Dr Phil, 0s:

A lot of principals out there find the time commitment and financial commitment of managing one practice a huge burden never mind 23 and that's why I'm really excited to welcome our guest today. His name is Dr Phil Friel and he has exactly that he's got 23 dental practices and still moving to acquire more. Phil has obviously been on an amazing journey, lots of learnings, lots of wisdom to share, and that's why I'm really looking forward to today's episode where we're going to get into precisely all of those things. I've been looking forward to this podcast because not very often I get to talk to someone who's started from quite literally zero dental practices and went all the way up to 23 and soon to be 25. It's certainly something that is unprecedented on the Dentists Who Invest podcast and there's going to be so many learnings on that journey, and that's why I'm really excited to have Dr Phil Fryle with me today. Phil, I've done a little bit of an intro for yourself before we jumped on the air, but maybe it might be nice to hear a little bit more about you.

Dr James, 1m 8s:

And then let's talk about this journey and all the learnings that have come about because of it, absolutely, I think. Well, first and foremost, I'm a dentist. That's what I qualified, uh, and that's my passion. I'm still working as a dentist, um, and around eight, nine years ago, um, my brother and I started out on a journey to to grow a group of dental practices and, yeah, as you say, we've gone from zero clinics right up to 23. At the moment we're acquiring, continue to acquire, in Scotland and, yeah, it's been a really exciting journey.

Dr Phil, 1m 39s:

Great to be doing it with my brother, a family member, and enjoying the growth, the journey, uh, so far and looking forward to what's to come hell, yeah, okay, well, listen, I find it really fun with these sorts of podcasts to almost walk us, to go on the journey together and maybe just start at the start and talk about what inspired us really to think. Okay, actually, because most dental dentists are happy with one or maybe two, you know, on how does that happen, how does that evolution occur or what needed to be in place? We'll cover all of that in just a second. If we just go right back to the very start, your first dental practice circle, what era did you acquire that?

Dr James, 2m 22s:

first. First, I think there's two parts to the story Before the main story, the prologue, if you like. I left university. I've always been very enthusiastic about anything that I've been involved in Myself and a friend and colleague from university set up a clinic in 2006, 2007, and then sold that one to move around three years later. Reason being it was slightly outwith Glasgow. We were quite young, we were looking, I suppose, to find out our niches, which then turned out to be the same niche, and we've both progressed from there, which is great to see. It's always great to catch up on the journeys that both of us had. So that was a real solid learning. To begin with, From there I moved closer to home. I was working for one of the bigger corporate groups at that time and I suppose through frustration at not being able to get what I wanted when I wanted it, and that's I don't mean that in a selfish way, you know, but from the point of view of the management of patients, the requirement for specific equipment to make the patient journey easier, the ability to progress quickly and change quickly. I wasn't feeling that and I very quickly decided, between you know, the kind of corporate aspect of dentistry and the NHS that neither of those things were really what I saw myself as a clinician. So the opportunity came around and I grabbed it, you know, was able to take over and buy a building in a very affluent area of Glasgow. Bizarrely, in a pub on a Friday evening I was chatting to my wife, who's also a dentist, and the chat behind us overheard. You know, as soon as we were both dentists we started chatting to him. He said I own a building that's a dental clinic. Where is that? It was where I worked. I'm looking to sell it, I'm looking to buy it and we did the deal on Monday. No, way. It was just I'd been kind of lucky. I know some people say you make your own luck, but I think there is an element of luck as well. So that was a pub on a Friday night and I ended up with the building that is really the heart of our dental group now, which is Advanced Dentistry in Hindland. We're shortly going to expand the size of that. The building next door we purchased again another fortuitous meeting and purchase of that. So that's really how my journey started as a dentist, as a practice owner, and that was back in 2009. So we set up Advanced Dentistry or I set up Advanced Dentistry single surgery very quickly going to six surgeries, and it's been operating as six surgeries for around 10 years. Fast forward to 2016,. My brother was a bond lawyer, is still a lawyer, but was a bond lawyer in London selling all manner of global businesses, two of which were fairly well-established corporate dental brands, which were fairly well established corporate dental brands. He was moving back after his wedding, wanted to settle in Scotland and that type of law, that type of banking law, just doesn't exist in Scotland. So, rather than commit to life and commuting, we came up with the idea or probably he came up with the idea of why don't we grow a group of dental practice as family-owned, as founded by two brothers one will still work clinically as a dentist Just almost assessing what would differentiate us from a market in terms of dental groups that, to be honest, we didn't really know much about, groups that, to be honest, we didn't really know much about. So, yeah, I think after the initial, we can't do that. That's not the type of thing that two brothers from Basque will do. We then actually thought, well, why not? I think if we're as committed as we are, as enthusiastic as we are, then we'll give it our best shot and we'll do as good a job as anyone. So I think that stays with us, that drive, that ambition when it is evenings, when it is weekends and as you grow the group of practices to where we are just now, it's reflecting on that journey. Our first clinics were clinics without borrowing from the bank. We wanted to do it ourselves. So you buy struggling clinics, distressed sales, and that's what we did for the first five or six painting the clinics ourselves, decorating the clinics ourselves. I'd much rather paint a wall and spend the money on marketing than a painter when you're setting things up. And that's good as in good stead. You know, and I think it's something, knowing the intricacies of every single clinic we have is still something I want to do and still something that we do do because it is important. You know, very easy to be labelled with the C word in dentistry. You know, when you own a number of clinics, you become a corporate. You know. But the reality from our point of view and I know that there are others who work in the same way you know that the corporate entity is when the founders no longer have a controlling interest. You know, we own the company. So so we are the founders and we have the controls. So you know, and I myself meeting our dentists in protected time every six months, traveling around the clinics, being able to be involved in strategy, making the decisions that we feel are best for the clinics, being able to change that direction very quickly, interviewing every dentist, visiting the teams evenings, weekends. You know that that's what we do. That's what we, uh, we enjoy doing. Um, and yeah, that's how we'll continue and and you know what it's it's.

Dr Phil, 8m 37s:

It's interesting because one thing that struck me whenever we had, whenever we initially met, what was it? A month, two months ago, something along those lines uh was, you were telling me how and we'll come into this and we'll circle back to this and you know in due course, of course, throughout the, the, the, the, uh, the procession of this podcast, uh, but you were, you're still in the clinic three days a week, three long days as well, and I mean, obviously you've got a lot of dentists. Let's say, uh, they get to maybe four or five practices and they start to step away from the clinic and what a lot of them would say is where's the hours in the day? But the truth is, you can always conjure more time if you delegate correctly, or at least that's my belief and philosophy. So there's got to be some serious, you must have some serious uh crack, uh practice managers or somebody helping you out on that front in there somewhere. But we'll come on to that in just a second. Uh, but yes, anyway, um, I like how you've obviously still got your sleeves rolled up and actually got involved in the clinic from the point of view of it's. Yes, it's. It's contributing towards running the practice or, you know, setting up the practice, but it's also getting to know intimately each and every dental practice so that you have an understanding of how they work and you know the layout of practices and what have you. I think that is really interesting and also unique as well, and it looks like it's worked, which is cool. I just want to. If we just go back to that journey, uh, so let's, let's just recap this 2016. That was when you got your second practice and then it's basically been an average of an acquisition every six months since then. Have I got that right?

Dr James, 10m 17s:

yeah, I've been, you know, um 20, 20 feet clinics over over eight years, um, so it's maybe a little more uh that. But yeah, it's been a relatively slow journey. You know we are relatively slow growing and I think not really through choice initially, but again, it's been a very fortuitous outcome for us. We were in a market in Scotland, as consolidation started, that there were three or four players who were far bigger than us, with far more investment behind them, and we just didn't stand a chance. You know it was the offers going in. You know we're working through the offer that we think we can make, that we think the clinic's worth. I'm desperate to grow our size and not be at two clinics for a year. You want to be at three, four, five, six, seven. It is a bit of a numbers game then, and that's natural, as any business grows, as any business progresses. But we lost out on a great many clinics, um, and you know, while that was a bit demotivating, demoralizing, we stuck to our guns and eventually settled on the fact that, um, there was a there was a real opportunity rather than just buy what's available and make it fit the model, to actually look at what is our model, how do we want that to work, and then looking for clinics that fitted that model or could be made to fit that model more easily, rather than just shoehorning anything. And that you know there's a lot of parameters in that, from geographic to economical, to the fabric of the building, how the clinic's been cared for over the years. You know, and you go from the point as I said earlier to you know, buying and do it up if you like. You know a distressed clinic, one that's not really been for whatever reason, given the, the input that has been required to allow it to fulfil its potential and us being able to give that in the early stages allows it to fulfil its potential the value grows and you can then grow further as a result of that. Now it is more established clinics, it's larger clinics. Our last three or four purchases have been minimum seven surgeries. Minimum seven surgeries in each clinic, you know. So seven, eight, nine and 10 surgeries, so bigger beasts that we can do more with, you know. So our average number of surgeries per clinic is over five. That's pretty big. Yeah, we're not lumbered. I suppose is a fair term with the kind of one surgery two, surgery three surgery clinics. Although you know, reviewing, looking back on things which we regularly do, three surgery clinics, potentially with a view to expand, might well be one of a number of sweet spots in any kind, any growing group of dental clinics well, you know what one of the hardest things in business is to sit on your hands sometimes and to be like, okay, cool, there's opportunities out there, but do they fit what we're trying to achieve?

Dr Phil, 13m 38s:

because there's that little part of your entrepreneurial brain that just feels like you want to be doing something constantly. But what I like to remind myself is when I have that little tug of war of energies in my head, I'm like okay, James, but it's actually less work for you if you just sit around and wait for a little while in the long run, because the real opportunities will come. So I like to remind myself, if my goal is to get to where I want to go in the most efficient manner, actually sitting on your hands is what you've got to do sometimes and you've got to just fight against that little urge to feel like you're constantly doing something.

Dr James, 14m 9s:

Anyway, your brother, you're so right, you're so right. I mean, we've caught on it before. You know and I think you know. Reflecting on my own journey as we discussed, you know it is a race for me. Initially, I wanted 50 clinics by the time I'm 50. I've still got three years to do that, but that's no longer the goal, you know, because that results in, you know, 50 being the number, and you just need to buy clinic after clinic after clinic to reach your goal. The reality is sitting on your hands. Um, you know you're not sitting doing nothing, but you can actually look at what you've got and you know, is that fulfilling its potential and actually focusing on what you've got and doing that rather than bringing more into the mix, can be just as productive, just as successful and, if I'm honest with you, a whole lot more cost effective, uh than, uh, simply just buying practices.

Dr Phil, 14m 58s:

You know so you're 100 right with that it's, it's, you know, and I still, I still, uh, I've just, I've been through that so many times where I've taken action and I've been like man, if I would have just waited, this would have been easier. You know, we've, we've kind of all I learned. We've all learned that the hard way, to a greater, lesser degree, um, and entrepreneurs are very prone to want to feel busy all the time, but are they necessarily being productive or doing things in the most effective manner? Not always so. Because I've been through that and done it wrong, I've kind of realized now that actually sometimes the best thing to do is just to take these hands and, just, you know, sit on them. As we were saying a second ago, you were talking about your brother your brother has your brother's a lawyer, right? He's a lawyer, yeah, yeah, right, interesting. And then I think, uh, from our conversation before he, your brother had experience in buying and selling dental practices before you guys joined forces, right?

Dr James, 16m 6s:

negotiations that he is involved in as our group grows requires both. But yeah, he was a bond lawyer in London. So buying and selling everything from Jimmy Choo, ray Ban, michael Jackson's estate, you name it. You know some very interesting stories, but two of his big transactions were dental groups sold to pension funds etc.

Dr Phil, 16m 25s:

So he was involved in those transactions I'm so curious to ask, curious to ask obviously you're the dentist and obviously have experience in running the practice, and then your brother, you're, you're a team, you're a duo, right, and you've both perpetuated this journey of success. How, what does your brother bring to the table in terms like what is the? What is the, the key parameters, uh, that you guys use to be able to identify, right?

Dr James, 16m 48s:

this is a great opportunity you know, I think I think I would summarize it by saying there's so much involved in it but the confidence to just, you know, speak your mind to the fact, um, he's as invested in the growth, the stability, the efficiency of the business as I am, and you know it's gone from. You know I'm speaking today from our head office in Glasgow. It used to be around the kitchen table, you know, at our parents' house eight years ago before we had this facility. But yeah, I mean I think just that interaction before we had this facility. But yeah, I mean I think just that interaction. My side of it as a dentist, as a clinician, goes in one direction. His side, as co-owner of the business, co-founder of the business, the legal brain, goes in a similar direction, but they are slightly different. And I think when the two of them come together, particularly when it is, you know, siblings, um, trying to drive a business forward, with both, uh, hands-on involved in the business, it makes for a really good mix, you know, and it's it's not absolutely not that we agree on everything. You know, sometimes our best progress is when we actually disagree, um, and you know, and that's not uncommon, but disagreeing but actually respecting the input from each side and the certain clinics that we've gone for or directions that we've moved in, that have been, you know, brought to the table by Christopher, brought to the table by me, but just that confidence in interacting and speaking your mind and, you know, being able to interact on a daily basis, multiple times every day, and in addition to that, you know, it's our head office. That's probably one of the biggest differentiators, you know, between an owner-operated clinic and a group of dental clinics family-owned in our case, or a corporate entity. You've got to have this head office facility, this head office structure and I think, knowing when I'm in clinic, this head office structure, and I think, knowing when I'm in clinic, the other founder of the business is in head office, with individuals who we handpick for the various roles there that have the same ethos, the same work ethic, the same belief, you know, as as we do. So it almost then becomes a bigger family, you know, and that sounds terribly tacky, corny and it's not meant to, but it is. You know, it's individuals who are in there and all going in the same direction, all with the confidence to agree, to disagree, to dispute, and you know, knowing that we heard, knowing that we listened to, to allow the progress, to allow us to continue our rowing in the same direction. So, yeah, it's very good.

Dr Phil, 19m 48s:

Awesome. So that's the ins and outs of the little dynamic that you have there, because you've obviously complimented each other very nicely to be able to achieve this. And it was him coming on board that instigated everything, so I achieve this. And it was him coming on board that instigated everything, so I knew that he must be bringing something to the table which you've nicely articulated there. I'm interested to know. There's a there's a fact. You know there's a lot of dental practices, dentists and principals out there and they've got one practice right and they just can't physically get their head around what they need to do in order to either free up the cash flow or free up the time to get to the next level. Is that a phenomenon that you've encountered before, that you've got a bit of awareness of?

Dr James, 20m 26s:

Yeah, I think, both in general terms but also within our group. You know, I suppose it is a mindset of business to some degree, but self-employed business, you know, where dentists are self-employed, there is a tendency to want to do everything that comes their way themselves. You know, and you know be that. You know, one of my biggest bugbears is hygiene treatment. You know, we have phenomenal I don't mean we personally, but the United Kingdom some phenomenal hygienists, phenomenal therapists, each of whom have a specific treatment provision that they are expert in. So why should they not do the area? Why should they not do the area? Why should they not take care of the treatments that they are specifically trained in? And in a lot of instances, dentists will want to do the quick scaling to get the fee for that, rather than actually put it to a hygienist and focus themselves on what they are more expert in, more advanced treatments, etc. So, um, there is a lot of um that I totally understand the reasons for it, you know, and I think, um, often, when we are discussing and embarking that, uh, embarking on that route with, with some of the dentists, there is a um, a tendency to kind of not really feel it's going to work. I suppose a fear of letting go of that fear, that treatment type.

Dr Phil, 22m 4s:

But very quickly you know when the diary is managed, they have more time, they're able to do more of the treatments that they wish to do, then you know, everything becomes clearer and they're able to progress on that that way and fulfill as much potential as everyone else you know I'm I wanted to ask that question to you before I came on today, but you've made me appreciate why that was a good question to ask from a whole other angle, because I was just thinking of it from your perspective as in maybe part of you felt that you were unsure what to do to get to that next level. But if you think about it, there's this whole other dimension to it, because you actually see these people day in, day out. You see these principles when you're acquiring your practice, so you're able to see across different practices, what you feel will really help, and, as you've articulated just then, part of it is delegating the stuff, part of it isating the stuff. Part of it is how can I say this? Yeah, do, yeah, delegating certain treatments to people that have probably have more expertise in us. Let's be honest, because they're the hygienists and they do those sorts of things all day long, and us focusing on the things that maybe, uh can be higher ticket uh is part of the equation, uh, so that our time is used more effectively. And all of a sudden, you've just that maybe can be higher ticket is part of the equation, so that our time is used more effectively. And all of a sudden, you've just unleashed this huge amount of cash flow in your business and you're probably working less as well, which actually ties into the exact two things that I was saying a second ago. It's for me. What I've come across is they either can't get their head around how they can get their business to be profitable enough to be able to have a spare cash, or they're just so busy doing things that they're like how do I manage one clinic, never mind frigging 23 or whatever you know?

Dr James, 23m 47s:

I think you're right. It's being caught in that quamlar. You know, and I think I know what I need to do, but I'm too busy to do it. So when I get quieter I will address it. But the reality is you will never get quieter. You know, and I think I think I was the worst at it. You know I speak from experience and there is there is almost a security in being booked for six weeks, for eight weeks. You know, I now see that as a real insecurity. You know, if I'm booked that far ahead, you know, there is an, there is something wrong. You're unwell, you take a week off, patients are having to book three months hence. It's just not a great way to be working. I think more and more maybe it is me getting older, but looking after number one, I can't see patients if I'm not well. I can't see patients if I'm not well. I can't see patients if I'm not 100%. I can't see patients if I'm stressed, I'm run down, I've got too much on my plate, I don't have help around me, and that was a really, really difficult lesson for me to learn. And I think back to as my brother puts it you're going to have to stop being clinical unless you can become more efficient. So it was just constant it was intense, it was non-stop. You're not really at your best when you don't have reflective time and there's certain things that I do now, certain things that we do together. We golf really badly, but regularly together. The first nine holes is business talk. The second nine hole, absolutely no business. It's he and I. It's family. How are his family wife, kids same with me, our parents, our brothers, our sisters? Because that's something that can quite easily be forgotten. It's important to really reap the benefits of sibling ownership in a business, but it's important not to forget everything else that goes around, that you know. The business is important, but it's not the be-all and end-all, you know. So I think, from that point of view, my efficiency has been really helped with. You know, I was the last person who I ever thought would have an executive assistant, but it's changed my life, literally changed my life In terms of someone who has access to emails, manages diaries, tells me what to do basically and when to do it, says no to things that I would have said yes to. And you've met Natalie, you've discussed Natalie. In terms of setting up this, I'd still be trying to put this together, trying to put this together, but that's all dealt with. You know, that's been really important. In addition to that, working with two nurses at all times, both phenomenal and really allowing their careers to progress in terms of what they do that I'm, then just dealing with that. You know me flapping about with emails. Just the volume of emails is suffocating, or was suffocating. You know I now finish my day. I look at my pinned emails that you know, natalie has pinned. I then look at my drafts that she has, you know, started. I then just finish and that's my two things I do my pinned emails and my draft emails. Then I got on to the more general ones and that type of thing. You know, you actually, I suppose, initially start to feel a bit guilty when you're thinking wait a minute, I might be up to date. I'm not going to be up to date for 10 years, you know. But you don't think that because then another wave comes. But at least you know you've got a bigger team around you, uh, that can help and that can assist. And actually, you know it's back to the dentist, hygienist, therapist model. You know I've got individuals who are far better at controlling diaries, uh, efficiencies, organizing what needs to be prioritized, and you know, know, prioritising that saying no to things that I just won't have time for, you know, because you end up, I suppose, reputationally you say yes to everything. Great, great, Phil's going to do that, Phil's going to do it. Phil never gets around to doing it, and that's the reality you know. So you end up, I suppose, being the guy who says yes but doesn't complete, as opposed to now the guy who says yes but doesn't complete, as opposed to now the guy who says yes and efficiently completes, and that's been really good.

Dr Phil, 28m 27s:

That was actually a big mental block for me because, being from, I guess, middle class Northern Ireland, if someone would have said to me, yeah, you've got a virtual assistant or an executive assistant, I mean part of me would have been like who do I think they are? You know what? I mean? It's kind of it wasn't something, I was just like to me that was just not, you just handled your own stuff. That was how I thought, and I'm not saying that's right, it's just how I thought right. But then the day that I was like maybe I just need to get over this and just have someone who actually helps me do these things, is that you just never look back, do you? Because you're so much more efficient, and here's the thing you can focus on the big stuff. Right, that's actually really going to push things forwards too. So, yeah, completely on board with that and it is. There's like life before and life after. That epiphany at least it was for me. Anyway, it's on and this is what exactly, yeah this. This is it right. It's like a mindset thing as much as anything else, and it actually leads me on to what I was going to say next. This is obviously how you've been able to still maintain three days in the clinic, and these are longer days as well 12 hours yeah, I'm generally.

Dr James, 29m 34s:

I generally do eight to late um tuesday, wednesday, thursday. It's just a working week of three days. You know that's good for me. It works well. I have the Mondays and Fridays in and around our clinics working, sometimes seeing cases in clinics where you know it is a skill set or a specific implant treatment type or soft tissue graft surgical type work that our dentists want me to look at, or just meeting the teams, meeting the dentists, seeing the clinics and that works really well.

Dr Phil, 30m 9s:

It is under review.

Dr James, 30m 12s:

you know the my main issue with in terms of efficiency if I'm in head office, so to speak, or in and around the clinics on a monday, there's always items that hang over onto the tuesday and similarly on the friday when I'm back out uh, in clinics and head office the tuesday, wednesday, thursday, clinical, there's sometimes little hangovers from from that as well that need dealt with. So I had toy with the idea of going three weeks clinical, one week non-clinical and again, like all these processes, I don't know what's right, I don't know what will work, what won't work.

Dr Phil, 30m 47s:

But the one way to find out is to try it and see audit it and see what works.

Dr James, 30m 53s:

Same as diary zoning, why we zone the diaries? Again, I thought I was the last person to zone my diary but my diary is zoned and it's stripped and we can't really mess with that, otherwise it knocks onto everything else. So I think just that level of organisation that we can really borrow from other industries in terms of that set up and how it works. From a patient's point of view it allows them to access me more readily rather than me. Just. You know my working schedule, my working life being dictated by you, know who calls, when they call, what the issue is and how persuasive they are on the telephone. You know you end up with a back to back, no time to breathe, no time to reflect, no time to consider various different treatment plans. You know it's all in a bit rushed, which is no good for anyone. So we're well out of that, thankfully.

Dr Phil, 31m 56s:

Hey, good stuff. And I mean, yeah, it's. This is the thing, because past a certain point, time becomes a bottleneck and you're just too spent to be the best version of yourself. So unless you want to spend your whole life being in that zone which is horrible and no fun then we kind of almost have to get over these little mental obstacles and learn these things. And, as you were saying a second ago, past a certain certain point, you know there is no, there's no textbook and how it's done. You kind of just have to do it and see if it works for you and then, if it doesn't, well, you can always just roll back or mix things up again. There's, I think. People sometimes think there's a science to it, and there is, but a lot of it is just trial and error and seeing what's working. The point is that at least you're trying to make some progress rather than just staying where you are in that zone of just being so busy and spent all the time. Anyway, I've been through it's. I think every business owner's just been been through a similar journey and had these epiphanies at some stage. One thing I wanted to ask obviously you're in the clinic three days a week, and then there's the other four days a week, right, and there's just not going to be enough bandwidth. I'm sure you go for whole weeks and you don't even think about certain clinics, right, just because it's a bandwidth thing. You know, we're only humans. There's only so many hours in a day, there's only so much brain space. How is that structured, as in, how are those practice structured in terms of who manages what? Is there a pm in every practice or is there, like an area manager? I'm interested to to know.

Dr James, 33m 17s:

So, again, just like any process, it's a process that we're just in the process of reviewing and changing. At the moment I move towards a PM in every practice, you know, depending on the size of the practice. Again, a fee surgery clinic versus a team surgery clinic. It is a different structure there. It may be an operational supervisor in the clinic versus a PM and then a couple of regional individuals who oversee those areas. But in terms of actually the management of that and the time for that, one of the things that I really focus on and really appreciate the benefit of team focus on is strategy Actually discussing where do we want to get to and how do we want to get there, and that overall direction in whatever aspect and they are many and varied if everyone is on the same mindset, then that rollout among a larger number of clinics from an agreed strategy is far more successful.

Dr Phil, 34m 30s:

Amazing. So KPIs, I'm going to guess, are part of that.

Dr James, 34m 35s:

KPIs yeah, in terms of treatment types white space, hourly rate, agency usage for nurses, staff absence for nurses, absence in general, where, again, it's not me as a clinician but led by my brother we know we have 130 chairs in our estate. How old is each chair? The benefit of things like Power BI? That we know exactly. We had a conversation yesterday about a chair needing repair and you've got the information at your fingertips. That's £2,500 spent on it over 12 visits in the last 12 months. So they're coming out, you know, every month to repair that chair. How old is the chair? 17 years old, it's done, you know. So there is then a drive, proactive drive, rather than repair, repair, repair. You know, it's not just the repair, it's the downtime, it's the inconvenience, the patients when the surgery is done, but just driving. You know 135 chairs with an average age of eight and a half years. How do we get that further down? You know. So that is. It is a real benefit when we know our oldest chair is 13 years, 12 years, 11 years, 10 years, and you're proactively replacing these chairs rather than just waiting until something goes wrong. I think back to one of my reasons for doing what I do and, as the group knows, our dentists know that I say all the time I should be happy to work in any of our surgeries and that is a pretty big statement when you've got 23 clinics, 130 odd surgeries. But in the last two years alone we're around £4 million reinvestment, both in rejuvenating, improving, modernising, replacing equipment, improving equipment, improving the number of digital scanners 7 CT scanners that we invested to make these clinics as good as they possibly can be, I think is a big commitment, both in terms of time organisation but financially as well, but it's vitally important. Ultimately. That factors down from dentists to team members, to the patients under our care, which is ultimately the most important thing.

Dr Phil, 37m 20s:

And yeah, you know the number of times I've heard uh people who've had uh multiple practices emphasize how important it is to have good data. Well, it's, it's. It's essential, because then you can just make these decisions. Otherwise, you're just making it out of emotion and, you know, maybe licking a finger and sticking it in the air. How did you the list of kpis that you have? Is there like a big book of kpis somewhere, or were these just things that you just gradually added to a list with time and you thought, hey, this would be good to measure, or this would be good to measure, or something like that?

Dr James, 37m 49s:

there are, I suppose, some some basics. You know that. You know, um, if people, if dentists, are not there, or if you're short of dentists, or if staff are not there, staff are unwell, you can't see the patients, the patients can't have treatment. There's no income from practice. All of you know if there's a lot of white space in the book, but it's then reviewing and auditing the processes that affect each and every one of these. You know. So, in terms of staff remuneration really important, that team members are vital. They've got to have a structure that they know I can get from here to there. I can see the progression over the years with the experience that I build up, with other additional skills that I acquire and that I'm taught, and we fund our nursing teams through that. You know they're more motivated, they want to do more. It builds up what the clinic can offer in these individual areas across the country. So all of the and there's many and varied parameters in terms of KPIs and what a KPI is in a specific clinic at a specific moment in time. So all of that is a mix, but, yeah, you know, it allows you to move in the direction that you want to move in and I think the important aspect of that is the communication of that. You know, because we're in a market at the moment where dentist percentages, for example, at 50 percent across the board, you know, and rightly and rightly so, we want teams who are trained, who are well paid, who are well qualified yes, I mean, and the kpis will vary and change from time to time depending on a specific clinic, specific clinician requirements, the geography, etc. And it's important that we are on top of them to make sure that we are driving specific areas of the business in the way we want to do that you know?

Dr Phil, 40m 0s:

one thing I was really curious about, because I've heard a lot of principals say this who get to the maybe five, six, seven dental practice mark. They say that the banks stop giving you funding because they see you as too risky. They don't want to put all their eggs in one basket. Is that something you've heard? And also, number two how did you negotiate that or how did you, yeah, how did you navigate that whenever you hit that level?

Dr James, 40m 20s:

So, I think it's about having the right knowledge and the right support. You know, from a financial point of view, we've certainly had no real resistance in terms of funding. You know, I think it is very much. I don't know whether that's a Scotland thing versus UK-wide, but it is a green sector, as they say. You know is where it needs to be in terms of the parameters that are set. Then you know, we've not had any issues from that point of view. Perhaps you know, as I mentioned back at the start of the podcast, we have been relatively slow growing, despite our best intentions at the start. For me to get to 50 points with a turn of 50, we may still do that. I've got a couple of years to go, but you know, it may be that that has something to do with it. But certainly the financial control, it's imperative. I suppose that is the only area that I would say we are truly corporate and I think for good reason. The financial control, the efficiency of that, the corporate infrastructure, is vital to protect what we want to do and the individuality we want to do it with from the growth and clinical and business progression point of view.

Dr Phil, 41m 52s:

Interesting. There we go. So that's maybe it's an English thing, you know. Come to think of it, because it's something I've heard principals say before. Perhaps there's more to it, as you were saying a second ago, or yeah, this is an interesting one. Yeah, that is an interesting one. I'm interested to know one other thing what is the? What's the why, what's the overall mission, like the objective, what keeps you going when things get really tough and keeps you pushing forwards? Because a lot of people, when they get to a certain number of practices, they start to kick back and they start to relax. I'm just interested what gives you that fire, so to speak?

Dr James, 42m 32s:

Yeah, I mean, I think, all manner of aspects of it. You know, I think the pride in growing a business that continues to grow, that continues to improve, is one thing. You know, the determination to succeed, you know so very often, and I think it is a mindset that people will come with problems, but certainly our senior leadership team and and that that filters down to others don't come with problems, come with solutions. You know, and it's a real pleasure dealing with individuals who you know this has happened, that's happened, here's what I'm going to do and here's why I'm going to do it. You know, and we certainly try to culture a belief in all of our team members that you know, if decisions are made on the spot, with the best of intention, perfect, you know it might not be the right decision but if it's been thought through and processed, you know, with a logical progression, then absolutely fantastic. And I think that being able to see that in the progress of individuals, you know particularly some of the the longest standing members of staff, you know who've been with you 10 years and just worked up to to different levels. You know dental nurses who now have a role in management and you're thinking, oh my God, how are you performing? I would never have thought that. Remember we met all those years ago. You were a trainee. You were occasionally off on a Monday if it was a wild weekend and these individuals are actually now feeding into those figures which allow us to make decisions. And these individuals are actually now feeding into those figures which allow us to make decisions. And you just have a belief in individuals and you know how they are excelling, how they are, you know just performing, how they're integrated and involved in the business and that's a real pleasure and I think it's that aspect of things, from a business side of things, that is a real driver. I think obviously the family side of things working with my brother is great, you know, and the wider family in head office, but I think first and foremost, you know, I'm a dentist. As I said at the very start, that's what I qualified in being able to know how many patients are responsible for us. I think sorry how many patients we are responsible for is the biggest driver, you know, because it is from our head office point of view. It's very much an inverted pyramid structure. The patients are at the top of that, you know. That is why we have the business. In order to deliver what we need to care for those patients, we need clinical support teams, and everything else that's right down to the cleaner is as important in that, because we want clean clinics that are welcoming, that have the right, that are welcoming, that have the right ambience, that have the right smell. These guys are in the six o'clock in the morning every single morning to make it. So, you know, but I think I think the biggest driver with all of that is the number of people that we are responsible for and who rely on the decisions that we make, you know, and that is not only our 230 nurses, but their partners, their families, etc. You know, it's the dentist, their partners, their families, their ambition. You know, ultimately that sits with Christopher and I. We are at the very bottom of the pyramid, being squished by everything above, you know, and that sense of responsibility excites me, it's what drives me, it's why I work every day of the week, even when I'm on holiday. People say I take my laptop where I go. I suppose it's the mindset of the entrepreneur, of the business owner. I'm sure you're exactly the same. It gives me great pleasure to spend two hours in a beachside cafe getting caught up with my emails. I can do that. I couldn't have done that 20 years ago when I started out, but I can do that now and it's back to that responsibility. The fact that I'm on holiday should not make a difference to those who rely on my input when I'm gone. But similarly, the flip side of that back to the efficiency that you spoke about and the support that I have being an entrepreneur and business owner shouldn't affect my family. I should still be there, I should still be present. I take every school holiday off, apart from the summer. I'm not quite there with the seven weeks off at the summer, but I will get there, I know I will get there, and I think the family aspect of it is vitally important as well, and it's all of that in the mix. It's not an easy balance and I do drop some plates from time to time. I get that, but as time goes I probably spend more time with family. I do actually get the parents' nights now that I never before I get to school performances that I never before. I watch a lot of rugby, et cetera, and I'm as involved in that as I need to be and I should be, which is great. So that was a very long answer to a simple question.

Dr Phil, 47m 54s:

It was a perfect answer and thank you and something so useful one. One big illusion I had about the world of business before I ran my own businesses was that you have to be it has to be 18 hours a day, every day. It really doesn't pass a certain point you're leveraged and you actually have more free time. Generally, there's a lot of effort at the very start to get things up and running. You front load it almost, but then you build your own schedule and you have more free time, and that is the thing that I love so much and I'll happily do seven days a week if I have to do a little bit here and there, to be able to have my own schedule, and it sounds like you have benefited from that as well and it means you can be there for the family, you can move things around, go to the school recitals, all of that cool stuff, and that's why I get really excited when we talk about business and we do these sorts of podcasts. So thank you for sharing your time, wisdom and knowledge, Phil. I'm already looking forward to the next episode. You're very welcome.