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Tue 19 Feb 2008 04:00 AM

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Overheads & underpaid

With rising costs, pricey licensing laws and high lab charges, Dubai's dentists are feeling the pinch of small business. Dr Ahmad Amer, owner of the The Dental Spa, tells Middle East Dentist about the realities of practice in an expensive emirate.

With rising costs, pricey licensing laws and high lab charges, Dubai's dentists are feeling the pinch of small business. Dr Ahmad Amer, owner of the The Dental Spa, tells Middle East Dentist about the realities of practice in an expensive emirate.

Many small businesses in Dubai are feeling the strain of inflation. How do you think dentists are faring?

We can’t ignore the public demand for reasonably priced dentistry, but we are taking the crunch of the inflation.

Dentistry is certainly expensive. The amount of investment that has to happen behind the screen, the amount of licensure that we need to go through, especially in the UAE market, is just huge.

People think that this market is not well regulated - on the contrary, it is over-regulated in comparison to European markets or the Northern American markets. It's extremely expensive, extremely long and time-consuming.

On the other hand, the profit margins for a dental business are extremely low when compared to any other industry that you might think of.

Doesn't tight regulation guarantee a minimum level of competency?

Dental providers here are from different backgrounds and educational levels, so the country needs to ensure these standards are adequate. I totally understand and support this as well.

But to go through every nitty-gritty and prove that we are who we say we are, then we have to go through this endless verification process. It is loaded upon us expense-wise and time-wise.

I don't know how we can meet in the middle and reassure the patients, but still put bread on the table.

Is this impacting on the number of dentists willing to set up a practice in the emirate?

It is driving up the costs and reducing the profit margins - making the job entirely unprofitable and uninteresting to highly trained professionals. We now have major problems attracting the right individuals to this market.

This is an expensive city to live in - for any well-renowned, well-trained professional to make a living they need a decent income, like in any other market.

You feel the toll of the licensing process here, especially if you are running a successful practice. It's frustrating and leaves you unwilling to expand any further.

You know that if you attempt to introduce a new service to this market that is really top of the line, you'll struggle with every step.

Are fee schedules reflecting these rises? Is it putting dental services out of the reach of the general community?

Dentists have to put the price in a segment that will have a reasonable profit margin after the costs of rates and the expense of licensing requirements.

It's very difficult to justify these high prices to expat patients from western markets, which is why profit margins are diminishing by the second. We can't ignore the public demand for reasonably priced dentistry, but we are taking the crunch of the inflation.

I am sure that a lot of my colleagues share the same point of view. We're on the line of living here, or going back to our countries. If it is not as sustainable as at least our own native markets, then there is no point in our staying.
I hope it doesn't get more expensive for the customer, but it is a vicious circle.

Have you tried to carve a niche in the market with the Dental Spa?

I think I've been able to offer quite unique services, but there is a lot more that I would love to offer. In North America, for example, I can offer lip-fillers.

We’re on the line of living here, or going back to our countries. If it is not as sustainable...then there is no point in staying.

Here, it's a big no-no with the authorities. I understand that, but we are trained and licensed to offer these services in the countries we come from.

Does the dental market in Dubai compare favourably with North America, in terms of the supplies available?

It's a major problem that we face. The international companies have no direct presence in this market.

They deal through local agents. People are selling stock that they know nothing about. Equipment we use regularly is not available, or it is way overpriced.

In my case, a lot of the stock I get shipped directly from the states. It is an added cost, but it's still cheaper than buying it locally.

I'll create a lot of enemies by saying this, but there are no professional agents here who know what they are selling, how to sell it and to whom, or how to price and maintain [products].

The amount of after-sales service here is minus 100. They keep promising you they will show today, tomorrow, 10 days later and nothing happens.

Can you access new dental products?

It's difficult, because the size and the volume of the market here in comparison to the international market is small. The representatives always sell the same thing.

There is no interest in what is new and beneficial - they only stock products really in demand that they can sell with a bit of profit margin. There is no contribution by suppliers to the education of the dental community.

Are regional laboratory services of an international standard?

Dental laboratories in this region know nothing about modern dentistry.

The service is horrifying and price-wise, they are more expensive than in the States. It is a monopoly and you are bound by the time factor.

I can't send my cases back to US because it takes time and courier costs and it is just not practical.

I'm not aware of all the dental labs on the market, and I don't want to generalise, but I've been here almost five years and the dental labs I know about are not top notch - price-wise or service-wise.

You've stated that, increasingly, dentists need good business skills to survive practice. Is this something that should be taught to undergraduates?

Most dental schools don't teach us a lot about surviving on our own in practice.

They teach us how to look after patients, but not ourselves. I was lucky enough to realise that at an early age and I sought extra education in the art of business; how to be professional and up to the mark in your service offerings, but also how to look after yourself as well.

It is a matter of sustainability. If I am a frustrated doctor, I am a useless doctor.

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