29 years in dentistry. Not as a clinician — as the person who builds the business around the clinician.
Ronel Van Der Spuy. Dental Practice Consultant.
Most dental principals reach a point where the practice is generating reasonable revenue, the clinical work is good, and the team is capable — but everything still depends on the principal being there to hold it together. Evenings get eaten up by admin. Problems that should be handled by the team land back on the principal's desk. The diary fills up but the business never quite feels under control.
That is not a personal failing. It is a systems one. Dental school prepares you to treat patients exceptionally well. It does not prepare you to design the systems, processes, and frameworks that allow a practice to run without you at the centre of everything.
That gap is fixable. It is a systems problem, and systems can be built. It is what I have spent 29 years understanding — first building and running a practice myself, and now helping other principals do the same.
Built from nothing. Tested by everything.
Starting from scratch
In 1997, my husband and I opened a squat dental practice in Newbury. We bought a building, refurbished it as a dental surgery, and opened as an NHS practice with no inherited patient list and no established reputation. The first day the phones went live, the answerphone blew up. My husband started by himself. We very quickly had to open a second surgery.
In 2005, when the NHS changed to UDAs, we knew the model had to change. The new contract felt like going to the supermarket with a full trolley and being told you could only pay for a basket. The economics did not work. We made the decision to convert to private and launched our own membership plan — the 20/20 Smile — so patients could spread the cost of their routine care without depending on a third-party scheme. That put us in control of our patient relationships, and it changed everything.
What nobody tells you is that the real test of a business model is not how it performs in a good year. It is what happens when the floor falls out.
Tested by crisis
In 2008, practices across the country were haemorrhaging patients. The financial crisis emptied diaries. Ours stayed more than 80% full. The membership model, the patient relationships, the systems we had built — they held.
Then COVID-19. By then we had sold the practice, though I had stayed on to run it — so this time the systems were being tested without their founders owning them. I remember pulling the door shut and not knowing when we would open again. When we were allowed back, we went back fast: PAPR hoods, proper protocols, a team that had been looked after. Our patients came back. The practice survived, and then it grew again.
But the result I am most proud of has nothing to do with revenue. It is the nurse we took on at 16, with no experience in dentistry or professional life. We trained her properly — not just clinical skills, but how to carry yourself, how to be part of a team, how to grow. She left at 23 to move away. At her last Christmas party, I looked at this confident, capable young woman and thought: I did something real here. Her parents are still patients. They still thank us.
That is what 29 years in this industry actually looks like.
Key milestones
1997
Opened a squat NHS practice in Newbury, Berkshire, from scratch with no inherited patient list. Second surgery added within the first year.
2005
Following the UDA contract change, converted to a primarily private model and launched the 20/20 Smile membership plan.
2008
While other practices struggled, the membership model and solid systems meant patient retention held through the downturn.
2019
Completed the sale of 20/20 Dental Practice. The buyer was purchasing documented systems and a functioning team — not just a patient list.
2020
Closed during lockdown, returned as quickly as possible with full PPE protocols. The practice survived and continued to grow — under new ownership, with the systems still running.
Today
Working with a small number of practice principals to build the non-clinical foundations their practices need to thrive.
29 years of direct operational experience
Covering practice management, finance, HR, compliance, patient experience, and marketing — not as a consultant observing from the outside, but as an operator who built and ran a practice for over two decades.
Masters in Educational Psychology
Informing how I approach team development, staff onboarding, and behaviour change within practice teams. The human side of systems work is often where the real difference gets made.
Dental practices. Exclusively.
I am not a generalist business coach. I work exclusively with dental practices, and I bring direct operational experience — not theory — to every engagement.
Practical work. Specific to each practice.
I work with a small number of dental practice principals at a time. The work is always thorough and the relationship is always direct — not a generic programme applied from a distance.
I rebuild the non-clinical foundation: reception systems, staff protocols, onboarding processes, patient experience standards, and KPI frameworks. The parts of the practice that should run reliably whether or not the principal is there.
If you are thinking about stepping back from the chair, growing the practice, or planning an eventual exit, the time to build those foundations is before you need them — not after.
If that is where you are, the right starting point is a conversation.
Ready to talk?
A 30-minute call. No charge, no obligation. We look at where your practice is operationally, what the gap looks like, and whether working together makes sense.