You wanted a practice, not a project management job

By Thomas Coates

Starting a dental practice should be exciting, but coordinating property, compliance, funding and multiple advisers can quickly become a second job. Thomas Coates explores the value of joined-up support.

There is something genuinely exciting about starting a dental practice from scratch. You have found the location, started thinking about how the practice will look, perhaps chosen a name and begun imagining the day the first patient walks through the door. After years of working in somebody else’s practice, you are finally going to create something that is entirely your own. Then somebody produces the to do list.

Suddenly, the exciting new practice involves solicitors, landlords, accountants, funders, builders, equipment suppliers, the CQC, employment documentation, associate agreements and, depending upon how you are setting up the business, potentially a Shareholders’ Agreement or Partnership/Expense Sharing Agreement as well. All of these things are important and all involve people working to slightly different timescales. Before long, you can find yourself spending more time coordinating professional advisers than thinking about the practice you actually want to create.

When every workstream overlaps

None of these individual elements is particularly surprising. The difficulty is that they are all happening at roughly the same time. While the solicitor is negotiating the lease, the funder may need information about the property. The fit out cannot progress until certain property matters have been resolved. The CQC application needs to move forward in time for the proposed opening. Staff need recruiting, contracts need preparing and equipment needs ordering. Meanwhile, you presumably still have patients to treat and a day job to do.

That is where the excitement of creating a new practice can sometimes become buried beneath administration. You started the process because you wanted to build a fantastic dental practice, not because you harboured a secret ambition to become a full time project manager coordinating six different sets of professional advisers.

One team, one opening date

It is precisely because we have seen that happen that we decided to bring as much of the process together as possible. Our fixed fee startup service allows the property work and initial CQC registration to be dealt with as part of one coordinated process, with our Dental Employment and HR Team able to assist with the contracts, handbooks and Associate Agreements that follow. Where there is more than one owner, I can also work with you and your accountant on the appropriate business structure and put the necessary agreements in place from the outset. We also work alongside specialist dental funders and other advisers so that, as far as possible, everybody is working towards the same objective and the same opening date.

The idea is not to turn something personal into a package. Quite the opposite. It is to remove as much of the professional administration as possible so that you can concentrate on creating the practice you actually set out to build.

Opening is only the beginning

Perhaps the most enjoyable thing about a new practice is that opening the doors is not the end of the project. It is the beginning of it. What starts with an idea, a spreadsheet and a potential building can become a thriving business employing dozens of people and treating thousands of patients. There may eventually be additional associates, new shareholders, another surgery, another site or perhaps the acquisition of an existing practice to sit alongside the one you created.

Much further down the road, there may even come a day when you decide to sell it. By then, the lease negotiated when the building was empty, the corporate structure chosen before there were any patients and the agreements signed between the original owners may suddenly become enormously important again.

That is why we enjoy becoming involved at the beginning. Our aim is not simply to get a new practice through the legal and regulatory work required to open its doors. We want to understand the business you are trying to build and be there as it develops, changes and grows. The best professional relationships in our sector are not built around one transaction. They develop over years as advisers become people you can pick up the phone to when something happens and you need somebody who already understands the business.

Starting your own dental practice should be one of the most exciting stages of your professional career. There will inevitably be a formidable to do list between the initial idea and the first patient walking through the door, but with the right people around you it does not have to take over the experience.

Whatever we eventually decide to call a “squat practice”, if you are thinking about creating one, we would love to be there at the beginning.