18 Apr 2024  •  Blog, Practice Management  •  8min read

Mixing things up in practice

Dentist and owner of Abbey House Dental, Amit Jilka, explains how he makes things work in a mixed practice.

I began my career as a predominantly NHS dentist. Then I trained in implants and sedation as we wanted to offer our patients a more high-end private service. Which meant, within two or three years of buying the practice, we started more and more private work and that’s what ultimately led us to having our own membership plan alongside our NHS contract.

We informed my NHS patients by letter that we’d be going private and that another dentist would be taking over. Quite a number of these NHS patients did go private with me. But they weren’t all of the ones I would have expected to stay, so you can’t really predict who will go with you and who won’t.

We were a bit concerned that a lot of patients would be unhappy about the situation. And yes, we had a few patients who were upset, but not as many as I thought would be. So clearly, I wasn’t as important as I thought I was!

High value NHS contract

We decided to remain a mixed practice as we have a substantial NHS contract with a large number of UDAs. The contract value is so high that I didn’t really want to part with it. At the time, we were developing another building across the road that we were converting to fully private. So, we felt that we could offer both services and keep them separate within that structure. Which meant if patients wanted more private dentistry, they could go to the other building.

Since going private, we have substantially increased our revenue. We’ve also been able to develop a much larger team as we’re offering a wider range of services. The skill mix has increased significantly with our therapy team leading the way. We have treatment coordinators that are able to scan and do sedation assessments. So just by making that move to private, we were able to offer loads of different services, which in turn increased the team’s capabilities. This ultimately resulted in us offering a much better service for our patients.

Although there are many benefits to the practice of introducing private dentistry, patients benefit too. The main one being the variety of treatments we can offer, cosmetic treatments are crucial for us. Being able to provide patients with dental implants and sedation amongst other things at their own convenience is a huge benefit to them. We also run out of hours sessions, late nights and Saturdays as well. Private patients like those timings, and it’s a much more relaxed and more patient led service in private practice rather than the target driven service of the NHS.

Reducing my personal NHS commitment was inevitable as I was confident that this was the type of dentistry I wanted to offer. I went private seven or eight years ago now, and two years ago I went implant only. As we’re now a multi-site practice, being able to cater for lots of different types of patients was important to us. We now have our Invisalign® implant type of patient, regular general dentistry patients who are on membership plans and then we have our NHS patients whose care is delivered by the younger NHS team.

Our NHS and private patients don’t usually mix. In our location in Stone, Staffordshire, we have three buildings. The first is a five surgery NHS practice, then across the road is our hygiene and therapy building. That is where NHS patients who have been referred for therapy work are seen. It’s also where our private and plan patients have their hygiene appointments. And then we have the third building which is again, five surgeries. This is purely private, high-end dentistry. It’s where we have our CT scanners, iTero scanners, and all of the gadgets that you’d expect a private practice to have. It’s a nice split. It also gives the hygiene and therapy team empowerment as they have their own area and their own team as well.

I believe we have a good setup, in terms of training other dentists. Our associates join us as an NHS associate. They grow their skills and we mentor them in lots of different things, and then they move forward into private dentistry.

This way of progressing was common in my generation dentists. However, the younger generation doesn’t seem to want to do any NHS work. There seems to be an appetite for them to just go straight into cosmetic dentistry, which is worrying because they’re only a year or two out of university, they haven’t done any kind of substantial dentistry. This means we can struggle to recruit NHS dentists.

Future plans

We recently opened a squat in Stoke-on-Trent. That is also a five-surgery practice, but with the difference of having a whole academy built on the top of it. We have conference facilities, training rooms and off the back of these we will be running more courses. We’ve started to do a few. So far, we’ve ventured into composite bonding, how to increase your dental implants, how to increase your Invisalign® numbers, and we have one coming up about how to build a squat dental practice.

I can see this side of things taking up more of my time in the future. At the moment, my timetable is one week clinical and then the next week is admin only. So I’m only doing clinical work every alternate week. And of the clinical dentistry that I’m doing it is probably 95% just mentoring and not really seeing my own patients. I don’t think I’ll ever stop being a wet finger dentist though. I enjoy that aspect of it and I think as a mentor, you can’t mentor unless you’re in it and doing it. But I think seeing my own patients will come to an end and I will become more of a full-time mentor and trainer.

Advice to anyone considering introducing private dentistry

Three pieces of advice.

Do it sooner rather than later. We procrastinate a lot with these decisions; thinking that patients are not going to be happy, we’ll get complaints and how will we manage all of that? In reality, a lot of patients will join you and they will go private with you. Those that don’t, as long as they’re being catered for, it’s fine. You must go on what you want to be doing and the type of dentistry you want to be offering your patients.

Try not to worry about being booked up as much as you used to. As an NHS dentist, I remember my books were filled up for three to six months with no space to get anything in. When you switch to private, you can be booked up just three or four weeks in advance. Getting comfortable with that means that you’re more productive and your turnover naturally increases. Also, this means you can provide a good service to your patients, because they will be able to have their treatment sooner rather than waiting three months. So many dentists get scared of the diary being a bit gappy, but ultimately you are more efficient.

Embrace the team as they are critical for your success. You need to get everybody on board, including the reception team and the nurses, so they all believe in it. If everybody who is part of that chain believes that the path that you are taking is the right path, then it’s a much easier conversion.

About Amit

Amit is one of the owners of Abbey House Dental and has been developing the practice and its facilities since he bought it in 2012. He has had extensive training in Dental Implants and has been placing them for over 10 years. As part of his training in dental implants at the Royal College of Surgeons, Amit visited prestigious dental institutes in Germany and Italy to gain expertise. He went on to gain a Master’s in Dental Implantology and Oral Surgery in Rome, Italy.

Amit is the practice Clinical Lead and mentors other dentists in dental implants and sedation. He is a nationally accredited sedation mentor for dentists in IV and RA sedation. His practice is now limited to dental implantology.

Amit has grown his dental practice from a two-surgery NHS practice to having 19 surgeries over four sites offering the full range of dental disciplines. He has grown his team from four staff members to over 100 and recently launched his own training academy.

He was awarded The Probe’s Dentist of the Year 2023.

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