NHS dentists are looking for a way out
It is a sad fact of life that many of us find ourselves in the wrong job. As a dentist, you might not think that you have made the wrong career decisions. After all, you studied hard and qualified, you have a respected role in society and a specialism that will always be in demand, and that you can expect to earn a good salary from.
There is a growing need for dental work from an aging population, increasing concern about dental standards and growing demand for the perfect Hollywood smile.
But, as recent reports suggest, more than three quarters (77%) of NHS dentists are dissatisfied and don’t see themselves working in the NHS in five years’ time.
The latest Dentistry Confidence Monitor report from Practice Plan suggested that around 30% were thinking about retirement – possibly early – and a smaller proportion were looking about changing their career altogether. However, more staggering is an overwhelming 46% want to move into private dentistry.
What is going wrong?
The probable answer is, of course, that the NHS has problems with resources and there is a constant pressure to get more done with less. Patient care may suffer when there is a pressure of time and money on practitioners, and practitioners themselves may suffer when there is an elevation in stress. It is recognised that high levels of stress and anxiety and a lack of confidence in the future of the NHS are taking its toll on job satisfaction enjoyed by NHS dentists and, indeed, on the mental health of the profession. Stress levels for those working in the NHS certainly appear to be rising – working under the UDA system, increasingly bureaucracy and the pressures of regulation - and fears of being sued by their patients - all appear to be fuelling a low morale for NHS dentists.
These worries about patient complaints, and frustrations about being unable to provide the quality of treatment required, are simply adding to the financial pressures. The current government contract with NHS dentists makes it very difficult for them to squeeze enough time for patients, and especially those with complex needs.
And, unfortunately, it looks as though the problem is getting worse. The BDA has already pointed a worsening dental recruitment and retention crisis, with more dentists leaving the profession early and fewer young people joining. A recent Laingbuisson report suggested that the number of new dental recruits has fallen by a fifth in just two years.
The prospect of a shrinking profession will simply make matters worse. In its fifth edition of the Dentistry UK market report, Laingbuisson suggests that the dentistry market should be valued at £7.1 billion in 2017/18, and that the demand for work is growing, even if NHS funding is not.
However, the same report showed that while the NHS spend amounted to some £3.5 billion, the private sector dentistry accounted for £3.6 billion. Despite economic concerns affecting the population in general, it looks as though there is plenty of scope for private dentistry - indeed, going private may be the only way to deal with the pent up demand for dental treatment.
Private practice could mean leaving the restrictions, frustrations and pressures of the NHS far behind. Private dentistry is now on the rise after a static period as the economy has recovered over the last decade and the desire for a perfect smile has grown, while NHS services are hampered by a restricted public healthcare budget.
But if you are a dentist currently working in the NHS, is it possible to go private?
It may not be simply a matter of stepping off the conveyer belt of a busy NHS dental practice and into a relaxed well-appointed private service. In fact, many practices offer both.
There could certainly be some important financial benefits for becoming a private practitioner. Being able to offer cosmetic procedures not available on the NHS is lucrative, and will mean additional profits as well as more professional satisfaction. As a newly qualified dentist, you'll earn a salary of £31,355 if you work in the NHS.
Most dentists go on to work as self-employed contractors in general practice, mixing NHS with private work. In this setting you can earn £50,000 to £110,000, while wholly-private dentists can earn £140,000 or more once they develop their practice and client list.
Becoming a private dentist
If you are not currently a practice owner with an NHS contract – in which case you can simply start to look for private patients to treat alongside your existing lists– there may be two ways into private practice.
The first may be to buy into a private practice as a partner. Partner Buy-ins are common with larger dental practices and may offer an opportunity to bring in new talent as part of an expansion plan, or as a way for an existing partner to leave the business, often to retire. You will, however, need to provide funding to acquire the share of the departing partner.
With a Buyout, you may acquire the entire practice. In both cases, the sums involved will reflect the turnover of the practice, and obviously a new partner joining as a junior would expect to pay considerably less than someone taking over an entire practice – but you may still need to raise funding in excess of £100,000.
The second way into private practice may be to set up a new ‘squat’ practice. Paying for premises, staff, equipment and everyday running costs might stil lneed more than £100,000 worth of investment in the first year alone. There will be premises to pay for and very substantial equipment costs. Even if you buy used equipment, you are likely to need to pay more than to £75,000 for everything you need to set up in practice.
You’ll also have ongoing staff and operating costs to deal with. A receptionist will be essential, and you are likely to need an assistant. Electricity and business rates will have to be budgeted for - and remember, simply opening the door for business will not bring in the patients you need. You will need to budget to advertise your presence and invest in marketing, establishing a local presence and setting up a website to build up your patient list.
You may need to borrow working capital to keep your practice running until it becomes profitable, which could mean having months of operating expenses to cover.
Finding financial solutions for dental professionals
As a dental professional, either setting up on your own or buying into an established practice, many lenders will be happy to lend to you. Your status represents a good business risk and you can prove the viability of an existing business with accounts. But finding the most appropriate solution for your needs takes a thorough understanding of both of the lending market and the products available on it.
At Rangewell, we have the expertise you need. We know the lenders who can provide solutions for the dental profession and we can help you find the most appropriate solutions for particular needs, whether you run a squat dental practice or multiple branch surgeries.
If you are ready to get out of the NHS, contact us now to get our expert helping with funding the next step in your career. Plus, our service is free.