Dr. Nicholas Meixner, owner of a dental practice, shares his experience as a practice owner and how he managed to grow it.
Have you ever thought about owning a dental practice? Owning a practice can present challenges that you might not have anticipated at the outset. Today, we catch up with Dr. Nicholas Meixner to find out how he manages his day-to-day workload in a practice and how he was able to grow it over the course of 18 months.
Dr. Payman Langroudi: We're here at the BDA, at the Mini Smile Makeover, I'm here with Nick Meixner. You have a practice in Stratford upon Avon and you also work in London. What kind of practice is in Stratford?
Dr. Nicholas Meixner: It's a majority private practice. We have a very small contract with the NHS.
Dr. Payman Langroudi: How long have you had it?
Dr. Nicholas Meixner: For 18 months.
Dr. Payman Langroudi: And how many dentists work there?
Dr. Nicholas Meixner: 4 in total at this time.
Dr. Payman Langroudi: So there are four full-time employees?
Dr. Nicholas Meixner: Part time, everyone works part time.
Dr. Payman Langroudi: All generalists?
Dr. Nicholas Meixner: Yes.
Dr. Payman Langroudi: Is the kind of work you do minimally invasive?
Dr. Nicholas Meixner: Yes, we try to keep this as much as we can, absolutely.
Dr. Payman Langroudi: So tell me what your thought process was before enrolling in a course like this. Did you think you needed to improve your compositions or what was the story?
Dr. Nicholas Meixner: Well, I really like composite anyway as a means of improving the patient's asceticism. It's minimally invasive, too, which is always the best way to go. But it's a good thing to offer patients. A course like that allows you to improve on what you're already doing, essentially. I actually did a restorative course.
Dr. Payman Langroudi: Where was that?
Dr. Nicholas Meixner: It was in Manchester and was very good, but it didn't offer much in terms of aesthetics.
Dr. Payman Langroudi: A more traditional approach?
Dr. Nicholas Meixner: Yes, just general improvements and understanding of materials, which is important. But this allows you to form your own way of doing things and as you get the right aesthetic when you're blending edges and in the aspect of polishing etc.
Dr. Payman Langroudi: You've been a practice owner for 18 months. If someone else who is an associate is thinking about opening or buying a practice, what are some of the pitfalls you would suggest they watch out for? What would you have done differently?
Dr. Nicholas Meixner: A lot of things. Personnel is always a difficult area, so you have to build a really good team and that takes a lot of time.
Dr. Payman Langroudi: What was it like before from a cultural point of view and what is your goal now?
Dr. Nicholas Meixner: It's about the patient journey and trying to resolve this, whereas before it was about not having discussions at the reception and having a much more streamlined professional approach to things.
Dr. Payman Langroudi: So, when you looked at the office, did you think that there were improvements you could make here?
Dr. Nicholas Meixner: Yes, absolutely. We're still here, we're still doing receptions right now, we've got surgeries to do up top. We're trying to get everything in order.
Dr. Payman Langroudi: So you saw something that maybe was a little undervalued, because it wasn't fully explored. And then you thought, I can do more of this. That's one approach. Another approach is to find something that's already working well, and have you thought about that?
Dr. Nicholas Meixner: You are the kind of person who buys a house and renovates it.
Dr. Nicholas Meixner: No. It just came about because my uncle was running the practice. So I basically bought it from him. He was good, it's a great practice, a lot of really good patients, a lot of goodwill, a good reputation. Then it was about developing that and building on it as something new for today. It takes a lot of effort and work.
Dr. Payman Langroudi: What do you think is the best thing about this course?
Dr. Nicholas Meixner: A lot of things. I wanted to work with a good network of people and see what happens. Also, anything is good to improve your skills. A lot of times you don't have the time... you think you do. You always improve things as you work with each patient. But to have someone like that sit down and go over everything with you and say, look, this is where you're probably going wrong; that's really helpful. It's good to have that kind of practice as well.
Dr. Payman Langroudi: Are there any treatments that you have introduced into your practice that didn't exist before?
Dr. Nicholas Meixner: Yes, absolutely. So just simple things like talking to patients and giving them a little bit more in terms of what can be done with minimally invasive dentistry.
Dr. Payman Langroudi: Do you also deal with orthopedics?
Dr. Nicholas Meixner: Yes, my wife does orthodontics. But on Monday, for example, I have a midline diastema closure (it's one of the reasons I wanted to do this course so much), which I've done before, but it's nice to be able to look forward to doing it again and delivering it even better than I did before.
Dr. Payman Langroudi: How do you feel about working with your wife?
Dr. Nicholas Meixner: Very well, she is a very good dentist, but she is much more involved in the management side, whereas I am just a dentist; I love what I do and I enjoy it.
Dr. Payman Langroudi: So she handles personnel, rotations, all that?
Dr. Nicholas Meixner: Yes, he's very good at this.
Dr. Payman Langroudi: Actions?
Dr. Nicholas Meixner: I think the nurses handle the stock, but yes, she oversees everything.
Dr. Payman Langroudi: Tell me about Dipesh, do you like his teaching style?
Dr. Nicholas Meixner: Yes, he is very honest and learns from his mistakes, which is another very good thing as well. He shows where he went wrong, which I think is very important because it makes us feel like we are “normal dentists” and that we all make mistakes and that it is important to learn from them.
Dr. Payman Langroudi: People say that sometimes with an associate professor, they feel like they're at a level where "I'll never get there." I think it's always important to keep in mind that it's been 7, 8 years since they graduated from dental school. There's a journey that anyone can go through.
Dr. Nicholas Meixner: I think it's one of those things where if you focus on your niche and you love it and you're good at it, it's good to develop that aspect. Also, what I like is the methodology of it. Once you understand the right methodology, you can get pretty close to it in a controlled and confident way.
Dr. Payman Langroudi: How many years ago did you qualify?
Dr. Nicholas Meixner: 6 years ago.
Dr. Payman Langroudi: From where?
Dr. Nicholas Meixner: From Kings.
Dr. Payman Langroudi: If you were talking to someone who had just qualified as a dentist, what would be the 3 key things you would advise?
Dr. Nicholas Meixner: First of all, you make mistakes. Unfortunately, although it's pretty scary to make them, you have to sit down and learn to learn from them, not always worry so much about them. The second thing is to have goals. I had a lot of goals and they changed every year.
Dr. Payman Langroudi: Are you good at this? Do you set goals and set out to achieve them?
Dr. Nicholas Meixner: I try to be. I think it's good to have things that we want to pursue, but they change so much that you can't predict the future. Sometimes you start doing a course and all of a sudden it changes and you might find that you want to do something else. So it's really important to be flexible about that. The best thing is to always be patient-centered. For example, where I work, it's quite an older generation, so I'll probably look at implants. But actually, I really enjoy this, but I still do it and I'll probably look at doing it in the future. So you have to do what you enjoy, but also what's in the best interest of your patients.
Dr. Payman Langroudi: Do you have a 10-year goal? What do you expect to do in the future? Are we considering more offices?
Dr. Nicholas Meixner: I would like to consider multiple practices. Given where we are in the rural area, I think a large center probably wouldn't work. So multiple offices would be ideal. I also want to be really good at what I do, and that's why I'm doing dentistry, essentially. There's no point in doing something half-heartedly. I would love to be, probably not a specialist, but I'm definitely moving in that direction.
Dr. Payman Langroudi: Why did you settle there? Are you from Stratford?
Dr. Nicholas Meixner: Yes, I'm originally from Birmingham.
Dr. Payman Langroudi: Was there a case somewhere near where you live? Or do you now live near where you practice?
Dr. Nicholas Meixner: I'm a partner in London and my uncle basically came back and said, if you're ever thinking of selling, I'd be interested. He said, "yeah, okay." That was it.
Dr. Payman Langroudi: Was he partly responsible for you choosing dentistry?
Dr. Nicholas Meixner: Well, yes, obviously. But the person who actually introduced me to dentistry was (my dad is also a dentist) a colleague of my dad's who did implants. He did a course that he let me go to for free. A patient came in, had all his teeth pulled and implants put in, and he walked out with a big smile. It was amazing, it completely transformed his life, and that's what got me into this field.
Dr. Payman Langroudi: Coming from a family of dentists, (Dipesh also comes from a family of dentists; both his brothers are in dentistry), do you think you had an advantage compared to someone who didn't come from a family? I didn't come from a family of dentists. I have an uncle somewhere who's a dentist, but do you think he had some kind of perspective that someone else wouldn't have?
Dr. Nicholas Meixner: Kind of, I would probably say more of an understanding of dentistry is, but these things are changing massively. My approach to dentistry is very different from my father's. They're both right, there's no wrong answer to this.
Dr. Payman Langroudi: I think this patient-centered thing you were talking about didn't exist back then.
Dr. Nicholas Meixner: I think it was, but in a different way. I think we underestimate how good the old dentists were, because a lot of those things still work. It's only in the new generation that we're saying, actually, maybe this isn't right, but it's only been around for about 20 years. I think we were pretty quick to embrace that. There's been some changes in direction, but I think the old dentists are really good at promoting patient care and conversation and making it all about the patient, I think unfortunately sometimes these days it can feel like patients are coming in on a conveyor belt. I think we need to move more towards making the patient feel like they have a relationship with the dentist. And I think that's what the old dentists are really good at.
Dr. Payman Langroudi: What is your favorite thing about being a dentist?
Dr. Nicholas Meixner: Quite a few things, actually. I love my job. Making things with my hands and improving things, I have to say that it's something that I really enjoy, it gives me a lot of satisfaction. Pulling teeth is quite fun, that challenge of pulling them out, we all know that feeling. But also the relationship with the patients, when they say: "I don't want to go anywhere else" or "Thank you so much for doing this for me", that's really nice.
Dr. Payman Langroudi: I gave up dentistry seven, eight years ago.
Dr. Nicholas Meixner: Do you miss it?
Dr. Payman Langroudi: I miss people, I don't miss teeth. I missed teeth at first. But now, as 8 years have passed, I don't miss teeth anymore. As a dentist, you don't realize how many people you know, but now I see the same 15 people every day. Whereas before, I saw 15 people a day.
Dr. Nicholas Meixner: That's what it's all about, isn't it? We're here to help people, ultimately. It's also amazing how many people we see and you start to get off topic pretty massively. You're here to talk about teeth, but you end up talking about their families and whether they've lost someone, etc. Because it all ties together.
Dr. Payman Langroudi: In a small town, good news travels fast, but you also have the opposite effect? Is it a double-edged sword?
Dr. Nicholas Meixner: Possibly. We are still relatively new to this field and it is always a factor to consider.
Dr. Payman Langroudi: But it's so huge to make everyone happy. I would worry more in a small town than in a big city.
Dr. Nicholas Meixner: Yes, I've noticed the pressure more now. I'm much more critical of how I work and I feel that because I'm a director, technically, you put more pressure on yourself to make sure it works. It's slowly getting better and a little more relaxed. And you have to learn to trust the patients as well. We always say that stress for dentists is a big issue, they have to trust us, but you have to learn to trust the patients.
Dr. Payman Langroudi: Listen to them.
Dr. Nicholas Meixner: Yes, absolutely. So it's kind of a jelly period; it just lasts a while.
Dr. Payman Langroudi: I won't take up any more of your time and enjoy the rest of the course.
Dr. Nicholas Meixner: My pleasure, thank you very much.
Source: enlightensmiles.com
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