As you may know, we run a Dental Clinic in Mwanza, Hope Dental Centre (HDC). The profits of the Clinic help to fund the work we do in training medical officers in Emergency Dentistry in Tanzania.

It’s becoming very clear early into this new year that our work here in Tanzania is growing at an exciting pace. To help with these changes, we require more people to join our team and we have 2 exciting opportunities available.

HDC Business Manager – to enhance the clinic systems and processes ensuring the clinic is running efficiently and effectively, giving the patients a positive experience.

HDC Principal – to promote efficiency and quality within HDC and ensure all clinical procedures are delivered to a high standard.

Both roles are for 12 – 18 months and would be ideal for a married couple or 2 individuals. Assistance with living expenses will be available. Please click here to see a PDF with more information on these positions.

If you are interested or would like more information, please contact jo@bridge2aid.org before 10th February 2012. We are looking for these positions to begin in September 2012 or before if possible.

We look forward to hearing from you!

Are you frustrated by those jobs that keep appearing on your ‘to do’ list?

Does your heart sink every time you think about all the things you’ve been putting off?

Can you imagine how wonderful it will feel to finish those tasks you’ve been avoiding?

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The PROCRASTINATION BUSTER DAY guarantees to get you into action once and for all. By taking part you will:

► Get started on that project you’ve been putting off

► Get jobs done that have been on your to do list for AGES

► Take action and keep the momentum going

► Do more in one day than you have in weeks

► Raise money for charity…

You don’t need to travel anywhere. All you need is some jobs to be done and access to a phone on Saturday 4th February (10am to 4.30pm)

A day like this is worth its weight in gold. I find it incredible how much more I achieved than on an ordinary Saturday. It really works. John Cutts, Personal Development Consultant

I found the PBD a fantastic and productive use of time and well worth the investment. It enabled me to totally rearrange my home office to make it more manageable, plus I completed a number of other items that had been on my ‘to-do’ list for months. I would recommend this to anyone!

Anna Golawski, Work Life Balance Coach

Your investment is only £35 (£5 of which is donated to charity). Success is Guaranteed.

Please do join us for an energetic, enjoyable, dynamic and productive day. Spaces are limited. For more information call Annabel on 01747 871196 – email Annabel@annabelsutton.com or visit www.annabelsutton.com

Location: Cheshire

Description: The Old Surgery is a beautiful, fully refurbished Dental Practice and has an experienced, motivated and enthusiastic team.

We are primarily a private practice, but we also hold a contract with our local PCT to provide and accept Oral Surgery referrals. We have a long standing referral service and for a number of years have received in excess of 100 external oral surgery referrals (MOS, LA, IV sedation) per month. In addition to our current Specialist Oral Surgeon our great team of support staff are experienced, fully qualified and have successfully run a well-organized and streamline service for many years. We are looking for a highly motivated, enthusiastic oral surgeon to join our fabulous team.

The position requires the delivery of services mainly on Saturdays (max 35 per year) but there is also opportunity to work some sessions on weekdays. Remuneration will be calculated on a UDA basis.

To find out more about joining our team you can call:

Daytime – 01270 589134 (practice direct line) or Evening 01782 751468 (Steve Lomas – Partner) or email oldsurgerydental@tiscali.co.uk .

More information about The Old Surgery can be found on www.oldsurgerydental.co.uk

My name is Karen Coates and I am Dental Advisor for The British Dental Health Foundation and as you are probably aware, we provide resources for the profession and other organisations
to help to raise awareness of oral health matters.

We would love to be able to increase the amount of resources that we produce ‘in-house’ however we are struggling to find images that we are able to use. We wondered if you knew of any dentists that would be happy to donate any images to the Foundation? In particular, images of dental erosion, gum disease, teens teeth, ortho but we would be very grateful for any images which we could add to our rather dated library. If you could help the Foundation at all please contact me at karen@dentalhealth.org or 01788 539784.

By donating your photographs to the British Dental Health Foundation (BDHF) you will have given permission for the BDHF to use, duplicate and copy the aforementioned material. The BDHF will only use the photographs or images to accompany their educational resources and will not use them for any other means. The BDHF will not pass on any of your images to third party companies, with the exception of a customer purchasing a temporary online licence for BDHF educational resources. In this case, the images will only be used for educational purposes and will prevent third parties using your photographs for advertising or commercial gain. The BDHF acknowledges you as the owner of the intellectual property rights of the material.

On Monday night (23rd January) I attended a meeting of the Heart Your Smile committee down at the lovely Caffe Caldesi in Marylebone.

Expecting to meet “the usual suspects” we were delighted when Seema Sharma arrived with a group of 4 students from Guys in tow. They introduced themselves as leaders in their student community and the old-timers around the table listened with increasing appreciation of the work the students are doing to advance the reputation of dentistry in their local urban communities. From mobilising the student body to educating local schoolchildren, they have a full curriculum of activities and a well-populated social media tribe.

Their enthusiasm was infectious and lit up the room.

Contrast this, if you will, with the “conversations” that take place in “grown-up” dentistry:

In the professional domain:

• CQC
• OFT
• Recession
• Competition
• Redundancy
• Succession

In the public domain:

• Ferrari-driving celebrity dentists
• Over-prescribing
• Lack of consistency
• Whitening confusion
• Short-termism in treatment modalities
• Pricing

It is very easy to take a gloomy outlook – and that is precisely why James Goolnik and the founders of Heart Your Smile have created a campaign that intends to bring a positive message about UK dentistry to both the profession and the public.

Which brings me nicely to a look at the role or PrivateVT in the future of UK dentistry. To begin – my company, BKH Holdings, has invested in PrivateVT – and so I have a vested interest in the success of the venture – I’m biased – and you will have to take that into account as you read.

Nonetheless – think about the commitment required by private principals:

• an investment of £15,000 in the year-long programme of e-learning, residential courses and training delivered by a growing panel of expert trainers
• a further investment of £32,000 in a year’s income for the VT
• time allocated to mentor the VT
• a target production of £120,000 gross from the VT in the same year

And think about the benefits of joining this new tribe of forward-thinking private principals:

• a VT who has been interviewed, vetted and chosen by the practice principal
• a VT who is open-minded, keen to learn and grateful for the place in a private practice on the VT Plus scheme
• a VT who will have had a track-record of achievement at dental school and in FD1
• a VT who will be benefiting from training and coaching from some of the best of breed in the clinical and non-clinical community
• a VT who will be groomed in high quality clinical skills
• a VT who will evolve great communication skills chair side
• a VT who will learn how to ethically sell treatment
• a VT who sees themselves as an integral part of the team
• a VT who will go forward to advanced courses as an associate
• a VT who will be interested to attend conferences and take part in emerging trade associations
• a VT who will understand the role of the internet and social media in business and in life
• a VT who will not live in the past but who will invent the future
• a VT who may well be interested in succession planning

Which brings me to one of my favourite points about PrivateVT – the opportunity to grow your own purchaser.

Look at what happens in larger professional practices. The older partners have shares. The younger partners forego income in order to build up capital accounts.

In time, the older partners retire and are paid out (sometimes in stages) by withdrawal from capital account. Then the younger partners step in to become older partners – and the cycle continues.

No mad valuation formulas, no corporates marching in and changing everything to the dismay of those left behind. No haggling on price – formulas are agreed at outset.

No new faces suddenly taking the reigns – consistency all the way through. It’s like an escalator, with VTs becoming associates, then junior partners, then senior partners – over timescales measured in decades and not years.

Creating consistency, good brand standards and long-term security for team members, patients, suppliers and owners.

A dental practice model that can only appeal to the public and to the regulators.

Why wouldn’t you do that?

PrivateVT takes the passion, the enthusiasm and the optimism shown by the 4 students at Monday night’s meeting – and bottles it for your future.

Take a look now – there are only 20 places available for 2012-13.

PrivateVT

On the left hand side circle number one represents NHS dentistry.

In the middle circle number two represents affordable, private family care and on the right hand side circle number three represents cosmetic, advanced and specialised dentistry.

The circles can intersect to varying degrees.

For example, the last time I looked approximately 85% of the turnover inside IDH was NHS dentistry and 15% private and specialist whereas the mix for Oasis might be closer to 60/40 (my guess).

Similarly, you can take a look at a lot of family dental practices and realise that at the lower level they intersect with the NHS (circle number one) by providing children’s or exempt contracts and at the upper level they intersect with circle number three by providing a range of cosmetic, advanced or specialised procedures.

In any given dental business these circles exist and intersect to some degree or other.

In fact, in a large corporate may have a small number of private or specialist practices then the circles form themselves into a pyramid shape and intersect with each other in the middle (I hope you can get the visual).

Perhaps 10 or 15 years ago it was possible to set up one dental practice that would attempt to provide services across all three of these circles and the people who visited their practice were happy with the commonality of the branding, the interior décor, the customer service experience and the clinical care.

However, in 2012 more and more patients are beginning to firstly realise and secondly expect that as they move from one circle to another in their treatment needs then there may well be a different brand, a different interior décor, a different customer service experience and (dare I say it) a different level of clinical care by reference to the materials and procedures that are used.

After all, it’s been for 10 years now that the BDA have defined the difference between NHS dentistry and Private dentistry as being:

1. Quality of materials used
2. Range of treatments available
3. The amount of time that you are able to engage with the dentist

As time goes on, it’s becoming more and more difficult to offer a consistent branded experience across all three of these circles – in fact, what one does see on a regular basis is businesses that are becoming more and more confused in the mind of the consumer because they are attempting to be all things to all people.

So the future is likely to become about polarisation of the branded experience.

And circles that intersect less frequently.

I want to share with you an example of a dental practice that I was recently asked to take a look at from a valuation perspective.

An independent private practice, which offers a full range of family maintenance services and a significant bias towards the provision of cosmetic and advanced treatment.

One of “those practices” that would win an award at a dental awards ceremony.

A practice that has been around for a while and that has an excellent management team and great systems as well as very experienced owner clinicians and well-trained associates and hygienists.

In fact, it all looks absolutely fab-u-lous darling.

Reading up to date management accounts I find that the practice has got total revenues of £1.2m and a pre tax profit of £300k per annum, split equally between the two owner clinicians.

That’s a very commendable commercial result. The owners are reaching “the autumn of their career” and are beginning to look at exit options and, therefore, they have popped along to one of the independent valuers and asked them to take a look at the place.

Said valuers have visited and have produced a report which indicates that the goodwill value of the practice including fixtures and fittings is in the order of £800k in the current market place. The freehold, which is owned by the partners, can of course be valued independently and may or may not form part of a sale. Along comes another dentist who looks at the numbers, has a look at the practice itself and is delighted by what he or she sees.

In fact, the new dentist is very interested in living in this geographical area, keen to send his kids to local schools and relieved that his wife has told him this would be a lovely part of the country in which to raise a family.

He’s also looked at a 25-year-old patient database and a very long established team and realises that in actual fact he can walk through the door of this place, pick up the patients from the retiring and departing dentists and probably generate a very similar level of profitability in a short space of time.

There are two owners in the practice at the moment so he’s probably going to have to find a very good quality associate and/or a partner to go in on the deal with him so that he guarantee that each new owner’s average daily productivity is maintained.

On this analysis, he needs to find £800k to buy the goodwill and is in a situation to put £250k of that down as a result of personal savings/family money/sale of a previous practice and he’s therefore tapping on the door at the clearing banks and asking them to support him on the other £550k.

The good news is that the bank have been in, they’ve had a look at the proposition and have told him that provided that there is adequate bricks and mortar security either from his existing property portfolio or via the purchase of the freehold then they will more than likely support him on the purchase.

So this story is heading for a happy ending.

However, the existing owners wonder what it would be like if they pulled in an opinion from a dental corporate.

So along comes the acquisitions manager from the corporate and carries out a different financial analysis.

1. What happens if we buy this practice and leave the existing owners in there as associates for the next 5 years?
2. What happens if the existing owners are now moved on to a 45% associate contract based on their own personal production? If we do that and if we run the numbers based on our own operating costs and the revised associate payments then what do we come out with as a bottom line proft (what the accountant would call the adjusted EBITDA)?

Well the interesting thing is that the adjusted EBITDA for this practice if we put the owners back in as associates is £50k per annum.

So here we have the classic example of what’s known as “a lifestyle business”.

This is a fantastic business designed to pay the owner’s an income and stop there, because there is no responsibility to provide a return on investment for shareholders.

Hence the reason that most of the corporates are not buying private dental practices and equally the reason that those corporates who have bought private practices have often had their fingers burned.

There seems to be a fundamental conversation which is missing in the goodwill valuation marketplace and that is:

“Am I a dentist who is buying this practice as a lifestyle business and I want to replace the existing owners lifestyle with my lifestyle. Or, am I a corporate who is seeking to grow market share in this sector of the marketplace?”

I would argue that the lifestyle valuation of this business is £800k but that the corporate valuation of this business is going to be closer to £200k (equivalent to four times adjusted EBITDA).

That’s why at the back end of 2008 I performed over 70 independent private practice valuations on behalf of the IDH private and specialist division and did not make one single acquisition. In fact, after four months of very hard work, we realised that we were in the wrong place at the wrong time and my work shifted to improvement within the existing portfolio of private and specialist practices – a job which I thoroughly enjoyed and look back on with very fond memories.

Here we are three years later with exactly the same problem in the marketplace.

Which would seem to indicate that the only way that the owner of an independent private practice can get “out of the rat race” is to sell to another independent dentist who is prepared to pay “the lifestyle price” and step in!

For me, this represents a challenge to the existing owners in finding the right purchaser but also of course as the freshly baked Managing Director of a new private dental corporate it presents us with a huge challenge in terms of acquisition.

What I am definitely not going to sanction is a repeat of the mistakes made by earlier private corporates, some of which are still self evident in the marketplace.

So, we have to “re-write the rule book” and start again with a completely new philosophy and a new approach to corporate acquisition of private practices.

Right now I am working very closely with my management team to design that new approach.

What will it look like? Well, at this particular point its too early to flesh out the detail but if you were to ask me to guess I would say that we need to come up with a brand new acquisition model which gives the existing owners another 5 – 10 years in the business of dentistry but with the opportunity of significant wealth improvement over that time – as stake-holders in the corporate.

In simple terms, my conversation with the existing owner is to say “I can’t pay you £800k for your practice today but I can pay you £200k and give you generous share options in the corporate that we are building”.

Some will say “well why shouldn’t I take my £600k now (the gap between what you will pay me and what an independent purchaser will pay me) – and then I’m out of the game and risk free?”

Others may take the view “I’m interested in becoming involved in a venture in which I have share options and which could in a relatively short space of time return to me a multiple which would be far higher than anything I could achieve in independent private practice”.

It’s that debate and how we flesh it out in numbers and at the same time give the prospective vendors security that is consuming my mind at this point in time.

We hope to have some answers for you in the very near future but it’s an exciting proposition if we can get it right.

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Any organisation whether it’s a dental practice, a consultancy business or a dental corporate has a responsibility to manage its own reputation in the market place.

In fact, in the absence of self-management you simply leave the door open for other people to manage your reputation.

That’s why corporates have got such bad press in the UK dental profession – I can’t think of a single one of them that has made anything remotely like a decent job of managing their own reputation.

In fact, I go as far as to say that some of them have completely abdicated from this responsibility.

So what happens when you don’t manage your own reputation?

Somebody else does.

And in the United Kingdom that’s a very dangerous game to play because the reality is that most people who have any opinion in this country have a negative one.

“What’s the catch?”

“That will never work”

“It failed once so that proves it will never work again”

“People will never change”

“It can’t be done”

“They are all out to get us”

It’s hardly surprising therefore that forums are populated by people who are bad mouthing the role of corporates whether or not they know what they are talking about and interestingly whether or not they have actually worked inside them.

In my opinion it’s far too late for the existing corporates to do anything about that – the scene has been set and it would take an enormous job to shift them.

There’s a very interesting similarity here with Microsoft.

For years and years individual team members in the company were threatened on pain of expulsion that they should not write any blog posts or other comments about what was going on inside the company.

As a result of which the rest of the world managed the reputation of Microsoft and “imagineered” them into a big brother organisation that ruthlessly eliminated its competition.

It was only when Gates/Walmer and the Board decided to allow open blogging for all Microsoft employees that the reputation began to shift.

Slowly but surely individual employees within the organisation started to tell a story that was more balanced.

Don’t get me wrong. Microsoft were and are a very commercial organisation but, in the same way as dental corporates, they were often populated by unsung heroes who were trying their level best to do the right thing on a day to day basis.

As the internal bloggers began to tell the story of what was really happening within the organisation then slowly the reputation began to soften.

I don’t thing they are ever going to be regarded as a “kind” organisation (even in spite of the amazing work that the Gates family have done personally) but at least they are not quite the big brother that they used to be.

I think the dental corporates should have and could have taken a leaf out of that book many years ago but perhaps now it’s simply too late.

For any new corporate coming onto the scene (and I’m involved in two of them) then reputation management is going to be absolutely critical to success and the best way to do that is to allow the people inside your organisation to have a voice and to tell the truth about what’s actually going on on a day to day basis.

On the day that David Cameron speaks about “responsible capitalism” – I would like to promote a conversation about “responsible dental corporates” – and what they would look like?