenses, I can pass on the laboratory charges to the patients to pay for the high standard, and then it is entirely their choice if they want to have it done or not.  I can do it at that pace and that standard, which I feel is much more satisfying professionally than ever the “Wham Bam, thank you Mam”, rush through it in ten minutes, of the NHS.

 

I also think the ability to have more inward investment into the practice, because you are perhaps wary of creating an environment in the NHS where you cannot ever sustain the overhead.  You are at such fixed profit margins for the NHS, you can’t see massive inward investment, without cutting your bottom line to a very considerable amount.  You can plough the private profit margin back into the practice and create a better ambience and atmosphere.

 

Personally for me, I think it was also to establish a base line, to see how easily it could be done in the demographic social type of patient base we have here in this area.  We might not necessarily have been considered as an ideal conversion territory in that our social demographic was particularly biased towards NHS patients. 

 

Other than that was the desire to do more of my cosmetic surgery, which by definition is not funded by the NHS.  To some extent, there was a desire to take the pressure off me and be able to spend more time with my patients, do quality lab work and in particular anything that the NHS would not fund.

 

The opportunity to do or offer additional services was obviously limited by the nature of the NHS contract.  We were not offered the ability to do sedation, as there was a zero value on sedation in the NHS contract, despite the fact that we used to do sedation previously.  We also used to do orthodontics on the NHS but we were not offered an orthodontic contract - our PCT decided to centralise all those to only specialised practices and not those that dabbled in it.  Hence, we lost the opportunity to provide certain services on the NHS which we were previously providing quite happily. 

 

Another major pressure came from the fact that the new NHS contract was based on retrospective figures, which were 18 months out of date by the time they applied to us in April 2006.  Our practice had grown so much within the intervening 18 months that the financial sum offered to us was of considerable concern.  It was nowhere near going to cover the patient numbers that we actually had at the moment of conversion into the new contract.

 

 

And, what were your main concerns?

 

The loss of patient goodwill was a concern for us when we converted.  People had been seeing me for 15 or 16 years continuously.  Some of them certainly had their noses put out of joint by getting a letter in the post - saying ‘after I have looked after you for so long in the NHS sector, and maybe you had helped me build up my practice and stayed loyal as it established itself and got larger, I’m now kind of abandoning you for the private sector’. 

 

Some of them did perceive it to be that.  The negative publicity, and some of the patients being a bit antagonistic about it, was certainly a difficult thing for me and especially the front desk staff that had to take the brunt of those calls.

 

 

 

Why did you choose practiceplan?

 

I chose practiceplan because there was just something about the idea of being able to stamp my own identity on the plan. Not to have it marketed as Denplan in my practice, but have it marketed as my practice plan.

 

What your patients actually believe and trust in is the practice that they are the patients of. That’s why I wanted the scheme to have the identity of the practice, and not a third party, no matter how authoritative or well-known the dentist might think it is.

 

I think also with practiceplan was the fact that you were talking to people that understood dentistry pretty well, which was important to me.  I think the ability to understand the market place in which the conversion is taking place was critical, as opposed to perhaps with the greatest respect just talking to financial people, or marketing people.  You were talking to people who had a background in dentistry, and that was very important to me as a clinician.

 

The ability to have somebody to come and hold our hand in person was important to us as well.  The fact that the local area representative for practiceplan actually pitched up on the first conversion day to assist.  The fact that we could personalise the brochures and letters was important to me, in that we weren’t just sending out everything headed Denplan.  We were sending things out that said “The Houston Practice Dental Plan” with our logo on the front - that was extremely important for me.  I think also the fact that the costing, let’s be very frank here, the commissions that Practice Plan take off is not too onerous, compared to other competitors.

 

What was the secret of your success?

 

There are still unfortunately perceived notions that private dentistry is expensive, exclusive and not for the common man on the street.  Therefore, sadly as soon as they hear the words ‘private or conversion’ in a sentence, they turn their backs and look for an alternative.  So, you’ve got to have them on-side and keep them on-side.

 

To succeed you need to spend a lot more time talking to your patients in person, face-to-face about it.  I think the letter, by and large, is only the start of the process; you really have to book them in for much longer check-up appointments during the three month conversion period.  You have to do it in order to be able to sell it to them and talk them through their concerns; what the value for money element is, that’s going to come their way.  They take it much better from you, telling them in the eye, than they do from a letter coming through the post.

 

And finally, what is your practice like now?

 

I suppose the impact is that my day is now more under my control.  My day is less stressful because I can book in numbers of patients to suit my desired workload.  Also, I am now charging an hourly rate that allows me to make my bottom line figure that I need.  I no longer have to see 52 NHS patients just to pay the bills, I can see 15 private patients and still get the same level of income, so that’s been a big impact. 

 

As a result, it has allowed me more time to offer additional services such as the cosmetic dentistry, smile design and facial aesthetic medicine like Botox and Dermal Fillers.

 

I think it may have also given me a little bit more time for managerial issues.  I am not running around like a headless chicken on the NHS, trying to squeeze people in left, right and centre.  If there is a managerial issue I need to take time out to do, I will do that now as I have got time in my appointment book to create that space.