The Show Must Go On!

For those of all the Samera and Neem Tree team that made it to our Christmas Bash - well done for overcoming the snow - it was a fantastic evening and great to catch up with you all! As they say, the show must go on - with or without snow!

For those that did not make it, we missed you all, and you missed a great evening!

Have a great Xmas and New Year and i hope you all manage to get away to your loved ones!

Arun

Humbled...

“Sitting by the bedside, 12 hours a day, watching flashing monitors and colourful machines – assessing performance, touching, caring, prodding, whenever required….that is a day in the life of an ICU paedaetric nurse.

Sometimes forgotten, amongst the other heros, the paedaetric ICU nurse, is someone very special, that one must respect and praise, because without their care and love, many of our children would not be here today.

Thank you to all the ICU nurses for caring for my aashima and all the other sick children around the world, without you, our lives would not quite be the same.”

Groupon...myth or magic?

In the last 12 months the Group On (http://www.groupon.co.uk/) phenomenon has hit the UK, and most importantly UK dentistry. Virtually every second day, I receive my groupon email with a different dental practice offering a hugely discounted check-up, whitening, hygiene and even lingual orthodontics.

Even my team have asked me why are we not using Groupon in The Neem Tree.

One of my clients signed up to Groupon early on, and did well ( he negotiated a good %), whilst others I know said they would not do it again, after their first attempt. Groupon take anything between 30-50% of the advertised price, so after all this, there really is not much left.

The aim of Groupon is to tempt the customers who come for the deal, to take up more services, but in my opinion, many of these such discount searching customers are unlikely to take up the additional services, since they probably don't have the resources. They are just deal hunting, and unlikely to come back 6 months later for a full price check up when they can get another super deal from Group On elsewhere. Such customers are not in for building your patient goodwill, they are just deal hunters.

Groupon may bring an increase in the volume of patients, but all too often it brings a type of customer that may just be very difficult and cause far too much hassle for you and your team.

For restaurants and bars wanting to sell a few more cocktails on the evening, I personally feel Group On may work, but for a dental practice selling a professional service - one does have to question it!

There are many much better marketing techniques available to dentists, rather than jumping on the Group -On bandwagon, it makes sense to get back to the essential basics of marketing...for help see www.samerastudio.com.

We can also learn from the US on the Group On phenomenon, just look at some of these links which make interesting reading - not positive for dentists planning to use Group-on.

http://www.tysonsteele.com/posts/display/is-groupon-just-a-put-on

http://www.screenwerk.com/2010/06/11/groupon-sure-but-is-it-sustainable/

So in summary would I use Group On? No, I feel for our business model, it just isn't financially viable for our practice, there are many other better marketing avenues that will have a much more desirable effect.

No doubt Group-On is a phenomenon, but mostly for the owners of this clever business!

November 9th

Aashima's big day is November 9th.

This will be the day she undergoes her rastelli procedure. At the moment she is looking fantastic and the picture of great health. She is attending nursery, causing lots of trouble and being what a 2 year old should be!

On the face of it, she looks like a normal petite 2 year old girl, however as with many CHD (congential heart defects) children, its her little heart inside that is causing both her and us the pain.

Only last week we were back at the Brompton Hospital, and I was wondering does she really need the big op? To me she looks fine, but in my own heart, i know she needs it to give her the best chance of living a full life.

She knows that she has a heart problem but is completely unaware of the impending heart surgery.

I wake up most days (smita does too) thinking about this big day as it draws closer.....There is not much we can do, so we try to block out the impending event by keeping ourselves busy with other things....but it is always lingering there.

When the big day comes, i really am dreading signing the release form, and then holding her down to administer the GA.

According to her cardiologist, she will be home within 10 days!!! I truly pray this will turn out be routine rastelli, so we can all have some fun!

CQC

https://www.registration.cqc.org.uk/datacollection/welcomePage.htm

If you have not already, pre-registration enrollment for CQC ends tomorrow. Details at the url above. Not obilgatory to do by tomorrow but they are encouraging all dentists to sign up by tomorrow for pre-registration!

More red tape!!

Aashima

Yesterday was a huge day in our world. The day we met the surgical team at the Royal Brompton for my daughter Aashima. We had been waiting to meet with them to see what they were going to say.....

Two years back Aashima was born with various major congenital heart problems, she had 2 operations at her birth, but we knew that was a just a temporary fix, and in fact the big fix would have to occur sooner rather than later.

That big fix is now due to happen later this year, in October or November, and to be honest I have never been more scared of anything in my life. Yes, you heard that right, I am scared.....shitless. Not much fazes me, except concern for my children.

She has lived a really full 2 years bringing so much joy to us all, but now very soon she must undergo major open heart surgery so she can continue living life to the max!

We have done our research, spoken to doctors, and we know she is one of the best places to have the surgery, but open heart surgery on a 2 year old is not fun.

The planned procedure to be carried out is called a Rastelli procedure and is a 7-9 hour operation, whereby the heart will be stopped and she will be put onto a Heart-Lung Machine. If all goes well (which it will) she will be out of hospital after 10 -14 days. Part of the procedure involves putting in a conduit into her heart, this will require replacing later in life too.

Aashima and my wonderful Parus are my inspiration. They are everything to me. I do feel very blessed with everything and everyone I have in my life, but to take my daughter and allow for open heart surgery to be carried out on her is a responsibility i thought i would never have to face. But those are the cards i have been dealt with, and now I must play the game to win, for the sake of my wonderful daughter, Aashima.

Finally, if anyone reading this blog knows of anyone who has undergone the Rastelli procedure ( i know it is very rare indeed) please can they contact me directly on arun@samera.co.uk

Never a dull moment

at The Neem Tree. Not even 3 months open and what a day we had today.
Yes a car straight through the shopfront!!!!! Thankfully no-one seriously hurt however martin our orthodontist did have a very close shave.

Well i guess it does say on the window come and meet our receptionist, i guess the 84 year old gentleman who visited with saab 9-5 forgot to leave the car behind.....all people are fine, thankfully.

Pretty much an adrenaline fueled afternoon - but now the shop is fully boarded up and secured. Tomorrow is another day and now the insurance claims begin!!!

Esher it is business as usual in Esher! The show must go on! The Dental Drive Through is Now Open!

The New Budget - Impact on Dentists

Today's budget from the new coalition government announced several key implications for dentists. In brief we outline the key aspects that will effect dentists in the coming months and years.

VAT increase to 20% from January 2011

The rise in VAT is not good news for dentists. As a VAT exempt service, dentistry will feel the impact of a rise in VAT of 2.5%. For example a practice spending £10,000 on equipment will face an additional £250 cost. Not good news!

Capital Gains Tax

George Osborne announced with effect from midnight tonight a rise in Capital Gains Tax to 28% from 18% for high rate tax payers. As most dentists we work with are high rate tax payers, this again is not so good news.

However, on a better front the entrepreneur relief (available to business owners) which reduces Capital Gains tax to 10% remains in force but with a rise in value from £2m to £5m! So for the entrepreneurial dentist growing their business, this is good news!

Annual Investment Allowances
The Annual Investment Allowance (AIA) will be reduced to £ 25,000 a year with effect from April 2012. Currently the AIA is £100,000 a year. This means in summary you will be better off bringing forward your Capital Expenditure before 2012, as this will help reduce your tax bills earlier. From 2012 the allowance of £25,000 is a big reduction, and hence will not benefit dentists.

Following on from this the capital allowance rate will fall from 20% to 18% in 2012, again not a good thing for dentists, as the level of capital allowances that can be claimed after the annual allowance has fallen.

Income Tax - Increase of the Personal Allowance

Mainly aimed at low income workers, the personal allowance will rise by £1000 from next tax year. This is good news for low pay workers as they may fall outside of this earnings bracket. The eventual aim of the coalition government is to raise the personal allowance to eventually £10,000. The impact on dentists will be minimal.

Small Company Corporation Tax Rate Reduced

This will be reduced by 1% to 20%, making it more tax beneficial to be running a small company. This in effect makes it a more compelling case for incorporation for certain types of dental practices.

In Summary

Tax rises and cuts were expected. However, this budget is a bit of a triple whammy for dentists, as VAT rises by 2.5% and the capital gains tax rises and the annual investment allowance falls, there is not much good news here for dentists.

The only hint of hope comes in the guise of a 1% drop in small company corporation tax for those dental practices which are already incorporated. If you were considering incorporating, this maybe the final straw for you to take that path.

Motivating your team

Watch this - a very worthy 10 minutes!

The First 3 Practices....Mistakes made

Around 6 years ago The Neem Tree Wandsworth opened its doors to the public. Over the last 6 years we have learned loads about opening practices and for sure, our latest practice is by far our best practice, in my opinion.

Why? Well on several factors, namely costing, look, location and marketing.

Most dentists never go beyond one practice, and quite often many make their mistakes on their first practice, in terms of location selection, equipment provider, budget......One practice is enough for most sensible people. But then again we probably are not that sensible when it comes to opening businesses. As you can probably tell, we quite like opening new practices.

Hindsight is a great tool, and we can see that we made many mistakes in our first Wandsworth practice, when we compare it to our latest Esher offering. Just 3 of the mistakes we made in our first practice include:

1. Being sold way too much equipment by the dental trade. Only buy what you need, not what you may be need. Although our first practice looked great, we were pretty green, and dare I say it over kitted out our first site and hence spent too much.
2. Our location, although not bad, near a main railway station, we probably would not choose the same location again. We would probably want a busier location.
3. Our team, some of our team from 6 years ago still remain at our Wandsworth site, but we have seen our fair share of nurses, receptionists and dentists. The key learning point from this was the hours of operation. Although, we created hours that worked really well for the patients, for many of the team this was not so good for them - hence them moving on!

In our Esher site, on all counts we have been so much more careful on all these fronts.

1. Equipment - This time around we have been much more sparing on our equipment spend and who we bought it from, however, we did have a major issue with x-rays (see below)!
2. Location - The location has been a hit - opposite Waitrose has had the desired effect and certainly beaten our expectations in terms of patient bookings (64 new patient registration in just the first 2 weeks!) Daily we are now getting between 1-3 bookings. Although our marketing has been pretty good, if I do say myself, the location and of course the look of the practice has helped significantly.
3. Although our hours are long, with Saturday's included, they are much more structured and the team we have in place, including dentists, all appear to be working very well together!

Some Key Mistakes We Made

In setting up a dental practice in Esher, we of course made some mistakes, but nothing too major!

1. X-ray Supplier - Our x-ray supplier went AWOL after we gave him a deposit of £2500. We are still awaiting a refund, so if you are reading this blog Mr X-ray, expect some not so nice letters from lawyers to be coming your way soon. Luckily, we, with help of some great suppliers, we managed to get an X-ray system (Durr) installed the morning of opening, just before the first new patient!

2. Flyers - Our strategy of printing a lot of flyers and getting them distributed to local homes although theoretically good, practically is proving to be a problem, mainly because of the quality of the distributors. We know we have a problem when patients are calling us saying they have just had 10 flyers put through their letterbox!! Not a great first impression! Two companies sacked so far, third time lucky!

Over the years we have compiled an invaluable list of people or companies NOT to use. If you want this you will need come on board one of our programmes.

Photos!

Some nice pictures of the new practice can be seen here!

IPAD dentistry

The media is ablaze with them, the whole world wants one, and just about every media outlet is telling us how the IPAD can change our life? Well can it?

I have been lucky enough to be playing with my new IPAD and have been thinking how it could benefit a dental practice. Top suggestions below:

1. Before and After pictures - will be so easy to show to patients, they will be pretty impressed with the swipe across the screen to show them how they could look! Just the sale of one big case and the IPAD has virtually paid for itself!
   
2. Videos - Show patients videos personally key treatments possible and the outcome
3. Play music/video - etc - great for keeping patients and the kids entertained in practice
4. Design a patient history form, they then complete it on the IPAD and it is zapped straight into your computer software system
5. Be the talk of the town! - ok this won't be forever, but image is everything, so showing to patients you invest in the latest technology will only benefit your practice. Patients know about IPAD's but they have no idea about the latest burrs - so they will assess you on their terms!
   

I am sure there are many more, but don't dismiss this as a fad, the IPAD will change how businesses interact with customers!

Give it a go

Arun

A great first week!

The Neem Tree, Esher has caused something of a stir in esher. Since we opened the doors on Monday, over 40 people have booked appointments and we have really great momentum.
The team have gelled and its looking good for the forthcoming months ahead.

Last weekend was a real tight push, working 24/7 but the result has been worth it. Were there problems? of course, are they all resolved? No, but hey, that is what makes it even more exciting!

Just a few pictures of the finished product! Much more to follow on opening of neem tree 3!
have a great weekend and enjoy the sunshine!

The last few days

A few more pictures as we end the build of The Neem Tree, Esher. All coming together in this 300 year old building!

Lots to do!

Last 2 weeks and lots to do, by us and the builders, as you can see, but all very exciting!!!

Pushing through the 25th Mile!

My London Marathon Adventure

What an experience! Did I finish it? How hard could running 26.2 miles be?

Watch my video summary on Youtube here!

The Start

The start was very exciting as I set my running pace at under a 4 hour marathon pace. The support from the crowd especially at the early stages was amazing, as young and old came out to support.

Even more amazing were some of the runners - blind, one legged...if they were doing it, surely so could I.

The Middle

Up to 13 miles , I felt good, my body was not hurting and my plans for a 4 sub hour marathon were on! I was thinking I felt so good that perhaps I could do it nearer 3 hours 30 mins?

From 13 miles to 16 miles, as we headed eastwards and through the Docklands, I could start to feel my body saying take it easy Arun, enjoy the race. The longest I had run in my training sessions was 16 miles, so up till this point, I was doing OK, but albeit it slower than the Kingston, 16mile Breakfast run.

It was between the 16 miles to 25 miles stage that I could feel my body beginning to break down. Mile 19 at Canary Wharf was tough, but the reverberations of the shouting crowds against the shiny building gave me some of the energy I required. However, by the time I reached mile 20, I knew I had to stop trying to get under 4 hours, and just cross the finish line! Now my objectives had changed!

The Last 2 Miles

At Mile 23 I saw Smita and Parus, my son, and Ajja yelling me on, which gave me a very welcomed boost, but the pain was still there...and my legs were beginning to hurt. Through the musty tunnel at Blackfriars and all that lay in front of me and the finish line was a couple of miles - I could do it!

Or I thought I could.

There was not one time throughout the whole marathon that I did not think I could not finish it. Mentally I was 1000000% prepared, but was my body?

As the crowds yelled me down the Embankment, and a few others were falling beside me, i knew I had to crack on.

Mile 25

But then at mile 25, cramp hit my left hamstring - Ouch! I could not move. Passionate yells of encouragement came from the crowd - I did not look, I just re-focused. 20 seconds later I was slowly jogging again, albeit in great pain. I could do it.

But then 600 yards from the finish line, cramp appeared in leg number two, but through resolve and pure determination, I gritted my teeth and pushed through the pain to reach the finish line in a respectable first marathon time of 4 hours, 12 minutes and 17 seconds.

Full details of my time are here.

What an amazing physical and emotional experience. Painful? Yes. But I loved every moment of it. It was worth the £5788(as I write) raised for the British Heart Foundation. Thank you for all the wonderful donations I received from all across the world!

But would I do it again?

Straight after finishing I felt never again, but 3 days on, I am now itching to submit my entry for my next marathon!

If I can do it, so can you! See you next year?

Lots of Love

Arun

P.s. Watch my video summary on Youtube here! You can see how i really looked after the big event!

24 Hours to Go

I am so excited about running the London Marathon,i have 24 hours to go and the excitement is just getting bigger and bigger! I can't sleep!

This is my first marathon and i have been training quite hard, but as we all know, life always gets in the way of best laid plans. Kids, trips, business, new practices.......all great things but all distracting me from some of the early morning runs!

The day will be hot tomorrow, so lots of water and lucozade sport, but i hope to set a good time, but most importantly, i want to enjoy the big day with the 30,000 other runners! Amazing 30,000 runners running 26.2 miles across London!

My inspiration to run is my little daughter Aashima - whom, along with her brother, Parus, are my driving force in life. My aim in life is to inspire my children to do some great things in the world - i hope this will inspire them one day to help others too! As that is what matters, not what you have, but how we can help others!

I am raising money for the British Heart Foundation, i would love you to contribute if you have not already, and if you have a MASSIVE thank you!

I have almost raised £5000 making me the second biggest fundraiser online for the 2010 London Marathon for the British Heart Foundation so far - just behind the man doing the marathon in the armoured suit! But more would always be welcome!

You can donate at http://original.justgiving.com/arunmehra

See you at the finish line

Lots of Love

Arun

Latest Planned Pics

How the building looked when we got the keys!

Planned frontage of the practice

Design, Design, Design......

The importance of design is so important in society today. We buy Apple computers because of design (and functionality), we buy cars, houses and just about everything because of the design. In addition, patients buy dentistry because of design, of chair, surgery, reception, website.....the importance of design is essential in dental practice today.

When we set up our first wandsworth practice i was quite hesitant in getting a designer involved, I perceived it to be expensive, however, we made the right decision by getting the right design agency involved. Any notions that i could do the job of a designer were quickly dispelled by realising these guys were excellent at their job.

From the way the light comes in to the practice, to the position of the reception desk, they all need to be considered in creating an ambiance that customers want to experience. Getting the right designers is essential in doing this

Well what is a right designer?

From my experience, i know there are a few designers/architects etc in dentistry, but from what i have seen, most of their work is pretty much the same, just badged a little differently each time, no great consideration of brand and ethos has been considered, but most importantly addressing customer needs has not been considered.

When we chose our original designers/architects, we chose a firm that had little knowledge of dental practice technology (they learnt quickly) but they certainly understood what customers wanted. In my opinion, that is the essential aspect that so many dentists forget, what do customers want and to experience? Designing a practice around brand and customer experience is essential in today's private dental age, any good designer and architect can learn about the dental aspects they need to.

Just a few pictures of current plans for The Neem Tree 3 show above. All in development at the moment but pretty exciting when you see it on paper. Lots of decisions to be made.

If you want to get involved in detail to see The Neem Tree 3 develop from a concept to a final practice then don't miss out on our "Hands- On" Setting Up In Practice Programme starting 12th March 2010...more details here.

Week one - New Dental and Office Site

2010 has started off with a bang! New Site for Samera offices and The Neem Tree!

I plan on blogging about our progress in developing a new Neem Tree and Samera offices over the next few months at our new site in Surrey. I hope this will prove to be an interesting read for anyone interested in the trials and tribulations of opening a new dental practice plus offices for Samera.

Week One

This has been a really interesting and exciting week after Xmas, although i was supposed to be away, my trip was cancelled due to a few family reasons, i have been in constant discussion with designers, contractors and all manner of sorts of people who will help us achieve our objectives.

The first person we have taken on to deal with the project is Pete, he is our designer and also our project manager. We have learnt from previous experiences always hire a team that can do a much better job than we could. Pay the professionals for their expertise, don't try and do everything yourself, as it will rarely be as good as a professional!

He has drafted concept drawings for the offices and also is in the process of putting the drawings together for the dental practice too. Since the building is a grade 2 listed building, it is pretty old, we also have employed russell to be our structural engineer, design is important, but so is structure, so we don't have a failing building!

Problems we have encountered....

Such projects are fraught with issues and problems, just in week one we have experienced:

1. Problematic structure - since the building is 17th Century, trying to get the drawings of the building right, from under all the existing buildings has not been easy

2. Snow - No show of builders due to snow (kind of expected)

3. Police - A visit by the police.....more on this later!!!

4. Budget Management - Keeping the costs as low as possible! already some hidden unknown costs are appearing, so we will have to manage costs accordingly, keeping to a tight budget will be key here.

As I write the builders have already taken alot of the old debris off the walls away, tomorrow is a site visit, lets see how this goes!!