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Vital guide to dental practice management

The business aspects of dental practice have changed a great deal in recent years. Dentistry has been evolving rapidly since the formation of the NHS in 1948, with numerous changes to dentists’ contracts, growing business requirements and patients’ expectations exerting an increasing influence on all aspects of dentistry, resulting in the swift growth in dental team roles and the formation of the dental practice manager role (DPM) in most practices across the UK.

For practices with an NHS commitment, this role has become more important now than ever before. The introduction of the new contract in April 2006 has placed more pressure on dentists to meet Clinical Governance (CG) and Continuing Professional Development (CPD) requirements. They also need to keep abreast of employment legislation, health and safety regulations, GDC guidelines and NHS regulations.

The DPM can make a valuable contribution toward all of these requirements, lessening the burden on the dentist and ensuring that the guidelines are met throughout the practice.

Good Practice

A good dental practice will operate a hierarchical system with patients’ interests and the dentist at the top and other members of the dental team supporting them and ensuring the practice runs to its optimum capability. In practice the dentist provides a product and the patient is the purchaser; it is up to the DPM to help deliver the most efficient service possible. The DPM role, in most circumstances, is supportive and of value to the dental team and patients alike.

The contribution of the DPM is most important in the implementation of a new area of NHS practice, Clinical Governance. CG aims to unite managerial, organisational and clinical approaches to improving the quality of dental care. This draws on practice management skills, requiring an ability to research, design, plan and implement initiatives and in so doing, to demonstrate to the rest of the world the range and scope of the DPM’s skills.

Demands and duties

There has been a huge increase in administrative work in dental business due to the legislation and the need to run increasingly sophisticated management skills. Changes in how dentistry is delivered today have influenced change within the team and the need for each person to be aware of and committed to the continuing development of their professional skills, all of which a good manager will facilitate. In the past, the only admin required was to get patients to sign and to process their forms, but now there is a whole host of other paperwork to complete to run a profitable modern day dental practice. No-one becomes a fully competent manager overnight: management competence is the result of training, experience and reflection. Typically dental practice managers’ responsibilities may include:

  • Designing and implementing an agreed administration. The DPM will help implement and deliver all dental services by assisting in the development of patient care procedures to ensure maximum contribution to the practice’s profitability.
  • Developing a business plan. Preparing reports for outside corporates such as the Inland Revenue, preparing end of year accounts and maintaining an efficient banking system. Using the agreed administration system within the practice the DPM will run monthly reports for things such as bad debts, failed and cancelled appointments, stock flow and petty cash.
  • Team management. The DPM will need to recruit, train, motivate and discipline staff in line with an in-house practice policy. They should be able to compose staff contracts, job descriptions and responsibilities. Organisational skills must be of a very high standard for duties such as staff holidays, sickness, time keeping and arranging team meetings. The DPM should assist in the implementation of an appraisal system, along with the Principal.
  • Offering consultation advice and guidance, following advice from a dentist on private treatments available.

Working relationships

The professional relationship between the DPM and the dentist is vital to ensuring a healthy and profitable business. Clear aims should be made by both parties so that each knows what is expected of them: open communication plays a vital role in this. Every management system must be established and administered with clear, well communicated aims, and the results carefully monitored.

Formal training within the communication sphere was not widely available until recently. I have had to develop my own skills without much assistance. There are few courses offered or books written on the subject of communication skills. This aspect of the DPM’s role is probably the bottom line of success in dental practice and is widely linked to the team’s ability to share information; interpersonal relations are very much at the forefront for good working relationships. The DPM has a pivotal role in the dental team communications, which is still evolving.

Adapting to change

The DPM’s duties and responsibilities are defined by their respective dental practice. Individual DPMs need to adapt to changing circumstances which should operate successfully in accordance with their perceptions of the contribution expected of them, drawing upon their experience of what has or has not worked in the past, and their own personal characteristics.

A good DPM will get results by making best use of human, financial and material resources available to them. They will aim to achieve these results through hands-on involvement.

Dental practice management has a lot to offer individuals seeking a career which will develop their sense of independence, pride in their work, self-worth and confidence. A good DPM can expect enduring respect from employers, colleagues, family and friends.

I would describe dental practice managers as indispensable to dental practice in the twenty-first century, and as a profession we must ensure that this status quo remains.

Further reading

1. Covey S. The seven habits of highly effective people. London: Simon & Schuster Ltd, 1999.
2. Armstrong M. How to be an even better manager: a complete A to Z of proven techniques and essential skills. London: Kogan Page Ltd, 2004.
3. Mason R. Finance for non-financial managers in a week. London: Hodder Education, 2003.
4. Rattan R, Chambers R, Wakley G. Clinical governance in general dental practice. Oxford: Radcliffe, 2002.
5. Mullins L J. Management and organisational behaviour. Switzerland: FT Prentice Hall, 2004.

Training

There are various levels of training for dental practice management available in the marketplace.

The British Dental Practice Managers’ Association (BDPMA; see www.bdpma.org.uk) recommends studying a general management qualification as the skills required are similar to those required to manage in many other industries. Many of the BDPMA’s members have achieved nationally recognised qualifications in evening classes or by distance learning, such as those linked to the Institute of Leadership and Management, the Chartered Management Institute or the Chartered Institute of Personnel and Development.

Sue Gorman, the author of this article, began working in dentistry at age 16, and after 30 years as a DPM, completed the BTEC Professional Diploma in Dental Practice Management. The course is equivalent to an NVQ Level 4 and represents one year of study, either in workshops or through open learning studies, with close contact with a tutor.

Units of study include:

  • Dental Practice Management Skills
  • Administration and the Law
  • Marketing Dental Care
  • Team Communication Skills
  • Personnel Management Skills for Dental Managers.

Evidence of work within the practice is also required.