Stephen Gates looks at the sea change occurring in the UK dentistry market and how this may affect p...
Stephen Gates looks at the sea change occurring in the UK dentistry market and how this may affect public perception of dental care
IT is a market going through a period of fundamental change and major upheaval. New players are joining and some of the old status quo is being challenged.'
Perhaps not a surprising statement
in today's business environment. But applied to dentistry? surely not. And yet under the tranquil exterior of dental practices across the country we can see and recognise a major sea change. And it is a change with the potential to bring dentistry right up-to-date in terms of that most important business philosophy focusing on the customer.
But why are these changes occurring? And what are the implications for purchasers of dental benefits for both individuals and businesses.
To put the changes into context, one of the most fundamental reviews of the future of dentistry was conducted by the independent think-tank, Demos in 1996. The Demos report provided a review of the three fundamental driving forces for change in dentistry and provided a range of scenarios for the future.
Driving forces in the market
The first driving force is increased consumerism. As the public becomes better educated about dentistry and the options available to them, they will become more demanding of their dentist. Demos summed up: 'A culture among service consumers in which they think of themselves as active, choosing customers rather than passive patients or recipients.' Demos foresaw a change in trust patterns for dentistry, moving from a position of absolute trust to a position of conditional trust.
The second is corporate bodies these are the legal entity required to allow a non-dentist to be involved in owning and running a dental practice. There are currently five or six active corporate bodies who are buying up individual dental practices, the largest of which, Integrated Dental Holdings, has amassed a chain of over 300 dentists and 500,000 patients in a two-year period. The corporate bodies can achieve economies of scale in running and operating dental practices that the traditional dentist operation from a converted house will find it almost impossible to realise.
The third driving force is chains. The emergence of dental chains was foreseen by Demos more than two years before the launch of Boots the Chemist dental practices and Specsavers' recent announcement that it will be opening 100 practices over the next two years. These chains will benefit from the customer service, retailing and branding skills of their parent companies, and have the opportunity to change the expectations of customers via mass communication and advertising.
Of the methods of funding (see box on following page), it is the private dental market where patients pay for each item of treatment they receive and dental payment plans where patients pay on a monthly basis to cover their preventative and treatment needs which are now showing the greatest expansion.
On the basis of the declining availability of NHS dentists an increasing proportion of dental patients are making important decisions about funding their ongoing dental care.
A number of people have made the decision to visit the dentist less regularly. Mintel research in 1997 showed a 42% agreement with the statement, 'the costs of treatment means that I only visit the dentist when I need to'. Mintel comments: 'The data shows there has been a substantial decline in regular attendance in the period, showing that the main impact on consumers of higher charges and/or dentists leaving the NHS has been to discourage attendance.'
Payment plans
For a growing number of people, the emergence of dental payment plans is providing the opportunity to budget for regular dental care.
These dental plans, while originating in the personal market, are increasingly becoming part of the business armoury of corporate benefits and intermediary-based products.
Most excitingly for clients, these plans are based on the concept of 'preventative dentistry' the fundamental belief that it is better to pay your dentist to keep your mouth healthy than to pay them for each item of treatment delivered.
If your dentist is able to keep your mouth healthy so you do not need fillings, they are still rewarded. Dentists who are paid on a per item basis receive only minimal payment if there is no treatment being carried out.
One of the key areas for people to be aware of in choosing a dental plan is the relative lack of knowledge about dental cover and treatments. Corporate buyers are increasingly requesting products which are both simple and transparent if we are at a stage where a customer can tell the difference between the many different types of filling, then surely it is acceptable to recommend a product with inner limits on payment on each of these items and provide a top level of payment cover?
Concepts
The four guiding concepts in this area would seem to be:
l Fair pricing ensuring the dentist can make the most appropriate recommendation for the customer and not be bound by policy inner limits or major exclusions.
l Accessibility ensuring there is a network of dentists available to provide service for the product and provide added value benefits such as 24-hour call outs.
l Comprehensive products ensuring that most items of dental care/ treatment are covered.
l Transparency ensuring clarity when describing to the customer what is covered or not, given that differences in dental treatments can sometimes be complicated to understand.
The market in the provision of dentistry is changing rapidly. It has been described as the professionalisation of what was once a cottage industry. Dentists are increasingly introducing and using the latest business and customer techniques to keep their patients' loyalty and to demonstrate how they are providing value for money.
Sea change
At the same time, the chains of dentists operated by Boots and Specsaver will be fighting hard to carve out their own niche and will be attempting to provide differentiation in the basis of customer service and imagery.
This revolution may well lead to a sea change in the perception of dentistry among the public.
Stephen Gates is head of marketing at Denplan
Four main types of dental plans
l Capitation plans are the most established form of paying for dentistry, available via over 5,500 participating dentists. Full cover is provided for the majority of items which are carried out by a dentist (although items such as cosmetic dentistry and dental implants are excluded). The monthly payment, most of which is passed directly to the dentist, provides an incentive to focus on the oral health of the patient rather than the dentist claiming per item of treatment undertaken.
l Membership/maintenance plans are new to the market and provide a basic level of cover (check-ups, hygienist visits and so on) for a monthly fee, with the patient paying extra if further treatment is required. Their main drawback, one which is limiting their uptake by patients, is the lack of cover for the more costly dental treatments, potentially leaving patients seriously out of pocket.
l Of the few individual insurance or cash plans available, some provide cover for items of treatment on a per item basis and others an overall limit in treatment for certain categories.
l Corporate dental cover is a growing area of the market, with companies recognising the benefits of providing dental cover to their staff. A corporate buyer summarised the benefits of corporate dental plans from a staff perspective: 'It is one of the few staff benefits that you can use regularly. You do not need to be dead, retired or ill to benefit from it, which is the normal focus for many staff benefits.'
