Impossible predicament/AMA

[dentalwoe]

Hi, have NC for this in case I'm identified..
I'm a practice manager for a large Dental surgery (England)
Mixed NHS and Private.
I have approx 30,000 historical patients.
Existing Dentists are handing me back their NHS contracts, as the pay is so dire, they can literally do half the hours for the same money.
Today I have interviewed yet another prospective NHS Dentist, when I told him the UDA rate (they get a set amount per 'unit of dental activity they do').. he said no on the spot.
The Reception staff are abused daily with people insisting they are ENTITLED to an appointment, people in pain are sitting for hours.
Not quite sure what my point is, just that after 20 plus years in this job it's becoming impossible.

Join the club!

Totally crap.
This whole government reform talk is getting laughed at
£20,000 golden hello?
Then can make that in 3 months with private work
Absolutely dire situation

How much profit does the practice make?

In private treatment, over a million this last financial year
NHS is in a deficit to the tune of almost £200k

Surely the practice should absorb the NHS and pay the dentists the difference? Still 800k profit. Doesn’t it get written off as a tax loss anyway?

The whole dental situation in the NHS is bonkers. It is widely reported that dental problems are attributable to poor physical health e.g. cardiovascular disease. Ive never understood why dental care is the "poor nephew"

@Greentangerines not sure what you mean?
The NHS pay the practice a set amount for the NHS contract, if that is not fulfilled, the practice pays that back to them
The point to my post was that it's becoming impossible to continue providing NHS services while recruiting Dentists is so hard
The amount of private work is by far surpassing any kind of profit that can be made with NHS treatment
I have spent my entire career arguing that we see patients not customers, but sadly now, dentistry is seen as business rather than healthcare

@YorkshireGoddess don't I know it!
Only a couple of days ago I had to beg one of the Dentists to see a patient about to undergo surgery, who had a loose tooth
This man just didn't have £200 for a private extraction
Thankfully we got it sorted for him, his wife was so grateful she cried
Parents are taking out finance to pay for braces, the whole thing is just awful

It is a complicated problem and one that unfortunately needs a total political reset to be solved. The simple reality is that the NHS is not able to fund dentistry and until they are honest about what they can fund .. the situation will persist. They do really need to fund a simple and limited range of dental treatments effectively such as making sure children get good quality dental care not the current 5 minute quick looks they get so that when they get to 18 they actually are able to fund their own private dental care because they actually have really healthy teeth and simple extractions for adults etc so that you avoid a situation where someone in agony can’t be relieved.
It is really sad but the average quality of care is so poor now that it is a genuinely a backwards career step for many dentists to practice NHS dentistry as they only have 5-20 minutes to see an endless conveyor belt of patients and the sheer inability to provide any care to the excellent level they were taught to just leads to de-skilling and depression as well as opens the dentists up to potential law suits by our many no win no fee legal firms.

The average dentist pays £6800 a year ( indemnity or insurance) just to be able to practice dentistry. The average dentist is only very minimally subsidised by the UK to get their degree and indeed about 50 percent of the current dental workforce graduated elsewhere and so funded their education themselves or studied in the UK as foreign students paying £24000 a year for 5 years to get their dental degree. Most dentists who are 8 years qualified have averagely spent upwards of £140000 on their education and continue to spend all through their careers.
If one patient successfully sues a dentist their indemnity costs could go from aforementioned £6800 a year to £24000 just to be able to see a patient.
Now add this to the fact that you had only 5 minutes to see that particular patient and tried your best within that timeframe and yet you could still end up losing your career...
I know two dentists who have committed suicide directly as a result of this.

A NHS dentist is paid about £40 for an NHS root canal treatment. The materials used to perform that root canal cost £40… try explaining that… then explain how dental nurses , dental hygienists ane dental practice managers who are largely women (90 percent of the work force) have their career earnings depressed and devalued so much that they can earn more doing a far less specialised job such as stacking shelves when their current jobs literally are rather skilled because they work in the NHS dental system that pays so poorly… how empowering is all the education that they have invested in to improve the lives and that of their families?

NHS dentistry is at present a poisoned chalice and it’s not all about money but rather having a fulfilling career with a decent work life balance…
I would not want any of my kids to work in the current NHS dental system. The “ wealthy dentists “ who are supposedly making so much money probably get taxed appropriately.
All the dental courses and their fees are easily checked out on google…. It’s all very well feeling entitled… Specialist orthodontics study an additional 3-4 years costing another £70000-£80000 with a fair helping of hard graft to actually pass your exams and achieve the qualifications .. if you took finance out to get that qualification would you expect a fair return on your investment and hard work?

” The practice” is not an intangible corporate machine or robot. The practice are humans same as the rest of the populace who go in to work daily same as everyone else. Absorb 200K of loss on work you are actually doing day in day out? I used to make soaps on Etsy.. So absorb the loss on physically making 200 soaps because I put in enough effort to actually make effort on 1000 soaps…..especially when those loss making 200 soaps still have full customer rights..surely a better idea is to use the effort used for those 200 soaps to do some charity work..much safer and much more rewarding