Are you prepared to take a 20% cut in income?

This article is an essential  read if you are self-employed or engage staff on a self-employed basis

If you have been looking at the dental press and social media recently, you will be aware that HMRC is looking at associates and whether their self-employed status can be justified. This follows fast on the heels of some landmark cases such as Uber and Pimlico plumbers. In the debate about employed vs self-employed status, dental commentators have been suggesting that if HMRC decides that dental associates (and hygienists and therapists) are employed rather than self-employed it will result in a 20% drop in salary and a massive drop in practice valuations.

Are you prepared to take a 20% drop in income?

If not read on.

I do appreciate that much of what I have written in this article may be unpalatable to you, especially if you are new to being self-employed.  My motivation for writing this is to keep you safe and help you to protect your salary and practice income. Read on. Failure to do so may cost you multiple tens or even hundreds of thousands of pounds. Can you afford not to know?

The HMRC has lots on information on its website helping you decide whether or not you are employed or self-employed. There are no hard and fast rules, each case is assessed on its merit and a decision is made looking at the balance of behaviours self-employed vs employed. If you want to retain your self -employed status and continue to benefit financially, you have a vested interest in ensuring that the probability is heavily weighted in your favour of you being self-employed.

What does the HMRC say?

On the HMRC website,  https://www.gov.uk/working-for-yourself,  they suggest that you are probably self- employed if you

·         run your business for yourself and take responsibility for its success or failure

·         have several customers at the same time

·         can decide how, where and when you do your work

·         can hire other people at your own expense to help you or to do the work for you

·         provide the main items of equipment to do your work

·         are responsible for finishing any unsatisfactory work in your own time

·         charge an agreed fixed price for your work

·         sell goods or services to make a profit (including through websites or apps)

How much this describes you and your working patterns?

Let’s look at each of these in turn and challenge the status quo by asking a number of questions.

run your business for yourself and take responsibility for its success or failure

• Do you run your associate position as a self-employed business?
• Do you market yourself to your potential customers (principals not patients)
• Do you have a business website?
• Do you employ team members?
• How do your raise your business invoices and issue payment receipts
• Do you take the full financial hit if there are no patients?
• Do you choose you uniform?
• Is your uniform branded, if so with whose logo?
• Do you find your own clients?
• How do you run the finances of your business?
• Do you do all the things a normal business does?

have several customers at the same time

• Do you work for more than one practice?
• Do you work for more than one principal / partner within the same practice?
• What makes you self-employed and not employed, working in several places on a part-time basis?
• How do you raise your invoices to prove that you have several customers at one time?

can decide how, where and when you do your work

• Do you decide your own working hours or are they stipulated by the practice?
• Do you take holidays, if so how many how long and who decides?
• How frequently do you review and renegotiate the hours you are available?
• Can you decide how you treat your patients?
• Can you decide where you work?
• What financial outcomes or UDA numbers are you contracted to provide?
• Your contact how many weeks of the year is it for?
• How frequently do you have a contract review or renegotiation with your customers?

can hire other people at your own expense to help you or to do the work for you

• Can you sub contract the work out to a locum, therapist or hygienist if you choose to?
• Are you responsible for paying your sub-contractors, or does the practice contribute to these fees?
• Can you choose your lab, and do you pay for them or does the practice contribute to lab fees?
• If you are away for extended periods of time for holiday or sickness, do you organise and pay for the locum cover?
• If you have an agreed target for UDA’s etc, and if you have a shortfall on what you have agreed to provide, do you bring in locums and pay them to help you reach your target?
• How much choice do you have over your choice of locum, hygienist or therapist.

provide the main items of equipment to do your work?

• How much dental equipment and materials do you provide and fund yourself, or do you expect your principal to provide everything?

are responsible for finishing any unsatisfactory work in your own time

• You may not invoice the patients for remakes and replacements and do you reimburse your principal for their surgery costs and staffing costs, so that you are totally responsible for the unsatisfactory work? If you don’t the practice is subsidising the remakes and you are not responsible.
• What provisions have you made to provide replacement treatment and to cover the cost of remakes and replacements after you leave?
• If the practice holds set aside fund for the provisions you have made to cover the cost of replacement of unsatisfactory work, how long is this held for?
• How are patient complaints managed are you responsible or is that dealt with by the practice manager?
• If complaints about your patients are managed by the principal or manager are you invoiced for those services, ensuring that you are responsible for managing them?
• If there are problems with work done by or complaints about your subcontractor, do you manage them or leave them to the practice to take care of?

charge an agreed fixed price for your work

• Are you responsible for agreeing the remuneration package you have with the practice?
• Can you set your own patient fees?
• How often do you renegotiate and change your renumeration package?

sell goods or services to make a profit (including through websites or apps

• Do you sell and goods to your patients, and do you make a profit on them?
• Do you sell services to your practices and to the patients, do you make profit on them?
• How do you track your costs of sales to measure your profit?

I believe that when the terms of engagement of an associate, hygienist or therapist are done well, the self-employed status can be substantiated, and yet when it is done without thought, consultation, consideration it has the potential to leave associates and principals in a very vulnerable and costly position.

For many being self-employed has many financial advantages and it also has its own responsibilities with have a cost in time and money.  To stay safe, it is important that you and your principal understand the responsibilities of each method of engagement.

Whether you are a principal, associate, therapist or hygienist, if this article has raised any questions for you please call 07989 757 884 or e mail Jane@IODB.co.uk

And we can talk through your personal circumstances and ensure that you are working and being paid in the correct way.

“A problem only is present in the absence of a truth-full conversation”

Let’s talk

Will you take the life-line when it is thrown to you?

Many many years ago when I was relatively new practice owner I was blessed in many ways let me tell you about two of them.

Firstly, I found an incredible practice manager, she was very organised, everything in the office was colour coded and we had policies and protocols in place that would please CQC today even though that was 25 years ago. My manager was on top of everything and so I was able to focus on what I did best and enjoyed most, clinical dentistry. Owning a practice was a joy, someone else was taking care of all the drudge, the money, the HR, compliance etc for me.

That was until. . . .

I received a phone call from my accountant informing me that multiple tens of thousands of pounds were missing from my account. At that point my manager disappeared like a puff of smoke. As the days went by the magnitude of the problem became evident, it was more than missing money, debts had been run up, the bank accounts were empty, the team were unhappy, and patients had deserted us. It was a mess, and I did not know what to do, I was drowning in grief, confusion not to mention the debt, my constant worry was how I was going to pay my team at the end of the month.  I knew I was flailing around being busy, trying to do something and achieving not very much. Well-meaning friends offered me sound bites of ideas, opinions, chocolate and wine and whilst they were concerned, they didn’t understand business let alone the business of dentistry and so without sounding ungrateful they were not of much help. If truth be told even in the crisis and panic I was not doing anything differently. I needed a professional an expert who understood my situation who could help me correct the mistakes and put me on a trajectory of success. I needed a life line.

Buddha says, “When you are ready to learn the teacher appeared” and like a fairy God-mother my first business coach turned up on my doorstep with the life line I was in desperate need of.

 My technician had given them the heads up that I was struggling and that I needed some professional help.  “At last, someone who will listen to me, understands and knows the answers.”.

 In that first meeting, my coach instilled me with the confidence, I could, with their help, transform my situation, clear the debt, rebuild my team, patients and have a very successful practice. They had the life-line I needed, and I knew I had to grasp it is I was not going to drown.  I knew there was going to be a cost, and I had no idea how large it would be, even back then it was about £1000/month, for a minimum of 12 months and more likely 36.  I had no chance of being able to find that sort of money each month, I couldn’t cover the bills I already had and that were still coming in.  And what about the time it would take, where would I find that?

“I can’t afford it” I sobbed. My coach challenged me, “Can you afford not to?”.

In that moment I knew I had a choice. A professional coach was offering me a life-line which I could take, and survive, albeit being short of money and time, or I could refuse it and take the cheap sound-bite advice from well-wishers, for certain drown and taking with me my team, adversely impacting their families.

“Fortune favours the bold” Virgil

I signed on the dotted line without knowing how I would pay for the expert help. It was the best decision I could have made. Within three years debts were cleared and the practice was on the success trajectory as promised. Those three years were tough; ups, downs and unexpected curved balls and we made it. I invested time and money and got way more back than I invested, I fell in love with dentistry and practice ownership. It was only though working with an expert, who had thorough understanding of the business of dentistry and who encouraged me to have the boldness to make the courageous decisions that I resolved the problems at deep holistic level rather than using sticking plaster solutions, that I created a lasting success.

I now as a coach and trainer I am helping dentists who are in a similar position that I was 25 years ago

Social media is filled with stories of dentists in deep despair and fear due to many things including;

Financial uncertainty and increasing debt

Compliance

Over reliance on the NHS

Challenges with the team

Challenging patients

Defensive dentistry

Patient dissatisfaction and complaints

GDC

Stress and mental health issues

Failing physical health

Self-harm, suicide, drug and alcohol abuse

Facebook and other social media platforms are now filled with an abundance of well-wishers who offer sound bite advice and little substance.

I hope that if you are a dentist in need of a life line, you seek out a professional who can offer you one, and if your fairy Godmother appears and throws you one you grab it with both hands and do what you have to do to make the changes you are desperate for.

Einstein tells us, “Insanity is doing the same thing over and over again and expecting a different result.”

Now is the time for you to take a different approach and with investments starting at only £300 month we have made it easily affordable for you to make your future better than your past and present.

I wish you every success and however bleak it seems at the moment, tomorrow the sun will rise, and it is a new day filled with new opportunities

Call me or e mail me if you would like to, because now is the right time to make your good practice great.

Jane

Why I am considered to be a TRUSTED as a coach

Trust is essential when you are choosing your Dental business coach and trainer.

 I have worked with many dental practice and business owners over the years who have asked for my support in growing and developing their practices. When the principals first contact me, they are generally lurching from crisis to crisis, frustrated, disillusioned, exhausted and some are ready to either sack their whole team or sell up.  Because of working with me, my clients say that their teams are transformed into a cohesive group of people that work together, sharing the load, freeing up the principals’ time and headspace. patient satisfaction increases as does the value of treatment plans and treatment plan uptake and the practice functions in a simple predictable way. Ultimately working together, we can increase profit and reduce stress.

I recently had a client tell me what i have heard many times before, "I wish I had started working with you when I first met you. I thought I could do it on my own and I didn't need a coach or trainer. Over the last few years my practice and finances deteriorated and my morale was at an all time low. When we started working together and my practice and my self confidence changed  beyond recognition. You have enabled me to do what i couldn't do alone and so much more besides. Thank you."

I have been reflecting on recent  client feedback I have distilled insights about why I am TRUSTED as a Dental Business Coach and Trainer.

Truthful.                 I am clear and honest, one of my overseas clients described me as ‘ruthlessly compassionate’. I will speak as I find, with my focus on enabling you to achieve your outcomes. I will not say what I think you want to hear instead I will reveal what you need to need to hear. I am truthful about my fees and your investment in time and money, I will always give you estimates up front and show the best way to obtain a return on your investment (ROI).                                                                                                         

Reliable.                I am an accredited coach with the International Coach Federation and a former practice owner, I have a created a unique approach that when we work together will make your good practice great. Because I am committed to your success our 12-month coaching programmes and Patient Centred Sales – BEST CHOICES workshops have a 100% money back guarantee.                                                                                                         

Understanding                   Because of my unique skills as a dentist and coach I understand the pressures and challenges you and your team experience. I continue to do wet -fingered dentistry to stay in touch with the environment you are working in.    

                                

Supportive.                        I know that being a principal can be emotional tough and mentally demanding, I am here for you. I offer coaching sessions at times that fit around your clinical working hours and I can offer flexible payment plans to suit your practice. I have created a community of like minded dentists and team members who support one another sharing ideas and experience and I have a portfolio of resource material for you to use too make life easier for you.                                                                                                                         

Thorough.              Challenges in businesses seldom if ever have one causal factor, invariably the frustrations and difficulties occur when minor glitches from several operational areas and combine. Rather than offering sticking plaster solutions and symptomatic relief, I work with my practice owners and teams to delve into all areas of the practice to uncover and resolve the all the influencing factors creating long term sustainable success.                                                                                                                     

Encouraging                                  Turning around either a failing practice or taking a good practice to greater levels of achievement, will have its ups and downs, there will be times of frustration as you learn and hone new skill, this is normal and to be expected. Though holding you accountable and creating the space to reflect, think and make decisions, I will keep you focused on your vision and wish list and ensure that you celebrate your stepping stones and landmarks.                                                                                                                 

Dedicated to your success.          When you choose me as your coach and trainer, you have my 100% commitment and support. I will be available to do all that is necessary as your coach and trainer to ensure that you get the results you want and deserve. Where appropriate I will give you access to useful resources and introductions to other experts and potential team members to save you time and money by accessing short cuts to success.

Whatever stage you are in your career, If you are dissatisfied with any aspect of your practice such as finances, the team, the time and stress associated with running the practice or being a dentist, and want to find an easier way, because you want to focus on your dentistry, your hobbies, friends and family, call me today on 07989 757 884 and discover how together we will make your good practice great.

Or e mail Jane@IODB.co.uk  to schedule a call with your TRUSTED coach.

Remember TRUSTED means

• Truthful
• Reliable
• Understanding
• Supportive
• Thorough
• Encouraging
• Dedicated to your success

I look forward to hearing from you.

Jane

It is time to make your goals STRONG

It is time to make your goals STRONG!

Most people have heard about having SMART goals and targets, and I think it is time for you to make your goals STRONG.

Many time, I have worked with clients who have set goals and targets and they have even made them SMART and still they haven’t achieved them. They become disheartened and disillusioned, sound familiar?

There is another better way, which is why I have developed the STRONG goals framework

What is something that you would like to achieve?

Ideas could be;

ü  Run a marathon or other sporting challenge

ü  With an award for best young dentist or another prize-winning category

ü  Become a Patient Care Coordinator

ü  Run a clinic for people who don’t have access to routine dental care

ü  Overcome a physical, mental or emotional health situation

ü  Move to a new house or job

ü  Buy or set up your own practice

ü  Double your salary by providing high quality genuinely needed and indicated dentistry

ü  Loose weight

ü  Give up smoking

ü  Start to exercise regularly

ü  Whatever you choose.

Whatever you want the key is to make your goal STRONG and here is an introduction to how to do this.

S = Starting position

Be honest about where you are now. Don’t make the situation better than it is, worse than it is be truthful about your current situation. If you want to run a marathon and don’t own any trainers and can’t run more than 3 steps that is your starting position. If you want to run your own practice and don’t know anything thing about the 12 facet of running a successful practice, acknowledge it. If you want to be a PCO and your boss does not know what one is, and you have not had any training, name it.

What are the positive by-products of your current situation, and which of them do you want to retain?

No deletions, distortions or generalisations about the truth.

T= Target

What is that you want to achieve?

This is the area that I find most people spend insufficient time thinking about and getting clear and specific. Their goals are vague, and their outcomes are even vaguer. If you are determined to achieve your goals, there are some things you must consider and clarify;

ü  Why do you want to achieve this goal?

ü  How is achieving your goal going to serve you and others?

ü  What do you want, not what don’t you want?

ü  How will you know you have achieved your target, what will you and others, see, hear, think and feel?

ü  How long do you want to achieve this goal for?

ü  When do you want it, when don’t you want it?

ü  Who do you want it with, who don’t you want it with?

ü  What will be possible the unintended consequences of achieving your goal?

ü  How does this goal align with your beliefs, values and identity?

ü  How does your goal relate to your human needs, meta programmes and representational systems?

R- Resources

What do you already have and what do you need to support you in achieving your goal?

Things to consider

ü  Resourcefulness

ü  Time and diary organisation

ü  Money

ü  Motivation

ü  Role models

ü  Coaches

ü  Trainers

ü  Mentors

ü  Cheerleaders and motivators

ü  Accountability buddies

ü  Materials, kit and tools

ü  Motivational drive

ü  Reflection and rest

ü  Clear and specific action plan

The most common reasons why Patient Care Coordinators (PCO) don’t succeed are because they are not given an appointment book, a space in the practice or any training. They are given a job title and expected to get on with it. Sound familiar?

Practices fail because enthusiastic dentists believe that having clinical skills is sufficient and they don’t need to invest in learning business, leadership, and management skills.

People don’t maintain a desired weight  because they don’t have both towards and away from strategies.

What do you need to guarantee success?

O = Obstacles

Who and what don’t you need around you if you are going to achieve your dream?

Common obstacles are family and friends who will become energy vampires, because they want you to stay as you are. If you know anyone who has given up drink, drugs or other addictions you will know that success in these areas requires a radical change of friends and companions

Identifying potential obstacles to get over, under, through and beyond will help you identify resources that will serve you in your success.

Remember what does not serve you sabotages you. Again, time to reflect and be honest.

N = Next steps

Create your action plan, break it down in to small achievable steps, because any goal can be achieved if it is broken down into small enough steps

.

Write your plan down because “The discipline of writing something down is the first step to making it happen.”

Get an accountability buddy and a coach. Who was the last person you saw obtain a gold medal, championship shield or trophy of any kind who didn’t have a coach? A coach is key to your success and in the words of Usain Bolt “My coach is pushing me harder than ever to make sure I stay at a good level.”  Recruit one today and work with them hard and frequently.

G = Going

What do you need to do to keep going?  What will you want and need to support you when the journey to achieving your goal is getting to hard or too easy?

What will you use to start and maintain your progress over the forthcoming, days, months and years?

What can you and can’t you influence?

Who can help, support and encourage you when things are tough, and you are feeling vulnerable or want to give up?

How will you measure, acknowledge and celebrate you progress?

What are your mile-stones?

Are you ready to start to make you goals STRONG and achieve them?

If this article has raised any questions or you recognise you would like some coaching support or guidance contact us today, on 07989 757 884 or Jane@IODB.co.uk