Back in 2004, when many dentists were bumbling along with the old NHS contract, we decided to open up a squat dental practice. No experience of setting up a dental practice, just plain business ideas and clinical knowledge to back us up. Most dentists we spoke to said we were mad not trying for an NHS contract, but we believed, and still do today, that being business-like in our approach to delivering dentistry would ensure our success. It did.
To date, we have done pretty well by taking the less travelled road, and with the prospect of further changes in the NHS, we only anticipate things to be even more difficult in the NHS for Dentists.
So now we want to share with you how you can go it alone and set up your own successful dental practice.
Putting it on paper
The first stage in setting up the initial practice was putting down onto paper what we wanted to create. We had ideas, dreams, even aspirations, just like you probably do, but it was imperative to start putting these down on paper as the first step to making it really happen. Using sound business techniques, we clarified our vision of what we wanted to create and then most importantly started putting a business plan together.
After a couple of months, we had a great looking business plan, with many ideas. However, these ideas looked wonderful on paper, but we had no location!
Learning Point 1: Clarify your vision of what you want to create and seek assistance to put a detailed and well thought through business plan together.
Driving around London at night and finding a location
How could we have a wonderful business plan and idea with no location? Well our plan had identified exactly what type of customer we wanted to come to our dental practice, including their psychographic and demographic characteristics, all we needed to do was start looking for suitable premises! Premises with D1 planning don’t come up regularly, so we started scouring London for suitable properties.
This meant walking and driving around looking for suitable sites at particularly strange hours of the day. We found our first site in Wandsworth Town, after driving back late from dinner with friends in North London. Days later we agreed the contract with the vendor.We followed the same approach for our subsequent sites in Canary Wharf, Esher,Surrey and Fleet Street -always checking out the competition, visibility of the premises and the amount of traffic passing by. Hours spent doing this proved to be very valuable indeed.
Learning Point 2: Finding the right location to open your practice is critical. Don’t settle for second best, walk around different areas and speak to many agents and you will eventually find a suitable location for your dental practice.
Becoming pregnant was not part of our equation, we had to create a flexible business model
A week after agreeing all the terms for the premises we found in Wandsworth Town; Principal dentist, Smita, who was supposed to be doing most of the dentistry (particularly in the early days of the practice) was in fact, pregnant. Although this threw us momentarily, we decided to take the plunge anyway. However, we decided we had to re-design our business model, where from an early stage, the practice would not rely upon the earnings of the Principal dentist –pretty much unheard of in the setting up of a squat dental practice.
Learning Point 3: In business, you have to be flexible and be ready to change your ideas and plans quickly. Don’t be inflexible, always be ready to adapt and change as circumstances change
Hiring an expert external team
The next few months were very exciting. What we had on paper was now being transformed into reality. Our next stage involved hiring experts to help with the business, something which we firmly believe in. Cutting corners can appear to help in the short-term, but 9 times out of 10, this approach can eventually come back to haunt you. So we hired a design team to aid us with the branding and design of the practice. We knew we had to create something special that stood out in a crowded environment. Their expertise was essential in creating a brand that ensured we got the right customers.
Learning Point 4: Build a team of experienced professionals from day one, don’t try and do it on your own, as it will be much more difficult to reach the lofty heights of success if you try and do it alone. People you will need include accountant, lawyer, designer, website and digital marketing experts just to name a few!
Raising cash and being tight with the purse strings
With great designers supporting our start-up, we now needed associate dentists, especially since our business model was not going to have our own Principal dentist earning for a while. We knew we had to be careful in our set up costs, so armed with a detailed business plan and robust financial forecasts, we approached various banks to support the venture.
Our plan, which was paramount to raising the finance, was approved by one of the major banks and we got the go-ahead to move forward. That said, sticking to our budget was also essential in successfully getting the business off the ground. Not spending on superfluous dental toys was an essential aspect to doing it right too. Hard negotiation and saying NO to salespersons was an essential part of the set up process.
Learning Point 5: Put some tight financial management into play by setting a budget, negotiating hard and keeping a close eye on your costs. Don’t get too excited and spend more than you have to use.
The old cliché –TEAM
Whilst the practice was developing, in parallel, we had to hire and build a team of associates and nurses. Did we get it right first time? Of course we didn’t! Do we still make mistakes? Of course we do, but we have pretty much experienced anything and everything that can occur within a team. However, without a dedicated team, the business would not be in its strong position today.
Learning Point 6: Yes, it’s team again. You will need to hire your practice team too, so its imperative to start looking early for quality people to join your team. Don’t hire them because they are cheap, hire them because they can help you build your business.
Pre-opening Marketing –The First Day
With our first team in place, and around 6 months after finding the premises, we opened the doors of the practice to the public by holding “The world’s first tooth-brushing class!” A bit cheesy, but it worked, plus it certainly got the local community involved. We offered discounted check-ups and various other incentives to get people through the door.
Before we actually opened (due to our pre-opening marketing exercises) we had over 50 patients booked for appointments in the first 2 weeks. During those first few months, the business grew, then grew some more, whilst being blessed with our first child. As the business went from strength to strength financially, we felt (12 months on) that we had designed a strong enough business model that could be sustained and replicated again, perhaps on a higher risk scale.
Learning Point 7: As part of your business plan, make sure you have a detailed plan of marketing in place. Don’t just wait for patients to come in, you will need to be active before you open and even more active in your marketing once open. Make sure you have sufficient budget to do this, else you will open a practice with no patients to see!
Think BIG! So roll on practice number two
Despite what other people said (including our bank at the time) we decided to take a MASSIVE step for us-the decision to open up a practice in 2006, at Canary Wharf. Bigger overheads, higher profile, based in the shopping malls, but also more to lose if it went wrong!We were confident that using the same sound business acumen and techniques we had used on the Wandsworth Town practice would ensure that the new practice would be a roaring success.
Within 12 months of opening, the Canary Wharf practice was doing extremely well, and growing beyond our expectations. Right location, right team, and a bit of luck.
Learning Point 8: Always think big, else go home. You need to think about growing your business, it may not be another location but it could be new services or more surgeries, but always be thinking about how to grow!
And then practice number three all due to Systemisation!
Our first two practices started in 2004 and 2006 respectively, both of which were in good London locations, with leasehold premises (as the freeholds were not available). Then, in 2009, after exiting a local Waitrose in Esher, we saw a disused and empty building that looked perfect for our next site.
Following discussions with estate and planning agents, banks and structural engineers, we received the keys in December 2009 to our first, freehold commercial premises of over 3500 square feet, which was to contain practice number 3.
Within a couple of days of receiving the keys, the police called us to say we had a homeless man living in our shed –it was actually very sad, especially since it was snowing and minus 5 degrees outside. Eventually things warmed up and we mobilised our team. It was now May 2010 and practice number 3 in Esher was officially opened in an affluent Surrey town. Third time around, we knew much more than the first time, but we also had written systems in place, which was key for our expansion plans.
Learning Point 9: Write down everything and put systems into place for everything you do as this will help when growing and developing your team.
But then out of the blue…Remember always be flexible
We were approached by a leading Healthcare insurer wanting to buy us out –again we were 50/50 but eventually in May 2013 we sold our Canary Wharf site. It was not in our plans, but it made considerable sense for our personal needs (we have young children) and this worked for us financially too.
Learning Point 10: Always be ready to sell, and we were in this instance. At the time we were not even considering a sale, however, if the right offer comes along, it is sometimes a much better idea to receive much more than you thought you would get and secure one’s financial position.
The Neem Tree Fleet Street and Notting Hill gate were born
In late November 2015, The Neem Tree Fleet Street was born, and a year later Notting Hill gate opened too. Both in fantastic locations for a practice to serve the many working people in their respective areas. Our ability to open in a location like this came from us taking the big step back in 2004 into the unknown. The Neem Tree brand is growing with partners across the UK, so if you want to be part of it do get in touch.
Learning Point 11: However, soon after opening, we decided to sell these sites, as we were always ready to be flexible and as in point 10, the offer was too good to say no.
Would we do it all again?
We have learned so much, worked with some wonderful people, and have helped secure the financial future for our family. We achieved this whilst encountering so many challenges, but this has made us stronger and fitter and ready for the new challenges that lie ahead of us all.
Learning Point 12: Live a life of no regrets and learn from everything you do!
So is setting up a practice for everyone?
Honest answer, probably not. It requires stepping out of your comfort zone many times -working extremely hard, taking decisions that impact not just you but many others, and basically putting yourself on the line. If you relish that kind of challenge and possess an appetite for calculated risk-taking, then you probably need to set up your own dental practice!
Learning Point 13: If you want to grow, you need to take risks, so if you have the appetite of being your own boss, become a serial but calculated risk taker.
Help with Setting up a Successful Dental Practice
If you have read this and feel you want to set up your own practice, then we need to hear from you.
With advice from a team of dentists and business experts, who have put their money where their mouth is, our Setting up in Practice ‘Boot Camp’ event is exactly what you need in order to support your dreams and make them a reality.
For further information about our next Setting up in Practice Boot Camp make sure you click here.