Fulham Dentists – Choosing and executing a business strategy

The owners of Fulham Road Dental in Fulham, London, Mark Brown and George Cheetham, share their experiences, advice and lessons learnt setting up a squat dental practice. We kick start with the business strategy.

There are many ways to go about setting up your squat practice, but the most important thing to consider is that you’re going to make mistakes almost daily. But mistakes create the opportunity to learn, implement change and create the blueprint for future practices. As we reflect on our growth over the past 15 months, there’s so much we know today that we didn’t know at the start of this journey. Needless to say, it was a significant learning curve. But without a doubt, we would do it all over again. If nothing else, we believe we’re changing the way patients experience their dental treatment.

Finding the right business partner

If you plan to have a business partner, then finding the right person is probably the most important aspect to consider when starting up a dental practice. A squat practice has more financial risk, which owners need to understand. You need to be aligned and keep the long-term objective in mind while you deal with the day-to-day challenges of starting up. You also need to get comfortable with your monthly operating cashflow having a negative sign in front of it. Our business partnership is unusual but not uncommon in the dental industry. Mark isn’t a dentist, and his experience has primarily been in private equity. However, we believe our different backgrounds and experience provide the ideal platform for constructive debate and idea generation. It also helped that Mark had been a long-term patient of George’s at his existing practice in Wimbledon Village. The biggest benefit of finding the right business partner is the ability to make quick decisions. One of the biggest challenges to quick decision making is the availability to speak to each other during the day, given George’s patient commitments. Decisions are often made during lunch breaks or through communication on Whatsapp.

Come up with a business strategy

The volume of decisions that need to be made requires that both parties are comfortable trusting each other’s judgement. All decisions require some form of risk taking, and it’s important not to shy away from them, especially the difficult ones. Discuss the range of outcomes you’re prepared to accept and avoid the ones that can have a detrimental impact on your business (for example, don’t ‘bet the house’ on any one decision). You can always course correct when things go wrong, unless the consequences are fatal to the business. Without formally defining our roles, George has focused on the clinical and recruitment needs of the business while Mark has been responsible for the operation and finance aspects. Agreeing on the business strategy and ensuring that the owners are aligned is critical.

For Fulham Road Dental, the most important challenge is changing our patients’ perceptions of visiting the dentist.

We understand that most patients don’t necessarily enjoy going to the dentist, but we also believe that, as a sector, we need to improve their overall experience. Therefore, providing dentistry in an environment that promotes a great patient experience was fundamentally important to both of us. We’ve combined a patient-friendly environment with great clinical care to ensure that patients enjoy their dental visits. A relentless focus on their patients is fundamental to the vision for the business and is something the entire team looks to promote daily.

Why a squat practice?

The reason Fulham Road Dental was set up as a squat practice was down to mature dental practices commanding very high prices given the number of active buyers in the market. An added complexity is that implementing change at an existing practice to reflect your ambitions for the business can be very challenging and often requires numerous staff changes, which can be unsettling for the team and patients. However, the obvious benefit of buying a practice is that buyers can often arrange bank financing, whereas a squat practice requires shareholder funding from the outset. Most financial institutions aren’t prepared to lend money to a business with no trading history.

It’s important that the entire team understands the principal risks associated with a squat practice.

Without a doubt, it takes longer to grow the business and reach the cashflow breakeven point.

Having to fund the business monthly is something that you need to plan carefully for and build in some reserve.

From planning to reality

It’s probably prudent to plan for sufficient financing to ‘ride out’ the first 12-18 months. It requires significantly more investment than you’d ever initially plan for. You need to be prepared for days when the phone hardly rings and patients are few and far between. You do, however, get a lot of feedback from patients, which gives you the confidence that you’re executing on your chosen strategy. Planning is a big part of the initial journey, but you eventually reach the stage where you need to take the leap of faith and commit.

For Fulham Road Dental, signing the lease agreement turned an idea into a reality. From that date onwards, we were financially committed to the project and needed to get the practice refurbished, recruit the team and be open for business in a short period of time. Realistically, this entire process from signing the lease to seeing patients will take five to six months, given the current lead time on dental equipment and building supplies. Fulham Road Dental opened to patients in May 2021 as a general and specialist practice focusing on providing an exceptional patient experience through the combination of investment in:

• A warm contemporary high street Fulham Dental practice
• Technology designed to give patients a fully digital experience
• A leading clinical team in the field of dentistry