Being your own boss

Trainees who hope eventually to set up their own dental practice should carefully consider the pros and cons, says MDDUS dental adviser Claire Renton

IT MIGHT seem quite early in your career to start thinking about setting up your own practice but it’s something that will likely cross your mind at some stage in the near future. While many practitioners will choose to practise as an associate, a career in dentistry also provides an ideal opportunity to become a partner in your own business.

So how do you decide if branching out on your own is the right move for you? Becoming self employed is not an option that will suit all dentists and each of us have our own views and careers preferences. But before making a decision, it’s wise to consider some important factors.

Location, location, location

This is often one of the most important decisions we make in our lives – where to live and work? If you are considering setting up a new practice or buying an existing one, location is just as important as the cost. Often the location of our practice will determine the type of patients we have and the treatments we offer. Practices in a city centre are more likely to have a predominance of adult patients who fit in dental appointments around their working lives. Are you prepared to work across normal lunchtimes and after office hours to more easily accommodate these patients? Practices in the suburbs are likely to be more family orientated with a mix of families, young professionals and older patients. Would you like this mix in your working life?

By choosing your location carefully, you can also determine factors such as whether the practice will be an NHS practice, mixed or entirely a private practice.

Being the Boss

There are undoubtedly some huge advantages to being the boss. It’s your choice who you employ, you usually get to choose the best nurse to work with in the surgery and the receptionist will always be smiling and happy to help! You get the chance to set the tone of the practice; you lead the team and direct the progress of the practice.

Simple things like having leave for family events and holidays can be arranged without having to ask for time off. You can set your own hours and no one will question you when you want a half day for Christmas shopping or a round of golf. Critically, your employment is guaranteed and if you are settled in one area of the country then this might be the sensible choice for you.

Being the principal of the practice also means that you choose the dental materials and equipment you want to work with. If you want to try out a new material you can do just that without having to justify the added expense to anyone – except, perhaps, your accountant.

The flip-side of this scenario is the considerable responsibility you will have in this role. Being an employer brings with it a wide range of legal obligations and you will be required to comply with and stay up-to-date with all relevant legislation governing areas such as employment law and health and safety. These obligations will, amongst other things, dictate how you go about hiring and firing staff, how you treat them during their employment, the policies you must have in place and the type of practice environment you will be expected to provide for them.

As a member of MDDUS you have the added benefit that we are the only defence organisation that offers a free in-house employment law advice service for members who have employment responsibilities as well as for practice managers within MDDUS group schemes. This offers invaluable expert assistance in this often complex area, helping to ensure things will run smoothly for your practice.

If you decide to set up your own practice you will also be responsible for the financial management. Employees must be paid on time, the bills need to be settled and your income and outgoings will have to be monitored closely. You will have to set up a system to ensure that these obligations – as well as the many other financial duties you will have – are fulfilled. Of course your staff can help immensely with these tasks and your accountant is likely to offer a simple payroll solution for the staff salaries, but at the end of the day you are in charge and the buck stops with you.

The main advantage of running your own practice is that you have far more control over your income than you would have as an associate. You are in a position to engage associates of your own in the practice and although you might not make a huge profit from their endeavours the accumulating goodwill and expansion is yours for the future.

Investment choice

So if you decide to become the boss what further choices do you have to make? Well, besides location, the biggest one is whether you decide to buy an existing practice or set up a ‘squat’ practice from scratch.

While it presents a more affordable option, there are some risks to setting up a squat. An initial large outlay for premises and equipment with no guarantee of income is not a prospect to be taken lightly in today’s economic climate – it will likely take many months before you start to break even. However, setting up a squat gives you the opportunity to make your mark on the practice from the off, hiring the staff you want and practising your own brand of patient care.

In contrast, the advantages of buying an established practice are obvious. Someone else has done most of the hard work before you and you start your life as a principle with an established business and a fairly guaranteed income in a practice which the local community recognise. Of course, if this is what you chose to do it’s important that you ensure the departing principle is not going to set up a squat down the road and take all the goodwill with him. Your solicitor will advise you of clauses to include in the sale agreement to prevent this from happening.

The other big advantage is that the staff generally stay when a practice changes hands. This can be invaluable as patients feel a continuity of care and the transition from the previous principle to you is made more easily. Setting up in this way, however, is perhaps initially the more expensive choice although banks are sometimes more likely to offer a loan for the purchase of an existing well-established business than for setting up a squat with no likely income for a while.

There is obviously a lot to think about and a lot of decisions to be made here. We are lucky as dentists that this profession offers a huge variety of career opportunities. So which ones will you take advantage of?

Claire Renton is a dental adviser at MDDUS