5 minute read
RIDING THE WAVE
We speak to Brisbane practice owner David Kerr about coping during the COVID-19 shutdown period and planning for life after it
By Robyn Russell
Tell us a bit about you and your dental practice.
My name is David Kerr, I am the part owner with Darryl Marsh in Today’s Dentistry, a medium to large sized family dental practice in the northern suburbs of Brisbane.
I have been a dentist for 22 years and our practice has been established for over 30 years. We currently employ 20 staff including five OHTs.
If anything, we are a little unusual in that we have more oral health therapists than dentists and hence a very large proportion of our business is preventive – Darryl was one of the first to implement the use of dental hygienists over 30 years ago.
Apart from the current COVID-19 crisis, what are your views on private practice dentistry in the past year or so?
Even before the current situation, dentistry has seen the rise in direct-topublic corporate practices in addition to those being re-branded by acquisition. I think this has definitely put a squeeze on all private practices; through competitive market presence for those that are independent, but also other practices associated with health funds has seen cannibalisation of those health fund provider relationships.
The oversupply of dentists has added to, and likely fueled, the competitive aspects of corporate dentistry; and has somewhat threatened the modern dental practice workflow, especially with the dental hygienists and therapists. I think anecdotally we are seeing the decreasing dental disease rates (socioeconomically impacted of course), and more and more practices are generating a higher percentage of the revenue via elective dentistry procedures. I feel this has had a stacking effect that COVID-19 is now exposing rather than causing?
How did the COVID-19 crisis affect you and your practice?
The business was hit and the effect was felt very abruptly. It was total shock. I was immediately forced to look at numbers, cut expenditure and evaluate the business extensively. Something, I am guilty of, although not always, is being sloppy in terms of the business side of dentistry. For a long time we have benefited from good cash-flow, there's been money in the bank, and we've worried about clinical stuff rather than business stuff. There have been some big lessons learned during this time for me, but I don't think that I'm alone in this. In particular, the evaluation of costs and returns for both practitioner and staff, but also for returns on risk.
What effect has the crisis had on your team?
There is no doubt that the whole team were in shock. We had to stand down our OHTs when their roles became untenable. Other staff went on to reduced hour contract variations and practice hours were reduced to emergencies only. Staff members' partners and families were also stood down or made redundant, adding considerably to the stress.
To add an extra layer of complexity, many staff are mums who are having to deal with their kids being off school.
However, after the first week, the team’s mindset seemed to settle. We were lucky that our amazing team started to think about the ways we could take advantage of the downtime. Many did further CPD courses on offer, thought about ways to prepare for the upside time, and get ready for the 'go time'. All of this has put our practice on the right foot now that restrictions are now being lifted.
What strategies have you and the team been using during the restriction period?
Since the announcement of the Job Keeper allowance, preparation for the return to regular practice has been our big focus. Sure, we have been seeing emergencies, but really the most productive use of our time is engaging with our database and brainstorming ideas moving forward.
The world has changed. Social media, videos, virtual consults, cold calling our active patient database, email campaigns for engagement and keeping patients agile. We have also been working on improving our marketing messages and recall strategies that were old and antiquated.
The most productive and valuable meeting of all was a full-day session with our OHTs, where some great stuff was created and is currently being implemented.
When restrictions start to ease, what changes do you expect to see in the dental landscape?
The reality is that all practice owners will reset. Make no mistake, they will all know their numbers and will be less sloppy on the business side. They will likely determine that their risk is not matching their reward and will look to their staff to add value to their roles. Going to work as an employee is unlikely to look the same post-COVID.
We all talk about the negatives, what are the opportunities?
With every problem there comes an opportunity. Especially for dental hygienists, oral health therapists, and all practice staff members for that matter. Outside all of these negative and horrible times, remember that practice owners, hopefully for the most part, have got your backs. They love having you as part of their practice because you are dedicated to the health of your patients, you are highly educated, hard working and critical thinkers. And in my practice, the patients love this too.
We all need to embrace a recalibration of what our roles will be moving forward. I no longer think that doing recall visits is going to be enough. Dental hygienists and OHTs will need to explore ways to increase the intangible value of their roles by increasing activities.
It is not necessarily about seeing more patients and decreasing appointment times; but, for example, assessing how effective you are at transferring higher productivity beyond your scope into the dentist’s schedule.
I think it is a wonderful opportunity to find some real-world clinical communication training, hands-on and relevant courses to improve your scope of practice, add to the schedule of services that you can provide, or at least confidently communicate and use modern technology to provide something very different to what your patients have seen previously.
As a dentist, I have transformed the way that I have practiced over the years, by training in orthodontics, sleep dentistry and dental implants to increase my scope. While I am aware that dental hygienists and OHTs do a lot of CPD, I feel that this needs to translate into something that practice owners are looking for. I encourage all of you to look for these opportunities. •
