Dental corporates pledging support for dentists rebuilding in a post-covid market
From left to right: Shawn Charlwood, Nyree Whitley, Faizan Zaheer, Sarah Ramage, Aran Maxwell
Dentistry is seeking to get back to 2019 patterns of work and levels of service provision since the global Covid-19 pandemic hit, and some dentists are choosing to work with the dental groups or corporates to help them and their patients get back on track.
The need to return to pre-Covid provision levels is pressing. The British Dental Association (BDA) said recently that a full year's worth of dental appointments have been lost since lockdown.
In its analysis of Freedom of Information data released in February, the BDA said almost 40 million fewer courses of treatment had been delivered since March 2020, when compared to pre-Covid levels.
The need for more support was recognised by officials when in January of this year, NHS England pledged an additional £50m for dentists to provide additional urgent care for NHS patients (around 350,000 appointments) with funding available until the end of March, being paid on a sessional basis.
Rebuilding
The dental corporates or groups, which are estimated to run around 12% of the dental market (around 1,500 of the UK’s 12,500 practices), admit there is lost ground to make up for.
Dr Nyree Whitley, Group Clinical Director for {my}dentist which has around 600 practices in the UK, says: “Despite the heroic hard work of dentists, millions of patients are still struggling to access the care they need.
“So, while things are by no means normal yet, our teams across the UK continue to see as many patients as possible and we’ve been able to increase capacity safely thanks to the chain of protective measures we have put in place.
“We’re doing more than ever to help clinicians grow their incomes now that we’ve started to return to normal.
“We’re currently making record investments in locally targeted, digital marketing to support clinicians in growing their private careers. We’re also investing in growth projects throughout the UK to further increase surgery capacity across our network and offer extended opening hours, where this works around a clinician’s family life.”
Sarah Ramage, Clinical Director at Bupa Dental Care UK which has more than 470 practices across the UK and Ireland, agrees that the industry is still not back to normal.
“Following the initial three-month closures at the start of the pandemic we were able to put the wheels in motion very early on to make sure everything was in place for a safe and compliant return once we were able to open again, enabling our practices to return to face-to-face care with just a few days' notice,” says Ramage.
“However, we do know that dental waiting lists have been exacerbated by the impact of the coronavirus pandemic over the last two years and although Covid restrictions have eased, we’re not quite yet back to business as usual in dentistry.
“For example, the NHS has asked us to prioritise urgent patients over routine care, delaying some people’s regular check-ups.”
First-hand experience
One of the dentists who has enjoyed a positive experience with corporates is Dr Aran Maxwell-Cox, who currently works across two {my}dentist practices – one in the West of Scotland and the other in County Durham – providing a mix of NHS and private dentistry with a focus on facial aesthetics, cosmetic dentistry, clear aligners and education.
“I started working for {my}dentist in 2015 when the practice I was working for was bought over,” he says. “I stayed for a year before I fancied a change and tried a different independent practice in the South of England. That role was not for me unfortunately and I moved back to my previous role at County Durham where I have been ever since.
“Having had discussions about relocating home to Scotland, {my}dentist were more than supportive in helping me find a role and transition my time between the two practices.”
Maxwell-Cox acknowledges his initial scepticism of working for a dental group, saying: “When {my}dentist took over the practice initially I did have reservations as I had heard such negative things about corporate dentistry in general and I was very apprehensive.
“However, returning to the company in 2016 was the best career move I ever made. They have supported me in developing the career I want in private dentistry, so much so I have been able to drop my English NHS commitment completely.”
Clinical support
One of the main advantages of working for corporates is the support that comes with this, in various forms, argues Whitley.
“The main benefit to clinicians of joining {my}dentist is the support that’s available,” she says. “Being a clinician can be a really difficult job, and that’s why my first priority is to support dentists so that they can support patients.
“This can be support for clinicians to grow their careers – for example, by finding a better balance between their NHS and private work, taking advantage of training opportunities at the {my}dentist Academy, or by just having another dentist to talk to.
“But it is also the support we offer to help clinicians to do their jobs more easily and to make sure they always feel they’ve got someone to help if they need it. That’s why we have an industry-leading central support team who can take some pressure off. That might be through central handling of patient queries, or simply by getting people on the ground quickly to deal with facilities or IT needs.”
Bupa’s Ramage concurs about the various benefits of working with corporates, such as career progression, pathways into a variety of special interest areas, competitive benefits and HR support, flexible working patterns and the ability to relocate within the business to other practices.
“A group also helps to make sure the practice is busy, that all hiring and staffing is taken care of, and that everything that clinicians need is in place, allowing dentists to focus their time back on face-to-face patient care,” says Ramage.
“There is also the opportunity to work with some of the most up to date technology and resources. We also have a larger arsenal of technology, resources, and often budgets available to put into upgrading services, securing high quality materials and equipment and attracting patients.”
Maxwell-Cox agrees the support on offer is invaluable, saying: “{my}dentist have invested in my development and their large network of clinicians means I have the support I need and I can always ask for help.
“{my}dentist’s large size allows for courses that can be offered to clinicians at a discounted rate, meaning increased access to good quality training. I completed my training with ClearCorrect in 2019. I have also been promoted to the role of Clinical Development Manager, a role in which I can help other clinicians on their career path and development.”
Job security
During the early stages of lockdown and restrictions on dentists’ ability to work, job security gained a higher degree of importance for many in the dental profession – something that may have made corporates seem even more attractive.
Chair of the BDA’s General Dental Practice Committee Dr Shawn Charlwood says: “One of the potential attractions of this is that you are working for a larger organisation so some of the opportunities within that larger organisation might be appealing.
“It might be different roles within the same organisation or it could lead to some career progression. If you were trying to develop a special interest, they would potentially be able to support your training and development and because you are part of a multi-site organisation, you could use those special skills in a number of different sites.”
Different work models are also on the table, as Charlwood adds: “We are aware of a number of employed roles within corporates, so rather than the self-employed model widely used within general dental practice, some corporates have been advertising employed roles.
“That may lead to lower bottom-line pay on your payslip, but there will be the benefits of employment such as sickness [pay], maternity/paternity leave or a holiday allowance, and perhaps indemnity costs.
“In the last two years with Covid, a lot of dentists have thought that would be very attractive when at the beginning of Covid, dentists were, in essence, not able to work so their incomes were much reduced.”
Over-control?
Concerns are sometimes raised about a corporate dentist having less autonomy at work than dentists in non-group practices – a concern robustly rejected by {my}dentist.
Whitley says: “In many ways, I think this is a myth. At {my}dentist, we’ve worked really hard to listen to clinicians and act on their feedback. One of the changes we’ve made is to invest in our clinical support team. Their job is to make sure clinicians feel in control of their working lives.
“That’s not just about feeling in control of your career but also feeling in control of the kind of dentistry you do, the hours you work, the support you get in your role, the materials and equipment you have access to, the team around you, and the environment you work in.”
Ramage believes that many independent practices can struggle to keep up with ever-changing regulations and policies as well as administration jobs, such as hiring staff or ordering supplies.
“Corporate dentistry takes care of all of this for the dentists and allows them to concentrate their time on patient care, and where they want to go in their career,” she explains.
The BDA’s Charlwood adds: “It suits some people and it doesn't suit others. A lot of dentists like being part of a smaller team and they feel they have more influence and more independence in terms of clinical freedoms – the materials and the laboratories they use – but it’s not applicable to all corporates.
“Some corporates take a fairly relaxed view of all of those things and others have much a more prescriptive type model where you have to use their laboratories and specific materials. But that can be true of an independent practice as well!”
Whitley argues that dentists working for corporates are able to focus far more of their time on clinical work rather than on the administration and the management side of the job.
“At {my}dentist, we’ve invested to create the leading clinical support network in UK dentistry. That means we can support dentists in managing complaints and queries from patients as well as taking on much of the business admin that comes with owning a practice or that some clinicians might face in independent dentistry.”
Corporate growth
The dental groups are keen to grow and are seeking new practices. According to business property adviser firm Christie & Co in its latest Dental Mid-Year Review 2021 published in June of last year, it saw an increased number of buyers coming into the market in 2021.
This included both established dental companies who had put their expansion plans on hold in 2020, and new entrants to the market.
Furthermore, in its annual Business Outlook report published in January of this year, the company said it had seen “strong buyer appetite for dental businesses” throughout 2021, with corporate operators being particularly active.
Whitley says her company has an exciting future, explaining: “Every year, we run a survey to help us understand what we’re getting right and what we can do better. As a result of that feedback, we’re making record investments in the support we’re offering to clinicians, in our practices, and in our frontline practice teams.
“In the next 12 months we’re set to invest in projects across the UK to refresh our practices, offer more surgery space and help clinicians to grow the careers they want.”
Flexibility
The opportunities and flexibilities offered by working for a group are what make it all worthwhile, argues Maxwell-Cox, who concludes: “I am so lucky now to have such a varied role, where I can work at two amazing clinics and have a role within the business aspect of dentistry. I would recommend working for {my}dentist to any one of my colleagues irrespective of their career stage.”
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Freedom to focus on the jobTeam working, access to a range of experts, diverse career paths and time to focus on the clinical job – these are all part of the appeal of working for a corporate, says Faizan Zaheer, a specialist periodontist and implant dentist based in Manchester and Regional Clinical Director for Bupa Dental Care. Zaheer qualified as a dentist in the Republic of Ireland in 2009 and then moved to Manchester where he is still based. He first started working for Bupa Dental Care nine years ago when it acquired a private practice in Congleton, Cheshire in which he was doing some weekend work while doing specialist training to become a periodontist. “I didn’t have any reservations about taking a job with one of the dental groups,” he says. “At the time, I was more concerned about finding a job that suited my needs and allowed me to do the clinical work I was interested in, in a setting with an established patient base and a great team around me. Bupa Dental Care in Congleton ticked all those boxes for me. “You also get a lot of additional benefits that you might not get if you're working for an independent practice, including having robust systems in place for compliance and patient safety. At Bupa Dental Care that is all taken care off. I can just come in as a clinician, treat my patients and I can go home. All the rest of the admin, the compliance and the maintenance is taken care of.” The company also offers a clinical community of highly skilled dentists, area clinical leads, regional clinical directors as well as compliance teams, he adds, saying: “Working for this company makes you feel like you're part of a big team and if you have any questions or need support you can easily get access to an expert in the right field.”
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