Niall Hutchinson’s red wine social media posts are designed to provoke discussion on some of dentistry’s thorniest topics.
So get ready for a robust and full-bodied discussion as Payman chats with one of dentistry’s most outspoken and engaging characters.
Niall and Payman take crack open a red to take on everything from the saturated dental courses market to NHS dentistry, the role of corporates, and much more.
In This Episode
01.44 – Red wine
07.31 – CPD and profitability
26.28 – NHS – the second coming?
36.23 – Skills Vs soft skills
39.42 – Going private
44.13 – Price increases
47.28 – Corporates – a force for good?
57.50 – A little backstory
01.03.58 – Staying engaged
01.07.51 – Specialism Vs generalism
01.11.38 – Invisalign
01.15.47 – Business secrets
01.24.29 – Choosing associates
01.28.29 – The labour market
01.30.24 – Black box thinking
01.40.55 – Best and worst days
01.45.15 – Fantasy dinner party
01.48.13 – Last days and legacy
About Niall Hutchinson
Dr Niall Hutchinson qualified from Queen’s University Belfast in 1987 and spent four years as an associate in Northern Ireland before moving to the UK.
He is the owner and clinical director of Cherry Tree Dental Care, near Wantage, Oxford
[00:00:00] The thing is, if you want to enjoy your dentistry, if you want to actually like your job, I think you’ve got to go private. At my opinion, you really got to. Nowadays, I don’t think there’s any choice. The funding is just appalling, and I admire people who try and do it for feeling that they have an ethical obligation to it, feeling that they have a moral and more moral obligation to do it. Yeah, do it for a while. Pay back what you feel is your moral obligation. As I said, I did dentistry for 16 years in the NHS, so I think I more than paid back any sort of moral obligation to society on that. But as fast as you can, I would move on.
[00:00:48] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman, Langroudi and Prav Solanki.
[00:01:06] It’s my great pleasure to welcome Lyle Hutchinson onto the podcast. Nile is famous or infamous really for his red wine posts that he’s been doing lately practise owner principle and has lately set up a group that’s I think one of the most important groups in dentistry now is called not such a good day at the orifice where where we look at errors and things that didn’t go so well. And my sort of antidote to the Instagram generation where everyone’s patting everyone’s back and everyone’s showing off about the things that did go well. It’s lovely to have you now.
[00:01:42] Hi, Payman. Thanks for inviting me on.
[00:01:44] My pleasure. My pleasure. We thought it would be fun to do a red wine podcast. And I’ve got to admit right now, Nile, that the bottle that I’ve chosen I haven’t got because of my my wife’s Lebanese. And so I had thought I had a bottle of matzah in the back of my cupboard. But obviously, I think that some some somewhere along the line. So I’ve got I’ve got what I call my steak wine. It’s a Bordeaux. It’s a scent Himalayan thing. The main reason I like it is that it’s on Zap, so I can push a button and it arrives within 10 seconds.
[00:02:21] Oh, yeah.
[00:02:23] What have you.
[00:02:24] Got now out in rural Berkshire? We don’t have that, I think. I don’t think we’re ready yet. But I’ve got I’ve got it. I’ve got a Australian Shiraz with me here, you know, which is not bad. Yeah. I must admit I prefer the French red wines, but yeah, the nice shiraz is not bad at all.
[00:02:42] Excellent. My favourite thing about wine is this this sound here.
[00:02:47] Oh, yeah, I know.
[00:02:49] It’s the sound. Fine. I never get quite screwed up so I can say why they broke the lid. Because you don’t get a problem with being caught. But it’s not some kind of the cork satisfying side of the cork coming out. And you just that moment that you think, I’ve just got the wine, it’s fantastic. You know, it is. It is that you know, I think there’s a who as I said, we used to live in France for a year and the French taught me to appreciate a lot more wine. And that made me realise that I actually sort of moved as straight away to Chile and Argentina. I know they do very, very good wines. I sort of have gone back to French wines, but they really certain, you know, that appreciation of the whole thing about wine, not just the drinking, but the opening of the bottle and whatever else, you know.
[00:03:34] So, you know, we’ll get into red wine itself later. But I guess the red wine post is kind of a kind of a get out clause, isn’t it? Now, like, it’s almost like in this era of sort of political correctness, you can say something a little bit more, sort of, I don’t know, the controversial.
[00:03:58] A little more cheeky. And you can put red wine post on it and then it’s cool. We can we can all discuss it. And I think it’s been an excellent series.
[00:04:08] Yeah, it came eventually it came out of one evening. I can’t remember my first ever post, but it came out one evening. I was genuinely drinking a bottle of red wine and I was sitting there thinking really pissed off about something, you know, it was really irritating me and I thought, Cool. So it’s on ground. Grant Macquarie’s business marketing group. And I saw that I’m going to put this up and just hashtagged it because it was sort of it was an anti Instagram hashtag. It was a hashtag red wine post. You know, I’m not Twitter, Instagram, I’m not anything like that. But I thought it was sort of slightly ironic and I thought, you know what? And it just seemed to catch on. And yeah, it certainly divides opinion. There are a lot of people out there who think I troll with it and I’m just an irritating so-and-so. But the genuine questions, I mean, they don’t always hit the mark the way I want them to. But the genuinely r question, people say, Yo, actually you ask the elephant in the room, you ask the question that a lot of us have been wanting to know the answers to. And it’s interesting the way that I mean, sometimes I have a very definite opinion on what what I think on this thing. But quite often I’ll go, actually, I don’t have a really strong opinion on either side, but it would be just interesting to see what people think. And sometimes people pick up very valid arguments and I go, Actually, that’s a very valid point. I actually never thought of that as the latest one. I think. I don’t know if you saw it at the weekend.
[00:05:39] I did 200 responses.
[00:05:41] Yes, 200 plus responses. Yes. And why do we pay any attention to this red round poster? He’s a tosser or whatever, you know. Instead, he’s.
[00:05:52] Basically he spreads hate and division of the profession. And I actually sort of I did post to that.
[00:05:58] I think I. Never thought that myself.
[00:06:01] Well, no. Yeah, but it’s an interesting sort of. I’m actually a great advocate of profession. I’m an older dentist. I’m 57 for any of you listening. And I qualified in 1987 when, like, your composite came in one colour, you know, and it was occlusion by IP. It was, you know, everything was nothing was like your nothing. You know, we, you know, we still did blacks cavities, we did all that sort of stuff. So it was all it was a pipe dream, all that sort of stuff. So I sort of look at it and I look at the profession today and I go, Is it taking a path that I am proud of? Totally proud of? And I would say, yes, I’m yeah, I am so proud of most dentists that are out there. But there are a few angles to where I think, are we really a profession anymore? Are we going down a bit more of a car salesman or whatever, you know.
[00:06:56] Yeah. So that initial post was it. This one is the religion. Will there be a second coming or will it still be funded by five? No, no.
[00:07:06] That wasn’t the original post. Yeah, that was so I wasn’t. Yeah.
[00:07:11] Which, which one was it. Half the.
[00:07:14] Way back. I’ve about 24, 25. It was way back last October I think it was. But yeah.
[00:07:20] Yeah I was in the group so maybe yeah. Maybe that’s what I’m missing. Yeah. What it was. I think we should answer some of these. I think, I think we should talk about some of these red wine posts I think is a good place.
[00:07:31] I mean, it’s a good point. Yeah, yeah, yeah. Look them up and we’ll we’ll see what goes on. I mean, okay, back to it. Right. Let’s, let’s go for the two most recent ones. Right, CPD.
[00:07:39] Yeah, go on.
[00:07:40] Right. Do. Why is there a sudden proliferation of CPD? Well, I mean, if you look.
[00:07:50] At it because. What? Go on. Yeah, go on. What do you think?
[00:07:53] Yeah. Since just nine years ago, right. Cpd when you had a few courses, section 63 type courses, you had a few courses here and there. Tipton was a bit of a novelty. Yeah, things like that was all. But no, no. For courses everywhere you look at, you know, everybody’s doing the bloody course. So one thing is, why are there so many courses? Is it the lack of education for undergrads nowadays? I don’t know. I mean, I don’t want to put that out there because that’s an easily thrown out thing against on the grounds of qualified say, oh, you don’t know as much as we did when we qualified back in the day. I think that’s too easy an accusation to make. Or is it the fact it’s easy money? You know, and I’m not saying it’s easy, easy money because I know there will be people going out there. How dare you say that? The amount of hours of time I put in working on these lectures and I go, I agree with you on that. You know, and it’s very it’s not something I ever want to do is run the course. And I can certainly see that for hours. Know you do put in hours of it, but equally well, it must be something in for it. Is it ego or is it money or what? Or is it the desire to teach? I don’t know. I mean, what’s your opinion on it?
[00:09:06] Yeah. There’s definitely a lot more than there was. One thing I hope you’ll agree with me now. When? When we were coming through. I mean, I’m maybe seven, eight years younger than you when we were coming through. There were no courses. No. I mean, I remember thinking as a as a young associate, I remember thinking, I want to learn something about private dentistry or I want to learn something about cosmetic dentistry. And there was nothing. There was. There was one course, I think. And so a much happier overall with too many courses than too few. Yeah. The reason of why is there so many courses? I think a big part of it is, you know, the younger dentists don’t want to do NHS dentistry.
[00:09:51] They, they, they’ve got to build their CVS or they think they’ve got to build their CVS. And going on a course has become a CV builder. Yeah. And I think we both know, you know, it’s not it’s not what you do on the course. That’s the key is what you do after the course with that information. Certainly that’s that’s really the key. But as for the question of profitability, you know, I run several courses. I’ve got a I’ve got I’ve got a horse in the race here. One thing I would say about it is it’s it’s high risk. It’s high risk. Running a course and, you know, you can toss up whatever you want to toss up, but the risk factor is important. So we’ve got a composite course, which, by the way, we didn’t just start when it became fashionable. You know, we’ve been doing it for 12 years now. But but we for the first four years of that course, we were making a loss.
[00:10:47] Yes. No.
[00:10:48] With that. So. So. Don’t forget the risk side now. Is there. Is there money in it? There is a little bit. It’s a tiny part of our our bigger business, our bleaching business. But and I don’t teach the course. So so I’ve got to pay a speaker as well. But but stuff costs money that people don’t realise, you know, just shipping all the drills and things to the course just cost £1,000, you know? Yeah. And no one, no one thinks about that. And then we’ve got team and you know, there’s loads of reasons.
[00:11:22] Yeah. The reason it brought it up was two or three people pm me and saying you know, you know it’s fair enough because they’ll come on to the quality of courses as well. And do we need to have independent feedback courses in a minute? But some, a couple of two or three people pm me after that first one which was about quality and said what about the price? Of course because they really have gone up. I mean I remember the day courses used to be 299 quid, 250, 199 quid. There are now a standard 700 plus and certainly some of them are heading up that way. Not if that’s what the cost. That’s what it costs, you know. But I think there’s a little bit of cynicism from some that’s out there, as you probably pointed out, possibly quite wrongly. But and I have no strong opinions on it. I’m quite happy I’ve gone on many courses that I pay the best part of £1,000 for a day, and I’m quite happy to do that provided a good course. You know, I have no issues with that.
[00:12:18] And the other.
[00:12:18] Thing might be as to why there’s so many courses nowadays, and I think it was just poked as well by a couple of people going, oh, you know, going to mention the cost of these courses, you know, so I know what you mean. Multiply everything up and just get, oh, you must be taking this by the Monday in the day. That’s incredible. You know, so why why did you do a course? Why did you what got you into doing courses then?
[00:12:43] Well, we sell composite and the composite that we sell. You’ve got to learn how to use it. It’s a particular way of using it. Okay. But but but, you know, one thing I’ll say is, you know, the this same course, the same lecturer in Chicago is twice the price.
[00:13:05] As the one we do. So, you know, and, and I’ve been to those courses in Chicago and in all over America and dentists come pay the price of the course and almost the whole room buys the materials. Right. And, you know, they they’re just they’ve got a different outlook. And by the way, they’re not just the very young dentists who turn up to the courses. You get all sorts of dentists turning up to the courses, trying to learn a new skill. Yeah, but, but I think, you know, it’s an important question. Of course, I thought the the troubling word in your post was profiteering.
[00:13:39] Yeah, I know. Do you know what? That was a clumsily used word. I said, to be honest with you, the reason why it was trying to link it in with yeah, I know it was a very tough thing and I think that created a bit too much animosity, to be honest with you. Yeah, I didn’t mean profiteering in that way. What I was trying to equate it with was quite a few people are quite quick to throw accusations at dental companies that this bit of plastic. Right which is a bit of. You are charging me 200 quid for a bit of plastic that if I went into it would cost me a couple of quid if it didn’t have to work for dental use on it. And so I was sort of trying to sort of play with that idea that it’s okay for it. So it’s okay to slag off dental companies for charging what you think is an X amount of money. Are you charging excessive amount of money is what I was trying to get at. I think I was. Yes, I wasn’t meant to be insulting. Mike, this is the thing about the red wine posts there. Never.
[00:14:36] Don’t worry about insulting. Don’t worry about insulting. You know, it’s a concept, right? But I mean, I do see some profiteering around around dentistry. So I’ll tell you where there’s profiteering, right? You can go to the IBS, show the world’s biggest dental show. Yep. And the cologne isn’t equipped to have that many people come descend on it. And the three star hotels suddenly become £500 a night.
[00:15:03] Yeah, and they’re pretty, pretty awful.
[00:15:06] And you’ve got no other choice but to go there and spend that money. And I think with PPE, there was a question of profiteering, you know, with it. But at the same time, you know, it’s you know, obviously I’m in with that side, too, right? I supply dental equipment, dental, dental stuff, and our stuff’s expensive stuff. Our stuff isn’t cheap stuff at all.
[00:15:28] Yeah, yeah, yeah.
[00:15:30] But but you know, the comparisons that sometimes people make and dentists make with a piece of plastic, you know, there’s huge regulatory nightmares in in supplying dentists. You know, if, if I want to supply my toothpaste in India, I have to pay a compliance company over £100,000 just to say hello, you know, just to get into that country. Yeah, in in Russia. Well, before when Russia was the thing, you had to pay £1,000 per ingredient per product for regulatory compliance. And then, you know, there’s a competitive thing. And, you know, I don’t know, it’s one of those things that, you know, the market will decide and profiteering sounded like the wrong word for it.
[00:16:16] Yeah. No. And with with with hindsight, I wouldn’t have used that word. And I think that’s what went wrong. I mean, now.
[00:16:23] But let’s get let’s get to this question of, you know, as a dentist, let’s say you’re booked up 11 weeks ahead. Should you put your prices up or not?
[00:16:32] Yeah, absolutely. And I mean, it was it’s a it’s a hypocritical post. And asmuch as that, you know, your patients would look at me and what I charge and my hourly rate of which I average are about sort of 275 to £300 an hour. I work in rural Oxfordshire and patients would look at me and go, Oh Jesus Christ, you’re ripping us off, you know? And yeah, you do get accusations. I mean, I suppose I’m paying for your holiday and I’ll go, Yes, I actually do say no. Yes, yes. You are just a very, very small amount, you know, and if I know that they’re an electrician, but like if I got you to come on wire or something up in my house, I’d be paying for a very tiny bit of your holiday as well. But, you know, it’s, you know, don’t get so much.
[00:17:17] To recognise that dentists of our era had their thing about, oh, don’t, don’t turn up to work with your nice car.
[00:17:25] Oh, yes, don’t.
[00:17:26] Do the practise up that whole thing. But the younger ones, they’ve gone the other way, you know, they want to turn up in the Ferrari. Yeah. So that the patients think they are successful dentists you know. And that’s the kind of change in society.
[00:17:42] I’m not sure. I’ve got a Tesla and it’s parked outside the practise and they might have come on bloody Tesla going oh nice car. Ooh. And some of them are genuinely interest because it’s a Tesla and some of them are like you can tell it’s just angled. You know, the funniest one I ever had was when they took over this practise. Took this practise was like six years ago. This bloke came in for adjustment and his dentures and they go over visits and she said, Oh, what happens? They all dentists. And I went, Oh, she’s retired. And he went, Oh, I suppose he’s gone to a her holiday home in the Caribbean that she’s bought with my money, that I paid her twice over two separate visits. So I actually looked up on their say what they actually paid and they paid 800 quid over seven years. And I just went, Oh God almighty. But I mean, yes, you’re back to what you were saying. I think dentists and and this is partly why I was sort of bringing it up about the thing. I think dentists are very remiss. I’m actually a great supporter of all the dental companies, and I think they do an absolutely valuable job. You’re a company, everybody else’s company.
[00:18:51] We would not have the progression in dentistry if we did not have the companies investing in all the dental equipment. I mean, I use a company called RPA, Dental, Exxon and so on. Brilliant. Dental company best of every use. Not plugging them, obviously, but they are very, very good and the equipment they’ve supplied has enabled me to do much better dentistry. I mean, Saric, for example, I’m a big Saric fan. Saric is just amazing, you know, and you look at it nowadays, but if originally back in the day Simmons hadn’t taken on then, then I hadn’t taken on and threw a lot of money at it because Saric is quite often, you know, oh god, look at the price of £100,000 for I go, Yeah, but look at the value it brings to your practise at the end of the day. And the same with your enlightened equipment. Look at you have the best whitening stuff on the market, you have the best, you know. So the value is there and I think people do take cheap shots. So yes, it may have been a bit of a cheap shot that back to the CBD. Are you profiteering? You know, but it was meant to. Yeah.
[00:19:57] Anyway, back on debate and it did it stimulated debate. Right. That’s, that’s what.
[00:20:01] It was there it stimulated about. Yeah. I was, I went at one point nearly 200 replies wow I but, but back on and I have no no aversion to anybody charging whatever the market will stand for a dental course. But then back to what the previous week’s post was, what about the quality? I mean, have you have you been on dental courses Payman recently. Have you have. Yeah or.
[00:20:31] Yeah, yeah. Yeah. Well I stopped practising ten years ago but but I’m at a lot of dental courses. Yeah, I’m at a lot of dance courses. And look, you’re right. Let’s talk about the quality of courses and the question of where is the review site for courses? Because you’re right in that you do tend to get a lot of back, back slapping, back, back that. What did they call that when when people are just only talking about the positives. That does happen and it happens more with some courses than than others. And I’ve always wondered about that. You know, is it is there some some way, as the course provider of making that virality happen, that make people talk about you more and want to be part of it, but you don’t hear the negatives very much. And what would you think the reason for that is? I mean, people don’t want to be seen to be that that guy, I guess. So the anonymization of it.
[00:21:27] Yeah, it’s a bit like the red.
[00:21:28] Wine is a good idea.
[00:21:29] Yeah, it’s a bit like I stick my neck out and people do say to me privately, So why do you bother to stick your neck out? You just get a lot of flack sometimes. Why do you bother? And I said, Well, I’ve got to that age in life where I don’t give a shit anymore. And but I’ve got that age in life where I basically go, You know what? Sometimes I’m not willing to stand up and just sort of listen to all the sort of back slapping and all the same people going, Oh, hey, brilliant course, fantastic or whatever, you know, all sort of. And especially for younger dentists nowadays, I think us older than this have a responsibility to younger dentists to make them realise what the profession is about. And it’s not about Instagram, in my opinion. I know some people will argue differently. It’s not about solely cosmetic online, it’s not about solely Invisalign. You know, it’s a lot more than that. So but. Well, so I do stand up for what you’re saying. So why are people sort of worried about giving negative views? Mainly because of that pack mentality? Some some course. And I’ve had personally experienced this. I have been blocked. All right. By someone who took exception to something I said on the dentistry top 50 for actually for putting the dentistry top 50 thing up. That’s another one to come on to. But I got blocked. And so there are people out there who would block you, who had bully you, who would actually just go out of their way to say, you know, you possibly do nasty things. So ultimately, I think a lot of people are very scared. And also there are a lot of people, again, are scared to say the counter opinion because there are a lot of if a lot of people.
[00:23:05] Oh, it’s a brilliant, brilliant course. Brilliant course. And you’re going actually, I didn’t think it was all that. You know, you’re the one that’s going to stand out, aren’t you? And I know. And the problem is all that feedback forms your hand back in that they at the end of the course it’s all named, it’s all GDC numbered. Yeah. No. Fine. Well who’s who’s written them. Are you going to write. Somebody said I think it was Jaz or Drew and when something went. All right. So a brilliant course, a genuinely really good course gets five stars, a crop course gets four stars. And I do think there it needs I mean, people came on and said, yeah, we’ve tried this before. It hasn’t really worked. Maybe there needs to be a consensus of reason. I’m not I’m not senior enough in the profession or well respected enough in the profession to be able to do this. But maybe, maybe people like through is not so keen on the idea. I know that it doesn’t seem so keen on, but guys like you, Payman or Jazz, I say, is a really decent bloke and you know people who are highly respected. To get together and say, we are going to start this and we are going to start some sort of independent review site for courses. And whether it works, whether it brings benefit, I personally you’re not going to get in theory at the GDC, you should be doing it. But they do everything else but the actual stuff that would be useful.
[00:24:24] Yeah, they.
[00:24:27] Do absolutely everything else. You know, I’m so mad. I mean, I come from the day you do you remember coming from the day when when you could just write exam ESP and that would be enough for your notes.
[00:24:39] Yeah. When I was a dentist, that’s what it was.
[00:24:42] I remember. I remember, I think I remember.
[00:24:44] I remember showing an associate of mine. My old notes have notes from the I think it was the eighties. And I went and we counted the number of visits the patient had on the, on the old brown record forms, you know. Yeah. Yeah. And there were 24 visits, one side, 24 appointments on one side. And they’re all things like exam, ESP, upper left, six amalgam, no le or something like that. And that would be it, you know, that would be your notes and you’d get away with it, you know, oh go for those days. But yeah it is, it’s a changed field ultimately. But yeah, I do think so. Back to the the peripheral vision of course, is how do people tell what’s the good course, what’s of course now people have said to me or gets around in the grip, fine. Yeah. But only if you know people who have been on the course or, you know, the right people don’t ask or there’s something the other. So, you know, it’s surely it’s time that somebody has an evaluation of an independent. And I think it should be anonymous personally, because I think anything the way it would be done and this is the way I would view it would be done. You would people say, well, you could you could have trolls giving you bad reviews, just competitors giving bad reviews. Just Oh no you’d have to upload it wouldn’t it would be anonymous on the front but at the back end it would you whoever controls it would be saying, right, show me your cpc’s certificate. You’ve been on the course. Who are you? What’s your DTC number? Okay, that’s your opinion. We’ll post that anonymously, but we can verify you have been on that course. Yeah, but whether it takes off or not, who knows? You know, maybe there’s too many dentistry.
[00:26:25] Interesting one.
[00:26:26] Yeah, it’s an interesting one.
[00:26:28] Let’s move on to the next one. Let’s talk about that. What of you? You’re fully private now. The NHS one.
[00:26:37] Yeah, yeah. Is it religion? Is there going to be a second coming. Is that. Yeah. Yeah, yeah, yeah.
[00:26:44] Probably private. Right.
[00:26:46] I’ve got small NHS children’s contract. Yeah. Which is. Okay. Cheers. My friends in the back side. Then they really is. The only reason we keep it on was whether my last practise, we went fully, fully private in 2006 and we lost loads of children, but we actually lost quite a few families as a result of that, whereas we would have kept them on and we kept the children’s contract, probably we kept the adults on privately. So when I took this practise over, it had a small children’s contract. Initially I thought, Oh, I’ll ditch it. But I thought, No, I don’t want I’ll just keep it. We ended up treating the children for virtually free in the last practise it was in, so I thought it better to get some money than no money. So that’s how we kept on. Yes. So I have a small so it’s not that I’m talking in case people think, oh, god, you know nothing about the health service. I was a health service dentist completely. I know. Or not under the UDA system. But from 1987 through to 2003, I was completely an NHS dentist for 16 years, so I know what it’s like at the sharp end of the NHS and it was bloody awful and it was actually my GP who advised me to go private.
[00:27:55] I went to them and she pushed a box of tissues towards me when I was in my early forties and I burst into tears myself in the consulting room and she went well and GP’s with next door to me where I work and she went now you know the number of my patients and she went, you’ve got three choices. You either have a nervous breakdown, that’s where you’re heading for, you either give up dentistry, but you’re too good to do that or you give up the NHS and ask. Gp’s are jealous of the fact that you guys can give up the NHS. And so that’s what we did. I gave up the NHS for others. Oh my God, that was the most stressful time in my life. But there we are. The abuse I got from patients like that, that was incredible. One guy drove up in his new series of five series BMW to say, you may want to be a millionaire son, but not on my money. I’ll never forget that. He walked in the room. He said, I’m here for a check-up for the habit. And I was just like, Oh, my God, there we go. That was unbelievable. But anyway.
[00:28:51] So there’s lots, there’s lots of people right now considering leaving the NHS.
[00:28:57] What would be your advice?
[00:28:59] Yeah. To me obviously it’s a different we were sort of I wouldn’t say we were the frontiersmen because the, the true frontiersmen of going private were actually, funnily enough, reading what you call a moral mountain origin. And Stephen nor wasn’t it 1990 them plan where they they were the true frontiersmen. What happened was 1991 they had a fee cut of 7% and a lot of people went private. Then that was truly frontiersman charity. That was really, really unusual back then, though, we were still early on, reasonably early on to do it. All I would say is I think you’ve got a different scenario. I think patients are probably yeah, probably more appreciative of the fact that you’re stuck between a rock and a hard place as a dentist nowadays. You will still get them. Think. Oh yeah. Well yeah it was some plan for your bloody test side or whatever. You know, a certain neighbour was going private. I would not be parked my Ferrari outside the door but I would. I think the thing is if you want to enjoy your dentistry, if you want to actually like your job, I think you’ve got to go private. That’s my opinion. You really got to nowadays. Yeah. I don’t think there’s any choice. The funding is just appalling and I admire people who try and do it for feeling that they have an ethical obligation to it, feeling that they have a moral and more moral obligation to do it.
[00:30:22] Yeah, do it for a while. Pay back what you feel is your moral obligation. As I said, I did dentistry for 16 years in the NHS, so I think I more than paid back any sort of moral obligation to society on that. But as fast as you can, I would move on. But is it the problem with it? It back to the original question. Is it religion? Yes, it is very much in this country. It ended up in the bloody London Olympics opening ceremony. If you remember, they had whirling beds, this, that and the other. And I think I read the times at the time and said what other country in the world would put their health service in the Olympic opening ceremony? None. You know, so it is religious. It is a religion in this country and that’s what we’re fighting against. But NHS, I mean, dentistry has never been entered fully integrated into the NHS almost since 1950. I think it was charged upon start charge upon for treatment in 1950. So yeah, that’s the difficulty. Will it have a second coming. No, simple. They may try, but they just don’t have the money. They don’t have the. They don’t have the. What’s the word I’m looking for? They they don’t have the the the really the government aren’t really that interested.
[00:31:41] It’s all political manoeuvring. And it’s sad, actually, the way I mean, I think if they if I mean, my my personal thing would be if if you had it, we could have an emergency core service that was not tendered. I think tendering needs to stop. Right. Personally, would my opinion tendering needs to stop. I think it’s ridiculous situation. You know, I think then every dentist could offer every dentist may include probably could offer an emergency core service to help people out. That would spread the workload out a bit more evenly across the country. Stop this thing about. We’ve got a short what I love is the headlines. I’ve got a shortage of dentists. No, I couldn’t find a dentist. You couldn’t find an NHS dentist. That’s different. You could have gone privately. Yeah. You know, it’s all these head and it couldn’t find a dentist for three years. Did you try? You know. You know, but. So if the president said got rid of Tendring, we’re going to let everybody do have a core service. And then after that and obviously then you’re going to have to have income support, whatever it’s called, not as universal credit, not sort of area covered and run on those bases. And they’re covered for that. But beyond that, yeah, it’s really got to be a private, private service. But I don’t know. Yeah.
[00:33:01] So look, it’s interesting what you said about the Olympics because I’ve recently been using the NHS for medical services in the family and I definitely don’t want to lose that. No. As, as, as something that by the way even in medical it’s got loads of problems, right.
[00:33:25] Issues and so on. But, but I definitely wouldn’t want to lose it because I also have been using private medical services a lot. My family has. And that has all of its own issues, a whole lot of its own issues over treatment issues and problems like that. But as far as dentistry, I mean, I did vet and I remember the moment it was was very near the beginning of it. I thought to myself, I’m never going to do NHS dentistry. I was completely pissed off with. I couldn’t believe what the situation was, you know, like what you had to do for what. And, and, you know, I also admire people who make it work. Yeah, I feel I feel like making it work. It’s almost a martyrdom thing where, you know, dentistry is a stressful job and you really need to pay be paid. I don’t know what the number would be. You’ve got to be paid 70, 80 grand to be a dentist because it’s a proper stressful job. Yeah. Yeah. And if you’re if you’re doing it properly on the NHS, you’re not going to make that.
[00:34:33] You know.
[00:34:34] And so, so you’ve got that choice of do you do the best for your patients or do you martyr yourself to the system? And I remember back then as the vet thinking, I will do whatever it takes to go private. And this was a long time ago when it wasn’t so fashionable to do that.
[00:34:53] I found a guy who’d gone private and you said 91 was early found a guy who’d gone private in 68? Yes.
[00:35:03] I made him an offer he couldn’t refuse and he took me on. And that was it. I’d never, never did an NHS after off the vet again. But now I see, you know, people, good dentists, people going on courses, people with good knowledge, working in the NHS. And I think the biggest problem for me is a lot of the work that NHS dentists do as far as learning is learning how to survive in this system. Rather than, you know, learning how to fix teeth. Yeah. You know, it’s understanding the bureaucracy of it. I mean, it’s such a and the funny thing, when you talk to NHS dentists who want to make the leap, a lot of them are worried that they haven’t got the skills or something. And I think to myself I could never have done NHS. Like you’ve got to be a very, very good dentist to pull that off. Yeah. The short periods of time to get people out and not coming back in with problems, you know. So my advice to anyone who wants to make the leap is make the leap. Make the leap. And and and private dentistry. Now, you’ve been in it for a long time now. I think the soft skills are just as important as the clinical skills.
[00:36:23] Yeah. And then the funding that’s going to come to you, I think if patients don’t judge you. Well the judge in a number of ways, but the probably the number one. Do they like you? You know, there’s I don’t know. There’s a classic story by the medical profession. I remember being quite a few years ago, you may have heard.
[00:36:43] This about who gets sued and who doesn’t.
[00:36:45] Yeah, yeah, yeah, that’s right. And the answer was nobody gets sued because they were all lovely. All right. And the guy wrote and basically went, thank you for all your care and attention. And you looked after me superbly. Well, I realise there were just one of those things that was very behind. And then what they conclude it was people don’t sue people they like. And that’s very true and very, very true in life. And it is the soft skills. I learnt that very quickly on my free for my I was the very first year of at Payman 1983, the very first year it was optional. In my year we didn’t have to do it. All right. Okay. I don’t forget. How many years did you spend at dental school? Were you four or five?
[00:37:26] I was five. I was I was the first five.
[00:37:29] I was for four years at dental school. I was and we were the Queen’s and Belfast was the shortest dental course in the UK by one week. Edinburgh was the second shortest by me and my first boss I went to. He was a superb dentist, but a grumpy so-and-so, absolutely grumpy so-and-so, and his practise was failing. I remember we used to have to pull people out of the sofas because the bottoms had fallen out of them and things like that. And I said to him, Why don’t you buy a chair? Why don’t you buy some new chairs? And he went, Oh, NHS doesn’t bloody pay me to buy waiting room furniture and Jesus sort of thing. When I moved out at the end of 80 and I went to a place and nearby a guy he had, you remember the Siemens em one chair, the really Rolls-Royce Siemens erm one chair. He had that himself and you still get crap equipment with associates but you had Siemens in one but he invested and he could talk the hind leg of a donkey. He really had the Blahnik, he wasn’t that good a dentist, but he had the blarney, as we say in Ireland, he was supremely successful. He had people coming from far and wide flocking to him, all that sort of stuff. I very quickly learnt that actually not not such a personable bloke, failing, really personable bloke, not such a good dentist succeeding immensely. And really that’s when I very quickly learnt the soft skills were vitally, vitally important and it’s still the same today, you know I think patients just go, was he a nice chap? And that’s the more important thing that they will forgive you a lot if you’re nice to them.
[00:39:04] Yeah. Yeah. But it, it, it doesn’t mean be nice and then mess up their teeth. It’s be nice and keep, keep it simple. Keep it simple. Yeah. And anything you can’t do, refer out.
[00:39:16] Yeah, exactly. And this is where I would yeah. This is where I would agree with ADC. If not don’t often. But yes. Speak within your competency. Don’t be afraid to refer. Really. So yeah. Just because you see so-and-so on the Instagram having done this, you won’t see the fact they’ve got nine of them that are a bit crap and they both know that. Yeah. You know, you know it is one of those things, you know.
[00:39:42] But Niall’s the guy, the guy sitting, let’s say, like you, he’s done for 16 years a bit much. Let’s just say he’s done, I don’t know, five years of NHS. Yeah. And now he wants to make the leap and very simple. Be nice, don’t hurt people, you know, painless injections. I would say the most important thing you can do and then as soon keep it simple, if you haven’t got super duper skills, if you’re not a full mouth dentist, don’t, don’t try and be. Yeah. Until you get the skills and then refer out. It’s as simple as that. I mean, any dentist could be a private dentist as long as they follow those rules, right?
[00:40:21] Yeah. Yeah.
[00:40:22] I don’t need special knowledge.
[00:40:24] Most patients just want straightforward dentistry. They don’t want total rehabs. They don’t want film with implants. I don’t want this. What they want is to have teeth that are functional. Don’t give them much problems. Look. Okay, feel okay. And that’s all they want. And they want a nice person to do it for them. That’s what they want. They want someone they can trust. My big thing would be intraoral cameras. If you’re going private, make sure you have a really decent internal camera. Show everything. It builds trust immensely if you can show them. Particularly if, as I say to my associates, I go take the patients on the story, particularly when you’re doing the treatments. You you say you’ve got consent. You’ve you’ve shown them at the exam and you said, see, this big crack filling here, you know, carries whatever. And they consent. They come by. Show them. Remind them why they’re in today. Then show them when the feeling is removed. Show them what it looks like underneath. They normally look pretty. Yuck. You know, shown when the care is removed, show them the various stages, take them in the story, show them the cracks. Show them that you build so much trust that the next time you say to them, actually, we’re going to crack, they’re there, you know? But ultimately, you’re right. I mean, it isn’t rocket science. But one of the things I would say to young dentists, they do tend to come out and just to be focussed. Some of them is and particularly if you’re working for corporate, I would actually take your time, do things properly, right when you’re starting off in your career.
[00:41:48] Don’t worry about the money. All right. Even if you’re I mean, most people, my son, being an example, has graduated with a master’s and whatever else from Lisa. And he’s on 30, 35 grand a year. 25. Now, a lot of dentists come out and think, oh, I should be heading sort of high. 60, 70, 80 ground. Most graduates don’t earn that at that stage. What I would be saying to you, be happy with your 25 to 30 grand, but build your skills now. Take your time. Use the rubber dom. Learn to do a filling. Learn to do the difficult extraction, etc., etc., etc.. Even if it’s onto the NHS, the corporates can’t complain because you’re doing everything by the book, you know. So you’re doing good dentistry. Just take your time and build those skills particularly well. As you said yourself, even if you haven’t done that, you don’t need a huge amount of skills to go private. It’s just been nice, as you say, being nice to people doing basic good basic dentistry. Yeah. And this is back to where people look at. I mean, I was talking to someone the other day who said, where are the associates, young associates nowadays who want to just do general dentistry. They all seem to want to do bloody bonding and Invisalign and you know, that’s all they seem to want to do nowadays. And I’m going, Yeah, I just find that weird because you know, most I would say 90% of patients, 95% of patients don’t want Invisalign or bonding. Yeah, they really not interest in it. They’re interested in good basic dentistry and plenty of money to maintain that.
[00:43:28] Yeah. As long as you’re charging appropriately. Right. And that’s another problem.
[00:43:32] No, exactly. And I think I think we’ve got to do is we’ve got that. You’ve got to start. You know, we’re worried about what people will think about us when we charge fees and all that sort of stuff. I think that’s, you know, that’s a whole different area of mindset of it. But somebody said to me once you think about Harrods, they don’t aim to sell every whatever designer dress to. They don’t aim to sell a designer dress to everybody who walks into Harrods. They’ll only be a certain amount of people will buy them. And that’s the same with your dentistry then, that you will find your market, you will find your people will. You’re not to be scared of your fees. Yeah, but.
[00:44:13] How often do you put your prices up in your own practise.
[00:44:17] And annual? Late January? We we do it routinely. I mean, if we need a mid-year tweak, we will do mid-year tweak. Patients don’t notice when you put your prices up, but you get the old one who does, right. Okay. You will get the old. I think there was a statistic that came out somewhere from Harvard Business School or somewhere that might be apocryphal, but 14%, you can put your prices up by 14% and no one will actually notice. And funnily enough, we stuck are not quite that high, but we stuck our examination fee and our hygiene fee up by almost 11% this year. Not we had one patient mention it. So yes, the fee increases is only in your head then they.
[00:44:56] Yeah. In fact that boss of mine, the one firm that had gone private in 69 or whatever it was, he had a thing about if the patients aren’t complaining about the prices, they’re not they’re not high enough. And he used to annually put the prices up. And I remember I remember thinking, that’s not a big increase. Why is it even bother? But then when I stayed, I stayed in that practise for four or five years and after four or five years it was a big difference. Yeah, if you get 12 12% a year after four or five years is a significant difference.
[00:45:33] Yeah, absolutely. But you’re right, it’s indirect. If you do them regularly, patients don’t notice. I think sometimes what happens is we had this issue when we first took over the practise, the plan prices hadn’t been updated for years, for years. So we had to bring them all into line with the fee per item. The fee per item. Prices had been put up, but the plan price has never been increased. So we had a real sort of backlash from patients going. What we want to put my plan price up from 12 to 17 quid a month. Yeah, well, you know, you’re on an absolute bargain. There are 12 months, you know, so it is doing it little and often and working your way through that. But certainly, yeah, I think turning the NHS, moving away from the NHS now it’ll be just interesting to see how over the next year or so what happens. I mean because I remember there’s an awful lot of dentists talking. They want to go private at the moment and I would encourage them to. But I remember back in 1991 we went to when there was a 7% fee cut by the NHS back on the old fee per annum service.
[00:46:36] We went a BDA meeting in Surrey where I was working at the time and I had just taken over my practise 25 and it was a dump and I was literally there six months and this fee cut came in. So I knew I couldn’t go private because it was a dump and I was just new to 25, new to the area. And but everybody in the room went and they sort of had to show hands who’s all going to go private and everybody stuck their hands up and barmy and a couple of others. Interestingly, I would say about half of those who stuck their hands up never did. So it’ll be interesting to see what happens. There’s a lot of bravado at the front end, but it’ll be interesting to see there will be how many actually do make that move. But it is something I think is much better on the other side. I enjoy my job much more. I am not a stressed yeah, etc. etc..
[00:47:28] Let’s move on to our corporates. A force for good in dentistry.
[00:47:33] Yeah, yeah, yeah. That’s an interesting one. What’s my view on that one? Yes and no. I must admit, when I when I come to sell this practise and I’m 57, so it’ll be a few years yet, possibly. But when I come to sell it, I don’t want to sell it to a corporate.
[00:47:52] Right ideologically.
[00:47:55] Ideologically and ideologically. I don’t want it. I think we need to have independent practises out there. I really do. All right. I think it’s sad that we’re all ending up as corporates. You know, there are good corporate, better corporates, less, by the way, than others. I don’t slag any of them off. I mean, we we are near Portman. And I have to say, I think Portman are run very well. They buy good practises. You know, they choose well, it’s run well then. Tax is an interesting another one that I just happen to notice that Hershey sold at the weekend to then tax you know I think that seems an interesting model I know I don’t you don’t know Jack and Deci and Rowling, do you at all, do you know? Yeah, I do. I do. Well, John’s a good man, was a good mate of mine, and he sold to Dan Tax and he’s recommended me Dan Tax highly, but equally well. I would quite like to keep it the independent sector because I do think it’s important for the you know, just what I mean if you’re a young dentist and you’re coming out today and you had no hope to own your own business, maybe, maybe a different mindset, I think. I mean, why did you do dentistry payment? Why? Why did you do Street?
[00:49:07] I was one of those. Didn’t know what I wanted to do. My parents said, hey, you know your uncle’s dentist, you like your uncle? So it was it was as terrible as that.
[00:49:19] Yeah, well, mine, mine, mine seminary. Terrible. I must admit, mine was a bit like I’m the youngest of five, and my two of my brother is much, much, much older than me. My eldest brother was 70, our doctors, and they both went, Don’t do medicine, it’s shit. And what they meant by that was they are not that time. I happen to have a very fun dentist in Northern Ireland who drove at the old quatre, went away on a skiing holiday once a week and had a 9 to 5 job and owned his own business. And that was what I quite like. They owned his own business and I went, Oh, I’ll be a dentist, you know? And that’s how I ended up doing that. But equally, equally shit reasons, you know, but it’s worked out for the best. And part of the attraction for me was the fact I could be my own boss one day. And I sort of think if it goes all totally corporate, I don’t think it ever will go all totally corporate. But if it did or if there was less opportunity for dentists, yeah, I just think it’s a sad, sad day. And if I look at some of the corporates you talk to, some of the youngsters, young professionals on the course are not youngsters. Young professionals are on the courses I made and they’re going, Oh yeah, I’m having to buy my own composite, I’m having to buy my own whatever, because the corporate will not buy this quality material for me. So I have to supply it all myself. And yeah, just.
[00:50:45] Just to be fair, lots, lots of independent bosses aren’t buying things as well.
[00:50:52] Yeah. So the red line post for another day came and that’s, that’s, that’s on the back burner actually. It keeps coming up and I think I’ll post that on this week, but it hasn’t come up yet. There’s other things that keep popping up. But yeah, that is a red wine post for another day. Yeah, you’re right. It isn’t exclusive to corporates. You’re absolutely right. It isn’t exclusive, of course. But I just think. Yeah, how are they forced for good? They’ve been a force for good somebody put out pointed out and the thing for practise owners Goodwill’s.
[00:51:24] For selling out.
[00:51:26] Yeah well it’s gone through the roof I mean back to what we were saying earlier when I first bought my practise, 1991, they were all sold through box yards in the back of the bdg and Frank Taylor was an auditor. Frank Taylor was actually Frank Taylor. He was an he had a little thing and practises were sold for the average of the previous three years turnover. Right. So the average of that on the third of that somewhere between 25% and 33% of the average of the previous year. Three is turnover. And so I bought my first practise which was turning over about sort of 180 grand for about 60 grand. Yeah, well, I know. Just mad, mad, mad, mad. And you know, it has totally changed. I mean, nowadays, you know, so so they have brought the corporates have certainly from the PRI, but from the associates point of view, I struggle a little bit more to see what they brought.
[00:52:26] Yeah, you’re right. On average, you’d probably rather work for a for a non corporate as an associate. My wife works for a corporate and they’re one of the better ones. They’re one of the better ones. Although when something goes wrong, the chain of command is just extraordinary. That’s one thing. And then another thing, you know, my wife is actually owns a quarter of enlightened. She herself owns a quarter of Enlightened. And you’d imagine the owner of Enlightened. Right. Could could make things happen from a whitening perspective in the practise. Yes. And the red tape they have to go through just to make a leaflet, you know, it has to be in brand with the corporates and so on is amazing as well. And then things like computers break and and don’t get fixed sometimes you know. Yeah. And you think this corporates got so much money why don’t they. Although although having you know, I’m talking to lots of corporates about bringing in light in in as well and it’s not a bed of roses running a corporate at all because it turns out the business model actually isn’t that lovely, other than they will then sell the whole thing off for even more bigger, even a bigger multiple. But but, you know, it turns out running these, you know, 300 practises, whatever they’ve got, it takes a whole team of head office and you know, that team needs paying for. And like anything when you grow it, I mean, you’ve got one practise, you know, but there’s several dentists. You’ve got, you know, way more than that. And they whenever they grow it, they find it very. Haunt keeping the thing as it was right. Keeping the culture as it was and and keeping everything going. And so they end up they end up exerting control with cash, essentially, sort of the easiest way for them to control. The thing is to say this is the maximum budget and you’re right in that dentistry doesn’t work well under those circumstances. No, no, that’s very true. I agree with you on that.
[00:54:30] Yeah, I’ve heard that story. And the reason why I didn’t I mean, I was quite interested in in in in the early days, back in the days of you remember Whitecross in London. What was it was yeah, yeah, yeah, yeah, yeah.
[00:54:44] Mendelson, yeah.
[00:54:45] Just passed away.
[00:54:45] And I took a strong interest in sort of having a look at the courtroom, but I couldn’t see maybe it was just me how it would work. Because again, what you say that I want to have really good practise of patients treated really well. So my first boss had in Northern Ireland had four practises. He went bankrupt. This was back in the early nineties. He went bankrupt and he said to me and he sort of put me off. Somebody said, never run more than one practise. He said the main practise was doing really, really well. The other three branches, squats, fair enough, as branches grinned as money bankrupted them. And he started again. But what I’m saying is that. So that’s between the two. I just couldn’t see how it worked. But I remember back in the day when I wasn’t idea what was what was the idea to the average day when it was originally called? I can’t remember what was called back in the nineties somewhere else.
[00:55:42] Now it’s called something and now it’s called my dentist.
[00:55:44] My dentist. Yeah. Yeah. No, maybe it was always idea.
[00:55:47] It was like that.
[00:55:48] Yeah. But yeah. No, but I remember Whitecross in London looking at them and London and going, Oh, nice idea.
[00:55:56] Nice, didn’t they? And there was JD Hull, if you remember.
[00:55:58] Yes, I remember JD Hull. I mean, he was he was a character. Wasn’t a he was a character. He was a character.
[00:56:06] He started out in South Wales, I studied in Cardiff so. So I’ve got some of his.
[00:56:11] Yeah, yeah. No stories character. He certainly, certainly remember that. I remember talking to him one time and he wasn’t, he was big into rugby, I’m big into my rugby so we got to talk about that sort of stuff. But he was going to almost take you down into hospitality and all that sort of stuff, you know, never, never, nothing ever happened. But yeah, no, you’re right. I do think that the advantage of independent practise owners is that their flexibility. Yeah, they can respond quickly. They can respond quickly to the market. They can respond quickly to everything goes on. And actually, the advantage is if you have a good principle and you have to have a good principle, I’m not saying I’m one necessarily, but you have to have a good principal who has strong leadership, a strong vision of what they want to do with the practise. They will be very successful. I think, unfortunately, a lot of principals possibly don’t have that sort of leadership skills, but yeah, they are. And therefore maybe a corporate is better for certain people, but not for everybody.
[00:57:15] Yeah, so I don’t think it’s impossible that they could succeed. I mean, in opticians they’ve certainly, you know, taken completely taken over except for the very high end ones, right. Yeah. And I think opticians are different to dentists.
[00:57:30] Yeah, they.
[00:57:30] Are. It’s it’s more a retail model than a service.
[00:57:34] I have to say where I say we were more veterinary like I would argue that. Yeah. And I think veterinary there are 40% or something on it or whatever. I don’t know. Is there 40% of the market. I’m not. Yeah.
[00:57:48] Yeah, something like that.
[00:57:50] Let’s go on to let’s go on to your story a bit more now. Why did you move from Northern Ireland? I guess you grew up in Ulster as well, did you?
[00:57:59] Yeah, yeah, yeah. I was born and bred there. I’m born 1965 in a place called Larne, currently Antrim in Northern Ireland, which.
[00:58:06] Is a port. I’ve been to Northern Ireland. Yeah.
[00:58:11] It’s a dump.
[00:58:13] Yeah. I mean the area. So I went to school there. I, my father, my father was stationmaster. Interestingly, it used to be the largest station in Ireland and then the beach came along and he ended up setting my father. I think it got my wanting to run my own business. My father, he ran his own haulage firm for years and my father left school at 14 back in the day. So I mean, yeah, he would have been he would nowadays he would have gone to university. He was a clever bloke, but now he had six children, five which survived. And there is I grew in Larne, so I ended up going to school there ended up, as I explained to you, already doing dentistry simply through the fact that careers advice was shite back then. I remember going to the careers teacher as it was, who happened to be the maths teacher as well, and when she said, What are you doing? And I went on doing maths. Physics, chemistry and said And what you think in doing for university now? I went, Oh, I’m thinking of doing dentistry. And she went, Yeah. Greg go and look under the yonder in the fine cabinet over there. And that was it.
[00:59:16] A little bit from Queens was Cuba. And that was literally my 5 minutes of career advice. And, and my brothers went, I don’t do medicine. So I ended up doing dentistry. And, and back in the day I, you know, you literally just fill in UCAS form. Even the personal step one was a bit like I like playing rugby, you know, sort of style. That was it. He had no interviews. No interviews. I don’t know if you. Did you have an interview.
[00:59:42] We had interviews.
[00:59:44] Yeah. Queens, we didn’t. No interviews. You just literally sent it off and you got whoa. Yeah. Offered you press and that was it. That was and I look at youngsters, young people coming out of school nowadays and what they have to go through to get into dentistry and school. And I remember we spend our first year, year and a half with the Medicks and I remember one anatomy lecture. They came to the front and went, We’ve got a medick who’s interested in transferring to dentistry. Does any dentist, do any dentists want to transfer to medicine? This is about six weeks in. Yeah. And I thought about it for an hour during that anatomy lecture going I went, Nah, can’t be there too much.
[01:00:21] Hassle on.
[01:00:22] The as I get switched to the doctor. So anyway, I ended up at Queen’s and Belfast did for years 1983 to 87, graduated, took the optional vet and then went from there and then basically had feet. And the problem with Northern Ireland, it’s it’s a very, very close community. And, you know, it’s complicated by obviously all the troubles. I mean, I was there at the height of the troubles. You know, I actually was in digs in the final year in the Royal Victoria Hospital in Belfast when the sniper fired at the Army post and top of our tower block, you know, you know, that sort of thing was on, you know, so it literally was a, you know, all outgoing all at the time. So I didn’t particularly want to stay in Northern Ireland. You always get attracted by the bright lights of England. My wife, well, my girlfriend at the time was English and her father was a surgeon in Chesney. I mean, I don’t know if you ever my father in law was a surgeon from India, and he came over in 1957 to do his FRCS and ended up in Northern Ireland basically because he couldn’t get consultant’s post in the north of England, as he says, because he was racially discriminated against, because he was Indian. He wrote to the BMA and went DMC and went, Oh, I’m not going to consultant’s posts here. Do you think it’s because I’ve got a brown face basically? And they went, Yeah, probably. What do you want us to do about it?
[01:01:55] And so I’ll tell you, let me tell you a story. My dad studied in Queens. Yeah, all right. In the fifties. In the fifties, yes. And someone asked him to be president of the Students Association, whatever. Right. Because he was neither neither Catholic nor Protestant.
[01:02:14] Yes, exactly. Well, it was a.
[01:02:20] It was very much like that. You know, I remember going to the Catholic chaplain and say, I’m a Protestant. Technically, I’m atheist nowadays, but I’m a Protestant technically. And I know Niles, a very Irish name and normally used by Catholics. I am frozen technically. And I remember going with friends of mine who were to the Catholic Chaplaincy for lunch, you know, because it was cheap and it was good and they, they wind me up. I said, Oh, you better keep a low profile to realise your problems, you know, that, you know. And I was going really isolating and yeah, yeah, I’ll have you chucked out of here and I’m going, oh Lord. But yeah, it was all that, all that was going on amongst fellow students, more banter. But there was a very serious edge going on outside in the real world and Belfast and the wider shrines of Northern Ireland. So I didn’t want to live there. I didn’t want to bring up children there. I felt that it was a very closed community. My personal opinion, I know plenty of my colleagues who stayed in a very successful and enjoyable life in Northern Ireland. So we moved over to England and literally I find a practise through the back as as a box as the beat and moved over when I was just turned 26 and started my first practise and took over a practise from another Irish woman who is returning to Southern Ireland and that was that. And I grew it from there basically. So eventually we outgrew the building and we knocked it down. We got an architect and we rebuild the building, etcetera, etcetera, and the rest is history. Yeah. Do I regret doing dentistry? No, I actually think it’s a great career. You know.
[01:03:58] You’re clearly completely engaged with with dentistry still. What would you. What would you say is the secret of that? I mean, is it is it the people that you love or is it the meccano aspect of it? Is it the business side?
[01:04:13] Yeah, meccano. I was never good at my count. I said, Yeah, I would like a bit more. But yeah, that’s why I don’t do implants. Why do not you go? Yeah, I’ll fit. I’ll fit on ladies and crimes using. Sorry, that’s more like Lego implants. But seriously, what is it about? It’s the people. It’s the people. It’s the people, you know, and dentists. We’re very lucky inasmuch as that we have that amazing ability to take people from who are in severe, severe pain to out of pain within a few minutes. Yeah. You know, help them or even just on a more mundane level improve their self confidence. Even people come in and it’s nice when people write reviews going, Oh my God, I was actually petrified at the dentist till I found you or I came to your practise or I came to their, you know, and we all in all our various practises have reviews like that. And I just like helping people, you know, then they and I think that’s what keeps me going about it. I don’t like all the things that anybody else doesn’t like. I don’t like the GDC, I don’t like the QC, I don’t like everything like that that’s come with it. And I and I actually don’t like the Instagram stroke, you know, composite bonding stroke, Invisalign. It has its place, but it’s not dentistry for me, you know, it’s an aspect of dentistry, but it’s not all dentistry. So, you know, I think there’s, you know, dentistry is about helping people and helping people is extractions, root canals, fillings, whatever, you know.
[01:05:46] I mean, you should you should know there is quite a lot of very valuable stuff on Instagram as well. Yeah.
[01:05:51] Oh, yeah.
[01:05:51] I know when you say Instagram, I know what you mean. I know what you mean. I know what you mean. Yeah, yeah. But but there’s lots of lots of really good education on Instagram too.
[01:06:01] Yeah, yeah, I know there is. And I have to say I have to say I do follow not not an Instagram, but quite a few Facebook pages that I think are vitally useful. Jaz does Nick Gulati is Gujarati page A etc. etc. etc.. Yeah, are very valuable and very useful. Yes. No, there are a lot of good stuff. It’s the stuff that you know what I’m talking about, the sort of the glamour do.
[01:06:27] Yeah, I do. And you know, I’m very involved in that space.
[01:06:33] Yes, I.
[01:06:33] Know you are. You know, I’m very Payman.
[01:06:37] Don’t worry. Don’t worry. They say whatever you like, right? At the end of the day. Know a line? Bleach bond. Right. So we’re big in bleach and we’re making bond, and we’re not big in a line. But I know what you mean. I mean, there’s definitely some overtreatment going on with composite bonding and some low quality treatment going on with composite bonding. And there’s going to be a bunch of failures very soon. I mean, composites are very unforgiving material.
[01:07:03] Yeah, absolutely.
[01:07:05] You know, stains very quickly. And but then on the other hand, I would say that’s the reason for learning it properly. And I don’t even mean come to my course. I mean practise, you know, practise a lot and talk to lots of people and and so forth. But it’s interesting, though, these days you can choose to be whichever type of dentist you want to be in a way, because there’s so much more referral. You know, in our day you were either a general dentist or you were a specialist dentist. And even specialist was a new thing, wasn’t it?
[01:07:35] Yeah, it was more. Or your dentist was more or more what. I qualified the other one at the hospital. Or you are a general practise dentist. Yeah.
[01:07:44] And then I know you quite like you quite like endo, don’t you.
[01:07:49] I do quite a lot of endo. Yeah.
[01:07:51] Yeah. So, so I, I stopped practising ten years ago, but in my last four years of practise, I didn’t do any endo at all. I just I referred all of them. And what I’m saying is you can you can choose to be an Invisalign dentist and be fine with that, or you can choose to be an implant guy. And just just go into that very quickly these days. What do you think about that? Do you think do you think do you do you also sort of mourn the loss of the generalist?
[01:08:22] No. As much as I think do I mourn the loss of the generalist? I don’t think we’ve lost the generalist totally. But there are things like implants. I genuinely do think they should be done by guys who are doing X number of implants a year.
[01:08:37] Lots of them.
[01:08:37] Yeah, yeah, lots of them. I really do think. Do you want to go to a hip a hip surgeon and get do you want to go to a surgeon and get your hip replacement done? But find out actually, he’s an abdominal surgeon. Just does the odd hip replacement once every six months.
[01:08:52] Well done. You know, and you know, so, you know, why should implants be any different? You know, so the likes of, say, Adam Glass food for want of a name or you know, quite there are loads of people out there. Roberti Yeah, yeah. Rob Morrissey There’s another good one. Yeah. Who I think Dominic Hurley tends to do mostly implants. Stuff like that tends to my name. Yes, I am very much a best for that in terms of, you know, Invisalign and so on. Yeah. Well now don’t get started on Invisalign. I do think once you get away from implants, once you get I do think there is a, there’s certainly a place for specialists, but there’s no reason why a good generalist can’t do 90, 80, 90% over to a standard that is more than acceptable for the JDC. Yeah. So, you know, so yeah, I think you can end up referring most of your business away if you end up referring too much out. But yeah, you know, I certainly I certainly think that and also sort of sometimes patients go, yeah, they don’t like going to another place. I know this is where it’s coming back to that people are bringing specialists in-house, aren’t they? More and more so. And that’s that’s a headache in itself, trying to keep them busy and trying to keep them on something the other. But yeah, if patients don’t like, they’ve come to see you, they’ve come to see your practise, they know where you are, somebody’s described also the patients are a bit like patients are a bit like cats or no. Yeah, that patients but like cats. Yes, that’s right. Rather than dogs. Dogs. Dogs are attached.
[01:10:32] To the building.
[01:10:33] Yes, the cats are attached to the building. Yeah. So on patients are a bit like cats. That’s how good the sale of goodwill works because they go, Oh, I’ll stay to the building. Even though a new owners come in, I’ll stick there because I know the building. Yeah, it’s a weird phenomenon, but that’s the way it works. And I think patients. So I do think there is and will always be a place for the general sense. I think what’s sad is that people sort of see that they should be doing more Invisalign and more bonding and more of this. You know, there’s nothing wrong with doing that, but at the expense of doing their general dentistry or they feel like they’re peer pressured into doing it because they’re met down the road, is doing a lot or they’ve seen someone on Instagram.
[01:11:16] I feel like I feel like Invisalign kind of feels like easy money, doesn’t it? That’s the thing.
[01:11:21] Yeah, it’s.
[01:11:22] Something. It’s not easy. Money is very difficult work, but not easy at all. But have you done Invisalign? Now, I noticed on your on your website, you guys do Invisalign.
[01:11:33] Yeah. It says my, my associate does Invisalign. I don’t touch the stuff. Yeah, yeah, yeah. On our website.
[01:11:38] Which is leaning on it, I feel like you’ve got something to say about Invisalign. Go on.
[01:11:42] Well, apart from that, like the dominator. Yeah. Apart from the fact that they absolutely dominate the market. What I find sad about Invisalign is the people that sort of chest, the diamond, the double diamond, the platinum, whatever status you know, that. Oh, don’t do this number. From what I understand, the fees are still incredibly high from Invisalign for their stuff. Even if you get diamond, double diamond or whatever status you’re on. Yeah. And if you talk to sort of certain orthodontists like Ian Hutchinson, for example, yeah, he’ll go Aligners or Aligners and my associates done the in Hutchinson’s course and she would go that well yeah, you can do them with Invisalign and you will get down to site their particular Instagram going, I can do everything on Invisalign, you know that. But there are certain cases on quite a lot of cases that are maybe better off with fixed, but you know, it is what it is.
[01:12:37] But I think that tide is turning though in a way, because I speak to a number of orthodontists who are Invisalign only Invisalign orthodontists, and it can do a lot more than it used to do. I mean, I remember when I trained on Invisalign, they were saying, you know, you can’t rotate teeth, you can’t you can do a lot more than it used to. But but this question of, you know, being aligns sort of ad, you know, like some people say, look, why are you putting Invisalign brand ahead of your own brand? Yes. And you know what? I get it. I do get it. Number one, the discount bit piece is is significant. You know, that that that apex diamond predator, whatever status they get it. I think half the price of of an.
[01:13:26] Absolutely significant chunk of money when you compare it to other.
[01:13:29] Compared to brackets. Compared to brackets. Of course. Yes. Yeah. But the other thing is, you know, align invented aligners. Yeah. They, they didn’t just go stick a name on, they invented it. I mean, okay, totally different management to to it was a totally different person, totally different management to who we’ve got there now. But, but having invented aligners that, that first mover advantage that they had and they’re now bigger than Henry Schein, I think the biggest, the biggest company in dentistry now or they’re definitely up there. I mean it’s basically align Henry Schein and then splice around, you know, there’s three or four investor, you know, the ones who own all those noble bio care and or ASC optic. And so, you know, I’ve spoken to a bunch of dentists about this. I haven’t got a horse in the race. I don’t I don’t mind one way or the other. I certainly know some dentists who’ve left Invisalign and then come back because they were unhappy with the alternatives. And I know others who’ve left and and they’re very happy. Very happy. I know some who print their own aligners, you know, make their own in house. So there seems to be a few ways to skin the cat. But the, the brand is super strong and there’s a lot of very happy people with the brand. I think they could do a lot more on customer service. I mean, yeah, they seem to be very poor on customer service, which is weird. You know, you’d imagine they take care of that.
[01:14:59] Yeah, I think it’s they, they almost are in that position of it and they’re so dominant that they feel they can just treat anybody the way they want. And that’s what the seems to happen. Then the single.
[01:15:11] I don’t think that’s it. I don’t think that’s it. No company thinks that way. I mean, it’s well, maybe, but you don’t become the world’s biggest dental company thinking that. I think it’s probably you.
[01:15:21] Know, there are a bit. But I just think I just.
[01:15:23] Think they’re growing so quickly that they can’t they can’t keep up with the growth themselves.
[01:15:31] So, yeah, it’s.
[01:15:32] The same reason Facebook is such a nightmare to deal with. You know, as an advertiser, it’s an absolute nightmare dealing with that company. But the reason is they’re just growing so quickly.
[01:15:44] Yeah, I.
[01:15:45] Think. I think that’s the reason.
[01:15:47] Tell me, let’s move on to darker questions. Well, before we do that, before we do that, let’s talk about you’ve run a couple of super successful dental practises, have been around for ages, employing loads of people, treating thousands of patients. What would you say that secrets to success outside of the clinical?
[01:16:10] Well, the sacred success are I personally might. Well, we’ve talked about this already is your personality. You know, you have to be a nice person to deal with.
[01:16:21] It’s certainly outside of patient care. I mean, I’m.
[01:16:24] I’m thinking more staff associates. Yeah. Outside the patient care. What’s important for me having, you know, in terms of what do you mean in terms of equipment and stuff like that or staff associates. Keeping people happy? Yeah. What’s important? I think you’ve got to pay people. Well, certainly nowadays that’s a big thing for staff. You know, that’s one of the big questions is the dental nurse crisis. You know, dental nurses have been absolutely poorly paid for donkey’s years, you know, treated like shit, basically, to be honest with you. You know, my it up. We’ve got nurses retiring. She’s 59 and she’s been a dental nurse since she was 16. And she started off nursing right in four inch stilettos because that was the rule for the practise back then. Four inch white slippers, you know. But, you know, she said we had to have that, you know, that was the rule, you know. And I’m going, oh, my God. Yeah. They’re always been paid a pittance. So it’s treating your staff well. The problem is with it is, you know, with difficulty with staff, your staff are key to the success of the practise. They really are. The front of house is absolutely vital. Yeah. You’re you’re your reception team. Your front of house is absolutely vital. If you do not have people who are reasonably intelligent, reasonably, you know, savvy.
[01:18:01] Resourceful, etc., you are screwed it really and you really are screwed. I mean, we have been through in our current practise so many from the past team, mainly because I mean, the thing is, you know, it’s funny enough, it’s what I my favourite programme at the moment is the sewing bee. I don’t know, you watch the great British sewing Payman there you watch the Great Britain now.
[01:18:24] And the great.
[01:18:25] You know, great British sewing bees on Wednesdays on BBC One, whatever it what it is, is basically so or as you come along and make clothes out of material and it’s like great British Bake Off, but for sewing. And as I said to them, it’s all about attention to detail. You know, it’s it’s you look at it and you go, right, okay, you’ve made it, you’ve made a dress. But the hems all wobbly. Why is the hair more wobbly? It doesn’t look quite right or one side’s long and the other it doesn’t quite fit correctly there. This colour thread doesn’t match or whatever, you know. And so all about it, it’s all the little details that go in to make a dress. You may look at it and say, That’s a dress, all right. But then you look at everything that’s gone in to make a lovely, lovely dress, and that’s like a dental practise to me. People sort of say to me, Oh, you know, you’re some we’ve been accused of nit picking, you know, say you’re saying, Oh, you need to be doing it like this and be like I say, no, I call it we have standards basically. And they and everything comes together to form the whole. But if you you know if you cannot and sorry people will Brit me for this but if you cannot write an email back to people and where we are a site of Oxford we get everybody from Oxford, professors of English and to all sorts of places people in fact if you cannot write an email that makes sense in perfect grammatical English, back to patients.
[01:19:51] All right. We’re screwed to start off with, you know, and it’s the detail is the little things like that, making sure you put your apostrophe in the right place, making sure you’ve done this, you’ve done that. But yes, staff are key. Staff are absolutely key. And once you find the staff, pay them well, treat them well, you know, look after them well, make sure that you’re nice to them. But even then, yeah, there’s no guarantee we’ll stay nowadays. Everybody wants to move on eventually. And in terms of the servants, the practise, I just think, you know, people well, I can never understand as you get dentists who will have a lovely house, maybe even a lovely holiday home or a lovely Ferrari or whatever, and then spend a little money on their practise. Yeah. Then they have a lovely practise. Patients appreciate it. They really do notice the difference. And it’s all those subliminal things that go in to make to make it successful personally.
[01:20:47] Yeah. I mean, the other thing is, look, the number of dentists, the number of people you speak to and they say, oh, I really like that so-and-so restaurant because the service is excellent.
[01:20:57] And you know, in terms of restaurant, you’ve got, you’ve got the food in front of you. So you can, you can judge the food. Whereas in dentistry, our patients mostly can’t judge. What we do at all. Our patients got no clue whatsoever that you’re putting this matrix on and wedging it and not understand. And the example you gave at the beginning about the guy who was the Great Panther wasn’t the best dentist in the world. And so they only have these other clues to go on and obviously the people. But, you know, it’s interesting, I go to a dental practise and with fresh eyes I can see things that people who work there can’t see. It’s a bit of the cobweb in the corner or a bit of something sticking off the ceiling. And these are all clues to the patient. And, you know, interesting thing now, do you do you guys serve coffee in your practise?
[01:21:51] Yeah. So so I’ve worked in practises where the coffee’s been terrible coffee and and was my fault. I was the associate there and I fully understand the reasons why, you know, we’re not a coffee shop where we’re a dentist and all that.
[01:22:09] When I take my BMW, it’s not a Rolls-Royce, a BMW. I take my BMW for service. The coffee is excellent, and I drive up and the guy, some dude opens the car door and welcomes me by name before I’ve even said anything. But I know how he does it, right? He’s got my number plate. He knows what time I’m coming. It still makes me feel good. It takes me upstairs. Latte or cappuccino? It’s a it’s a car garage. It’s not. It’s not a Starbucks either, right? It’s a car garage. Yeah. And so these and now it’s interesting. I must have been to a thousand practises in my career and even I, who knows the full story exactly, knows what’s going on and, and, and what’s going and what’s happening and whose fault it is and whose fault it is. And even now, when I walk into a practise and they offer me a coffee and I have the coffee and it’s a nice coffee, I start making judgements about this practise about the kind of dentist they are, even me who knows all about it. I know exactly what’s happening, I’m still making those judgements. So imagine our patients, you know, the non-clinical queues that they’re taking.
[01:23:18] Yeah, absolutely. And we will serve bean to cup. We have a bean teacup machine upstairs. Yes, we go to Costco and we buy Lavazza beans but we do bean, we don’t have that was the first thing I got rid of was the instant coffee, you know. I said, I’m going to bean cup machine. I bought it once and some later. We bought it five years ago. It’s still going strong. It’s brilliant. And patients come and go. Lovely coffee. Thank you very much. You know, selection of teeth and, you know, and it’s just not having that level.
[01:23:48] Of attention to detail, as you.
[01:23:50] Said. Exactly. And just having nice cups to serve it in and and the place being clean in the modern. And it’s all under decoration, not being too scuffed. I know you can’t help the odd scuff here and there and all that sort of stuff. I mean, there was I mean, not that I’ve gone to this, but I had in the last practise I remember we had a small tester pots and I used to get the nurse to go round and if there was any scuffs, sometimes I’d do it myself. I’d just paint them every week, just find where the scuffs were, repaint them with the tester so that we got rid of the scuffs straight away. So they didn’t hang around. But it’s things like that. People want to see. They can’t, as you say, can’t judge you and everything and anything else, part of your personality. But they will go often. Yeah. I mean, how many reviews have you seen where they go? Oh, lovely. Clean practise. Very modern, you know. Brilliant. Yeah. How do you know they’re brilliant? How many times have you seen patients where you go, God, they’re singing the praises of the previous dentist. And you go, This dentistry is pretty mediocre. Yeah, but the thing the patients are singing the praises about them. Yeah. And you go well yeah it’s because they’ve got a lot of the other things. Right, you know. But they’re really.
[01:24:59] What about associates and associates? What are your Top Tips? Top Tips? Let’s talk about what you look for when you’re hiring an associate and let’s talk about your bugbears. What’s the thing that pisses you off about associates?
[01:25:13] Yeah. What pisses me off? It was those associates outright who basically seem to think that the boss is ripping them off, that they’re making the absolute bloody fortune out of them. And then they they’re really pissed me off associates.
[01:25:27] Some of them thing was.
[01:25:28] Yeah. That wasn’t them. Who aren’t, who don’t, don’t sort of realise that they’re part of the clinical team, that they’re, that things like I’m trying to think what else. Because for both associates we’ve had associates that were that before I took over the practise had to go and work in as an associate for a brief, very brief period of time. And one of the other associates used to, if there was a gap before the end of the day, so say share the gap. And then the other end of the day, she would just literally walk out and tell the receptionist to cancel that sort of patient know. So would say, I’m not I’m not hanging around for 45 minutes to see Mrs. So-and-so for a check-up counsellor. And I’m going.
[01:26:08] Yeah, yeah. Know that’s extreme. And you don’t get that, but it’s, it’s.
[01:26:14] What are you looking for when you hire them?
[01:26:16] What am I looking for? I’m looking for very much. Can I talk to them? Do I get on with them? Can I talk to them? Because, you know, obviously you want people who are on board with what your way of thinking is. You know, I want to hear a good a good story from them. I want to hear that a certain certainly it will be a lot of I want to hear they can hold their own. They can talk to me. Honestly, I’m not so interested in clinical skills, you know. I know nowadays the thing is a portfolio, isn’t it? That seems to be the big thing. God, that was that. Jesus Christ never even thought about my day but a portfolio. Yeah. I’m not so interested. I can normally think well if you can talk good talk, if you’ve been on a reasonable number of courses, if you’ve done this, if you’ve done that, you know, and you know, you’re normally going to be okay and it’s, it’s yeah. Just saying, can you gel with them at the end. You’ve got to work with them day in, day out and, and that’s basically what I look for. And you know, there’s no I guess.
[01:27:24] If you could gel with them, then it’s likely your patients are going to gel with them.
[01:27:27] Too. Like dentists would attract people, attract people. They like them basically. Then there isn’t that old thing, you know. So at the end of the day, if you’re basically if you’re an irritating, irritable old bastard as a dentist, you know, then you’ll get irritable bastards of patients, you know, then they whereas, you know, you’re fairly relaxed, easygoing, sort of bloke, you’ll lose the ones that are irritable, right. Or the ones that think, oh, he’s a bit flippant. You know, I’m always sort of telling jokes and bad jokes and all that sort of stuff, you know? So lose the ones that think, Oh, he’s not that professional, he’s a bit flippant. I don’t want them particularly. And in that way I want more. So yeah, I want associate. But it is good to have a mix within the practise, different styles, different, you know, so that we, you know, patients always you don’t necessarily want the patient leave the practise, but you might say, well, you can go and see, they might go and see, can I go and see yens for example or whatever, you know. But yeah, the problem is with nowadays. Yeah. Trying to get an associate, that’s the thing. But there we are.
[01:28:29] Yeah. You know, it’s not limited to dentistry, right? There is a global shortage of labour and raw materials. It’s a funny time. I don’t know if you ever remember this in your time, Nigel. I don’t ever remember this sort of weird. It’s not even a recession yet. Is is whenever it is. The shortage of labour and shortage of raw materials.
[01:28:51] Yeah, well, yeah, the raw materials is certainly a big thing. Yeah. I mean, we, I have said to the staff, you know, whereas normally we did it just in time because we got a letter from Henry Schein or my email months ago going We can no longer guarantee next day delivery, you know. So I said, I don’t want to be run down to the last minute. Please give us a months, you know, like whatever. But yeah, no, to be honest, when I first qualified as a dentist and came to England, I could have walked into any area in England and been offered six jobs on the spot. You know.
[01:29:23] There were dentists.
[01:29:24] Yeah, I was a dentist. Yeah. But in terms of going round beyond that with dental nurses and stuff, no, I don’t ever remember such a shortage of dental nurses, such shortage materials, you know, and certainly. But you can see it in the wider economy. We were in Guildford today shopping and some of the staff we had to encounter in some of the quite posher shops, you’d go, Oh my goodness, they really must be struggling. Yeah, because, you know, calibre wasn’t there that had, you know, and whose somebody was saying who lives in London was saying that virtually every restaurant has a sign saying staff on immediate start you know.
[01:30:01] Yeah and I guess pressure on wages as well. Right because staff know that this is the situation.
[01:30:09] The staff staff know the situation, pressure and wages. And again, it’s fine in private practise, you just put your fees up, you know, at the end of the day. But the NHS, I don’t know where they go without, to be honest with you, I really don’t know where they go without.
[01:30:24] Let’s talk about some mistakes. What have been your biggest mistakes? I want to talk both clinically and business wise.
[01:30:33] Yeah, business wise. Clinically. Oh yeah. I’ve had quite a few. Yeah. From the, from the woman that I wanted to do, the woman that I injected bleach into her sinus and doing the nasty and, you know, doing the asked. And as she it’s quite funny, I was about 40 at the time and I was doing the Suede Rubber Diamond. She was quite quiet, everything was going nicely and she was sort of and she suddenly went, Oh, what was that? And I went, I’d just blown the three in one. And I thought, Oh no, it’s just nothing. Just air. And so we’re worked on a minute or two later, a re injected with the hypochlorite and a burning sensation in my eye. And I, I went, shit, I’ve just, just after I’ve done that. All right. So I sat her upright and took the rubber down off. Oh, no. Yeah. Luckily I had the thought, oh, shit, I’ve been injected, so I don’t know why. Just in my head I got let’s get local anaesthetic solution. I just got sinus and then pumped about four cartridges of Satanists through the root canals and just pumped it, pumped unprompted and sat her upright, took the rubber dam off, sat her upright, and as we sat her upright, she Oh my nostrils burning. Oh my God, my nose was burning. And all this clear drip out of her nose. Obviously, the hypochlorite and I can remember at the time exterior going to know this sometimes happens. Yeah, it’s rare occurrence, but it’s fine inwardly I was going I want my mummy, I.
[01:32:09] Really want my God.
[01:32:12] And I could remember thinking and I do need the loo right now, you know. And so definitely bra and trouser moment we ended up taking the two thought because it I just said oh it must be cracked, let’s take the two so send her up to the hospital. And she basically the hospital berates her because apparently she had a sinus thinning operation 20 years previous to that and never told me I said I was at least honest or to say to hell, even if you told me that, I probably wouldn’t have made any difference, you know. But she brought me a box of chocolates and apologised for actually putting me through stress and I thought was quite sweet and surgical emphysema as we discussed this on the on the on that. Not such a good day. There are office we cup the patients. Not everybody has but I think most dentists, if they’re absolutely honest, will have caught the patients. Tongue, cheek, whatever. Yeah, we’ve all had minor things. So things like that. Yes. Have happened. Nothing, nothing, nothing. So irreversible. You know, what.
[01:33:14] About what about where a management or patient management problem, where have the patients lost confidence and you know, or something?
[01:33:23] Yeah. Well, yeah, yeah. I’ve only ever been sued and once in my career and that was over a when I left the practise, my last practise to come and start this one. If I’d been there it would have been managed and handled. But yeah, it was just one of those things. I missed the root canal on a lower seven and blah blah blah patient and I end up being sued. Nice DLP letter came through for that, which was lovely, you know. So the yeah. So no in terms of yeah, we all.
[01:33:53] I’m looking for something. I’m looking for something that someone could learn from because you know I it’s a nice story the non the hypochlorite one but not, not much we can learn from that one.
[01:34:05] No, no, no, no. Yeah. So in terms of I think the things you’ve got, you’ve got to look for at the start with patient management is you will get red flags from patients from early on. You know, they will start throwing them up fairly early on if they’re sort of saying, oh, I can’t lie back, I can’t do this, I can’t do that, I can’t do the other. I think you’ve got to learn to pull out pretty quickly and say, I need to refer you on someone else. I think this is where your bacterial referral comes in. But yes, we do all get patients where we go that things aren’t going well. Right. And maybe, you know, they haven’t gone as well as you’d hoped, despite warning the patients. And the patients obviously very disappointed in terms of patient management. What I tend to do with them is look, I go look that root canal, all right. It didn’t work out as well as we thought it was going to. Unfortunately, it’s cleared up. It’s only eight months ago. I know a bit of crying on it.
[01:35:00] This, that and the other. Why don’t we get that tooth taken out? Because just keep them giving you problems. And I refund money. That’s what I do. Ultimately, people. People say to me, what? You refund money? And I go, Yeah, there’s no point in arguing. I work on that. I probably refund the practise refunds by. Under the practise turnover every year. Yeah. Now, considering we have a really good turnover in the practise, it’s nothing for a quiet line on. Patients will go fantastic. They stop complaining quite often. You don’t even have to refund the refund. You can just leave it as a credit on the the on the account. And they will either say well I’ll go and see so and so we’ll get the implant, that’ll be a credit towards my implant or that will be a credit towards whatever you need to do in the future. I just think personally, you know, it’s in terms of patient management, I think what you’ve got to make sure that, you know, after the money all the time personally patients will.
[01:36:04] Really I mean, refunds a good, good plan I think especially these days when you’ve got DLP around now. But tell me a story where you refunded money.
[01:36:15] Tell me a story where refund it. Well, yeah, I had one recently where basically again, it was a bit of this guy come in to see me for a second opinion. He was he had been somewhere else and what didn’t want to lose this up or six didn’t have a big feral on it. And I went, Oh yeah, tell you what, I can do that. I’ll refill that. I’ll put a crown on it. Hey. Yeah. Deep on the three times and six months, roots eventually fractured and went shit. So I ended up going, right, here’s your 1200 quid back on the wall where so bloody time, you know. And they I should have, you know, I was looking I think because he was, he had sort of gone I really want to keep this tooth, you know, and even though I had to.
[01:37:07] So on reflection on reflection, do you think you overestimated your own skill?
[01:37:13] You probably. I think one of the things about dentists with a lot of us are want to please people. At the end of the day, you know, we want to try and. Yeah, so you want to be the person who says yes, yeah. Yes, we can. I think that’s a danger we can all fall into sometimes. I mean, here rodents is a very good word. And I do like that phrase and I think we’ve all been guilty of here. I certainly have been guilty of Herod antics and that was a hero don’t situation. But unfortunately, I didn’t have my kryptonite with me and it all went head up. So I mean, even though we had been warned it might not work. What do I do? Do I turn around? I mean, how would you feel? I mean, if someone turned around you and said, I know you warned me it wouldn’t work, there was a chance that might work, blah, blah, blah. And my bond, when you said that, I thought you meant sort of like seven years down the line. Not. Not, yeah. How would you feel? You’d be pissed off, you know. So, I mean, refund the money and just chalk it up to another. Life is full of these learning experiences and unfortunately it takes sometimes more than once to do the same thing. I mean, I don’t know how many times I’ve done my career, probably right. But sometimes I just seem to never learn totally. I always go in, but I think it’s back into the people pleaser, into the trying to say, Yes, I can do this. You know.
[01:38:34] I think in private you’re always trying to say yes to everything because you’re trying to be a service orientated place as well. So you’re so you love saying yes. Yeah. And you’re right, you can get you into trouble. Yeah.
[01:38:47] There are occasions when you can you can certainly go. Absolutely. I don’t this worked out really well and patients really pleased with it. But there are sometimes you do have to know and say this is a bit of hero, don’t mix and I’ve got better of that over the years, but I still get all into the traps every so often. Yeah. And I think that’s partly why we wanted to put that page up about the failures that no matter what age you are, we have failures. We cook up basically, but it’s how you handle it afterwards. It’s apologies. One of the things I had a South African associate years ago who we were in the NHS and we got a complaint letter. Wait, this was about in the nineties and they about her, her, her attitude, she was really, really annoyed. So what happened was I used to say to her, you know, she, I’d say, why don’t you just say you’re sorry to hear that? So a patient come in and say, Gee, the way it would go is the patient would come in and she’d go. They’d go, I’ve got a problem that you’re feeling. Yeah. That you did last week. Yeah. And she’d go wasn’t my fault. Get a feeling the first place and sweets sort of out. And I’d say, look there’s nothing wrong with saying I’m sorry to hear that. And she’d go, I’m not apologising to anybody. And I’d go, You’re saying you’re sorry to hear that? And I think people sometimes get.
[01:40:08] Nervous escalating things.
[01:40:10] Exactly. Sometimes people get mixed up with the fact that, you know, saying sorry doesn’t mean you’re apologising. You know, you’re saying you’re wrong. It’s just say you’re sorry you had a problem, you know? And I think sometimes if you look at what. Say What do people want from the NHS? Sometimes they get complaints. They just want someone to say, I’m sorry that happened to you and this is what we’re going to do about it to make sure it happens again. Here’s your money back in case you know, this is what we and this is what we suggest we do is the next step they want. Quite often what people want from their dentist is just confidence. You know, they don’t want to be left hanging. A lot of dentists get in trouble because what they do is they just almost like things start going wrong. They abandon the patient. And I think that’s the worst thing you can do.
[01:40:55] And what about from a business perspective? I want you to tell me one of the like the best move you ever made and the worst or the worst day you had as as a professional, you know. From a business perspective, what’s the worst day and the best day? Best thing you did.
[01:41:09] Best thing I ever did. And I have to credit my wife for this. To be fair to her, was actually building the building the actually going ahead and taking a huge financial risk and knocking down her old practise building in in Sanderson Berkshire and building building that we’ve got currently because that a it won best practise of the year in 1999 building practise building 99 nine but it has.
[01:41:37] Did you build it from scratch?
[01:41:38] Yes, totally. We got architects.
[01:41:40] In. Oh, amazing.
[01:41:42] We got knocked down. We worked out of port cabins for a year. We decided we did. So then there was a double height, double bolted, all glass word. It was a way at raptures to come on and go, Oh my God, I’ve never seen a place like this before. Absolutely brilliant. And that was fantastic. And in terms of financially, that has worked out very, very well, a huge risk. And I remember at one time crying, crying just had my first child, Rory, who’s now 25, and I remember coming off the phone and the bank going, We can’t lend you any more money. And the Arctic going, We need another 50 grand. And I’m going, Gee, I’m crying, going, Where am I going to get this money from? You know, and I wish that I managed to get it from somewhere. Finished it. Yeah. Wouldn’t look back on that one.
[01:42:33] Is your wife is your wife is your wife more a risk taker than you.
[01:42:37] Would you say? And trust me, not. No, not but she got good judgement. She married me now she got you know she’s got very good judgement.
[01:42:48] So when you think, if you think of an idea oh really. When you think of, when you think of an idea and if she thinks it’s a good idea too, then you sort of go full in on it because you feel like she’s got good judgement.
[01:43:01] Yeah, the worst financial decision you want dentistry or just generally financial decisions you like? Yeah. Well, we see again, I have to say my wife, she warned me there was this sort of investment scheme I was desperate to back in. I had a bit of a low period in my in the mid 2000 so when I was about just turned 40, a mid-life crisis which you could call it, you know, and I’m desperate to get out down the street, desperate to try. And I really had and I somebody come along and said, oh, invest 35 grand into this property scheme. It will be brilliant. You’ll make a fortune. That’s something the other my wife went, don’t like them, don’t like them, don’t like them. And I went, Oh, you’re wrong, they’re fine, they’re fine. You don’t want their space, you know. So then you know. And I went, No, no, no, no. So I basically, against my wife’s judgement, took 35 grand of our money and invested. Yeah, it went tits up. Lost it all. Yeah. Loss of all. Yeah. So you know it’s one of those desperate and this factor when you’re desperate for the money, you make poor decisions, you make.
[01:44:12] Bad decisions.
[01:44:13] You make bad decisions, you know? And I think that’s what young guns don’t be desperate for the money. You know, money will come if you treat people correctly. Money will come and and you do. Yeah. So it’s not but yeah. Yeah, no. My wife, she will say I told you about them. She still brings up from time to time now and I’ll go, that was, that was 15 years ago. Now I play Sarah. I think we’ve gone past that, you know. But yeah, you know what? I still beat myself up about it. I didn’t see that coming, you know, I stupid it was, but yeah, that was the place I was in at the time, you know. So, you know, and probably going back to be an associate for too long. I sold the practise. I sold the practise in 2009 and then stayed in it for a few years. Yeah, I was probably wasn’t the best decision for that actually. But apart from that, yeah, I can’t say I actually have been, let’s say, very lucky with where I’ve ended up in life. I can’t complain.
[01:45:15] Excellent. We’re coming to the end of our time gap. So I’m going to ask you the same questions we ask all our guests at the end. Am to two questions. One is fantasy dinner party. Three guests, dead or alive. Who would you.
[01:45:31] Pick? Well, the weird with the first one is a weird one. It would be my wife’s great grandfather I use called Surfside Wazir Hassan. All right. Who was the founder of the All India Muslim League. All right. Okay. My way out. My father was from North India, originally from Lucknow area. I went to medical school and whatnot and was meant to go to Cambridge, but couldn’t go because my father in law was born in 1929. His grandfather was Uttar Pradesh. He was the Lord Chief Justice of Uttar Pradesh. Rajesh sounds fascinating bloke, absolutely fascinating and so much so. When my father in law grew up, he went to medical school, right? With a servant. Right. And I said and then looked on. I went and I said to him, Sir, your life when you grew up was very like Downton Abbey. And he went, he thought, Oh, yes, I suppose it was. He said, we had more staff and I mean, and so he had but his his his his grandfather was a fascinating character and actually has a street named after him in Lucknow. So, you know, he’s fascinating to meet, you know. The second one is my love of rugby, the Brian Driscoll of it’s simple but probably the world’s best centre, arguably. But we met him at London Irish when my son was seven and my son took fright and couldn’t go over and see him and God bless him.
[01:47:10] Brian O’Driscoll noticed that my son Rory was sort of cowering by a tree crying, and he went over and actually tapped him on the shoulder and said, And I just thought, You know what? You’re a decent bloke, actually. You know, you noticed that child was, you know, like that. And, you know, I suppose the last person I sort of I struggled with to think who I would like to have have along. Yeah, I really because there’s nobody I sort of hugely go, Oh God, yeah, it’d be great to have so-and-so along. It would be nice to have, you know, I think everybody would say this, but it’d be nice to have my father back just to see, because I think he was such a businessman. He’d be very proud of what I did. I think it would be nice he died before because I was very much he was 47 when I was born and he died when I was only turning 40 and I hadn’t hit quite the success I have now. And I think it would be nice for him to come along and then he could be very, very proud. You know what you know? So yeah, but yeah. So that would be basically my mix. Yeah.
[01:48:13] Very nice, man. Very nice. Interesting mix of people as well. The final question. It’s a deathbed.
[01:48:23] Yeah, yeah, yeah. Not that far. Not that far.
[01:48:28] Enough. Sure. You’ve got plenty of time on your deathbed, your nearest and dearest around you. What three pieces of advice would you give them?
[01:48:38] My first one is Don’t be a sheep. All really don’t be a sheep. In other words, do not follow the herd. The flock stand up for your own opinion because ultimately you end up with a very dissatisfied life. If you try and mould yourself, you are your own person and what you what you believe in is right. So definitely don’t be a sheep. The second.
[01:49:07] Yeah, the second one would be I had a couple I was torn up between exercise more, which is important to realise that later on in life. But I see trust that I think that’s what a lot of people would say. Wouldn’t it be trust your trust, just literally listen to your gut. If I’d listened to my gut about that investment I’ve made. Yeah. And the final ones are probably true, but slightly more tongue in cheek is yeah, don’t drink cheap red wine. Make sure you drink less of it, but drink better.
[01:49:47] I like that. I like that. Well, it’s been it’s been wonderful. It’s been it’s been probably our longest podcast ever because we had to go through the red wine bit. I hope you keep the red wine post going. Yeah. So you don’t get put off by by some of those negative.
[01:50:07] You can do. You can’t do. That’s the problem. Yeah.
[01:50:10] But, but you know, there’s a discipline in doing something and sometimes you feel like you’ve got to do every week. I don’t think you should do it every week. I think you should do it every time you’ve got something where you’ve spoken to someone, you know, that’s that’s the important thing. And you seem to speak to a lot of people. You seem to know a lot of people. So, yeah. So you seem to get a nice different views of of what what is and isn’t controversial. It’s lovely to see those. And I really hope the new group goes very well as well. Not such a good day at the orifice. I think every dentist should be part of that and and encourage everyone.
[01:50:42] It’s the posting is important. Yeah. Just to help other people.
[01:50:45] Contribute to that because you know the key point in this podcast is what were your mistakes, what can we learn from them? And you know, we don’t talk about our mistakes enough in this profession. We need to talk about them more. Absolutely. It’s been an absolute pleasure having you. Thank you so, so much.
[01:51:02] Now yeah, now I know it was a great. Thank you very much. Payman.
[01:51:07] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman, Langroudi and Prav. Solanki.
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