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If Dr John Carrigy has one point of encouragement to share with younger clinicians starting out—it is to focus on building solid relationships in every facet of your business. This has definitely been central to the building up and success of his Brisbane-based dental specialist practice, Foundation Dental Services. By Kathy Graham
If anybody embodies the traditional relationship-based and patient-focused approach to dentistry, it’s Dr John Carrigy and the team at Foundation Dental Services (FDS). As owner/founder of FDS, one of the larger periodontal and oral medicine specialist practices based in South East Queensland, Dr Carrigy is steadfast in his belief that the key underpinning foundation of the profitability and success of the FDS group is the focus placed on relationships with patients, the FDS staff and with the broader supporting community of general dentists and allied health professionals. It’s an ethos enshrined in the FDS mission statement, and it’s a message he wants to communicate to other dentists, especially those “who may be feeling a bit swamped by the rapid corporatisation of dentistry where sometimes the focus may seem to swing too far to billing targets and items of care”.
Dr Carrigy says he wants younger clinicians to know that there “is still a place for relationship-based and patient-focused health within the dental sphere”.
In fact, the time may even be right for the smaller suburban ‘family practice’ to make a resurgence—albeit a little bit more streamlined, flexible and technology savvy.
It would be wrong to think that the current FDS business model with multiple centres and 28 staff “evolved from nothing”, Dr Carrigy says. On the contrary, right from the start he had a clear vision of what he needed to achieve and how to get there. “When FDS began in 1997, apart from a name, it only involved one specialist (me), an instrument bag and one staff member who wore a myriad of hats—dental assistant/part-time administrator and marketing expert. In my own time on Thursday nights and Saturday mornings, while still working for the army, I leased spare chair space off friends in the dental world—to trial various service delivery models and develop systems to deliver periodontal, implant and minor oral surgery services with optimal flexibility and efficiency without losing the central focus on patient care.”
Dr Carrigy recalls consultations moved from 30 minutes to 40 minutes, sometimes to an hour. People told him “it couldn’t be done, you’ll go broke. Yet over 20 years later all the FDS clinicians are booked well ahead, enjoy their work and make a decent income,” he enthuses. “It is unusual for a specialist practice to have many internal referrals. But at FDS, referrals from patients of their family and friends is not uncommon.”
You read right—when Dr Carrigy first conceived of FDS, he held a commission in the Royal Australian Army Dental Corps. After joining as an undergraduate from Sydney University, he practised as a general dentist on various postings up and down the east coast of Australia. It was in the military that “Captain Carrigy” was schooled in managing both resources and staff. “The importance of a team in outperforming an individual was clear,” he says. “As was the centrality of clearly documented systems and ongoing training to produce ‘excellence’ in outcomes.”
After 13 years in the regular army and achieving the rank of Lieutenant Colonel, Dr Carrigy says he had to make a choice–“stay on in the military and move up the administrative stream or transition out into the private sector and remain focused on patient care and clinical services”.
He chose the latter and FDS came into being “strengthened by the military model of a central administrative cell supporting mobile and flexible clinical teams”. Today the practice has 17 chairs spread across four main central clinics and operates between 4-7 satellite services. Six clinicians provide support to a network of over 80 general dental practices within the fields of periodontics, oral medicine, minor oral surgery and dental implants.
Dr Carrigy says FDS is proof that the engine room of the economy and employment is the ‘small business’–noting that one FDS staff member following Dr Carrigy around with his one bag of instruments has expanded to now include over 28 ancillary staff, many having been with FDS for well over 10 years. “What is even more unique is how the staff at FDS have, in turn, brought their own family into the business,” he says. “If you ring FDS and think Megan and Kate sound similar, you’re right. They are sisters. If you think Ella looks like Megan, you’re right. They are mother and daughter. If you think Helen and Jack and Charlie seem very relaxed as a team. Well spotted. They are a mother and her two sons.”
Truly a family business—and it doesn’t stop there. Dr Carrigy’s wife, Bronwyn, is a general dentist and a solid support in building the concept while his three children are all dentists or studying dentistry (one is already a periodontist working alongside his father at FDS), and two of their spouses are also dentists. “So at the moment, the Carrigy family holds seven dental degrees between them with two more underway.”
Patients are referred to FDS by a network of general dentists, medical and other allied professionals with whom the FDS team works very closely, recognising the importance of collaboration in achieving better outcomes for patients.
“At FDS we serve two different groups of people,” Dr Carrigy says. “The first are the actual patients, the second are our referring general and other practitioners.”
Dr Carrigy believes that good communication is paramount in building and maintaining these links. For patients it entails “really listening to help find any underlying reasons for their concerns. Listen—then listen again. Often problems in the mouth are the result of more systemic health concerns. We’re into good, solid, basic holistic care of the patient in the sense that we know the mouth is not devoid from the body. And that sometimes we have to find out what’s happening with the body to try and fix the mouth.”
Similarly, a real effort is made at FDS to keep referring dentists ‘in the loop’ and central to managing the patient’s overall care plan—with regular update reports and ‘shared care’ whenever possible. “We work very hand-in-glove with our referring dentist, who we see as the central person coordinating the care for the patient. We as a specialist are basically providing a service to the general dentist.”
In addition, as part of developing a strong mutually supportive local professional dental community, Dr Carrigy has always sought out ways to encourage general ongoing dental education to deepen knowledge and broaden clinical skills. To this end, he has helped start up a number of dental study clubs. The latest is called ‘Synergy’, of which he is the current president. It has an active membership of over 80 practitioners on the Sunshine Coast and is spread between private and corporate memberships. Teaching on a weekly basis at Griffith University as an adjunct senior lecturer within the specialist training scheme “is another way to ‘give back’ to a profession that has given me so much over many years”.
So is the building of FDS now complete? “Well, I have this other idea,” Dr Carrigy says. “It’s a way to use some of the empty FDS chair time to help other young specialists get a ‘leg up’. It is called The Dental Specialist HUB and we are exploring the concept. Look it up. I think it will take flexibility in the dental specialist business model to the next level.”