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Mon 6 Oct 2008 04:00 AM

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Hire at will

Opening day is looming for your new practice, but do you have the crew to run a tight ship? The third instalment of Starting a Practice looks at picking the best people to steer your business to success.

Opening day is looming for your new practice, but do you have the crew to run a tight ship? The third instalment of Starting a Practice looks at picking the best people to steer your business to success.

As this series has highlighted, getting a dental practice off the ground in the Middle East can be a protracted affair. But while delays can prove frustrating, they offer hidden benefits in one area: employee recruitment.

For those in the healthcare industry, staffing is never an overnight job and the licensing process can prove equal parts red tape and tedium.

Things can change very quickly in this region in terms of salary packages and contracts.

Casting the net

Dentists need to be part clinician, part juggler, when striking out alone, keeping several projects in the air at once. Although clinic design and style issues may seem more pressing, leaving it late to pick your staff is a big mistake.

Healthcare professionals are generally wary about taking a leap into a new role without preparation. And when you consider that moving to the Middle East typically involves a change in country for candidates, an early start is advisable.

Mick Whitley, commercial director of healthcare recruitment firm HCL International, knows all too well the problems dentists face when sourcing candidates.

"There are a lot of hurdles facing new practice owners, not only in terms of licensing but in terms of finding people willing to move to the region," he says. "While moving to the Middle East can offer certain attractions such as tax-free salaries, there a lot of other considerations."

One of the trickier aspects of recruiting expatriates is balancing concrete job offers, often made well in advance, against a fluctuating market. Frequent changes in exchange rates and cost of living increases mean the attractiveness of a job package can change on an almost monthly basis.

"In the Middle East things can change very quickly in terms of salary packages and contracts," Whitley admits, "and if you are from North America, for example, you will probably not be used to that."

The current downturn in the global economy is unlikely to make the situation any easier. "It is a double-edged sword," he notes. "Some dentists might be pensive about leaving a secure job to start out in a foreign country and all the risks associated with that.

"However, there is a relative financial security in the gold and oil-rich areas of the region, cushioning it from the immediate impact of the global economy. This might prove a draw."

Expatriate dentists will also want to be assured that making the move will not halt their professional development. As a recruiter, it is vital that you can convince potential clinical staff that taking the step to the Middle East is not going to stall their careers.

"A big draw for staff is if you can give them access to hi-tech equipment, research and continuing education," recommends Whitley. "So if you can't offer them that, you should be prepared to fly physicians to those events. In the long run it will not only benefit them, but your practice as well."

Of course, practitioners don't necessarily have to look abroad for their staff. There are many local dentists already working in the region that might see the new practice as a positive career move.

With established dental schools at Ajman and Sharjah, the UAE has a large base of fresh graduates on course for the job market. While some expatriates will look to move on and find work closer to home, there will be many who want to stay on in the Middle East and build their career here.

New graduates can prove a useful investment to a new practice owner. Firstly, salary expectations will not be as high as those among established dentists and, secondly, the new graduate is likely to be more pliable to the practice's way of working than a dentist with set working habits.

As well as undergraduate candidates, the region has newly established postgraduate specialist courses starting up. With organisations such as Boston University Institute for Dental Research and Education opening their doors, the region will have a new source of postgraduate talent.

Thomas Kilgore, chief academic officer at the Boston facility, believes that the output of its first postgraduate course will be worth the investment. "Our students are certainly going to be extremely marketable when they finish," he says. "They will have a very highly respected specialty degree and will be a benefit to dentists that are hiring in the region." Licence to drill

Recruitment experts suggest starting the hiring process at least a year in advance. Dr Linesh Sagar, practice manager at the Dubai-based Noa Dental Clinic, learnt the hard way to stockpile candidates.

The complex licensing systems favoured by regional health authorities mean certain applicants, and particularly those from countries with less developed education systems, aren't guaranteed to receive approval to work.

A big draw for staff is if you can give them access to hi-tech equipment, research and continuing education.

"With the amount of paperwork required for the licensing system here, one wrong document and that can be the end if it," Sagar says. "It is a good idea to shortlist two or three people for each position to increase your odds."

Each Gulf country has a different approach to licensing expatriate dental professionals, but all have a reputation for owning fine-toothed combs. Once you have a confirmed candidate, brace yourself for some lengthy fax correspondence when applying for a license.

"The professional licensing process can easily take more than two months," reveals Dr Mohanahkrishnan of consultancy firm Eurohealth Group. The Dubai-based company specialises in guiding healthcare facilities through the approval process.

"For instance, in Dubai Healthcare City free zone, you have to introduce copies of the doctor's certificates and details about their experience to the Centre of Planning and Quality (CPQ).

They will send copies to the university that has issued them for confirmation...[followed] by a CPQ committee meeting. The application will be considered and they will decide whether the person can be licensed or not."

The process may sound tedious, but it is straightforward when compared to some federally-run licensing departments. Stories of year-long application processes are worryingly common among local dentists, and this is exacerbated in the case of auxiliary staff.

"There are a lot of problems getting auxiliary staff licensed with department of health, here," explains Dr Michael Formenius, owner of a dental clinic in the Jumierah area of Dubai.

"We are all running short of support staff, but when do find the right candidate, who has passed the necessary exams and has two years of clinical experience, you send them to apply for the licence.

"After waiting up to three months for the result you find that they don't pass. The rate of passing is very low. It seems to be quite an arbitrary system."

This looks set to change, in Dubai at least. The Department of Health and Medical Services (DoHMS) recently announced plans to bring all licensing under the auspices of one single agency, administered by the newly-formed Dubai Health Authority (DHA).

The move has been seen by many of the emirate's practice owners as a positive move towards more efficient regulation.

"I think it is very much a positive step, because for any dentists looking to come and work here, there is no guidance and it is a minefield," says Sagar. "A single body that handles everything from licensing through to the disciplinary process it will be so much easier, for both the recruit and the employer. It will certainly be better knowing exactly who you need to talk to."

The right staff

Like so many other facets of starting a practice, recruitment requires a great deal of patience. Start vetting potential employees as early as possible so while the physical aspects of the clinic are continuing, the administration of the workforce can run in tandem. Sagar believes dentists must have an idea of the type of person that would suit their practice.

"It is almost as essential as the business plan," he says. "These are people that will instrumental in growing your business, so you have to know the qualities you are looking for from day one."

Like most parts of the business process, there will have to be compromise. Dentists will not always get the candidate they are looking for straight away. However, Sagar warns against being too quick to give up.

"If you start the process early enough there can be some room for trial and error. Don't just go for the first candidate that comes along."

Whitley's top tip is to make sure that as much detail as possible is set down early on in the process. "I think the key thing is clarity - dentists need to know exactly what to expect, how much they are going to be paid, and what the benefits are likely to be," he says.

"Give as much detail about the role on offer as possible. That way they also know what the practitioner expects of them."

Next month, the final part of the series will look as how to market a new practice.

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