Inspired by change

Ipswich-based dentist Adam Hunter grew up in Switzerland, so his experiences of dental services were quite different to those of his UK colleagues. Adam had always envisaged that the practice he hoped to own one day would be closely aligned to the Swiss standards he was familiar with.

After graduating, Adam became an associate at Parkview Dental Centre, an NHS practice that he went on to purchase from the principal in 2008, moving to larger premises nearby in 2010. Today, Parkview is a well-equipped, fully private practice with seven surgeries, able to adapt quickly to the additional demands of the COVID-19 pandemic, however it took some deep soul-searching and a gradual loosening of the NHS ties to arrive at this point.

By 2012, Adam was becoming increasingly frustrated and disillusioned with the pressures and restrictions in his clinical work. The NHS contract wasn’t providing the practice with enough income to invest in the latest equipment or take on specialists to improve their services and he was not earning enough personally to compensate for the stresses of the job. Adam felt he was at a crossroads and needed to make changes, to the extent that he considered leaving the profession altogether.

“It felt like we were stuck in the slow lane,” explains Adam. “With limited funding, the gap between the services and techniques we were able to offer compared with those in private practice was getting wider and wider. The choice of materials was restricted, so we weren’t able to take advantage of the latest innovations to provide the best outcomes for patients, both clinically and aesthetically.”

At a meeting with local Denplan Business Development Consultant Frances Lynch, Adam discussed his predicament and explored the idea of becoming a Denplan member dentist. He felt the Denplan brand was strong, recognisable and reputable and Frances described how they could provide a great package of support to smooth the transition for those patients who chose to sign up for Denplan plans should Adam decide to go ahead.

“Taking what seemed like an enormous step out into the new and unfamiliar world of private dentistry was quite daunting,” says Adam. “I was reassured by the fact that Denplan as an organisation was very experienced in helping dentists to make that transition; clearly they knew what they were doing even if it was new to me. Their support is what cemented the decision in the end; I felt the move was a credible one providing I had the Denplan team on hand to guide me through it.”

Adam worked closely with Frances to begin a principal-only transition during 2013. The plan was to offer his patients the option to sign up to a Denplan budgeting payment plan or pay private fee-per-item and keep Adam as their dentist or to remain as an NHS patient but under the care of an associate at the same practice. Letters were personally handed out to Adam’s patients when they attended for their routine appointments explaining the proposed changes. This way, he was able to discuss all the options face to face with the patients. It was a very personal approach that worked well.

“I soon realised that those who chose not to sign up were being guided purely by what they perceived as being the cheaper option; they didn’t really care which dentist treated them, only that they remained ‘on the NHS’. Those who did choose Denplan did so out of loyalty to me personally, because they valued me as their dentist and because they saw the benefit in me being able to invest more time and money to offer them the best care. Fortunately, they were in the majority, and anyway it suited me to have a slightly smaller patient list so I could address what had become a difficult work/life balance. The regular income I’d be getting would compensate for the small reduction in numbers and I’d have more time to spend with each patient so the job satisfaction would inevitably improve too.”

While Adam’s long-term goal was for the practice to become completely private, he didn’t want to force this on his associate dentists or on his patients. A softer, more gradual approach felt more appropriate and would give everyone time to get used to the concept and the operational changes. However, within 12 months, the first of three associates decided to join him in converting her patient list to private fee-per-item or Denplan. She followed the same methodology, explaining the proposed changes and the benefits of Denplan monthly payment plans in person and offering plenty of time for patients to decide whether to accept or not.

By 2019, the whole practice was ready to take the final step to completely private dentistry. Any patients who still wanted to remain with an NHS dentist were directed to the NHS Choices website to find an alternative practice. Denplan provided support in the form of the largest ever mailing on behalf of a single practice, sending out over 8,000 letters to patients. Frances Lynch was on hand at all times to help resolve patients’ queries and to prepare the whole dental team by providing comprehensive training on Denplan products and services.

“We did encounter some initial resistance from a couple of members of staff,” admits Adam. “The NHS is very dear to people’s hearts as a principle and it can be hard to accept that in dentistry it may not always be the best option for patients. Denplan’s all-day training really helped to showcase the benefits and once the conversions began, everyone got on board with it and we really haven’t looked back since. Denplan now represents around 30% of our turnover and it’s increasing all the time.”

From a personal perspective, Adam has been hugely inspired by the opportunities that becoming a Denplan practice has opened up to him and his colleagues. “The security that a regular monthly income has brought has enabled us to invest in great new technology, including an intra-oral scanner, as well as specialist orthodontics and endodontics. It feels much closer to the Swiss practice model I had in mind for quality of care, though significantly less expensive for patients. It’s made our professional lives much more interesting and satisfying as we’re all continually extending our learning. There’s a perception among young dentists that they may not be experienced enough to charge private fees. This is wrong, of course – it’s nothing to do with experience, only about how you get paid. I now realise that in private dentistry you get to carry out more complex treatments, with as much time as you need, so you can become a better practitioner sooner.”

Adam has enjoyed meeting fellow Denplan dentists at their annual Forums as well as a number of social events organised by the Denplan team. “It’s great to feel part of something bigger, sharing experiences and learning from others. Obviously the pandemic this year has brought serious challenges for everyone but Denplan has been amazing with its support, including supplying all members with much-needed PPE, and the continued monthly income freed us from the anxiety felt by many other dentists. We were able to recover quickly after lockdown and are confident about the future. We’re still registering around 60 new patients every month, which is fantastic.”

The work/life imbalance that was at one time propelling Adam towards leaving dentistry altogether has improved significantly since converting to Denplan, with all the dentists at the practice now working four days a week. Frances continues to liaise with the practice team regularly and holds an annual fee review with them to ensure their income levels remain in line with the practice’s costs.

“I completely understand why some dentists are hesitant about giving up their NHS contract and taking the plunge into private dentistry,” says Adam. “There’s an anxiety about whether it will ruin the business, how the local community will react and of course how many of your patients will stay with you if you ask them to sign up to a payment plan. But I honestly believe now that it isn’t worth not doing it. There’s so much to be gained and I absolutely know that my patients’ care is all the better for me having made that choice.”