NHS dentists’ taxable income has dropped by 35% in real terms since 2006, down £45k to just £69,200, according to NHS Digital, while compliance costs have risen by 1,086% in the same period.
Yet still dentists hanker after the perceived safety of NHS contracts. Mixed practices in particular are seen by rookie practice owners as a safe bet, when all they really offer is an opportunity to either over provide to NHS patients or under provide to private ones.
You can’t grow your private business when your patients are mostly getting an NHS patient journey and know it. And you can’t grow an NHS contract. Meanwhile costs keep rising. That’s why you won’t find many seasoned practice owners interested in NHS or mixed practices.
So why do dentists persist with the NHS? The £7.1bn of revenue coming into the sector (KPMG, 2017) is shared among about 12,000 practices. About 60% of them are NHS, which take £3.5bn, and mixed and private practices make up the rest.
In 2013/14 the average dental spend per person was around £90, but only £34 of that was spent privately. That might seem to suggest that NHS is still the way to go, but don’t be fooled. Private practice profits have crept ahead of NHS net profits for the first time in almost a decade, and NHS reforms are in a mess.
It’s difficult if not impossible to provide quality dental care on the NHS, and unclear what NHS work can do for your career development as a clinician. It seems obvious where this all ends, even if your typical risk averse, conformist dentist won’t yet admit it.
The alarming power of social conformity is old news among psychologists. In 1951 a psychologist called Solomon Asch asked a panel of participants to say which lines on a flip chart were the same length. All but one of the participants was told to give the wrong answer and when they did, even though it was obvious the answer was incorrect, the real participant followed suit. In 12 trials, 75% of the real participants conformed against their better judgement.
We use a psychometric profiling tool with our clients called the Kolbe test and out of a score of one to nine (one being a preference for low risk) 80 per cent of practice principals we survey score between one and three. This suggests that dentists like to mitigate their risk and tend to resist early adoption of new services or ideas.
A preference for low risk is of course a healthy attribute. It can only serve you well in business provided you are interested in assessing the real risks around you — and interrogating the perceived risks. Perceived risks tend to crop up where there is an innate drive to conform to what the group is doing.
A reliable check against conformism is the act of looking inward instead of outward. If you can make some time for introspection, and try to come up with a set of achievable personal and professional objectives that really matter to you, you might discover things you hadn’t expected. Then you can look at what kind of business model might actually serve you. We’re here for no obligation advice if you need us.