Dentists are too cheap on their practice managers

by Blog, Business growth, Recruitment

Dentists are too cheap on their practice managers    

By Jonathan Fine. November 16, 2016.

There’s a business truism that says you get what you pay for. If you’re too cheap on something, the logic goes, you’ll only have to spend money on mopping up the mess when it doesn’t work properly. Another truism is if it’s too good to be true then it probably is.

They both contain the same wisdom which is don’t just look at price, use your common sense. Just because you can get away with paying under the odds for something doesn’t mean it’s a good idea. It may even be a very bad idea.

What do you think happens when you pay someone £27k to run a dental practice that turns over £850k?

You get someone who spends their time rostering, managing the diary and making sure the surgeries are clean and CQC compliant.

These are merely the lowest level tasks of a business manager. Obviously you need them done, but you need a lot more. You need someone who understands the numbers and can spot where the business opportunities are. You need someone who is a great team leader and can identify talent and, in particular, identify people who are better than him or her at doing stuff.

In practices in the UK and Ireland financial reporting usually happens once a year or at best every quarter. Because most practices sit in a comfort zone there’s apparently no pressing need for extra analysis. Maybe that explains how wildly underpaid and underperforming practice managers are.

Typically a practice owning dentist has very limited business experience and certainly no experience outside dentistry, and the practice manager emerges by default as one of their brighter nurses or receptionists assumes more responsibility. The trouble is this person too has limited business skills because they’ve never had the training, investment or experience.

A side effect is they micromanage the bits they know well and never see the bigger picture. Most traditional practice managers, when you’re trying to get them to do something different, will do anything to avoid doing it; they’ll blame the principal and try and work around the task as a defence strategy because they feel threatened.

The growth of your business is obviously limited by the vision and experience of your practice manager. To grow you need people who are prepared to take risks, but someone on £27k won’t just lack the experience, they won’t care. And you can’t really blame them. You’re a cheapskate.

I actually know only one male practice manager even though I’ve been involved with over 150 practices. If I was working in the leisure, automotive or hospitality industry I’m sure there would be an equal spread by sex, and this skew points to something very skew-whiff with dentistry, modern and shiny as it may appear to outsiders.

I’m afraid we just don’t take practice management seriously enough. If we did you’d have a business person running your practice for you like an MD (managing director) who ensures that all the critical business functions are working well and the team is properly led and motivated.

Don’t settle for a practice manager who comforts themselves by sorting out the roster for the next four weeks because Jenny’s away and Bob can’t come in on Thursdays. Of course that’s important, but more important is why are your ADYs (average daily yields) declining, why are you seeing less implant patients than last year, why has your attrition rate increased, why are you paying your clinicians 50 per cent when everyone else is paying 45?

A decent practice manager, like an MD, will ask and answer all these questions for you on their own initiative and sort out the rota, but you will have to pay them for it. Let me know if I can help with recruitment.


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“The growth of your practice is limited by the vision and experience of your practice manager”

Jonathan Fine, MD

Author: Jonathan Fine