The End of the Associate Dentist
In 1999, I was Chairman of Nottingham Local Dental Committee and all the talk was about ring fencing dental budgets and local commissioning.
Most of the people in dentistry then didn’t care or didn’t believe that it would happen. People used to laugh and scoff at the idea that we would compete with teenage sexual health for a budget after the virtual dental budget was removed.
People laughed at the onset of corporate dentistry or the fact that Boots would never make it, or that the influx of dentists from Eastern Europe would make any difference on dentistry as a whole.
Everything that was going to happen in those days happened and the face of dentistry changed forever and continues to change dramatically.
At the end of last week, I was sent a copy of the HMRC letter that they’re now sending out widely to dentists regarding the review of the engagement status of ‘associate dentists’.
This means that the much talked about review by HMRC into the self-employment status of dentists is underway, and they’re not wasting their time.
If you’re an associate dentist in your 30’s working on a 50% contract with a benign and demeaning principle, you won’t be doing that for the rest of your career.
Soon enough the self-employment status for associate dentists will be removed, for several reasons, but mostly because they’re not self-employed.
The opposite end of the spectrum was my father’s work as a Motor Mechanic.
He was most certainly employed by the garage owners where he worked who charged an hourly rate for the work that he provided and then paid him a salary, but still at the end of each week the ‘Snap-on’ man would arrive with his shiny van, full of tools for sale, and the mechanics would buy tools out of their own money that they would then use in the garage in a tool box that was locked up so no one else could touch it.
These were salaried individuals buying their own tools. In dentistry, we have the opposite, ‘self-employed individuals’ who refuse to buy anything.
How many associates do you know that invest heavily in the equipment that they use in the practice?
How many associates do you know that invest their time heavily in the acquisition of new patients or referrals to a practice to help the principle?
How many associates do you know who complain about the provision of the nurse, the dental chair or the equipment that isn’t available to them without offering any sort of support or assistance to renew these things within the practice?
It’s not the fault of associates, it’s always been this way, but for some years now many people have been talking about the death of the associate contract and the HMRC have just shot one right across the bow.
This review will take a little bit of time but the change will come and no one, and I repeat no one, outside of dentistry will complain that associate dentists become salaried and pay more tax.
For the record, it’s also impossible to pay salaried associates the same amount as self-employed associates because productivity was down and costs go up.
I’ve said it before and I’ll say it again a thousand times before I retire ‘dentistry will not reward mediocrity anymore’.
Blog post number: 1758