How a well-planned programme of borrowing can increase your practice's earning potential

Managing Director of Medifinance, Ray Cox, explains the importance of presenting an evidence-based case when seeking funding.

I'm sure you've heard the saying that banks lend money only to people who don't need it. Which at face value seems both contradictory and faintly ridiculous.But a cautionary tale highlights why perhaps there is more than a germ of truth lying there.

I was talking to a particularly successful practice owner recently who was looking to expand. His business was certainly profitable, and he had never experienced any significant difficulty in finding funding as and when needed. Essentially, he considered himself and his business to be 'a good risk' and that his relationship with his bank would stand him in good stead. This would, almost certainly, have been the case when that relationship was effectively between him and the Bank Manager, but things are different now. Firstly, he had to establish the right person within the bank to whom the funding application should be submitted and having done that send in his written plan for 'consideration'.He was not given any guidance by the Bank on what the plan should cover, but he felt he could put together a proposal that would produce a positive response.

Much to his amazement he was turned down flat. Why?Because, successful as his business was (and is!), he did not present an evidence-based case for funding. He made the assumption that a detailed, costed and realistic business plan was not necessary.

He was wrong.

How to prepare a plan that will give you every chance of sourcing the funding you need

Of course, rules are there to be broken and a good few entrepreneurs break them and still the profits roll in. But for we mere mortals, it makes sense to understand from the start that to run a successful business and maintain that success depends on one key factor…..being and staying informed.

This means you will run your business in a business-like manner. It also means that when you need funding the lender appreciates that your case is based on reality rather than speculation. 

So let's take a look at what will reassure the Bank/Lender and ensure that you not only secure the funding you need, but obtain the most favourable terms:
  • Above all, monthly management accounts will demonstrate you keep your finger on the pulse. It will immediately convince the lender that you have the level of commitment required to run a business responsibly. Quite simply, it is not being run well unless it consistently monitors its costs, its profits, its losses and its cashflow.
  • It always pays to have a good team of advisers that understand their roles and can lend authenticity and credibility to your business plan. An accountant with experience of the profession is a given, but, depending on circumstances and resources, you may add legal, marketing and financial advising expertise to your team.
  • Indicate your ability to delegate and put in place the reporting procedures that allow you to assess and implement the information provided
  • Be absolutely honest about the costs involved and the resources required to implement your plan. Do your research diligently and demonstrate you have done it. Do not attempt to ignore potential problems in the hope that 'something will turn up'. It rarely does!
  • As appropriate, support your application with evidence of your financial track record and management eg:
    - Loan repayments
    - Credit rating
    - Credit control
    - Management and control of overheads
    - Cashflow
    - Salaries, bonuses and pensions policy
    - Assets

If your business plan meets the above criteria, your application for funding will, without doubt, result in a positive outcome. It may require a little extra effort, but the longer-term rewards will more than justify the time it takes.

If you feel we may be able to help you with putting together a business plan and sourcing funding and/or you have any other financial requirements do please contact me at This email address is being protected from spambots. You need JavaScript enabled to view it. mobile 07785 757782 www.medifinance.co.uk 
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Is refinancing a sensible option?

 Ray Cox, Managing Director of Medifinance , feels that in the current economic climate, a review of practice loan arrangements could be a wise and financially beneficial decision.

The challenge I face whenever I am tempted to mention the word refinancing is to prevent people's eyes glazing over.
Nevertheless, I'm going to risk it.
Refinancing.
Taking into account the current market environment I think that many practices really could benefit from looking at the loans they have taken out over recent times. I say this because as interest rates begin to fall, the loan market becomes more competitive and terms and conditions (not to mention interest rates) reflect this. In short, by refinancing you could save a considerable amount of money each month. And, as I'll explain, there are other factors that could play to your advantage.

Why you may well benefit from refinancing

Of course, each practice and its finances are different, so what works for one may not work for another. There are naturally a number of pros and cons. But ask yourself if any of the following strike a chord:
  • Is it possible that loans taken out when rates were at their peak could be replaced by loans offering better rates, terms and conditions?
  • Have our needs changed and/or would we benefit, right now, from an injection of capital?
  • Is our loan portfolio complicated and difficult to track and administer?
  • Are our longer-term loan prospects perhaps being jeopardised by being seen to be too exposed to a plethora of current loan agreements?
There may well be other points to take into account and review. Other potential benefits for your practice may well emerge. In my own experience however, such an audit rarely fails to produce a positive outcome.

The factors you should consider

Let me set out for you the areas that should form the backdrop to any refinancing review. You don't have to do this, of course, but it's surprising how it can sharpen the mind and help you focus not only on short term needs but on your longer-term objectives……frequently highlighting ways of achieving those objectives more quickly and with less outlay.
  • Are you on course to meet your long-term goals and if not, what is holding up progress?
  • What short term and/or immediate requirements are causing problems and could an injection of funding, that does not impact negatively on cash flow, be helpful?
  • Is cash flow a problem if so what steps are being taken to address and overcome it?
  • Do we need to up our level of investment in the practice to keep ahead of the game and remain competitive?

A suggestion

Over the last few months, I have had meetings with a number of Practice Owners and their accountants specifically to look at their loan portfolios and review the benefits that could possibly accrue by refinancing. In a good number of cases the objective conclusion is to 'leave well alone' but, by the same token, we have, between us, unearthed some loan agreements which are, quite frankly, (and let's be kind) 'less than helpful'.
Even when the conclusion has been reached that there would be little or no value in following the route of refinancing, the time spent (as I explained above) is always worthwhile. Where the case for refinancing has been only too clear, better arrangements, terms and conditions have been put in place.
Other than setting aside a little time, such an exercise will cost you nothing. The potential benefits for you and your practice are significant.
If you feel we may be able to help you with putting together a business plan and sourcing funding and/or you have any other financial requirements do please contact me at This email address is being protected from spambots. You need JavaScript enabled to view it. mobile 07785 757782 www.medifinance.co.uk 
  209 Hits

Is there a right time?

Managing Director of Medifinance, Ray Cox, believes that a review of the way a practice is equipped may pay unexpected dividends.

I think that we can benefit if we are able to laugh at ourselves.
A very good friend of mine, who runs a pretty successful practice, was recently told by a long-established patient(client) that whilst she considered him to be an excellent dentist she felt that the overall feel of the practice was, to use her words, 'a bit tired'.
Now JS (as we'll call him) is certainly careful with money, but he's not mean. Equipment is replaced as and when necessary and/or when the lease runs out but that's about it when it comes to any sort of replacement/updating programme. By his own admission he hasn't really thought a great deal about the other factors that might impact on a patient's perception of his practice, so the 'tired' comment came us something a surprise. And not a particularly pleasant one.
However, and to give JS his due, he took it on the chin, and over a very pleasant and good-humoured lunch, we agreed that a patient's perception is reality and that he needed to understand this and up the game. Whilst we both acknowledged that every practice is different and there can never be a 'one size fits all' equipment strategy, we felt that there are other factors to take into account that may be easily overlooked. In short, planning for replacing/updating equipment should go beyond simply replacement when it reaches its sell by date. A far more holistic approach is needed.
Let me tell you (albeit briefly and without the accompanying glass or two) what we talked about and what considerations practices might well benefit from taking into account as they invest in their growth and profitability. Here are a few questions I think you should ask yourself……

On the basis that you get what you pay for what best describes our treatment equipment strategy?

Do we as a rule replace like with like? Do we look to upgrade where feasible? Do we 'wait till it breaks' and risk increased servicing bills? Are we confident that we are up to date on what products are available within the categories in which we are seeking to replace?

What is our policy for looking at providing additional/new treatments that could potentially increase revenue?

Do we actually have a policy and if so how frequently is it reviewed and discussed? What are the criteria for implementation? Even if the demand were there would we postpone opening a new surgery and simply accept that prices will rise whilst we delay our decision?

When a new client walks into our practice what might be their first impression?

Are we maintaining an investment in our practice as a whole?
If you were being graded, give yourself marks out of ten (and be honest with yourself or better still ask a few clients to do it for you) on:
Are we maintaining an investment in our practice as a whole?
If you were being graded, give yourself marks out of ten (and be honest with yourself or better still ask a few clients to do it for you) on:
  • Friendliness
  • Signing
  • Parking
  • Waiting area facilities and comfort
  • Overall décor, tidiness and cleanliness throughout the practice
  • Waiting time

As a practice are we investing in a working environment that not only helps us retain staff but also aids recruitment?

Again it's worth taking a critical look not only at treatment equipment, but also at rest facilities, toilets, lighting, staff parking and so on. Is there a positive energy about the place? Is staff morale high?

Do we try and stay ahead of our competitors?

And if we do, how? Have we recently checked out the competition and are there things they do better?

To Sum up

The point I want to make is that every type of equipment you purchase for your practice, be it waiting room furniture or CD scanners, is an investment and the better the investment the more revenue it will generate.
So when is the right time to invest in new equipment? In truth there is never a right time. Do you wait until something breaks before replacing it or recognise the signs of wear and tear and ever-increasing service bills and get ahead of the curve? Do you postpone expanding into another surgery to deal with patient demand merely to exacerbate the situation or be ahead of the game and bring the new surgery into use to deal with the demand as it happens? The new piece of imaging technology you know other practices in the area have…..do you wait until the price comes down or invest now and reap the rewards of better and faster diagnosis? There are many reasons for delaying new investment and probably the most common is the financial one. But whilst you wait for interest rates to improve the price of equipment just keeps on rising like a rainbow with no end. One answer is to speak to us and find out the actual cost of financing your investment. You may be pleasantly surprised.
If you feel we may be able to help you with putting together a business plan and sourcing funding and/or you have any other financial requirements do please contact me at This email address is being protected from spambots. You need JavaScript enabled to view it. mobile 07785 757782 www.medifinance.co.uk 
  139 Hits

Think positive thoughts and put them into action

Ray Cox, Managing Director of Medifinance, reviews the real opportunities and the advice and help available for dentists looking to start up their own practice

Ray Cox, MD Medifinance

 No matter how much you love your job, it's difficult not to feel somewhat jaded from time to time. I know that I get a huge amount of pleasure and satisfaction from what I do, but occasionally a feeling of 'been there and done that' can be hard to resist. And having worked with the profession for decades, I am only too aware of the stresses it can impose on dentists.

Allied with the seemingly endless media negativity and failures of politicians of all hues to grasp the realities of delivering dentistry, one can be forgiven for perhaps allowing a degree of cynicism to creep in. Yet despite the pressures, I find the profession overall in remarkably good shape and a meeting I had a week or so back at an event I attended, underlined its sheer enthusiasm and positivity and that fills me with a good deal of optimism.
One dentist at this event (I'll call him 'B') was little short of inspirational. What struck me as we listened to his story, was that his success was achieved not through any privilege or exceptional piece of good fortune, but through hard work, a clear sense of purpose, and crucially the determination to overcome and learn from setbacks. In short what he was saying (and with genuine modesty) was that what he had and was achieving is within the grasp of any young dentist prepared to make a positive commitment, plan carefully and accept that setbacks are never to be considered failure.

Translating positive thoughts into positive action.

If you go online there are vast amounts of advice on the values of positive thinking and sharing that positive thinking with others. It's well worth reading. As is attending motivational courses by many of the highly qualified and experienced dental business gurus. But the point that B emphasised was that you need to have a clear and realistic business plan in place from an early stage or positive thinking will remain just that.

Later in the day I asked B to talk a little more about the steps he took to put in place a plan that would make his dream a reality. What I found both reassuring and impressive was that his suggestions were not some combination of 'marketing speak' and techno jargon but rather a set of sensible disciplines that are simple to understand and implement.

I found myself nodding along. I hope you will too. 

  1. Talk with colleagues who have and/or are achieving success. Most are happy to share what they did to get it right and advise you of ways you may be able to avoid the pitfalls that are an inevitable issue for any and every business2. Be honest with yourself about your strengths; but equally be honest about your weaknesses and how you intend to overcome them
  2. Set clear business objectives and targets for yourself and ally them to the lifestyle that you want. This is crucial. We don't all measure success in the same way. At the same time write down and agree with your teams (see 6 below) your criteria for measuring success
  3. Don't think short term or be dictated to by immediate economic factors such as interest rates. 'Experts' are consistently inconsistent with their forecasting and frequently wrong!!
  4. Recognise from the start that whilst you may have a plan in place, many factors over the course of time will occur that will need you to review and adjust. Be nimble and flexible enough to deal with the unexpected and turn those problems into opportunities
  5. Define the sort of people you want to work with and for. This means your day-to-day work colleagues, your patients and your advisory team
  6. Recognise the importance of everyone's physical and mental well-being and consider what steps you can take to maintain both. This is not simply a nod towards 'being seen to do the right thing' but a genuine part of building loyalty and teamwork 

B and I agreed that we will be working together to assist and advise dentists who are looking to start up their own practice. This advice will cover business planning and strategy, budgeting and sourcing funding. Do please contact me, with no commitment on your part, on 07785 757782 if this is of interest to you and /or you have any immediate or longer term funding requirements.

  326 Hits

What lenders are looking for

What lenders are looking for

 Ray Cox, Managing Director of Medifinance explains the importance of presenting an evidence-based case when seeking funding

I'm sure you've heard the saying that banks lend money only to people who don't need it. Which at face value seems both contradictory and faintly ridiculous. But a cautionary tale highlights why perhaps there is more than a germ of truth lying there.

I was talking to a particularly successful practice owner recently who was looking to expand. His business was certainly profitable, and he had never experienced any significant difficulty in finding funding as and when needed. Essentially, he considered himself and his business to be 'a good risk' and that his relationship with his bank would stand him in good stead. 

This would, almost certainly, have been the case when that relationship was effectively between him and the Bank Manager, but things are different now. Firstly, he had to establish the right person within the bank to whom the funding application should be submitted and having done that send in his written plan for 'consideration'. He was not given any guidance by the Bank on what the plan should cover, but he felt he could put together a proposal that would produce a positive response.

Much to his amazement he was turned down flat. Why? Because, successful as his business was (and is!), he did not present an evidence-based case for funding. He made the assumption that a detailed, costed and realistic business plan was not necessary.

He was wrong.

How to prepare a plan that will give you every chance of sourcing the funding you need

Of course, rules are there to be broken and a good few entrepreneurs break them and still the profits roll in. But for we mere mortals, it makes sense to understand from the start that to run a successful business and maintain that success depends on one key factor…..being and staying informed.

This means you will run your business in a business-like manner. It also means that when you need funding the lender appreciates that your case is based on reality rather than speculation.

So let's take a look at what will reassure the Bank/Lender and ensure that you not only secure the funding you need, but obtain the most favourable terms:
  1. Above all, monthly management accounts will demonstrate you keep your finger on the pulse. It will immediately convince the lender that you have the level of commitment required to run a business responsibly. Quite simply, it is not being run well unless it consistently monitors its costs, its profits, its losses and its cashflow.
  2. It always pays to have a good team of advisers that understand their roles and can lend authenticity and credibility to your business plan. An accountant with experience of the profession is a given, but, depending on circumstances and resources, you may add legal, marketing and financial advising expertise to your team.
  3. Indicate your ability to delegate and put in place the reporting procedures that allow you to assess and implement the information provided.
  4. Be absolutely honest about the costs involved and the resources required to implement your plan. Do your research diligently and demonstrate you have done it. Do not attempt to ignore potential problems in the hope that 'something will turn up'. It rarely does!
  5. As appropriate, support your application with evidence of your financial track record and management eg:
    • Loan repayments
    • Credit rating
    • Credit control
    • Management and control of overheads
    • Cashflow
    • Salaries, bonuses and pensions policy
    • Assets 
If your business plan meets the above criteria, your application for funding will, without doubt, result in a positive outcome. It may require a little extra effort, but the longer-term rewards will more than justify the time it takes.
If you feel we may be able to help you with putting together a business plan and sourcing funding and/or you have any other financial requirements do please contact me at This email address is being protected from spambots. You need JavaScript enabled to view it. mobile 07785 757782 www.medifinance.co.uk 
  357 Hits

Take Your Time ...

Ray Cox, Managing Director of Medifinance explains why it pays to take a careful look at funding options when undertaking a major project

Ray Cox, MD Medifinance

In business, as in life in general, we are constantly making decisions, both big and small.We never consciously decide to make wrong decisions, but it is only after those decisions have taken effect that they can be judged good or bad.We simply must expect the unexpected and recognise that many variables impact on our lives.Having said that, I believe that it does make sense, where realistically possible, to minimise risk by drawing on experience.

Over the many years that I have worked with the Health Professions, sourcing funding has been relatively straightforward. Banks and lenders have taken the view that they represented a good risk and, as a result, most applications for finance went through 'with a nod'.In the current economic climate this has changed…..not dramatically, but significantly…… andfor major projects particularly, plans need to be seen to have been thoroughly researched, considered and realistic before money is forthcoming.

But I see this as a good thing.It focuses the mind, makes our thinking more diligent and mitigates against our rushing into making hasty decisions.

The point I really want to make is that when 'money is easy' we can fall into the trap of disregarding sensible financial management and the longer-term implications of our decisions.I'll give you an example …..

Recently a client of mine decided to set up his practice and fund both renovation and refurbishment and equipment with a single loan from his bank.He was being offered a good rate and, at face value, it seemed a good deal.However, what he had not taken into account is the shorter life cycle of equipment which would need relatively frequent updating and replacement.I pointed out that a single, consolidated loan would ultimately cost him far more than funding renovations and equipment separately. And we are talking thousands of pounds saved here.

Getting the balance right

No business can grow without taking a degree of risk but taking the time to plan carefully and review the options will be time well spent. So, my advice is always to strike a balance between ambition and caution. I have been fortunate enough to work with clients whose businesses have evolved and developed with considerable success but by the same token I have seen mistakes made that, with a little discretion, could have been avoided. I would never claim to have 'seen it all before', but Medifinance does have an unrivalled depth of experience of the healthcare markets and its funding. This is experience that we are happy to share with clients and potential clients without any commitment on their part. Another quick example demonstrates the value of marrying ambition with experience, taking a moment to step back, and as a result avoiding losses that could have run into hundreds of thousands ...

A long standing and very successful client wanted to expand and extend the existing practice. Concerned about the upheaval and impact on patients the decision was made to set up another practice with a 10-year lease to compensate for a short-term reduction in the existing facilities. I was concerned on three levels. Firstly, the effect on patients, many of whom might resent being selected to attend what was clearly going to be a less well-appointed practice, secondly, of course, the cost of setting up, and thirdly the long-term viability of running two practices.

We discussed these concerns openly and together assessed the pros and cons and the risks involved. In the end, working with the architect and builders, we went back to Plan A, amended the extension project with minimal impact on patients and without taking on the additional costs of setting up another practice. 

In conclusion

 Particularly if you are considering a major project for your practice, you would be wise to get an early overview of the likely financial, funding and tax implications before you start planning and briefing architects and builders. If you fail to do this a great deal of time can be wasted and unnecessary expense incurred as the project evolves. And as I have pointed out, sourcing the most advantageous funding goes a lot further than simply interest rates.

If you feel we may be able to help you with sourcing funding for your practice requirements do please give me a call. There is absolutely no commitment on your part. My mobile is 07785 757782 and my email is This email address is being protected from spambots. You need JavaScript enabled to view it. 

  679 Hits

Dental Practice Upgrade Funding #dentalpracticefunding #equipmentfinance

'Our relationship with Ray goes back a long way and he's the first person I think of when we need to source funding. He's always helpful, always reliable and always quick to respond.'

Dentistry on The Grove
  1252 Hits

Their experience proved invaluable throughout

 Really grateful to Ray for his advice and support in acquiring and equipping my new practice in Christchurch. His experience in finding exactly the right funding for everything I needed to equip my surgeries has proved invaluable throughout the project. I love delivering excellent dentistry and I now have the perfect working environment for me to continue doing exactly that.

Ella Aslani – Copper Beech Clinic

  1410 Hits

Private Dentistry September 2022

In this, the first of four articles, Ray Cox, Managing Director of Medifinance, looks at the key aspects of financial planning dentists should consider as their careers progress 

Based on working with and for the dental profession for many years I want to pass on some suggestions that I hope you will see as useful guidelines as your career progresses. This is the first of four articles (that will run on alternate months until next March) and will concentrate on the early years following graduation. Future articles will cover:

  • Setting up squats and practice purchase
  • Maintaining profitable and sustainable growth
  • Planning for retirement

None of these articles is intended to be a definitive guide or promote any specific product or service. Rather they will reflect the stages in financial planning taken by the majority of the dentists with whom I have worked. Having said that, it is important to recognise that every case is different, and needs vary from dentist to dentist and practice to practice. 

Finance in the early years 

The right way to borrow money in your Associate years is to borrow as little as possible. Whatever your financial circumstances, this is the time to be thrifty and put in place the building blocks of your career. Save what you can……sensible sacrifices now will pay huge rewards in the time to come.

One decision that will, of course, dictate how you move forward is whether you see your future as an employer or as an employee. That is for you to decide. All I would suggest is to keep an open mind, but the issues I will cover in this series are fundamentally aimed at those who want to run their own practice. 

Planning 

This is so important. There is no set formula but I would recommend writing down the way you see your career progressing and what things you feel you need to take into account (including funding) in order to reach your goals. Review your plan regularly keeping in mind that this is a steep learning curve for you and if it is your ultimate intention to run your own business, it is particularly important to observe what things work….and what things don't. 

Start to build a support team 

If it is your ambition to run your own business you are almost certainly going to need good, experienced and trustworthy advisers. In future articles I will spell this out in more detail but do not be tempted to cut corners and feel you do not need knowledgeable advice. So, use these first few years to make contacts and talk to colleagues with a view to having in place a professional support team when the time is right to take the next step.

You are going to need marketing, accountancy, financial and legal support and you would be well advised to think about companies that provide such services as surgery design, data base management, social media and training.

And a tip. Get recommendations from colleagues whenever you can. Some people are prone to rather exaggerate their achievements and capabilities!! 

Developing and enhancing your skills 

In my opinion this will prove to be a sound investment for the longer term. The perceived value of good dentistry is far greater now than it was just a few years ago. There will always be those who consider a visit to the dentist should either be free or only in an emergency; but this is their problem, not yours! Good dentistry merits and commands good prices. 

Putting it bluntly, the better you are at doing dentistry, the better placed you are to be successful. So if you are going to spend (or even modestly borrow) during your Associate days, this is where you should do it.

Life balance 

This may seem to be something rather outside the remit of a series of articles based on using and making money. But the bottom line is (to repeat an old cliché), Money doesn't buy happiness, and it's no good making bags of it if you're constantly stressed out and worried.
I would recommend setting alongside your business plan the lifestyle you want and the things that you will enjoy and find fulfilling. Then look to see how you can use money to achieve these. Putting it another way, a wise maxim is to remind yourself that you are not simply going to make money, but that you are going to make it work for you. 

Moving to the next stage 

My next article will address the major considerations that need to be taken into account when you set up a squat or purchase a practice.

If you wish to discuss, confidentially and without obligation, any issues regarding financial planning, you can contact Ray on his mobile 07785 757782 email: This email address is being protected from spambots. You need JavaScript enabled to view it. www.medifinance.co.uk

  1641 Hits

I trust them implicitly

When I made the decision to relocate my orthodontic practice in Taunton I knew I would need some knowledgeable advice on funding. My accountant recommended Medifinance and the people there have not only negotiated excellent bank loan and lease terms but have also sorted out and handled all the paperwork. Throughout it all, Ray and his team have been reliable and supportive. I trust them implicitly. 

Helen Griffiths, Confident Ortho

  1427 Hits

Never let me down!

Ray has never let me down. From my undergraduate days when he arranged the finance for my very first car through to helping me prepare my business plan and cashflow forecasts for my practice in Oxford, Ray has been reliably and consistently on hand. In addition to his knowledge of the financial markets (he constantly reviews the options), he has an invaluable network of contacts. And because he knows so well how dentistry 'works', he will always respond rapidly. His assistance in helping me invest and upgrade equipment post Covid was a case in point.  

Maria Hardman, Clinic 95

  1411 Hits