Does corporate dentistry offer the best of all worlds?
Corporates are a growing part of the dental landscape in the UK and can offer many attractive benefits for dentists young and old, but do they offer the best of all worlds?
Despite not always having the best reputation in the past, corporates have made their mark in the dentistry world and are continuing to grow and attract dentists at all stages of their career.
Although they have existed in dental practice for more than 100 years, corporates had significant restrictions placed on them until 2006 when the law changed to allow dental practices to be operated as ‘Dental Bodies Corporate’.
This changed the previous situation in which dental practices (with some exceptions) could only be operated by dentists as sole traders, partnerships and one or two other types of unincorporated entity.
Since then, corporate dentistry has grown and it is now made up of around 200 dental groups (companies or organisations operating three or more practices) with 2,000 dental practices holding around 15-20% of the dentistry market.
With services spread over NHS and private care, corporate groups are believed to hold more than 40% of NHS contracts in England.
The secret to their appeal is opportunity and a sense of true support, says Dr Nyree Whitley, Group Clinical Director for one of the largest corporates, mydentist. It runs around 640 practices in the UK.
Whitley, who also still practises as a dentist in Wrexham, Wales, and is a postgraduate tutor for the Welsh Deanery, says: ‘One of the clear benefits of working for a corporate, for me, is the amount of clinical support you have. You can be assured you are working in a compliant environment.
‘We have a clinical support network of clinical directors and clinical support managers – all practising clinicians who work within our estate. Alongside that, we have a network of 400 mentors and we also have our Academy which is a training academy.’
Colosseum Dental, which currently has 80 clinics across the south of England and is actively expanding its network, agrees that staff are supported in a comprehensive way.
Its UK chief executive officer Philip Buergin says: ‘It comes down to one thing – a dentist can be a dentist and take best care of our patients. At Colosseum, we provide the dentist with the support teams and structures to enable them to do that and flourish in what they do.
‘We take care of everything that is time and energy- consuming and not at the core of the dentistry profession – ordering supplies, managing paperwork – freeing up time for the dentists to perform their work.
‘We are present in eight countries across Europe with more than 250 practices and have a huge resource of specialists and an experienced team to call upon. Because of the scale, we can offer the latest technology in our clinics that benefits both our dentists and our patients. Our size also means we can support our dentists to have a comprehensive career path, for example sharing best practice in our Colosseum Academy.
‘Also, we offer our clinicians and support staff rotational programmes across Europe so they get to live and work abroad if they want.’
It is simple, says a spokesperson for Bupa Dental Care, which runs 470 practices across the UK & Republic of Ireland.
‘As a corporate, Bupa Dental Care allows dentists to focus on providing fabulous care to our patients. We ensure the practice is set-up appropriately, well run and full of patients. So as a dentist, you can focus on the treatment to the patients,’ they say.‘We are also in a unique position to support clinicians with their on-going career; whether they want to mentor, build their private base alongside NHS or explore areas such as management or governance.’
Smaller corporates are equally positive about the benefits on offer, shown by the clear enthusiasm of Mayur Pandya, who works as Chief Clinical/Operating Officer of Dental Care Group, which now runs 21 practices in the UK.
Pandya says: ‘We are able to provide immense support for our dentists – clinical governance and support, training and education, compliance, practice management, employment law and staffing support. This allows the dentists to focus on what they do best – looking after the patients.’
Corporate working offers dentists a world of opportunities, claims Lesley Brelsford, Clinical Support Manager (CSM) for mydentist who provides support to clinicians throughout North Bradford, Leeds & South Yorkshire.
‘What are the main benefits of working for a corporate?’ she says. ‘In a word, options. There are career pathways outside clinical practice, like Clinical Support Manager, mentoring, compliance and management.
‘Plus there are opportunities to develop and grow treatments which may not be in demand in the practice where you are based such as dental implants or orthodontics.”
Growing market share
The share of the market for corporates looks certain to grow as the career paths of dentists have changed in recent times, argues Whitley, saying: ‘I qualified in 1996 and the majority
of my colleagues at the time who stayed in general practice went on to become principals because that was the pathway.
‘The young guys these days are less inclined to go in that direction. They want to develop their career in dentistry but they don’t wish to own and run a dental practice. That in itself will potentially increase the number of corporate or DSO type organisations.’
Pandya agrees, saying: ‘I think there will be 7-10% year-on- year growth and potentially more than other sectors. There is a huge amount of interest from investors and investment is likely to grow significantly over the next five years.’
Next generation of dentists
A young, newly qualified dentist could do a lot worse than make a corporate their first place to work, according to Buergin, who stresses: ‘It’s a great first job because they have an experienced dental team with them to support, guide and mentor them.
‘A newly qualified dentist wants learning opportunities, to be working with the latest technology, and being mentored to learn the skills of working with patients and communicating with them.’
Young dentists are quick to see the potential in a corporate practice, argues Pandya, who says: ‘We are about providing high quality, affordable dental care and enabling our practitioners to have time for reflection to develop their skills. Young dentists will get that with us.
‘The learning potential for newly qualified graduates is immense. Everybody is learning, sharing knowledge, embracing peer review and working collaboratively.’
Today’s young dentists should be able to see the advantages on offer, as Whitley explains: ‘By coming into the corporate environment they are automatically a part of a huge network of other clinicians and they get that support from both a business perspective but also from a whole host of colleagues.’
Older and more experienced dentists should also be able to see the benefits of working for a corporate, claims the industry.
Dr Rod Ingham, who works for Colosseum Dental, qualified at Guy’s Hospital, London University in 1978 and sold his practice after 23 years to Southern Dental in 2006 before Colosseum Dental took over in 2017.
‘I am happy now, having the back up of a large organisation,’ says Ingham. ‘They provide help and support in working safely and ethically in a well organised environment.
‘Colosseum Dental have the financial input for new equipment and dental materials. They have an experienced team to watch over regulations and quality of service. Also there is organised training and support available, together with in -house access to specialist operators.
“It is a good place to work for new and experienced dentists because the company provides on-going training and support.’
Autonomy and control
Recent research¹ published in the BDJ suggested that associates working for dental corporates feel they have less control and autonomy at work, and are less satisfied with their jobs compared with non-corporate associates.
Bupa Dental Care’s spokesperson says: ‘Dentists tend to associate corporate dentistry with a reduction in – or worse still complete loss – of clinical autonomy.
‘This is not the case - it is the dentist who is seeing the patient so we believe allowing them clinical freedom is vital. They will also receive a broad range of support, materials and infrastructure to ensure they have what is needed to achieve exceptional patient care, in both private and NHS.’
The claim is also rejected by Ingham, who says: ‘I have full clinical freedom to provide the best ethical dentistry that I am able to give, with back up and support from the administrative team.’
Pandya agrees, saying: ‘They should come and visit our practices. There is always autonomy and control by all of our clinicians and we embrace the differing opinions that clinicians have.’
Whitley is equally staunch in her defence of corporates, adding: ‘Our dentists have complete clinical freedom. We don’t tell them what treatments to do on what patients and how long they take to do it.
‘We do have policies and procedures and some may criticise those in terms of restricting things, but if it is restrictive, it’s done so in the right way. We are committed to listening to our clinicians and their feedback.’
1. E. O’Selmo. Associates and their working environment: a comparison of corporate and non-corporate associates.
Br Dent J 2018; 225: 425–430.