Dental corporates offering job security in troubled times?

FO Dental Groups 2021From left to right: Nyree Whitley, Muhammad Jasat, Catherine Tannahill, Aran Maxwell.

 

Job security has become an issue for many professions in the past year thanks to the COVID-19 pandemic and in dentistry, professionals have also sought reassurance about their working life. For some, that security has come from working with dental corporates.

Dental services have been affected significantly during the pandemic with routine care shelved as only emergency treatments were given priority in the various urgent dental care hubs created across the country.

Despite some financial support from the government and normal services starting to resume, some practices have been hit badly by the closedowns.

This was made clear in a report1 from the General Dental Council (GDC) published in December 2020 that was based on a survey of 9,388 dental professionals and online focus groups.

It found a large majority of dental businesses and professionals said they had experienced, and expected to continue to experience, adverse financial effects as a result of COVID-19.

More than three-quarters (78%) of dental business owners in the survey reported a decrease in current income when compared to the same period last year, and almost two-thirds (63%) expected income to decrease over the next year when compared to the 12 months prior to lockdown.

Crucially, this appears to have had an impact on the professionals working in the practices.

More than a third (35%) of business owners said they expected to employ fewer staff in 12 months’ time as a result of the pandemic, under a fifth (17%) expected to make redundancies, while under a fifth (16%) expected to make changes to employment contracts for dentists and dental hygienists/therapists.

The BDA has recently carried out a survey of its members to gauge the impact of lockdown on dental practices following widespread reports it has received about patient cancellations, staff sickness and self-isolation. Results are still to be published.

Support at scale

In this climate, dentists could be forgiven for worrying about their job security, and some appear to be considering work with corporates which are estimated to account for around 15% of dental practices across the UK.

The scale of the companies and what they can provide is central to their appeal, says Nyree Whitley, Group Clinical Director for {my}dentist – one of the largest corporates that runs around 600 practices nationwide.

“Thanks to the hard work of the incredible team across {my}dentist, we’re in a stronger position now than we have been in years,” she says.

“There are, of course, huge challenges in patient access and we have never seen so many patients in need of care. But we are working flat out to grow capacity safely and make sure patients get the treatment they need.

“I’m pleased to say that we’re seeing more dentists joining our practices than ever before, so I’m confident about the future and believe we’ll emerge from the pandemic stronger than ever.”

Catherine Tannahill, Regional Head of Clinical Dentistry for Portman Dental Care, which runs 148 practices, also acknowledges the tough times that practices have experienced in the past year but believes that corporate support has helped.

“The number of practices that we have has increased,” she says. “I think practice owners are searching for some support. Having somebody else to give advice on the regulatory and compliance side of things, help with CQC [Care Quality Commission] and NHS contracts – that's why practices look to sell their practices and for dentists joining Portman, it gives them a future career.

“When you are for working with a corporate, you’ve also got the fact that you're part of something bigger. Bigger used to be a dirty word in dentistry, but now I think it gives a sense of security and a network of really high quality clinicians and specialists plus the network of the support team as well.”

Getting on with the real job

An often cited benefit of working for a corporate has been the ability to be free of the administrative and management side of the job and to focus on the clinical work.

Muhammad Jasat, a company dentist and Clinical Support Lead for Rodericks Dental, which has 112 practices throughout England and Wales, says: “The clinical support that is available working for Rodericks is fantastic and is particularly appealing to young dentists as well as the ability to network with other dentists.

“Professional development and personal growth is a key focus for Rodericks. There is an extensive range of CPD available exclusively for Rodericks dentists (and dental care professionals), which is now accessible remotely too.

“It’s reassuring knowing all the important things behind the scenes, that dentists don’t necessarily want to get involved in, are done by teams of people with a wealth of experience. It means we can get on with seeing patients, and doing the bits that we enjoy.”

Whitley agrees, saying: “It’s our aim to take as much admin away from dentists as we can via our practice managers and support functions, such as our facilities team, our patient support team, marketing, resourcing, legal counsel, IT, finance, procurement and health and safety.”

Pandemic impact

One consequence of the pandemic has been growing pressure on clinicians to think about the support they get in practice and whether they could benefit from the resources of a large network.

Whitely is certain that working with a corporate has increased job security during the pandemic, as she says: “Without a doubt, being part of the largest dental network in the country provides greater security and support.

“We acted quickly to keep our NHS dentists informed of how they would be paid throughout the pandemic, and we made all the necessary investments to ensure clinicians got the support they needed.

“Early in the pandemic we invested in giving dentists the tools to see patients remotely, via video conferencing services. Since then, we’ve made further investments across practices to ensure not only that clinicians are safe, but that they can grow their careers again. Most recently, this has included investing more than £1.25m to install air filtration units that have been critical in allowing private clinicians to see more patients.”

She believes that all the corporates have had to adapt to new ways of working, adding: “The last year certainly hasn’t been easy, but we’ve demonstrated that we have an agile business that can adapt quickly.”

Many clinicians in England were anxious about the activity targets that were set in January by the government but, as a result of the early action taken by the company and the investments made, she adds, the vast majority of {my}dentist clinicians were on track to receive their full contract payment.

“We’ve tried to be as fair and transparent as possible in how we’ve passed on payments to clinicians,” she explains. “We’ve also made the decision to pay NHS dentists in England upfront. This means that clinicians are receiving their full contractual payment each month and no deductions are being taken for underperformance until a reconciliation process is completed after the end of the financial year.”

Tannahill says that during the time of the pandemic, working for a corporate has provided practitioners with real job security.

“We've seen people joining Portman because they haven't felt that they've had that job security from some of the independent practices,” she explains.

“Practice owners have been having to look after themselves and not always prioritised the self-employed clinicians. So some have come to us because they felt that they've got that sense of security here and that we treat all clinicians equally.”

Thanks to the company’s compliance, regulatory and clinical teams, it has allowed practices to return to normal ways of working in a safe environment.

“Because we've had so many people working together towards that, we've been able to do it quite efficiently and clinicians’ income has be maintained, if not increased,” she adds. “We’ve seen a massive influx of new patients coming from practices that are struggling to be see patient numbers.”

Autonomy guarantee?

The suggestion that joining a corporate means handing over autonomy as a clinician is strongly rejected by the companies.

Research2 published in the BDJ in 2018 and 20193 found that associates working for dental corporates felt they had less control and autonomy at work compared to non-corporate associates, according to data from a survey of BDA members.

The authors of these studies found from interviewing associates that those with experience in both sectors believed that the non-corporate environment generally offered a greater level of freedom than corporate environments in relation to clinical and non-clinical decisions they were able to make.

All but one corporate associate said they had been limited by approved lists for the materials and laboratories they could use, and sometimes where referrals could be made, in contrast to those from non-corporate practices.

This is far from the case, according to Tannahill who says: “When we say there is clinical freedom, we mean it. It doesn't just mean that you can choose what types of treatments are on offer, it means that you can choose which material to use and choose which laboratories you use.”

Career paths

Newly qualified dentists choosing to work with a corporate can expect a myriad of career opportunities and variety if they are seeking it and, potentially, a job for life.

So argues Tannahill, who says: “It can offer a varied and diverse career path. Potentially, a clinician could stay with Portman throughout their whole practising career because we've got enough practices now and we're a big enough group that even if they wanted to relocate, we could put them with another Portman practice and we could find the right practice to suit that stage in their career.”

A record number (150) of recently-qualified dentists joined {my}dentist last year, something that the company attributes to the fact that they can easily access support from peers and ongoing training.

“Joining a national organisation means that young dentists have greater opportunities to further their careers,” says Whitley. “We offer endless training opportunities.”

Various chances to develop are within the grasp of young dentists, according to Jasat who explains: “At Rodericks Dental we have a dedicated programme for dentists that have joined us who have just completed Foundation training.

“This is our FD+1 scheme and is organised by a designated mentor. It involves hands-on study days (restorative, endodontics and oral surgery), zoom webinars, support with clinical cases and regular ‘drop-in’ sessions.”

 

 

 

Never on your own

Aran Maxwell-Cox, an associate at a {my}dentist practice in Consett, County Durham, is a firm believer in how the company has supported and helped him feel secure in his work.

“I started with {my}dentist when they acquired my practice in 2015 towards the end of my Foundation Training year,” he says. “I stayed on as an associate for a year then I moved on to another practice as I wanted to try something new. I was there six months before returning back to {my}dentist in Consett.

“I came back because I loved the practice, the team and the ethos {my}dentist had compared to the practice I had moved to. {my}dentist are very focussed on career development for associates and I love that.”

One of the most important reasons for his job satisfaction is down to job security during the pandemic, as he explains: “{my}dentist have been incredible throughout the pandemic. My job and pay has been secure and we have been well informed the whole way through.”

As for the best thing about corporate working, he says: “The amazing support network means you’re never on your own.

 

 

 

  1. General Dental Council. The Impact of COVID-19 on Dental Professionals. (17 December 2020) https://www.gdc-uk.org/docs/default-source/research/the-impact-of-covid-19-on-dental-professionalsa86215e8-2515-47b6-b116-0cc5655bf61b.pdf?sfvrsn=abfedcbe_5
  2. O'Selmo, E., Collin, V., & Whitehead, P. Associates and their working environment: a comparison of corporate and non-corporate associates. Br Dent J 2018; 225: 425–430. https://www.nature.com/articles/sj.bdj.2018.741
  3. O’Selmo, E., Collin, V., & Whitehead, P. Dental associates' perceptions of their working environment: a qualitative study. Br Dent J 226, 955–962 (2019) https://www.nature.com/articles/s41415-019-0258-y

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