As dental corporate firms are increasing their slice of the market, it appears that younger dentists are increasingly being drawn to what they see as attractive job opportunities.
Corporates account for around 13% (1,500 practices) of the total number of dental practices (around 12,500) in the UK – slightly up on the previous year – according to specialist business property adviser Christie & Co’s Dental Market Review 20191 published in June 2019.
In that report, the authors acknowledged there were continuing challenges with associate recruitment and retention – especially amongst corporate purchasers – which had driven demand towards urban locations over the past year.
Nevertheless, the corporates are keen to expand and believe they offer dentists good work opportunities in top-notch practices, with career development, training, and strong support for dealing with regulatory requirements and administration.
Benefits of corporates
Nyree Whitley, Group Clinical Director for mydentist, which now runs more than 600 practices in the UK, says: ‘I spoke to some new dentists who joined us recently. They all spoke about the amount of support you have.
‘They know they can come in and that the governance side of things is looked after, the staff have been trained appropriately, their diaries are managed properly, and they have support from a central basis with regards to dealing with patient complaints.
‘What they get with us is tailored support on a day to day basis from the simple things in terms of treatment planning, productivity, how to work as a team, to looking at their career progression.
‘We can tailor a dentist’s career from start to finish and they can progress within the business if they wish to, specialise in an area, or go and work in one of our advanced oral health centres.’
Rebecca Sadler, a Director of Clinical Dentistry at Portman, which runs more than 110 practices in the UK, says: ‘The main benefit to working as a dentist within Portman is complete clinical freedom which is something that many clinicians say differentiates us from most of the other corporates.
‘We don’t restrict materials or laboratory choices. Clinical decision making is your own. We are predominantly private although we do have little bits of existing NHS contracts within our group.
‘We have a fantastic network of high quality existing clinicians and specialists within the group. We are growing and hope to add to that.
A diverse career path is also clear attraction for dentists considering working for a corporate, she argues, saying that within Portman there are opportunities to become a lead clinician in a practice, a regional clinical lead doing more of a mentoring, development and supportive role, or a national level, go into a more administrative but still clinical role.
Regulation and bureaucracy
Help in dealing with the regulatory requirements that govern dentistry is another incentive for professionals to work with corporates, argues Sadler.
‘The regulators; the GDC and CQC [Care Quality Commission]; supported by the other regulations are constantly increasing and evolving. This puts a big pressure on independents and there are a large number of independent practitioners who have chosen to be bought by a corporate because they want that regulation and administration to be taken over by somebody else.
‘From a vendor point of view, many would like to continue to work but change their work/administration balance so they’d like to focus more on the dentistry and let somebody else take care of the admin.’
Corporates – sometimes referred to as dental support organisations – offer many attractive benefits to dentists, says Philip Buergin, chief executive officer for Colosseum Dental UK, which runs more than 70 practices in the UK with plans to expand that number to more than 150 by 2023.
‘Firstly, we stick to our goal of becoming an ‘employer of choice’ with a great environment and surgery, the latest equipment and all of our practices fully refurbished to a very high standard,’ says Buergin.
‘We have qualified, trained and very capable practice teams and practice managers. We also offer a very attractive remuneration and reward programme that is unique in the dental industry.
‘Furthermore, we have invested in a high-calibre clinical support team who are there to help and support and respond quickly to our associates’ needs. We are also able to offer supported education and development for our dentists.’
Colosseum says it has a different approach to dentistry than other dental chains, which is attracting recruits.
Ellen Coyle, Senior Clinical Resourcing Manager at Colosseum, says: ‘We are gaining real momentum in attracting dentists to join us and a significant contributing factor is that, contrary to other players in the UK, we are backed by long term investor Jacobs Holding and not a private equity firm with a limited holding period before they flip the business to another buyer.’
Whitley is also enthusiastic about mydentist’s retention rate, saying: ‘Our retention this year has been phenomenal. We have about 2,500 clinicians. In 2018-19, we had 68 leavers in the month of May and this year, we had 32 so it has reduced by about 50%. That is because we are now listening to clinicians and we giving them the ability to have the career that they want.’
Continued growth in the market is something that many of the corporates predict.
Indeed, in another report2 from Christie & Co published in January 2019 that looked at business outlook, Simon Hughes, Managing Director Medical for the company said: ‘While NHS dentistry is still considered highly attractive for many entering the sector, there is now greater sensitivity in relation to UDA performance.
‘The continued lack of supply of quality dental practices has underpinned prices, particularly in the higher price ranges, and the growth in the number of smaller dental companies has increased demand for larger practices, where greater economies of scale can be realised.’
That scale is something that corporates are keen to provide.
Colosseum’s Buergin says: ‘The sector will continue to grow. The increased administrative burden for dentists to comply with the regulators will prompt practice owners to seek the support from a structure and guidance offered by larger group practices.’
Whitley also believes corporates’ slice of the market will grow, saying: ‘The younger generation don’t want to work full-time, they want to have a portfolio career where they are mixing dentistry with doing other things or other aspects of dentistry to clinical dentistry. Subsequently, they don’t want to own practices anymore.
‘When you have got the more experienced guys who are getting to the end of their careers and wanting to sell, I don’t think there are as many people who want to take on practices. They don’t want the paperwork, stress or the hassle.’
The claim sometimes made that working for a corporate comes at the expense of autonomy is strongly rejected by the companies.
Portman’s Sadler says: ‘‘Within our practices, you are able to concentrate on the dentistry. If you want to use a material or a particular laboratory, providing that it is regulated, we will allow you full freedom to do what you want. Within compliant guidelines, you have autonomy.”
Whitley adds: ‘We do have a core list of materials that runs to hundreds of products in the same way that we have a core list of labs.
‘If they would like another material that is different to that on the list, we have a process where they ask if they can have it and then we review it so they can get approval for additional things.
‘We co-invest in some things with our clinicians if it is big equipment that they want that we haven’t thought of. In terms of clinical freedom, as long as it’s within their scope of practice, they can do what they like, but we have to have checks and measures in place. We are not looking over their shoulders every single second of the day.’
Charlie Steere, who qualified in 2015, has been working for Rodericks Dental since 2016 and is currently an associate at two of the corporate’s London-based practices.
His experience has been positive, as he explains: ‘Initially, I was a locum for them and I wasn’t sure where I wanted to work. They give you good rates of pay but you have to be flexible about where you work. Eventually, I decided I would move into London and was able to join the London practices.
‘One of the big benefits of working for a corporate is when you are newly qualified, there is a large support network that you probably wouldn’t have in a normal independent practice. They also do a lot of training and there are career opportunities with lots of places you can move to around the country.’
During his training to be a dentist, Steere says it was clear that there was an image problem with working for a corporate, saying: ‘There was a generally negative perception of the corporates. A lot of people try to avoid them if possible but I think that is an unfair perception.
‘For me, Rodericks has been fantastic. I’d recommend them to anybody. You feel safe with them.’
Corporate life has also worked well for Michael Santangeli, who qualified in 2016, and works for mydentist based in Leeds.
‘Having a corporate infrastructure helps to make the patients experience positive in a setting that promotes clinical excellence,’ says Santangeli. ‘The dentist can rest assured they are working in an environment that meets a high standard of care.’
Career opportunities are an added bonus to the work, he argues, saying: ‘There is no reason why working for a corporate should hold any motivated clinician back from excelling in their career.
‘At mydentist, their Manchester Academy promotes professional development allowing clinicians to go on verified courses at subsidised fees. This gives the clinician more confidence and competence at offering a wider range of treatments to their patients.
‘It is a great pleasure that within mydentist they have a dedicated admin and management team who help tremendously with this [focusing on clinical work], enabling the clinicians more time to concentrate on patient care in the clinic.’
- Christie & Co. Dental Market Review 2019 (26 June 2019). https://www.christie.com/getattachment/8e1fc867-9d62-426f-aa8f-873d8ed60e9e/Dental-Market-2019.pdf.aspx?lang=en-GB&ext=.pdf
- Christie & Co. Business Outlook 2019: Navigate, Innovate Accelerate (16 January 2019). https://www.christie.com/news-resources/publications/january-2019/business-outlook-2019-navigate,-innovate,-accelera/