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Beyond the SDR: Your future in dentistry

Ahead of our Life Beyond the SDR event, Kevin Lewis previews the day which aims to empower you to take control of your career in dentistry.

Kevin Lewis looks at the camera wearing a dark suit
Kevin Lewis BDS FDS RCS (Eng) FCGDent Special Consultant to BDA Indemnity

Life Beyond the Statement of Dental Remuneration (SDR) [LINK TO EVENT] will focus on the business side of dentistry, offering valuable insights for practice owners and associates at all career stages. We aim to give you a starting point to make informed decisions, with practical tips on offer from a range of speakers.


We will offer an environment to consider what the future might look like. The existing NHS contract coupled with the SDR has effectively dictated and defined crucial aspects of the relationship between you and your patients, without you having a say in it, but taking back control can help you to shape the future of your business.

Applying the rules of business to dentistry

We ignore the golden rules of business at our peril; and yet we can fail to notice how the NHS GDS contract progressively robs us of our ability to control our income, our practice costs, our profitability and cashflow, and a proper return on our investment in the facilities we provide and maintain. In simple terms, a business exists to make profit, and your income should be greater than your expenditure. As dentists, we are so used to swings and roundabouts, where you make money on some things, but lose money on others, with little control over the situation. Normal businesses do not operate like this.

In any business, not all the income that comes through the front door carries the same level of expenditure. In a private fee per item system, it is not someone else that sets what you charge, and you have much more control. No business would be happy to borrow money, take all the financial risk, but be told what to charge. If costs are bigger on one thing than another, you need the freedom to charge accordingly to run a viable business.

During the event, I will be exploring the concepts of price and value, costs and profitability. I believe it is a question of justifying what you are asking for. People are generally prepared to pay more for the things they value most; what this consists of needs to be their decision, not ours.

Are changes a shock to patients?

Many dentists fear that patients will no longer attend due to the financial shock of the transition. Moving from the SDR to capitation schemes such as Denplan, who will be attending to share details of what they offer, can be a gentler solution that offers more certainty of yearly income. This does offer security, but some patients will still take more time and incur more costs than others depending on the care required.

If you do not choose a capitation scheme, you can mitigate concerns around retaining patients with the level you set fees at. Many choose to test the water on a lower fee initially but sometimes this can lead to storing up a moment where you must charge more which can lead to patient frustrations.

Dentists often carry a weight of personal loyalty and accountability to patients, especially in areas where practices are smaller, and communities are tight knit. Ultimately, dental businesses need to be financially sustainable, or they will not exist. We are aiming to empower you to draw your own conclusion of what is best for you. Giving patients a soft landing with monthly payments may be preferable to larger, infrequent, payments but giving patients that choice tends to work best. Ultimately, you want to run like a normal business with flexibility and control.

Selling your dental skills

There are skills involved in any buying and selling transaction. Nobody really wants dentistry: they want the benefits of dentistry, and the peace of mind that comes with trusting and having confidence in the people providing it. That is what you are selling, and that is the added value you provide.

Highlight the benefits of private treatment to patients, and they can make the decision to pay for the level of care they want to receive. Put yourself in the patients’ shoes and think about what you would value and pay for. The principles of success we will explore during the event are straightforward, but often it doesn’t cross a dentist’s mind that patients will pay for your unique expertise.

The resistance to moving to private practice is much greater with a fee per item business model because the amount of money you are going to charge per filling looks a lot bigger than what you charged previously under the Health Service model. With a capitation scheme, because it is not a like for like comparison, you can earn the same money, but it doesn’t feel like you are charging such a big jump. On the other hand, patients who need little treatment can start to resent paying money out when they don't receive much in return - it can be most attractive to patients who have high needs and who cost you more to service.

What is the answer?

Respect your patients to spend their money the way they want to spend it. You are in business and the purpose of that, altruism aside, is to make money and have more coming in than going out. We will examine the issues with a business-centred approach, such as patients that fail to show for appointments, and how to avoid or minimise potential financial losses. I look forward to sharing some great ideas and insights from some of the leading thinkers in the world of business, to help us to think 'outside the box' of the NHS and the SDR.

We cannot work hard to earn nothing; it does not make business sense. You know your practice and area better than anyone else and one option is not necessarily better than the other as a blanket solution. Ask your staff to share their opinions, they will sometimes pick up on things you miss. Failing NHS contracts have conditioned dentists into a ‘price-taker’ mentality. ‘Life beyond the SDR’ is about putting you back in control, and considering if there may be a better way to be paid fairly for your dentistry.

You can join us with an early bird rate [LINK] until the end of the month to examine the options in greater depth. If you make any change as profound as this, move forward in a carefully considered way to minimise the worry for staff and patients.