Leading dentist Mitesh Badiani discusses how the Dentex Partnership Group puts portfolio building into practice for the entrepreneurial dentist
Life has never been easy for the entrepreneur; taking the difficult path is practically part of the job description. Whichever field your talents incline you towards, if you want to take anything other than the traditional route, it’s doubtless you will encounter stumbling blocks, roadblocks, and even complete dead ends on your journey. It is your ability to overcome these obstacles; to find solutions where others can’t; to reach outside the parameters of normal expectations, which marks your card as that of the entrepreneur. However, some difficulties are greater than others.
In dentistry, if you dream of taking the entrepreneur’s path; of expanding your practise and creating a portfolio, you face numerous challenges. It’s not so much that dentistry is particularly hostile to entrepreneurialism; more that for most good dentists there simply isn’t the time. Your patients are always your number one priority – if they’re not, you should consider a different career – but as a practice owner you have so many other demands on your attention. There’s staff training, practice maintenance, advertising, securing new business, financial management, profit and loss, and of course, compliance. With all of this to deal with, how are you supposed to even begin to embark on the creation of a portfolio of practices, let alone put in the hard yards of sourcing finance?
Why do so many dentists give up on the idea of independent dental practice portfolio growth?
Firstly, there’s the difficulty of time and resource management. On paper, managing multiple practices can look entirely feasible – and it is, with support. Every issue which demands your attention in your single practice – patient care, P&L, compliance, staffing, marketing – is multiplied by every additional surgery you take responsibility for, until it becomes never ending. But of course, you may not even get to that stage if you can’t first scramble over the hurdle of finance.
As anyone who has attempted to expand an independent dental practice will know, finding funding is one of the most difficult challenges to overcome. If you’re wishing to simply (I say simply, but there’s really nothing simple about it!) to enhance the services you already offer and perhaps increase your footprint, traditional financing in the form of a small business loan is an option. There will be hoops to jump through and endless red tape to negotiate, but it’s potentially there if you need it. Maybe. If your plans are more complex, however; if you envision owning a small portfolio of practices, then established funding routes just simply aren’t available.
Why? Well, it’s not just the purchase of one or more additional practices which takes money, it’s the bringing them into line with your desired standards, and juggling management across multiple sites. When you add into the equation the fact that most independent practices with multiple outlets are generally considered to be too big to sell in the event of retirement or exit, it’s no wonder that banks and building societies become skittish. This is why the unique partnership group model offered by Dentex is rapidly growing in popularity for those with grander plans.
Weighing up the funding options
So, what’s the solution? You could spend endless hours researching traditional financing routes and even more time with your fingers crossed, hoping that one of your applications is accepted. The greater your portfolio becomes, the smaller your chance of success.
While there are always high interest loans to be had, no one with any sense will wish to be tied into a financial agreement which has the potential to break them; although few reputable dental practitioners are interested in creating a portfolio purely for financial gain, it is only sensible to consider money and how the expansion will impact upon you.
An alternative route is the one which I took with Dentex; the UK’s only dental partnership group. Not only does it offer a secure funding arrangement which allows practitioners to preserve their autonomy, but it also provides the support necessary to ensure that the books continue to balance, that clinical excellence is maintained – and improved upon – and that you get to go home every evening without worrying about what the next day will bring.
Relinquishing control is anathema to any entrepreneur on principal, but the real beauty of a partnership group is that it allows you to retain as much, or as little, autonomy as you wish. For me, joining Dentex meant that I was able to retain a majority ownership in my network of practices, while gaining the funding and support I needed to grow even further and invest in patient care. For others, it could mean the ability to step back from management and refocus on clinical work, to reduce working hours, or to purchase equipment necessary to offer a new specialism or service.
Like most dental practitioners, I worked very long hours trying to get my practice to the standard I wished it to be, and even when I wasn’t physically at work my mind was running over related issues, such as compliance, recruitment, training for my staff and so on. It was gratifying, but exhausting. If I’d been working with Dentex at the time it could have provided me with the support I needed to breathe.
22 years and seven practices later, I was looking for something else. I still loved my work and I still wished to expand, but I also desired more time to explore other interests, including charitable dentistry, work overseas and mentoring. Joining the partnership group empowered me to do both. I retained full autonomy over my practices – every clinical decision that needs to made is still mine – while gaining the funding I needed to invest in new equipment, at the same time as being able to off-load certain aspects of practice management which had never really appealed, such as advertising. In addition, I am able to work with other members of the group, for example picking up tips on how to improve cross-practice financials, cutting costs and labour through centralisation and integrated systems.
This centralisation of other key practice elements – cash flow, P&L, training, compliance, maintenance – prevents duplication of administration and frees funds for use elsewhere, while at the same time enabling me to redirect my focus. While for now that focus is going into enhancing the services my team and I offer across my portfolio of practices, it’s encouraging to know that should I ever feel like returning to a purely clinical role, as some of my Dentex colleagues have already done, the support of the partnership group will allow me to do so. The whole idea of the model is that as long as you are committed to delivering clinical excellence, you can make the system work for you.
Change is currently underway in dentistry. As patients expect more than a filling for their money, and updated regulations work in tandem with new clinical indicators increasing the pressure to achieve higher QOF scores – in many ways there couldn’t be a better time for the entrepreneur. The old ways are fading out, in favour of patient choice and transparent processes. People want more, and the entrepreneur can deliver it… But first they must find the means and time to turn their plans into a reality.
Dr Mitesh Badiani is a Regional Partner at Dentex, as well as clinical lead at the Devon Dental Centre of Excellence and Plymouth Dental Centre of Excellence, with over 20 years of dental experience. He has received numerous accolades including: National Clinician of the Year by Primary Care Trust and lifetime achievement award for his charitable work both at home and abroad with his charity Smilestar. Mitesh is also a Clinical Assistant Professor for the University of Warwick and provides a variety of post-graduate courses through his practice in Devon.