[00:00:00] You know, you’re not good because you’ve got an excellent pair of hands. Of course it helps. Or I think you become experienced or good at avoiding problems by being able to look ahead. So before before you do something. You can see all the things that could go wrong. And therefore, you can you can avoid them. And that’s you learn the hard way.

[00:00:28] 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.

[00:00:45] It gives me great pleasure to welcome Dr. Farid TB onto the podcast. Farid, an old friend of mine, so he’s probably such an old friend. I can’t even remember the first time I came across you, but you certainly studied at the same time as my brother did, and guys that remember you from then, the kind of dentist that you know around expert at the sort of implant restorative end of things. Dentists send my family members to and have done that several times and failed to come through for them. High ethics, high skills. But on the other hand, not someone who courts attention very much. Principal of the extraordinary 76 highly st multidisciplinary specialist centre in the West End and Boston House Dental Clinic in the city, which I’ve also had the privilege of seeing another beautiful place. Good to have you, Farid.

[00:01:43] Thank you very much for the very kind introduction. I actually remember I don’t remember the first time I met you, but I am very, very fond of your brother. And he was a very good friend of my wife’s and they studied together and he was kind of watching out for her because he was a year or two above her. So, yeah, I’ve got a lovely family and we’re very fond of you guys.

[00:02:10] Excellent. And interestingly, our parents are neighbours now as well. Another have been neighbours for years.

[00:02:17] That’s another connection. They probably see each other more than we see one another.

[00:02:21] Yeah.

[00:02:23] So this this this show kind of is kind of like a life and life and Haim’s kind of show. Yeah, but. But I’m getting sick of starting it always with the same question of where did you grow up and all that? We’ll get to that, by the way. But I want to kind of get to the crux of as and as an expert in that implant restorative. I mean, much of dentistry is in it. Most of dentistry is there. What would you say are the are the key sort of learning goals for someone who wants to get into that field and become an expert in that field? What’s the what’s the roadmap to become that person?

[00:02:59] I can. I can. I’m sure there are many, many ways you can become good at a particular set of skills. For me, it was probably a lot of experience in every other field, apart from the field I ended up going into. So and that was one of the things that my tutors at college recommended I should do. So when I was doing dentistry, they said, Go and do everything, and then you’ll find out what you like and do more of the other stuff that you’re not going to be doing long term, just so that you understand it and you can communicate to people. So to do this backwards. My initial aim was to do maxillofacial surgery. I did dentistry at guys. I had the pleasure of meeting Professor McGurk when I became a house officer there and I was really, really fond of him and he was probably my first mentor. He looked after me and he recommended I came and did maxillofacial surgery at guys and did do the three year short and medical course and do max effects. And I was really keen and sort of raring to go and my wife had other ideas about my future. She said, You’re not going to go and do something and become a consultant in 15 years time. Do something that makes you more available without on calls and that sort of stuff. So I wanted to learn more about all surgery at that point. So I went and did a bunch of house jobs, senior house jobs that were slow coming left, right and centre. And I’d done some work in Ortho at Guy’s as a house job. I’ve done some work in the paediatric dental department, so I sort of did the other bits.

[00:04:41] I never had an interest in Perio, so I never was going to do that. But we’d done enough. You start off as an undergrad with Perrier and it covers quite a lot of your undergrad training. And by sort of elimination, I came to restorative dentistry and we had some talented people like Leslie Howe at guys who were inspiring. And that’s one of the things I recommended to my children, that they put themselves in contact with inspiring people, with people who enjoy life, enjoy what they’re doing, and are good at conveying that to other people. And those people will sort of drag you along no matter what life walk of life you’re in. They will drag you along and inspire you and motivate you to do other things. So those were sort of the early influences, to answer your question, how do you become good at something? You do do a lot of it. You know, I. The simple answer to it. I do martial arts. We have a general rule. Unless you’ve done 1000 repetitions of a technique, you don’t really know it. And once you’ve done a thousand repetitions in the technique, you then start to find out all the things you’re doing wrong. There’s a curve. I don’t remember the name of it. Where? Where? When you start doing something, you think you’re really good quite early on. And then the longer you do it, the more you find out how difficult it is. And by the time you’re an expert, you’ll probably end up at about 75% of where you thought you were ten years prior to.

[00:06:15] So how serious were you about Max? Max, I mean, do you still have a little part of you that says, what if?

[00:06:22] Well, no.

[00:06:22] I’ve built it into my practice. So ever since I started doing dentistry and practice, I’ve incorporated not maxillofacial surgery, but I’ve incorporated all surgery into my day to day. So I do my own. I don’t know whether it’s wisdom, teeth, extractions, episiotomy, sinus lifts, bone grafts, block grafts, whatever it is. I really enjoy doing it, which is sometimes quite difficult to explain to patients because they think you’re weird if you enjoy that aspect of dentistry. But I’ve always enjoyed it. Although my first experience of horror surgery was atrocious and I thought I would never, ever do anything again. I think it was my fourth year and I was supposed to take out an upper six and it was on the oral surgery department of Guys on floor 23. First tooth that was ever taken out and I slipped with the complaints and of this sort of centimetre, centimetre and a half laceration on the palate of my patient and started sweating and didn’t know what to do, called Mr. Shepherd, who just looked at it and said, Well, that’ll help. Don’t worry about it. It doesn’t even need a stitch. So that’s the chap at the expert end where he can assess something and just look at it and say, I’ll be okay, don’t worry.

[00:07:40] So out of the different aspects of being the sort of the boss of principle of so many people and so in two different big clinics, you know, you’ve got the clinical side and now you’re telling me, okay, even out of the clinical side, you prefer the surgical. So is that what you’re saying? You really enjoy the surgical side more than the rest?

[00:07:59] I don’t shy away from it. I enjoy it. And I’m primarily a dentist. I enjoy the company of people. Yeah, probably why I became a dentist.

[00:08:10] I was going to be my question. That was give me a question because I get the feeling I’ve never been your patient, but I get the feeling your chair side man is going to be really good. Like, do you have long conversations with your patients and get something out of that? Because that’s certainly the thing I miss the most about being a dentist is those long conversations with with people, you know, rather than the teeth.

[00:08:32] It’s a very significant portion of my clinical time. I’ve never rushed to patient. In fact, I’ve been told off many times by reception or by my nurse or who’ve been sort of coming in and out of the room trying to tell me that you’re running late for your next patient. Can you please get on with it? I want to get home. And I’m sometimes sometimes you can politely suggest that maybe there’s some waiting and maybe you should get on. But a lot of the time people have got significant things to share with you, and it feels inappropriate to interrupt them at an extreme. I had a patient who sadly is not with us anymore, and she was actually very influential in sort of in me setting up this practice at 76 Harbour Street. But she used to book two, two and a half hour appointments and sit down and just talk. And then we would run over by an hour and all I had to do was sit there and nod and listen to her. And when she first started doing this, she didn’t really want the nurse to be present, which was awkward. So I asked her to be sort of in the sterilised area next to my room, which there’s no door there. And then with time she started trusting the nurse also. So the nurse was also present and she was sort of pottering about doing things and she was just talk and she ended up unfortunately dying from a pulmonary embolism, which was just not diagnosed. She she’d had it for three weeks and people thought she had a cough.

[00:10:02] So how was she influential in you making the decision to start 76?

[00:10:07] All right. So I was renting rooms in Wimpole Street, 30, Wimpole Street and Rohan. Roger Rogers, who is still working here with us, is one of our dentists, said, look, we’ve got a case here. We need a dentist to assess her and get a treatment plan together and then can you come over? And at that time I was working in quite a few different practises. I was working in Oxford primarily and in Rickmansworth, and I think I was also working still at Whitecross in. Come out. So anyway, I said, Yeah, I’ll make time. And I went and met this woman and she needed quite a lot of work. It was a big implant case with everything dentistry has to offer. It thrown in root canal treatments, crowns, bridges, implants. And it was a really interesting case. We started going there on Saturdays and doing that on Saturdays, and at some point the person who had set this practice up couldn’t run it. He was from out of town and he thought, I don’t want to mention any names, but he thought he could sort of come into London and see what he described as as high value patients, and it just didn’t happen for him. So I started renting these rooms from him and started seeing patients that were referred in. One of the patients that got referred to me was also seen by Rowan, and she’d had a really, really ugly crown put on a central incisor, which was, I mean, the colour was just so off and this was supposedly done by an Australian expert.

[00:11:40] So I said, yes I can, I can certainly do better than that, can’t make any promises. And that was Bernie, this lady who who ended up bringing not only her extended family. I mean, I see her cousins and nephews and sisters, quite a lot of her family. They are absolutely lovely. Absolutely lovely. But what then happened as fast forward by sort of maybe a couple of years and I found 7600 st I started setting this place up and as an open evening we had a gallery and art gallery with a good friend of mine, Sari Sam’s, who’s an artist. She lives in Germany now, so fair use my rooms as an exhibition hall and put put screws into every wall that I have and hung up her artwork. And people came and I had Bernie as one of our guests when everyone left and we were tidying up, Fahri said, By the way, where do you want these? And I said, What do you mean? Well, your patient bought these for you, so she bought five pieces of art or Fahri for the practice as a sort of housewarming gift. So and sort of it developed from that amazing.

[00:12:57] Amazing story with 76 though. What was strange about it for me or different about it for me was how, you know, like the standard way to open a West End practice is kind of, you know, small and one room at a time. But with 76, it was almost intentionally you were coming in as as a sort of multi disciplinarian, sort of. You even had health and wellbeing from the beginning. Am I right about that?

[00:13:25] Yeah, yeah, yeah.

[00:13:27] That that I understand the rationale for wanting a centre like that, but quite a big, big chunk to buy it off. And you know, we all know the rents and things that are huge and doing the work and all that. Did you have moments before you opened and thinking, you know, what have I done here? And after you open, you know, how do you manage to fill a place like that? I mean, you know, with difficulty. I know, but but did you not worry about that?

[00:13:54] You know, parents, you know, they say ignorance is bliss.

[00:13:59] I dwell.

[00:14:00] In bliss. I love bliss. I’m a I just didn’t know any better. I this this property was belonged to the father of a friend of Anna’s brother. And I went to see them. I came here and they were smoky. They’re a petrochemical engineering company. Mr. Malik Shut, who’s unfortunately now passed away. He was a petrochemical engineer, MIT grad, really lovely man. So I sat down with them and I said, Look, this is what I’m planning to do. I have no patient base. I’m starting from scratch. I’ve never had my own practice. I’ve got maybe a dozen patients that I know that that will come and see me. But apart from that, we’re starting something from nothing. I really loved the space we’ve got. You’ve seen it. We’ve got big windows and beautiful. Good, good light. And but at the time when I when when I first saw there were there was yellow wallpaper, sort of dirty beige carpets. Everyone in this building smoked.

[00:15:09] And it was it was it was it that you fell in love with the building and you saw the potential from the building perspective and you thought, to hell with it, let’s do this.

[00:15:18] Exactly right. Exactly right.

[00:15:20] Really, it wasn’t like a plan that you were going to open them up.

[00:15:24] I really felt for the building that I was doing.

[00:15:26] The I’m I’m one thing. I’m I’m an optimist by nature. And like I said to you earlier, yes, man, I tend to go along with things quite, quite. Quickly and easily, and I make decisions very easily live to regret some of them. But on the whole, I’m good at making decisions quickly and most of the time it works out. And this was one of those. Would you.

[00:15:51] Say would you say you trust your instincts, like when you meet someone or something, you know, instinctively, whether it’s right or.

[00:15:59] Wrong, I should say yes to that. But as most people, we also get disappointed sometimes, you know.

[00:16:08] Yeah, yeah.

[00:16:09] But on the whole, yes. Let’s go with my God. God.

[00:16:11] Really? Really? Yes. Yeah.

[00:16:14] On paper, my business would have never worked. There was no scenario. I’ve since sort of learnt about business plans and doing things, so how people do things properly and we’ve got a few other things in the pipeline that we’re doing now and trying to plan things out and budget and da da da. But at the time, no, we you know, I took out a mortgage on the house, spent it on this place. We decked it out. I remember my parents coming in and they saw the wood floor going down and said, Hey, this is a bit extravagant. This is going to be a dental practice. Are you sure you want wood floors? And my my rationale was the price difference between having a wood floor and not a wood floor wasn’t actually that big. And yeah, it just looks so much nicer. And I wanted to separate out clinical and non-clinical areas by having demarcations in the floor. So the clinical area will have clinical flooring, but the rest of the place can look like someone’s front room, you know, can, can look comfortable. And I’ve always liked a minimalist look. I don’t like clutter. I don’t like things being on surfaces that annoys my wife to no end. So that was sort of this is my, my, my Zen place to I actually find my, my weekdays more relaxing than my weekends.

[00:17:41] So so okay. You’re saying there was no scenario where it could have worked, but it worked, right. With tenacity, with what would you say? What would you say? Well, whatever it is, you know, whatever you used the.

[00:17:54] Yeah, that’s it.

[00:17:55] All the skill, all the skill. All the skill. Okay, then give me, give me give me some of the some of the sort of inflection points that could have gone wrong. But for whatever reason, it went right.

[00:18:03] I’m a great believer in in luck in being you’re not both know we weren’t born in this country. We’ve just been born to the right parents who’ve done the right things for us in terms of education, immigration, whatever it might be for us to end up in this wonderful country. And then things have worked out. And in terms of dentistry, my first lucky junction was meeting a lady called Alyson Keele, who was my form tutor. So I schooled in Germany. I finished school in Germany. I was there for 11 years. I got my AP tour and then I came here and wanted to do dentistry because in the UK in 1991, it was the first year they had an integrated system where you could start seeing patients from sort of as a as a student year two. Whereas in Germany you studied non-clinical for five years and then in the last year you had to in the sixties you had to provide your own patients, which just didn’t make any sense to me. So this this sounded much, much better. So I came here with a view to doing dentistry. And in order to learn English, I started doing A-levels. And then the colleges that are applied to said, Well, if you’re doing A-levels, we don’t really know how to assess your German RB tour, so we’ll just take A-levels.

[00:19:29] And then I thought, Hang on, I’m just doing this to learn English. I’m not really doing doing it competitively, if you like to get high grades. But that’s that’s how it ended up. And in today’s world, I would have never gotten into dentistry. But coming back to Alison Keele, she was my form tutor and she wrote a lovely letter of recommendation to Peter Longhurst, I think, or actually to to all of the universities, because I got an unconditional offer from King’s a conditional offer from Guy’s Leeds. I went to the interview and they said, You’ve got an unconditional offer from King’s. Why are you here? And I said, Well, I wanted to see your university. And they said, Well, if you’ve got an unconditional offer from King’s, there’s obviously no point in us giving you an offer. And he was really rude about it. And I sort of thought, I don’t know, I could have, could have, could have gone to Leeds anyway. I ended up with guys and it was lovely.

[00:20:24] When was the first time dentistry came on your radar? I mean, why dentistry?

[00:20:27] I was 16, so my initial aim was to do orthopaedic surgery because well before that, that’s after I thought I would do carp and. I sort of I really love carpentry, and I think that’s my retirement plan. At some point I’m going to do more of that carving and that sort of stuff. But I thought, I like human interaction. I like carpentry. Orthopaedic surgery would would be my thing. And then I went to we had a friend who was an orthopaedic surgeon. I went to watch some of his colleagues work. And I thought, there’s no way I would be ever doing that. It just seemed really rough and brutal. And, you know, this is me prior to me having been exposed to any sort of clinical environment. So to go in and watch a surgeon put a wire through someone’s forearm six times before it actually worked, it was horrific. So I thought, no, I’m not doing that. And I want to actually deal with patients who can talk back.

[00:21:29] So but I mean, why the medical field? I mean, do you have medics in your family? Why why medical? Why why didn’t you.

[00:21:35] Become I’m actually the first dentist within my close family.

[00:21:39] So how did it come about? And why didn’t you go into business?

[00:21:42] Like like. Like my father?

[00:21:44] Yeah, why not?

[00:21:46] It never, never sort of tickled my fancy. Not because I was rebellious, because I wanted to do something more manual and not offer space and more to do more interaction with people. So I could have I could have become a sort of salesperson. I could have I could work in a shop easily, I think, or I could have have a restaurant that would have worked.

[00:22:09] But being the.

[00:22:10] Son of Iranian.

[00:22:12] And what and what a restaurant it would have been.

[00:22:17] But no, my.

[00:22:18] Point is that was was there an element of, you know, I’ve got one of my kids saying, I’ll do anything but dentistry now. Yeah. And okay, maybe he’s in a rebellious phase or whatever. But was there an element of watching your dad and something about what your dad did not appealing to?

[00:22:33] You know, I. I loved what my dad did, and I, I would go and help him whenever I could. I loved being in his office. I love being in his company, a company as a next to him, you know, spending time with him. I used to run errands for him all the time and it was a good time. So during the holidays I’d go into the office and I liked what he did and he was obviously he was quite successful, but it wasn’t for me.

[00:23:06] No, no element of wanting to carry on the family business, you know, something that that whole thing.

[00:23:11] No, no, not really. Not really. I like I said, quite early on, I knew I wanted to do dentistry and I knew I wanted to get married quite early on, both around the age of sort of between 16 and 18, my sights were set.

[00:23:24] What was that about? Why did you want to get married, don’t you?

[00:23:26] I wanted to have kids.

[00:23:28] Early on.

[00:23:30] Then.

[00:23:32] Really? Yeah, yeah, yeah.

[00:23:33] Go on. Tell me, where does that come from?

[00:23:35] I don’t know.

[00:23:36] I got I mean, my my father got married when he was 28, I guess I went to the age gap between myself and.

[00:23:44] My.

[00:23:45] Not to be huge. So I got married when I was 25 and we had money when I was 20, 28 I think.

[00:23:54] And he’s in uni now. Yeah.

[00:23:55] No he’s finished his working.

[00:23:57] It’s.

[00:23:58] My goodness. It’s working.

[00:24:00] My goodness. All right, let’s let’s go back then. So you were brought up mainly in Germany, born in Iran.

[00:24:06] So born in Iran. Moved to Germany when I was 878.

[00:24:11] No. Yeah.

[00:24:13] 1988. So we moved out of Iran three months after the war started.

[00:24:19] What are your memories of that? I mean, I was seven when I moved and I clearly remember Iran. Yeah, very different. It was very different to here. What are your.

[00:24:29] Memories? I’ve been going back fairly regularly until a few years ago, so.

[00:24:34] But what are your memories of the time when we were changing country? Did you did you know you were changing countries? Because we didn’t we were like, oh, we’re just going on holiday, right?

[00:24:43] So the first memory of the war I have was we lived on on the top floor of a three storey building. And I said, Mum, someone’s rolling an oil barrel on the roof. And she said, Don’t be silly, I can hear it too. But that’s not an all that. There are no oil barrels on the roof. So we both went on to the balcony and we had a huge balcony to look up and there was an Iranian jet chasing a MiG over Tehran. And what we thought was the oil barrel was actually machine guns, so we’d never heard it before. So we and it’s not like today where people play cod and all sorts of computer games and they’re very iffy with how things sound. And they can tell the difference between the sound and, I don’t know, a, an AK 47 and something, something different. Whereas in those days it was all new to us.

[00:25:35] So in Beirut, you get very good at. Knowing the difference between a firework and a gun.

[00:25:41] Here on.

[00:25:43] New Year’s Eve. They fire both.

[00:25:46] Of their friends.

[00:25:48] But go on. So then you decided to move?

[00:25:51] Well, I didn’t. As kids, my parents said, okay, we’re going to go on holiday.

[00:25:57] Yeah.

[00:25:58] So that was the plan. We went to Spain and we were going to stay out of the country for a couple of months. The war was going to be over, and then we were going to just go back.

[00:26:08] Yeah, and here we are, 40.

[00:26:12] Well, so when do you remember when you got to. When you got. We went to Spain first. How long were you in Spain before you got to Germany?

[00:26:18] We left Iran on a bus on one of the because they bombed the airport.

[00:26:23] So we left across the border.

[00:26:24] We we drove to Tabriz, where my family are from. So we’re from the north west of Iran. And then one of dad’s family members drove us across. Drove us to Turkey. And then we caught a bus from there to Ankara, then a plane from them to Hamburg, where we had family and then to Mallorca. And Mallorca was lovely. I vividly remember seeing seeing orcas and dolphins for the first time at SeaWorld in Mallorca. So, yeah.

[00:26:58] We hadn’t we in Mallorca.

[00:27:00] I don’t remember. A few weeks.

[00:27:02] A few weeks and then and then Germany.

[00:27:04] Hamburg. Yeah. And then the summer in California where Dad wanted to see if he can start working there, because it was quite apparent that we weren’t going to go back. So we went to camp and then Dad was basically just ferrying us from kindergarten to school to whatever, and he said, I can’t do this. So we moved back to Germany and that’s where we settled.

[00:27:26] So funny. We did the same the same move in to California to see whether we wanted to live there and spend the summer there and decided not to. Often think about what would have happened if we did decide to go to California. So Germany, you know, interesting place. What are your observations about the difference between German and U.K. culture?

[00:27:46] Okay. So I had a really lovely time in Germany and I’ve had very fond times in Hamburg, kind people, Germans on the whole, when you get to know them, there might be quite cold initially, but when you get to know them, they’re incredibly sweet and loyal as friends. And I had some very good friends in Germany growing up and went from sort of a fairly I need to use a Farsi word social guy up until the age of.

[00:28:20] What.

[00:28:20] Would that be, an English pansy?

[00:28:23] I, I don’t know what.

[00:28:26] You can say these days. There are many words you can’t use anymore.

[00:28:28] So.

[00:28:30] You know, whatever, whatever that is in English to sort of once the testosterone kicked in, I started doing martial arts and I started doing a lot of sport. And, you know, I started making friends and it ended up being a lovely, lovely time.

[00:28:48] Hamburg course, a beautiful town.

[00:28:51] It is a lovely place, but I left Hamburg when I was 18, so I saw a lot of London school and I saw some nightclubs there in the latter years, and that was about it for London.

[00:29:07] I work I work with Germans now. I work with Germans now. And for work I find them excellent. I really do. Very straightforward. One lovely thing about working with Germans, whether you’re buying from them or selling to them, price is not part of the conversation and it’s beautiful. When you take price out of the conversation, then you can talk about all the other things. And with most, most times with buying or selling something, price ends up being the only thing people are talking about and everything else goes out of the window and it just comes down to price. And it’s so refreshing in a joke, you know, I think in the same way as you can’t get a discount on a Porsche or whatever. Yeah. And then it works also when people are buying, we’ve got a distributor in Germany who has never, ever mentioned price. It’s just the way, you know, it’s not part of the the conversation. And the other thing is when we have stuff made in Germany, which if you know much about the Dental world, you know, the vast majority of stuff’s made in Germany anyway. Yeah, yeah, you’re right. You’re right. The majority is wrong. But certainly historically that’s that’s why it’s was in Germany and all that. Right. When you buy stuff from from from there, when you when you want to do something new, I don’t know. We wanted to do a desensitise or in a pen or something for the sake of the argument. When they can’t do it, they’ll say, look, we can’t do that, you know, or they’ll be very straightforward about it. Whereas some of our American manufacturers, you know, everything is possible until it’s not not possible. And it’s a refreshing thing for work now as a society to live in. I don’t know. I they’ve never lived there, but.

[00:30:43] They’re exactly the same when you live with a very straightforward, you know, if they don’t like you, they’ll tell you they don’t like you and they’ll stop communicating with you. And when when they become your friend. I mean, we’re generalising now and it’s a very mixed community and it’s becoming more and more mixed. Yeah. Especially in the last probably 30 or 40 years. But I’m I’ve always enjoyed that company and I’ve never experienced any sort of xenophobia or racism from from from Germans while living there. I lived there for 11 years.

[00:31:17] So you call it two guys. What were your first impressions of of dental school? Was it as you expected it to be or were you down about it? Or. Because I wasn’t very happy at all at the beginning. Dental school, did you did you take to it very quickly?

[00:31:32] Yes, it was brilliant. Freshers week was was a blast. I sort of I’d been living on my own in Guildford doing A-levels for for a year prior to that. Can you imagine. I was like between, that’s between the ages of 18 and 19 with all the hormones building up to my eyeballs. So when I when I arrived at guys, it was phenomenal.

[00:31:56] Where were your parents? Still in Germany.

[00:31:58] I was here on my own. Yes, they were in Germany.

[00:32:01] Oh, wow. So did you stay in halls in guys?

[00:32:04] Yes.

[00:32:05] Wolfson House. And remember, we you sort of freshest week. Everyone’s friendly. Everyone wants to be your friend and you sort of you very quickly find your your clique and the group of people you want to hang out with. And you go from there. And I met some lovely people with whom I’m still in touch. 21, 25 years on, 30 years on.

[00:32:30] I So were you as a student as were you studious? Were you near the top of the class or were you passing all your exams first time? Or what were you who were you?

[00:32:38] I don’t think passing your exams first time is makes you studious.

[00:32:43] I actually no, I did. I did. I did. It makes you a failure. I failed.

[00:32:49] Dental, public health and oh.

[00:32:52] My favourite.

[00:32:52] Subject and interesting. I’ll tell you why.

[00:32:55] More at home, you know more at Milan who sadly passed away earlier, earlier this year in May. And I used to play backgammon together. So when we were studying for dental public health, we said, okay, every day we get together, we’ll, we’ll, we’ll study together and then we’ll play some backgammon. What we ended up doing is not studying at all and played, you know, backgammon. You usually play to five. We said, forget that we’re playing 55, 50 classics.

[00:33:28] You think of the way of doing it. Yeah. So, so yes.

[00:33:32] It’s the only, only exam. I’ve failed in my life until very recently. I’ve recently felt something else. I failed a martial arts grading and it was devastating.

[00:33:44] It was because.

[00:33:44] I wasn’t used to it. You know, it’s been I’m 50 now. It has been years since. 20, 24 years, 26 years since I last felt anything.

[00:33:55] So did you. Did you have in your head that you were going to specialise from even pre preclinical days and it was kind of finding what you were going to specialise in. Where did you have that in your head? I’m going to be a specialist.

[00:34:07] You know what? When I said I’m going to specialise, specialise, my my wife said, what? You because I wasn’t particularly studious to answer your earlier question. And, you know, we were having a good time at uni, so I found it really unlikely that I would want to go and commit another four years to to study. But it probably was the best decision I took. You know, I’ve really enjoyed it. And it’s good to have sort of, you know, I am a jack of all trades. I’m not just talking in the dental sense. My some of my friends call me auto balancer, which which is sort of a monkey wrench. Right. It adapts to to most things. And I think I’m quite adaptable and I enjoy many different things. So specialising was good and it sort of gives you I guess it gives you kudos and it gives you recognition for being good at a certain field. But really I enjoy a lot of things within dentistry and there are many other things I avoid. And one of the reasons I set up this practice at 76 is because I wanted to have the people who are good at the things I’m not good at around me. So I can I don’t I’m really lazy. I don’t like writing letters, so I can just hand, hand over my patient to them and say, look, this, this is the problem. Do you mind dealing with it? And that that’s been probably my main motivation for setting up 76 was I wanted to have everything under one roof.

[00:35:45] So we’ll get back to the the the back story again. But let’s go back to 76 then to build up a referral base, enough to feed the number of specialists that you’ve got there. I guess it’s not just referral. I guess you get patients word of mouth from from patients as well. You’ve got you get you’ve got direct patients coming directly to you as well as referrals. Yes. That must be. Yeah. But to build up to to fill that place, it takes a level of I mean I don’t know as a, as a person in my situation, I’m like, I would think marketing is the way that you would fill that place up. And it’s strange because, you know, dentistry wasn’t ever about marketing. It was about it was about reputation, word of mouth. And you’ve done it the old way. You’ve done it the normal way. And it goes to show reputation, word of mouth. This is the way to to to fill these places up. But you still didn’t expand for me on, you know, what were the key things? What were the key moments, the key decisions that that made you succeed in this difficult situation? I mean, how did you pay the bills to start with? I did. You have hairy moments, remortgaged?

[00:36:54] Yeah. Yeah. After a year, I took out some more money on the house, but it was going the right direction, you know, it wasn’t.

[00:37:02] You could tell it that. Yeah.

[00:37:03] After. Yeah, I had grossly underestimated our expenses. Like by probably by a factor of five or something like that.

[00:37:11] You mean the build cost or the day to day expenses.

[00:37:14] Day to day expenses. The build cost was sort of you get quotes and that. Yeah. And I worked with a fantastic team, a Polish outfit. He, he was his name is Andrew Trajkovski. He’d previously studied theology and computer sciences in Poland and was the job market was great in Poland. So he’d come here and set up a construction company and they refitted this place in six weeks. And the reason it had to be six weeks was I had to see my first patient before the third. So I signed my contract on the 22nd of January and my accountant said, You have to be working before the 31st of March to be able to claim your expenses within the first year. So that was the reason we had to be open for the 31st of March. And I remember my first patient walked in, it was a Saturday and I was still sweeping the floor from the dust, from the builders. So when when my patient walked in, I sort of I thought elegantly but very clumsily, move the broom behind me, leant it against the wall behind me and next, next to me. And as I walked towards my patient, the broom hit the floor, made a massive crack. And it was very embarrassing. But to come back to answer your question, the fact is that made this practice successful. I had a very experienced practice manager John Sampson from would go so and again I can give you a long story about how I found Joss, but she was when we started working probably in her early 60.

[00:38:51] And she’d been a dental nurse since she was 16. So she came and she’d always worked in the West End of London, so she’d seen it all. She worked with brilliant dentists and knew her way around. I worked with a brilliant nurse called Barbara Scullion, who’s now moved down to Weymouth. Unfortunately, her and I got on like a house on fire and I came across Barbara in this practice I used to rent out in Wimpole Street, and then I actually stopped working for a while because I was working for a practice and Barbara didn’t have a job and I said, Please don’t go looking for another job. I’ll, I’ll carry on paying you until I find myself a practice because we just got on really well. And she was brilliant at what she did and my patients loved her. And the, the and they, the patients could see that we gelled and we worked well together. And a lot of the time, I mean, people still ask after Barbara and I speak to her every other week, know we’re still very good friends. So those were probably my two key people that helped me set up this practice. The other people that helped set up the practice where they’re specialists. So from word go, we had work Rowan working here with us. We had had mammography. Who did? Perry Over here we had Johnny Johnston started doing paediatrics and we slowly each each of us had had our own referral base.

[00:40:21] We then had the medical side and we used to do head to toe health care, which which is now evolved into something else. The Centre for Health and Human Performance is now mainly about physio and about getting people to perform at their peak. But I’m not involved in that business anymore and we sort of expanded that in 2012 and I stepped back from it for reasons we’ll come to speak about, as you alluded to earlier. But yeah, those were sort of the main, main avenues. We just had a lot of different avenues through which people were coming, coming into 76. And then a phenomenon happened, which I wasn’t expecting. People who came to see me for the last I don’t know, I qualified as a dentist in 97. I set this place up in 2007, so I’d been working all along. I started working in practice in 2008, sorry, in 1998, alongside doing house jobs and as a job. So I was I always had a sort of Saturday job or an evening job to work at Whitecross on Wednesday evenings between six and midnight while I was doing my postgraduate degree. And then when I had my own place, suddenly people recommended our practice to their spouse, to their siblings, to their family, and all of a sudden it started mushrooming. Whereas for all those years I’ve been seeing these people, they wouldn’t be referring anyone else into the practice.

[00:41:48] And I actually I still don’t know why that would happen at that point. But yeah, it was. I think the practice was quite welcoming. Joss was brilliant, Barbara was brilliant. And a real people, people, if that’s the word, the environment was nice. It was all new and plush and white walls and all fairly clinical and clean. And we have big rooms. I mean, for a dental practice, I think we have relatively big rooms and they’re quite inviting. So I think a combination of all of those things and then we put in some gimmicks right from the start. So the kids had in those days it was Netflix, it was a PS3 so they could watch things on the PS3 or play things on the PS3 while they were being seen. And it was nice to have headphones and a remote control in their hand. It took them away from dentistry and that’s sort of always been my aim to do dentistry in the least disruptive and most entertaining way possible. So other other bits around me provide the entertainment, and I mean this in the kindest way. Barbara, my nurse, was entertaining. She was brilliant to talk to people. I couldn’t get any dentistry done because my my patients wanted to talk to Barbara. It just was very welcoming and entertaining and that sort of that was probably the seed to making this practice grow. So again, going back, I think I’ve just been lucky with the people I’ve come across.

[00:43:19] I mean, it’s interesting because you when I ask you what’s the key things and you immediately went to people. You know, only you know, some people wouldn’t do that. You immediately went to people, people, people, people, people. You’re to keep people. And then these specialists and then you summarise it with people again, you know what? What makes you such a people person? I mean, is it just comes to second nature that to do things, you need people because you strike me as a perfectionist and perfectionist tend to have trouble delegating anything. Never had you does that.

[00:43:59] Never done it.

[00:43:59] Perfect in my.

[00:44:00] Life.

[00:44:01] So are you not a perfectionist?

[00:44:04] You you can you can always strive for perfection. But I have not achieved perfection in anything in my life. And I don’t think I ever will. I don’t think I don’t think it’s attainable.

[00:44:16] But, you know, things need to be a certain way for you. People need to be treated a certain way and all of that. Do you think do you think you sort of instil call it I mean, in business brand values, would you would you instil that in your people just because of the relationship you have with them? Or did you work work on it?

[00:44:38] No, I think I’ve just come across people who are like minded and those who have been like minded have stayed with us and have either adopted or added their flavour to the practice. And I’ve always wanted this practice to be a kind, caring place first and foremost. I’ve always wanted it to be a fun place for us. For me, I want to work in a place where I look forward to going in every morning. I don’t want to come into work environment where people are stressed or people don’t get on or, you know, I’d rather deal with that situation and end a situation if it’s stressful and we’ve had to do that and make sure everyone else that that’s sort of the machine carries on chugging along happily. And I think again, we’ve been lucky in that my current business manager, Emma Russell, has really contributed to that. Again, she was a young person, she is a young person. She hasn’t hit 30 yet who is a real people person. And she had no experience in dentistry at all. She worked at a vet before we advertised the job. She was a candidate and she had that sort of. Kindness and drive. That made me think, yes, she’ll be able to do this job without any previous dental experience. And within six months she owned it. And now she’s telling the rest of us how how to how to run things.

[00:46:04] Just brilliant.

[00:46:05] How how involved are you on the management side? You kind of leave that up to her and her teams or do you get involved?

[00:46:14] No, I think I do get involved because I’m asked a lot of questions every day, which which makes me think I’m involved. And also, when I’ve got the option of working in a room where the decon area is detached from, and I like being in the room where the deacon area is right next to me because it sort of keeps my finger on the pulse and I can see how things are done and I can. I only need to get up and look around the corner to see how people are, how things are done. So I think I like to be involved. I like to know what’s going on. And you know, I’ve been working with Emma now since 2018, so we’ve got a good understanding of the things I can do by herself and the things that still run past me. And to be honest, she runs more personally than I need her to see. She’s sort of she she she could be a lot more independent and I trust her implicitly.

[00:47:12] What does what does it take to to be a referral practice? You know, I’m sure it’s a struggle.

[00:47:19] To get referrals happy.

[00:47:21] It’s not a struggle. It is really, really enjoyable because, look, we’re here to provide a service where we’re. And it’s really fun. And it’s it’s I was going to say it’s an honour and it is, but it sounds a bit pompous. It’s really nice for people to trust you, to treat that patient, do what you need, and then ask them to go back and see them. And it’s kind of sort of we’re then showing off what we’ve done by sending the patient back and saying, look, this, you referred them in. This is what we’ve done. Here is an x ray of it. Here’s a report. Thank you very much. Would be happy to do it again. And that sort of that’s what’s kept us going. And we don’t have a huge referral base. As you know, I’m I’m a relatively although I’m a people’s person, I’m also a relatively private person when it comes to business. So we don’t splash around a lot. We don’t sort of I don’t think we advertise much. I think we do. Emma started putting things on Instagram that we do, but apart from that, we don’t really have much going on.

[00:48:32] So what’s the reason for that?

[00:48:34] I know it’s a comfort thing. I think I’m just not comfortable doing it. I’ve never been comfortable advertising. We used to advertise in Angels and Urchins for Johnny Johnson. We stopped doing that because we only had limited access to Joanna because she’s the clinical director at Guy’s and sort of her time became more and more limited. So we couldn’t actually put patients in with her. And the number of patients that she’d built up was so big that we really couldn’t take on much more. But now we work with three fantastic paediatric dentists. Sarah Johnson’s here, the other two are one of them’s new, and the other one is on maternity leave at the moment. But, you know, they sort of keep us going.

[00:49:20] Yeah, but what I’m saying is.

[00:49:21] Sorry, there’s babbling.

[00:49:23] No, I get it. No, you get it right. I understand what you’re saying, but what I’m. What I’m asking is to be a practice like yours. You do need to be out there a little bit for people to know you, but you’re not. You know, someone who for someone who’s been a very a risk taker, you’ve done what you’ve done and you turn up to work every day. Enjoy. You know, when I say it’s a struggle, you’re like, no, I enjoy it. Right? So you enjoy the process of of work. You know, it’s important. And yet you shy, shy away from it. Are you simply saying it’s just not you or are you saying what are you saying? Because, you know, you’ve got a hard time in the practice, very high profile periodontist. People know.

[00:50:02] Him well. He’s like, stop.

[00:50:03] Stop working with us. You stopped working with us three years ago, four years ago.

[00:50:08] Because I was like.

[00:50:10] He’s more involved with Pyrex Academy. So we’ve got kids in L.A. working in the kitchen.

[00:50:16] So, you know, it would make sense to be for you to be more sort of out there, more famous, more trying to caught attention. Are you saying it’s kind of I don’t know. It’s just not.

[00:50:27] You know, and the same way we’ve attract the patients we have and the patients that have trusted to come and see us the same way dentists have trusted us and have found us through recommendation. And I always find that’s a much more organic, much better way of starting a relationship and then nurturing that relationship because they’ve heard about you, they know who you look. Holly St We’ve got 500 dentists working here and we’re all busy, we’re all working. So competition doesn’t really come into it and we all have our style of doing things and we’re all different. So my patients or the dentists I work with will know how I operate and they’ll, they’ll recommend people to, to work with to that who appreciate the way we do things. And then there are the mysteries of this world and the Michael Hortons of this world and, you know, who have got their their referral bases were brilliant at what they do. And and it’s it’s good. So I don’t need to sort of advertise because it comes through organically anyway. We’re all busy, we’re all working now.

[00:51:36] But you don’t, you don’t need to water ski, but you still water ski. So what I’m saying is that you’ve got if you’ve got something against it.

[00:51:43] No, I don’t have anything against it.

[00:51:44] It’s just not me. I’ve just just never I don’t think we’ve ever been good at it or looked into getting good at it. And I’ve never looked at growing this practice in any other way than just organically. So it’s the only way this practice has grown is by, by reputation and by recommendation. And I like that. I’m comfortable with that.

[00:52:10] It’s kind of beautiful. It’s kind of beautiful.

[00:52:12] I’ve never I’ve never had ambitions to have have an empire or to to to I’m primarily a dentist. I’m not a businessman. And I’ve never been good at business. And what one thing Joss was really good at was business. And Emma’s really good at that now. So they they do the business side of things. I do mainly my dentistry.

[00:52:37] It’s good. It’s good to hire opposite strength to your own, isn’t it? I mean, that’s that’s a key thing. I’ve got a marketing manager who’s just, like, highly reliable, pushes me all the time because I’m not that cat, you know, that, you know, I need that person to keep on telling me, you know, what time what time will you have that in mind? But having said that, you don’t want to a group you did set up the second practice. How was that? Tell me the process behind that. What happened?

[00:53:06] My very good friend of 20 years plus parricide said, Yeah, I want to start practice in the city. Will you come and do it with me? And I said, Of course I will. That was it.

[00:53:19] Really.

[00:53:20] Feels like that was the process.

[00:53:21] That was it literally. That was the that was the process. He said, you know, I’ll find a place where will you come and run it with me? And I said, Yes, of course it will. Because by that time, yes, by that time, I mean we started that practice in 2014. By that time I’d been working seven years. We had some track record here at 76. It was it was working. It was working space. So and Farid works here with me two days a week. So he has been on the very inside of the workings of my practice. He knows everything. Whatever he couldn’t see, I would tell him. So, you know, he’s a very straight shooter. Lovely, lovely, kind human being. I couldn’t imagine working with a better person.

[00:54:02] So, look, both we know the differences between the practices in terms of just aesthetics and. Well, I do. One is very sort of old style, beautiful. And the other sort of state of the art modern and one’s highly street. The others in the city but. Outside of that, what’s, what’s the same about the practice? Are they both multidisciplinary specialist centres?

[00:54:26] We’ve got people like Robert Crawford working at Boston House, got fired for working there. So we’ve got sort of restorative comfort there. We’ve got Natasha writes in orthodontics at both places, so there isn’t really much of a market for paediatric dentistry in the city. But yeah, we’ve got specialists working at both. We’ve got. But the difference is that in the city we’ve got two general dentists working there as well cost us and. Anyway. We have dentists working there also.

[00:55:05] So did you go for the Invisalign and all of that?

[00:55:09] Natasha does Invisalign. She’s an orthodontist.

[00:55:12] Oh, you’ve got your specialist in. But the generalist, what kind of. What’s the profile? I mean, what are they busy doing.

[00:55:19] Cost us does a lot of general dentistry and a lot of implant work in aesthetic dentistry. He’s a brilliant dentist. He spent half his time at Boston House and the other half here at State DaVinci Dentistry. And he’s he’s a very, very good dentist with very high standards and does beautiful work. He’s half Cypriot, half Russian, treats a lot of Russian patients because he speaks the lingo. And a lot of Russians who come here, especially from embassies and so on, don’t really speak that much English or don’t like to speak English if they can get away with speaking Russian. So that’s the sort of people he treats. Other than that, we started the practice. I think you were there when I was putting up a sign outside, outside the practice and you took a picture of it. So yeah, other than that, it’s sort of a mix of general and specialist dentistry.

[00:56:18] So Farhad, you’re a bit of a daredevil type, but if adrenaline junkie, junkie type, all the all the stuff you did go through it. What do you do?

[00:56:30] Outside of dentistry.

[00:56:31] Yeah, yeah. Water skiing, fly planes. What do you do?

[00:56:36] I don’t fly. Well, my. My neighbour is Harold Pre-school. He’s a.

[00:56:45] Pilot.

[00:56:45] Pilot and he’s taken me up in his chipmunk, which was great fun. And he sort of does roles and loops and that sort of stuff in that plane, which was great fun. So compared to that, I’m definitely no daredevil.

[00:56:58] No, I like I like sports.

[00:57:01] I’m one of those weird people who, you know, you go into the gym and the music starts before a class and the corners of my mouth go up immediately. And I look forward to whatever punishment is coming our way and really enjoy it and laugh all the way through and look forward to sort of getting the best of the instructor by doing it. Extra ten Push-Ups at the end or whatever it is, it’s I think it’s a genetic thing. I don’t think I can take any credit for it. I’m just wired that way, but I enjoy exercise. So yes, I do. I know when. When we’re on holiday, when we’re anywhere near the sea. Everything from kitesurfing, wakeboarding, water skiing, wake surfing. I tried these new flight boards recently. Which. Oh, that’s pretty good fun. They’ve got a hydrofoil underneath them. So as you speed up, the board slowly rises out of the water, and you’re like the Silver Surfer. You were sort of gliding along without touching the water. It’s great fun.

[00:58:11] Amazing. It does look amazing that. Have you done just traditional surfing? Surfing. Wave surfing?

[00:58:18] Yes, I did. I could tell you a story about that. I nearly, nearly got lost in the Caribbean.

[00:58:25] It’s hard. Is there.

[00:58:26] By. Yeah. I haven’t surfed for a really long time. And then I started surfing and I started getting braver and braver and going further and further out. And then the waves picked up and the wind picked up. And I fell and hit my knee on the dagger board and on the dagger board on the board. So I couldn’t stand up anymore. And sort of 15, 20 minutes later, I couldn’t see land. It was quite an interesting experience. And then a boat picked me up and dropped me back off closer to shore, and they’d already scrambled someone to come and look for me.

[00:59:01] Oh, did you? For a minute there, I think. What if. No, you must. You must, boy. You must have. You know, when you could. Could you not swim?

[00:59:08] So sorry.

[00:59:09] Could you swim there for a minute?

[00:59:12] Well, it didn’t didn’t come to that. It was fine.

[00:59:17] Okay. We’re going to move on to the darker part of the show. Let’s talk about errors. Uh huh. I’d like to I’d like to hear about things that you think were maybe clinical errors. And I know you’re not the type to regret anything but things, things that you think were errors as far as the business side, the practice side. What comes to mind when I say that?

[00:59:40] I’ve. So in terms of the business, I’ve I’ve made mistakes in working with people that I shouldn’t have worked with. And they then it gets difficult, it gets, it’s easy and it’s, it’s, it’s a bit like it’s a bit like marriage when, when things are good and you’re first get married and everything’s good and you never think of anything that anything bad could happen and then something bad can happen. And then you sort of don’t see. A certain thing at the same way, and then it becomes difficult to to change or break that relationship. So that’s been difficult.

[01:00:20] But do you think do you think you went. Do you think you sort of went against your instincts and and then live to regret it?

[01:00:28] Absolutely. Absolutely I did. But, you know, you do things when when when you are when you’re starting out in business. There are always people around you who are in a stronger position than you are, because when you were starting off, you feel you’re the new boy or the weaker person, or at least I was. And I did go along with things that I.

[01:00:54] Shouldn’t it?

[01:00:57] You are not going into it any further than that.

[01:00:59] I probably best leave it at that.

[01:01:04] What about what about clinical?

[01:01:06] Clinical. I can. Where do you want to start?

[01:01:11] I’ll start with. Let’s start with a note. Oh, God.

[01:01:14] Moment. Okay. One of.

[01:01:16] The most.

[01:01:17] I mean, this is really skeleton territory. The most scared and embarrassed I’ve been was. I was working at Whitecross in Victoria. That’s 2001. Probably so about 20 years ago. I wasn’t specialist. I’d qualified in 97. So I’ve done some stage jobs and some part time practice jobs, and I was replacing a veneer for a young patient. So I as I’ve been taught, I taught some groups into it. I split it up and then I used a flat plastic to flick off the bits of veneer. And part of the tooth broke off with with the veneer. And I don’t think I’ve ever been so scared, embarrassed and shocked in my clinical practice. That’s certainly a moment that will live with me forever.

[01:02:17] How much of the tooth? How much are we talking?

[01:02:19] Oh, a quarter of it. More than more than needed to.

[01:02:26] Okay.

[01:02:28] Any more come to mind? As an implant guy, you must have had implant moments, right? You must.

[01:02:33] Oh, yeah, yeah, yeah. So I was placing an implant for a friend of mine. A very good friend of mine. A friend of mine that I’ve known since Germany. We’ve been at school together since we were 14. I was replacing his upper left second molar. And again, this is the same era, 2021, probably amongst the first 1015 implants I’ve placed, and I hadn’t assessed the radiograph properly. It was entirely my fault. So I left a flap, I stopped the osteotomy and there was not enough bone for me to put the length of implant I was planning to put in without putting about a third of it into the sinus. So yeah, that was a shocking moment and I had to explain to him that I won’t be placing an implant for you today, and I’m just going to close this up and let it all heal.

[01:03:28] How far do you go then before you realised that you’d done the prep?

[01:03:31] So I’d left it alone. I’d. Well you find out pretty quickly with the first first twist drill that you put in that it’s going into thin air rather than into bone. So yes, that was a fairly shocking moment. And he he was quite a nervous character anyway. So it’s. Yeah.

[01:03:54] Every day. I feel like I feel like you’re getting some catharsis out of these these these questions. I feel like you’re enjoying them.

[01:04:00] I’m not enjoying them.

[01:04:01] It was a horrendous moment, my life. But I also you know, that it’s I think tell me tell me about tell me.

[01:04:09] About this like this. But of course, as long as you only do them once and you.

[01:04:14] Learn.

[01:04:15] And it makes you a lot more astute and a lot more careful for the rest of your life.

[01:04:21] Listen, tell me tell me this. You’ve been experienced now for 25 years as a dentist that very sort of very top end of it. And the thing about experience is that you can’t buy experience. You can’t accelerate experience. Experience is the thing that takes time. That’s what it is. Yeah. But what would you say? Is it the stuff that goes wrong? I mean, I’m remembering a conversation I had with Andrew Dorward where he said, look, a lot of a lot of dentists, they think that by talking about the stuff that could go wrong, the patient’s going to be put off. Going ahead, whereas the more you talk about the stuff that could go wrong, the more they realise you’ve been around and they trust you more and then they’ll go ahead. Now is that what experience of 25 years at the end of the day? What does that mean? Things have gone wrong over those 25 years have made you this experienced person.

[01:05:17] I mean, when I when I talk to my patients about dental implants, of course, tell them implants. I’ve got a good track record. But the bulk of the conversation is telling them all the things that go wrong with them. So, you know, porcelain chips, off screws, brake implants can break if you become diabetic, if you start taking bisphosphonates, if you start taking other medication, that affects you. I mean, there are so many things that can go wrong. And I give them some statistics about what percentage of implants develop some form of problem.

[01:05:48] Yeah, but but listen, anyone could do that, right? You could just you’re a brand new graduate. Could do that if you’ve given that. But experience is in this situation, you as an experienced practitioner knows that in this particular situation, this particular thing could go wrong. And at the end of the day, what my point is, experience comes from things going wrong. I mean, it’s by its very nature, of course, it comes when things go right.

[01:06:16] Yeah, but you become good. You’re not good because you’ve got an excellent pair of hands. Of course it helps. Or I think you become experienced or good at avoiding problems by being able to look ahead. So before before you do something, you can see all the things that could go wrong and therefore you can you can avoid them. And that’s you learn the hard way.

[01:06:42] Yeah. Yeah. So that’s that’s what I mean. It’s very, it’s a really super like useful thing to talk about, which was we don’t talk about much, do we? It’s just one of those things we don’t I don’t know.

[01:06:54] We don’t know.

[01:06:55] I’m super, super comfortable talking about failures or things of that have gone wrong and my, my, my.

[01:07:03] One more, one more, one more, one more. It doesn’t have to be clinical because whatever you whatever comes to mind, whatever comes to mind.

[01:07:11] I think I’ve learned not to not to be a first adopter with things. So when Sarah came out, this was also in the 2000. I placed a lot of I switched to all ceramic and placed a lot of crowns and I thought, this is brilliant. And all of them failed. All of them cracked. I replaced all of them free of charge, and some of them would crack after two years, some of them after five years. But they would eventually break and they would always break the same way. So just because something’s new and people talk about it and people want to do it is not a good reason for me to jump on it. I only bought a scanner in 2018 because I want to. I didn’t want to be bound to to a single system. And I wanted the thing to be very predictable and sort of powder free and all of that. So we’ve only started using scanners since 2018, which is not that long ago.

[01:08:07] No, I think Basil said a similar thing and it’s look, you guys, you’re highly predictable with impressions. And then to then say, okay, even though you’ve got this highly predictable way of doing it, now, do it this new way. Introduce all these risks that, you know, you’re not you’re not taking those risks with with impressions. And I put that to him and I put it to you as well, that you have to tread an interesting line between doing the tried and tested thing that, you know, works. And you have to try new things as well.

[01:08:43] Because you want you want improve if you don’t try new things.

[01:08:46] Yeah, exactly.

[01:08:47] Exactly. You know, scanners have been around for, what, 25 years and we’ve only now trusted them because also the margin of error that I mean, you know, a lot of people use serac, but serac in the old days was was terrible, you know, the things people made chair site and fitted. You would never accept that from a technician. You would never fit something that hasn’t been stained.

[01:09:14] Polished and.

[01:09:16] Glazed. And yet because the dentists were doing themselves, it was acceptable to them to sort of manufacture this thing to fit it. And the patients don’t know about where rates and what what, what the roughness of the porcelain does to the opposing tooth, etc.. So and also the sort of as what we get, we get obsessed with marginal fit and marginal error and that sort of stuff. And, and that’s only become better than impressions probably in the last five years, five, six years. So I swear by it, I love my scanner. I use it on pretty much every patient now even to have it because I’m also getting older and I remember less so I never needed to look at patient’s notes. I remembered everything about every patient I used to see. That’s not the case anymore, so I need to rely on my notes a lot more now. And it is really helpful to have x rays and a scan of the patient to see, to remind myself what I’m looking at.

[01:10:16] What have you got? Three sheep?

[01:10:17] Yes.

[01:10:19] So take me through. Let’s say a patient comes to you from let’s say it’s not a referral. Let’s say someone’s come, you know, emails your clinic. Yeah. Says I want to be seen about my whatever the way patients will say my missing teeth. Yeah. What happens? What’s. What’s the next thing that happens there? Who gets in touch? Is it. Is that the TKO?

[01:10:41] Yeah, we’ve got a treatment coordinator daughter. She’s she’s lovely. And she is an Eastman trained nurse who decided not to do nursing anymore and decided to do initially reception. And now she’s become a treatment coordinator courses and she’s very personable. So they’ll get an email to fill out some some details about medical history and what the reason is who’s referred them. And they make an appointment and they generally, depending on what they’re coming in for, I mean, they’re been referred to me as either a patient to come and see me for a particular reason, or sometimes people can just to come in for an exam because they haven’t seen a dentist for a long time. And we don’t we don’t turn anyone away.

[01:11:28] So how long is that initial exam that you would give a new patient.

[01:11:32] At one hour? Every every every initial appointment is one hour.

[01:11:36] In the hour. What if what if you notice that, you know, I’m the wrong person to see you? Just you just give that our. What you think if there’s someone else who should. You know, I mean I mean, at the end of the day.

[01:11:48] Your patients kind of come in and I still need to do my full examination.

[01:11:54] And I got your full record.

[01:11:56] And speak to the patient and see what they’re after and what we can do for them. For example, if they’ve got periodontal problems, I then suggest they go and see hitn and what has often happened and I’ve said, Look, I’m really sorry you’ve been booked with the wrong speciality or the wrong dentist here. We’re not going to charge you for this appointment. Please make an appointment with my colleague and they will see to your need.

[01:12:25] Let’s say, let’s say you are right. And now you’ve done the one hour. You’ve given the patient some understanding of what you think, I guess, by this point. And then what do you do? Do you write to the patient with a treatment?

[01:12:38] Every patient, even if they need no treatment, will get a letter. Even if the letter just says you’ve got a clean bill of health, your teeth are good, your gums are good. We’ll see you in six months. Every patient gets a report.

[01:12:51] What is how do you get that? You dictate that. Do you actually write it?

[01:12:54] I write up my notes and Georgia will put put the letter together. I then read, read it, adjusted, add some bits to it, and then Georgia sends it off.

[01:13:04] And so how do you do it that day? Is that is that your process or how soon will I get that letter as the patient?

[01:13:11] It’s rare for a letter to be sent out the same day. It usually takes about a week or so.

[01:13:16] Okay. So I get the letter from you and you say, look, my recommendation is whatever it is. Yeah, three implants down here, two crowns and whatever. What what happens.

[01:13:26] Next?

[01:13:27] I’d be sorry to interrupt you. The I think the important part is to especially in this day and age, with with being aware of litigation, you you have to make sure you give patients options rather than rather than just a plan. So you go through various options. The most likely I mean, I don’t go through 12 different options. Even if 12 different options were available. You sort of establish at the of the examination stage what the patient’s after, what direction there’s there’s no point writing to a patient who wants another complete denture about putting six implants into that drawer. They know that the option exists. You discuss it with them, but you’re very quick and come to the OR they will explain for whatever reason that’s not what they want. And then you can mention it, but talk more about what they’re actually after.

[01:14:23] Yeah. So, so, so you give them two options for the sake of the argument or you give them a stabilisation phase in order, whatever it is. So now patients got this is, is the process that they will make another appointment to go through that with you or or what happens now depends.

[01:14:37] On the complexity of the the treatment plan. So if it’s something simple like a crown or a treatment, then no, I won’t see them again. They’re just looking to have that procedure done. If it’s a formal invitation, I’ll see them several times before we start, before we pick up a drug, because we first that is, depending on what it is, you might make a michigan appearance first, stop them grinding, then you might make a diagnostic workup, then you might build the teeth up in composite, you know. So it depends on what the patient’s coming in for.

[01:15:15] So let’s say it is a big job. It’s something something big like a full mouth rehab. Look, did you see the patient again? Let’s say you sort of figure it out.

[01:15:24] My aim is to show the patient in their mouth what they’re going to end up with before I do anything. So the best way to do that is with a sort of mock up in their mouth of what what things are going to look like. And that’s not always possible. But more often than not, it is possible to do that with a temporary, temporary mock up and we will use pro temp and the diagnostic wax up, make some indices and try it over their teeth or something along those lines.

[01:15:57] Have you ever bothered with the whole DSD workflow or.

[01:16:01] No, I haven’t. I haven’t. And maybe because I’m a dinosaur, maybe because it’s just not I don’t do a lot of I spend more time talking patients out of having cosmetic dentistry have it. I mean, I happily do it as part of a bigger treatment plan. I’ll happily do it for all the patients. I’ve many times refused to put veneers on on sort of 20 something year old. So it’s just not what I do. It’s not what I want to get known for. So that’s not the wrong practice for that. But I don’t I also don’t recommend them to have it done. So I don’t say so. And so we’ll do it for you because I just say this is not a reasonable thing to do. If you have some whitening, does have some bonding, then have some ortho and, you know, keep your teeth.

[01:16:49] Sure, sure. So, so but okay, let’s say the patient comes in again. You explain things. Let’s say the patient then doesn’t contact you again. Is that it? You leave it at that or is there a follow up process that you guys do?

[01:17:01] No, we don’t follow up. We don’t follow up on patients who I mean, we make sure they’ve received the our treatment plan. And as far as aware, I need to check with what the girl signs they do anything else. But as far as I’m aware, we don’t we don’t chase chase them at all.

[01:17:19] And what about the issue of price and costs? Do you get you get patients asking about giving them discounts, anything like that happen ever?

[01:17:28] Yes, I have been asked and I guess I’m fairly dramatic about it. I don’t like talking about money at all. I don’t think we’re an unreasonably priced practice where I think we provide quite good value for money. And I find it almost insulting to sort of. It’s not health care shouldn’t be an area where you want to skimp or save or it’s just not worth it. And also, I don’t believe in discounted products. So if you give a patient a discount or not, the outcome the patient expects will be the same. Right? If you have a crown done, you want it done perfectly and you want it done with the best materials to the best of the person’s ability. And that service has been priced at a certain level. Why would you why would you want to challenge that? Why wouldn’t you just go somewhere else if you didn’t want to have that done? Where where it meets your budget better.

[01:18:30] Is a nice Germanic way of looking. I like that. Yeah. I don’t like talking money either. It’s weird because some people are very confident about it and some people just aren’t. And I don’t know. I don’t know where it comes from. Like I hate sales.

[01:18:47] Let me give you I’ve got a I had a patient who seemed to be talking about my dead patients a lot.

[01:18:54] This chap.

[01:18:55] He was Egyptian and he came in one day and he said, Farid, I want you to replace my two front clowns. I said, Yes, sir. You know, I it was at the end of the day, I could I could work that day. And he wanted it done there. And then I sort of knew the calibre of patient I was talking to. So I said, Forgive me for saying this. I don’t ever do anything without telling my patients what the procedure is, how long it’ll take, what it will cost, etc.. So it may I, may I just impart that information to you? And he said, yes, indulge me. So I told him and he says, Right side, let me tell you something, just to put your mind at ease. I just flew over from Dubai where I spent whatever an obscene amount of money on his hotel room. And basically he said, You’re fine, just do what you need. So I’ve used him as an example. Whenever I feel don’t feel comfortable talking money to a patient. I sort of say, you know, I’ve had this said to me before, forgive me for mentioning this, but I don’t usually do things without telling you what the cost is. And then, you know, because these days it’s really, really rare for you to do anything without writing to the patient first. Anyway, it just doesn’t happen anymore. It used to be more more commonplace.

[01:20:08] So we you know, it’s times flown by. I think we’re an hour and a half in. We, we tend to finish these always with the same two questions. Perhaps not here, but I’ll start with perhaps. Your deathbed. Nearest and dearest around you. What? Three pieces of advice. Would you leave them?

[01:20:37] Oof!

[01:20:43] To have sympathy empathy sorry is is probably important to me to because you never know what’s going on in other people’s lives. So to show some level of understanding, to try and show some level of understanding towards others. To be kind. And the last thing would be, I would say the world and what’s going on around you doesn’t really care about how you feel. So if you want to be successful, I think you have to do what you need to do every day. Despite not feeling great, despite feeling great, despite that doesn’t matter. Your feelings don’t come into your day to day life. You have to have a name and take them off, deal with it.

[01:21:34] So it’s kind of like empathy, kindness. And then the third one, be like a discipline type. Yeah, something like that.

[01:21:42] Yeah, I.

[01:21:44] Yes, I think discipline is very important to me, but also a lot of the time you might, you might get out of bed and you might feel tired, you might feel drained, you might feel like not doing what you need to do. And I think one of one of the things that teaches you about this is having kids actually, because your child still needs feeding. You know, it needs burping, it needs nappy changing, whatever else. So whatever you might be feeling is irrelevant. You have to do it. And I think in life you can treat most things like your baby, like my practice, I treat it like my baby. I look after. It doesn’t matter how I feel about that or how I feel that particular day happens to be that. Most of the time. I feel really good about my practice and I really like being here.

[01:22:34] I love that body. The final, final question. Fantasy dinner party. Three guests. Dead or alive? Two. Would you have.

[01:22:47] My three guests are all that I’d I’d invite Mohammed, Jesus and Moses because I’d really like to know what they’d have to say about religion these days. I’m not particularly religious myself. But I would really love to know how much of what they supposedly preached or told people about is what we know about them today. So those would be my three ideal guests. I mean, I’d love to invite God, but I think he wouldn’t make it.

[01:23:24] What an.

[01:23:25] Interesting list. How interesting. Especially for someone who’s not very religious. I like that very much, but I like that very much. Jesus and Moses. So nice speaking to you. So nice speaking to you, buddy.

[01:23:40] It’s been an absolute pleasure. Thank you very much for having me.

[01:23:44] 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.

[01:24:00] Thanks for listening, guys. If you got this file, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we’ve had to say and what our guest has had to say, because I’m assuming you got some value out of it.

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