The universal language of practice management

Dr Phillip Palmer, October 2010 - Earlier this year, Dr Michael Sernik and I were invited by well-known Indian dentist, Dr Kumarswarmy to travel to India and give some practice management talks. Having never been to India, we were very interested in visiting the country as tourists, however from a professional standpoint we were concerned as to how different the practice of dentistry would be and what from our practice management material would be of interest to dentists there.

After some discussion as to whether to accept the invitation and what we would speak about we decided that we were up to the challenge. We arranged that between the 2nd and 13th of August we would travel to India to speak once for 3 hours at the Maulana Azad Institute of Dental Sciences in Delhi and twice for 3 hours at the Indian Academy of Aesthetic and Cosmetic Dentistry in Cochin (IAACD).

Before we left we needed to research the audience to find out what of Prime’s material would be relevant to an Indian audience. Asking many Indian dentists including Dr Kumarswarmy before we left we found that we were right to be concerned about the contrast between Australian and Indian dentistry:

• There seemed to be a world of difference comparing average practices figures in India and Australia. For example, while clinical fees in India may be at around 15% (maximum) of what a dentist would charge in Australia, it is possible forsome dentists in India to have similar or better take home due to their much lower costs involved in equipment, supplies, staff, rent and taxes. In addition, the money that one would take home in India can go further due to significantly lower living costs.
• There seemed to be a much smaller proportion of practices that are bought and sold in India than in Australia. There were two explanations I was given for this. I was told that in India a higher percentage of dentists will either work until they are forced into retirement or pass on practices to the next generation of professionals in the same family. That is, the children of the practice owner would inherit the practice
• Employee dentists are generally paid a fixed salary. Few practices incentivise on the % of collection (about 5% practices).

If I had investigated on a purely practice figures basis I would have assumed that there was no similarity at all between the practice of dentistry in Australia and India. Upon further investigation though, even with the figures involved in practicing dentistry being significantly different, the major stresses of a dentist were similar. Asking an Indian dentist about his professional stresses brought the same answers that we hear from Australian dentists every day including staff issues, time management problems, and communication problems with patients.

With such similar practice management issues, our Australian practice management material was found to be very relevant and pertinent to dental practice management in India. The feedback we received was extremely positive, and we were asked to give several more talks.

After one of the talks we were even asked to be guest presenters at an "Invocation Ceremony". Graduates, dressed in black gowns and mortar boards, of a 12 month Implant Surgery Programme were presented to a panel of 5 people: the Dean of the faculty of Medicine, the Dean of Dentistry, the creator of the implant program from the USA, Michael Sernik and I, on a dais in the impressive faculty buildings in Delhi dressed in red gowns and red mortar boards.

Prime Practice has spoken on practice management in six countries now (New Zealand, USA, Canada, China, Singapore and India). You would think that the practice of dentistry would have little in common across all these countries with the differences that exist in language, clinical standards, political systems and ideologies and overall wealth. However the more I travel and speak to dentists around the world, the more I realise that the ties that bind us go much further than the part of the body that we work in. It never ceases to amaze me how universal the themes of dental practice management are.