Kim Bigg
Hello everyone and welcome to Show Me The Perks. I’m Kim Big and with me today I have Greg Miller from North Adelaide Dental Care. Really pleased to have our first client speaker come into the Show Me The Perks podcast. I’ll throw across to Greg right now to give a brief background of his career and what his role is currently with North Adelaide Dental Care.
Dr Greg Miller, North Adelaide Dental Care, Perks Client, Chair of the Australian Dental Foundation
So my background is that I’m a general dentist by training. I have postgraduate qualifications in a variety of dental areas that are of interest to me, dental implants, dental sleep medicine. And I’ve been practicing for about 20 plus years now, both in Tasmania and in South Australia. I’m heavily involved in the professional association, both the dental association and the Royal College and I also chair the Australian Dental Foundation, which is Australia’s largest dental charity. My interests involve general dentistry, but a variety of other subspecialties as well. Fantastic. And are you a born and bred Adelaidean? I think technically I was born in Mount Gambier. I lived in a number of small regional towns and then moved to Adelaide for my schooling. As I said, left to…Tasmania for the beginning of my professional career and then returned back to Adelaide as it were to establish the clinic and have worked here ever since.
Kim Bigg
your university study in Adelaide?
Dr Gregg Miller
My initial undergraduate degree was done in Adelaide. My postgraduate studies were done interstate and overseas.
Kim Bigg
Fantastic. Clarifying this, so you’re a client of Neil Oakes at Perks and have been for a while. How long have you been working with Neil and Perks?
Greg Miller
Since 2007, I would say. So when I came back to Adelaide to instigate the establishment of the partnership in the practice I was in, Neil started giving advice then. He was advised to me by mutual acquaintance and it’s been a very fruitful partnership ever since.
Kim Bigg
Fantastic.Now jumping into your role with North Adelaide Dental Care, I’ll start with some, just if you can provide me with some quick fire stats. When did you start? Number of staff, number of dentists, et cetera.
Greg Miller
Okay, so North Adelaide Dental Care is one of our kind of leading brands within the group. The clinic was actually established in 1981 by Jonathan Rogers, who’s also a client.
Perks and actually was one of the reasons that I was introduced to Neil. He was with one of your other advisors at the time and we undertake general dentistry. We are of course based in North Adelaide unsurprisingly. The clinic itself operates with around six dentists and it has a number of ancillary support staff and it’s one of our larger clinics that’s based in Adelaide.
Kim Bigg
Just to give me a feel for that, obviously that’s one of your largest clinics. How many clinics do you have altogether?
Greg Miller
We have around 24 clinics, I think, at the moment. Across South Australia? Yeah, correct. We also have involvements in clinics interstate as well. And what motivated you to acquire the…
Kim Bigg
Was North Adelaide Dental Care the first one you acquired?
Greg Miller
Yes, that’s correct. That’s correct. So I initially went into partnership and then outrightly acquired the clinic.
Kim Bigg
Yeah, sure. And what was your motivation when you started? Did you always know once you left university that you wanted to lift your learning and then begin the process of owning your own practice? Or is this something that came to you over time?
Greg Miller
I think I’ve always had a strong independent streak. I think that dentistry is one of the last great cottage industries where everyone and his dog seems to have a small dental practice. There’s a significant wave of consolidation that’s happening at the moment, economies of scale and the alike. And so that is changing and the dynamics is changing. But when I graduated, much people were expected to or dentists were expected to go out, practice for a while, get your skills up and be comfortable with treating patients and then you would go on and found your own clinic or partner with someone and run a small business.
Kim Bigg
And is that a theme that’s changing in the industry? The theme of, you know, accumulation or people aggregating clinics and things like that?
Gregg MIller
Yeah, most definitely. I think that because of the high capital costs that are involved in establishing a dental clinic, and the niche types of equipment that patients are coming to expect and the various sub -specialties that need to be performed at an absolute high level, it is getting harder and harder for small clinics to operate. That doesn’t mean that they can’t and they don’t do a great job, but it just makes it a lot harder. And we have seen waves of consolidation.
some fruitful, some not so fruitful. Aggregators tend to get very excited. And there was a period about 10, 15 years ago where there was mass consolidation. And that’s when I was trying to establish our clinical network. It was very amusing to see a whole lot of deal flow coming across the table and knowing that you were being pipped by people who were paying way overs for things and now those chickens are starting to come home to roost.
Kim Bigg
Yeah sure and just you obviously run a very successful business for some time what are you know how have you what areas have you focused on when you look at those clinics to ensure your business runs as successful as you can obviously you’re careful about acquisition and making sure the acquisitions are sensible and have the right metrics is there anything that you live by that you work towards to make sure you keep a focus on their financial matters?
Gregg Miller
I talk to Neil, he gives me advice. I ponder that advice and then I do what he says. important thing is just common sense. Everything falls down to common sense and you look at the situation, you look at the P &L on the balance sheet and apply a filter of common sense over the top of that and then you make an informed decision based on that.
Kim Bigg
And in your experience the aggregators, if I could call them that, who make the incorrect decisions, is their part all, you know, they almost play the frame of aggregating without understanding?
Greg Miller
It’s completely different motivation. So, for us, we’re looking at a family business that will be multi -decade or hopefully multi -generational. For the aggregators, they’re looking at essentially building an asset and then an out. They have a very finite time period and a very distinct exit strategy, which is mass inertia, offload, out. Whereas for us, we are looking at what is going to really be in the long -term best interests of the business, where can we add value, where are we best positioned to play and what we think is going to happen in the future.
Kim Bigg
And when you think about the growth path that you’ve been on for let’s call it 10 plus years, what strategies were you thinking about when you were acquiring? Are you looking for location based? Are you looking for strategic sort of injections where someone may have a specialist skill set within the practice that you were looking to acquire? Take us through your thought process.
Greg Miller
Look all of the above. You have to be very introspective, and you have to realise what your strengths and weaknesses are and then you have to try to augment your strengths. And so that might be a regional focus in an area that you believe is underserviced or has potential for growth. That might be in a particular subset of professional skills where you believe that the group is light on or it might be in dealing with a certain individual or individuals that have particular abilities and capabilities that you want to bring on to the team. So, it’s a fairly eclectic mix of things that you’re looking for but what you really want to do is build yourself up.
Kim Bigg
Through that phase acquisition and growth is never easy and it comes with challenges, no doubt. How have you managed the challenges of growth as they transpire over the last five to ten years? And perhaps maybe even tying into what conversations and otherwise you may have had with Neil to support that.
Greg Miller
The biggest challenge for growth in our industry and indeed in South Australia has been the lack of growth in South Australia. You know, that kind of passive uplift, which means population, business -wise. That’s why we’ve sort of delved out of the state as well. And so. you don’t have that degree of passive growth and uptake. And as a result, you have to work hard for every yard and have to focus very, very closely on what you’re doing and, in a way, that’s made us more resilient, that’s made us more capable, that’s made us more focused because without that passive growth everything is kind of active and generated through what we’re doing.
Kim Bigg
Do you regularly review the clinics and locations, or do you occasionally divest if some of them aren’t there, haven’t worked out?
Greg Miller
Absolutely, absolutely. You have to set your ego free. You have to accept and look making mistakes or having calculus that’s incorrect is the nature of the beast. And no one ever shoots 100%. You just don’t do that. And to think that anyone does that anywhere in any business endeavour is really fool hardy and sows the seeds of making bigger mistakes. So you got to let your hubris kind of be parked off to the side. And you also have to understand when you should stick around and when you should fight the good fight and when you should get out. You never make a decision lightly, but once you decide to get out, it actually, in hindsight, you think, why didn’t I do that a few months earlier? Or why didn’t I? You can just focus on what’s important.
Kim Bigg
And the most challenging part of running a business, you’ve run it now for, I’m going to say 15 years.
Greg Miller
Look, the greatest challenge is knowing yourself, knowing why you’re doing what you’re doing and how to best focus back on those key kind of drivers. And also now the greatest challenge is there’s such a diversity of opportunity. It’s harnessing the right opportunities and running with them. There’s just such a diversity of choice. Every day there are new opportunities that arise, and you’ve got to sort the weed from the chaff. And that’s part of the great thrill and part of the great joy of operation. But it comes with attendant risks.
Kim Bigg
Yeah, shot selection and shot security. You mentioned earlier on, obviously, the Australian Dental Foundation. You’re the chairperson and clinical ambassador for Australian Dental Foundation. Can you tell me a little bit more about your role with Australian Dental Foundation?
Greg Miller
So the foundation started when we started going to aged care facilities because some of our patients started getting older. And so, we started following them out because they couldn’t come to the clinics anymore. Very quickly, I understood that there was a large portion of the population that wasn’t being seen. And so, we started doing ad hoc clinics. Over time, that grew really substantively because we started seeing the staff in the clinics and the family members in the clinics and the grandchildren of the people in the clinics that we were running.
And we realised that there’s this enormous, underserviced kind of group within the population.
Kim Bigg
And these are people who don’t have access to clinics.
Greg Miller
They’re access constrained basically due to a whole variety of means. And so, with the help of Neil in 2015, we sort of formalised the operations of the charity. And we now operate out of all pretty much of the mainland states. We just saw our 100,000th patient. So, we’ve sort of grown in scale and scope. We now have some retail product offerings that help support the charity. So, we have a range of oral health products, toothpastes and toothbrushes that are coming out in the stores. You’ll see us at the Royal Adelaide show. We’ll be there on the Yellow Brick Road. Handing out toothbrushes, fighting in the lion’s den of sweets and lollies and the alike. We’ll be fighting the good fight. And you know, that’s really emblematic of the foundation. We like to refer to ourselves as the third way. Basically, there’s a private sector, there’s a public sector and we as the not -for -profit sector are now enabling and empowering people to have treatment that wouldn’t otherwise be able.
Kim Bigg
So, you walk along the Yellow Brick Road, pick up your lollies and then pick up the Australian Dental Foundation.
Gregg Miller
That’s right. We like to think that the Yellow Brick Road probably has the most innocuous products that are being sold in the show. There’s some, know, actual derivative of real food rather than synthetic sugar and whatever else. you know, again, it’s emblematic of what we do. We seek the counterfactual, we seek to go where it’s difficult, we seek to have difficult conversations. It’s the same thing in aged care. There is a significant degree of ageism within the Australian community. You see it in the way that our aged care sector is structured and sort of hidden away and you see that different standards are held to individuals in aged care versus individuals in the broader community. And that’s why the foundation exists is to basically even out the playing field.
Kim Bigg
Can you provide a couple of brief examples of the work that Australian Dental Foundation or one example perhaps just in terms of the great work that it provided and the impact it had on the individual?
Gregg Miller
Yeah, absolutely. I’ll give you three examples in three different fields. So first of all, we undertake work with Novita, who are a great South Australian organisation. And we see children who are disabled and who have really significant constraints to getting to conventional dental services. And so we will go out to the Novita sites and see children there. And one case in particular that I can think of, that we undertook some work under general anaesthetic for that individual, was to remove some infected teeth and basically alleviate pain that the individual wasn’t able to communicate that they were in.
A second example is where we go to schools and in particular if we look at our operations now we operate with large trailers. They’re essentially like portable clinics that can go from one location to another. Yeah, sort of like a semi-trailer type trailer. And one of the sites that we visited is a refugee school, or a migrant school and that site, the vast majority of people that we visited because they don’t have Medicare cards. They’re not formerly Australian naturalised citizens, they’d never seen the public dental system and in their own countries, they’d never seen a dentist. And so, we were seeing individuals and some of them were older than average school aged children because they were doing ESL and whatever else. So, children and adults who had spent their whole lives never seeing a dentist and again, having a tendon dental disease.
And the third example would be where we go to aged care facilities and as an example we came across one individual who unfortunately was suffering from a really substantive goite, so kind of a growth on the side of the neck that hadn’t been addressed because it was basically hidden up by a scarf and the individual was quite embarrassed by it and due to the work of our clinicians they were able to get that addressed. So not a dental issue but a broader general medical issue and we were able to shine a light on disease and on problems and hopefully rectify it.
Kim Bigg
Yeah, clearly all three of those have some access issues, which is access in mobility form or aged form or financial matters. What role do you see for businesses in supporting local communities and charities of this type? How has your involvement with the Australian Dental Foundation supported you and your work with your business?
Gregg Miller
Look, I think it gives you a broader context for what you’re doing. I think it gives you the ability to sharply focus on what’s important and what’s not. I think it gives you staff and ability to see that there is a bigger picture. And it also, it strikes me, I have a real interest in Greek and Roman history. In particular, leadership in Roman times. And I think reflecting upon it, the Romans would look at the current context of business and political leaders and would find us incredibly boring, incredibly timid and incredibly unpatriotic and not sporting as societies. Because in their day, lots of social constructs that are not really applicable. We do a whole lot that’s a whole lot better. But in their day, civic leaders or business leaders or political leaders would really invest in the community. As an example, there were various consoles who would hand over the equivalent of thousands of dollars in today to every citizen within Rome They would just get a, you know, you get two months salary from the console or you get parcels of land or the console will take it upon themselves, fiscally or responsibly, to launch a various invasion. It’d be like Elon Musk, riding tanks out into Iraq or into Ukraine or whatever else. And instead, so little is done in this space and so little focus. So I’d urge colleagues to sort of focus on where they can best contribute to society, where they can best kind of aim their skills, because we have so many people that are so skilful and yet very little engagement with the not -for -profit sector and very little true, true kind of support for that.
Kim Bigg
Taking advantage of the privileged position they absolutely. Yeah. Now, a couple of final questions. What advice would you give to someone starting out in the healthcare sector as a small business owner?
Gregg Miller
Don’t be a small business owner. First up, get your skills. If you’re starting out, you need to learn your clinical skills first. This is the most important thing. Clinical skills are first, second and third. And once you get to a degree where your clinical skills are second nature, that’s when you should start thinking about the business role. Or whilst you’re doing that, develop a business mentor or some business support and then seek to undertake business. Your primary role is as a clinician in this context and not as a businessperson. So, you need to get your clinical skills first before you engage your business skills.
Kim Bigg
Excellent, I’ll agree with a lot of that. Australian Dental Foundation, if people want to get in touch or they’re interested in understanding more, is their website the best place to
Gregg Miller
Yeah, website, dentalfoundation .org .au is our website. You can of course see us on the yellow brick road. We’re at 175 Ward Street, that’s our head office. Look, we’d really welcome any clients or other Associates of Perks to reach out to us. The foundation does run under its own strength and donors is one of the big parts of that.
Kim Bigg
Fantastic. Excellent. Well, I’m sure those stories will resonate with people. Thank you very much for your time. I’ll wrap it up there. And yeah, as I said, really appreciate Greg coming in today, telling us a bit about his business and also about the Australian Dental Foundation. I hope listeners have learnt a few things from there and will take something away with them. But yeah, really appreciate your time, Greg. Thanks for coming in this morning.
Gregg Miller
Thank you very much, Kim. Thanks for the opportunity.
Kim Bigg
Thanks, Greg.
