Month: August 2020

Payman: Called from me, the CEO, to my top users. I should’ve been doing more. I’ve learned that now. A simple thing like that. Of course, there’s all the financial side. Luckily, I’ve got a partner who takes care of that stuff as you know, so.

Intro Voice: 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.

Payman: So, today we are going to talk to Jimmy Palahey, who’s got four practises in around Lincolnshire and Nottinghamshire. Jimmy, is that right?

Jimmy: That’s correct. Yeah.

Payman: Yeah. Nice to have you Jimmy. So Jimmy, just tell us firstly, pre-COVID, what your practises were like. The size of them, the number of people, the buildings, the kind of dentistry you were doing in those four. And then, three of those became urgent care centres, urgent dental centres. So really, what I’d like to know is what it’s like, first of all, how did you do that? Why did you do that? Why didn’t you barbecue like the rest of us? And then, what it’s like working in that environment.

Jimmy: Okay. So, let’s take a question at a time. The initial group of practises that we had, we always run a mix model, so we’ve always run a mix model. I’ve always felt the most suitable model for us.

Jimmy: I think it works well for us. I have a background doing NHS dentistry. Did most of my career doing that. And then, obviously always had one eye on private as well. But we’ve always approached it as a Pizza Express of dentistry, toward that sort of model. So, not high-end Michelin star and not McDonald’s, so kind of sitting in the middle. And we’ve always sat at that sort of position. So we’ve always built the practises, all four of them really, into that sort of position where we have a steady NHS income, and then also have the private on top.

Payman: When did you have your first one? How old were you when you started that? And then, when did you add the next three?

Jimmy: So we bought the first practise about 10 years ago [inaudible 00:02:15], and we bought a pretty standard setup sort of buy a practise offer, offered the practise owner. And then they were, they sort of ran it as much more of an NHS type practise.

Jimmy: And then, we sort of added in more services and expanded the practise and so on. And then, we sort of went through the tendering process, for new NHS contracts. And, that’s how we sort of expanded over the years. So, we expanded over the last few years into more sites in order to sort of just essentially able to treat more patients. And just to have a bit more activity going on. And then, obviously taking that original philosophy into the new practise to create that sort of mixed model.

Prav: And Jimmy, as a practise owner… And I see a lot of practise owners who have mixed practises and then grow. Personally, from a clinical point of view. Did you adjust your splits? Did you start doing more private work, or move, or at any point shift towards being exclusively private? And then, get the associate centre do the NHS. How has that been during the whole period of time that you’ve grown from say, your first practise up to four?

Jimmy: So, yeah, obviously I was doing a lot more NHS work at the beginning. Because, young couple buying a practise. You essentially got to put the graphic that you’ve got to have that grit and determination to sort of…

Prav: Sure.

Jimmy: Get ahead a few years. I’m sure everybody will say the same thing. And then, as we, as we have more conversations with patients and we stabilise our base, we can start talking to them about private work. And then, obviously introducing various clinical systems into the practise. So, whitening being one, for example. And then, implants and handles. So, sort of endodontics and oral surgery and just expanding into all the different stairs. And then, just making sure that, we cater for all needs really. We try to keep everything under one roof. I think that’s probably what the majority of practises are doing or aiming to do.

Jimmy: And, that gives you a natural platform to then expand on. And that’s what we’ve done.

Prav: And so, you as a clinician personally, do you do any NHS work now? If you shifted to be primarily working on the business plus private, or do you do still do a little bit of NHS? How does the structure work now?

Jimmy: So yeah, I probably do more private work now. As you said, work on the business. So, I do problem solving and all the other aspects of running a business. But I still do a little bit of NHS because there’s where my roots are. And, I don’t mind doing a little of that. I think in certain circumstances, NHS is very suitable. Private is obviously suitable in other circumstances. So, it’s just about giving people choice and then… I’m not pretty prejudice against one or the other. I’m quite happy to do both.

Payman: How did the UDC thing happen?

Jimmy: So, UDC thing happened. I also work with the LDC in Nottingham and we were approached as an LDC about UDC. Because the thing about LDCs is that no one’s ever heard of it. And quite frankly, in most of your [inaudible] different games with them very much. And we have many years where there was not much engagement.

Jimmy: And then, we were then mentioned in the documentation that came out from the CEO of the NHS about utilising the LDCs to create either UDC or to impart on the CBC. So from the outset, we were inputting on this, how we wanted our UDC to be sort of designed in our area. And I think as a group of LDCs, we did that. And obviously, as a provider of services, we actually provide an eight to eight service. And we provide seven days a week at most of our practises. So, we already have that sort of platform. And we are already quite happy to see NHS patients.

Jimmy: So it seems like a natural progression to then extend that out towards that UDC model. And ultimately, we were approached by the NHS to become a UDC.

Payman: So, you were running eight to eight, seven days a week before.

Jimmy: We were, that’s right. And, in a few of our sites we’re eight to eight, seven days a week. So, we find that works quite well. And we find it’s quite a good model for our employees as well. [inaudible]

Prav: Jimmy, quick question about that. In my own practises, sometimes I talk to my associates and support team about possibly opening a Saturday clinic or doing a late evening and stuff like that. You’ve obviously got something in you that we haven’t, that enables you to get team members to be able to come in late or, or do the weekend shift and stuff. How have you managed to sort of set that up? So, you’re able to operate on them hours. And then, how do the shifts work? Just, just give me an overview of that. I’m really curious about that.

Jimmy: So, probably a combination of wit and charm, let’s say that. Hey, that’s from me, that’s from my wife. This is not really my doing now. I’m not that charming really, to be honest. Yeah, it’s just talking to people, and exploring the fact that this is not a bad option for many people. They can turn their weekend into a weekday. They can do a lot more work in that weekday. Then as more things open up, there is more opportunity, it gets busy. So it’s just really, trying to spell out the advantages of working in this whole flexible way. And I think that, if people have children, that they can do the school run. And one way or the other, so they could drop in the morning or pick up in the afternoon. I think there’s an appetite for it. And it works, it’s a very productive way of working I think.

Prav: Amazing.

Jimmy: Yeah. I think that it does have its challenges. But then, all practise have their challenge to problem solving, as you said before.

Payman: So is it an eight to two, two to eight model?

Jimmy: Yeah. We run it more of an eight to two, two to eight. I think it’s reasonable, six hours and then their work is over, usually. Some people like to work more and that’s their choice. But, we’ve encouraged that sort of working.

Payman: But then, how about the manager? Are there two managers or just one?

Jimmy: So we’ve been through different scenarios. I think early on we had multiple managers, a manager per site. And, I think that now we sort of have a bit more of a dual practise manager role. We also have a team of about, let’s say five or six to look after all the sites. So, we all chip in and do a bit each. And, we all have our different roles. I think they’re quite role specific. We tend to spell those roles out quite early on. So, everybody knows what they’ve got to do. And, I think we sort of… And, then we can dip into other parts of the business as well. So we have a loose managerial structure. But, we tend to just allocate the roles accordingly.

Prav: Jimmy, how does it work for you as a practise owner? Because, I certainly know that during the times of operation, there are certain team members that are on call too, if that makes sense. And then, when the practise shuts, obviously I’m probably going to get a little less feedback and stuff like that. What does your work life balance look like? And, are you on call from eight to eight most times. Or, have you got that sort of covered, so there’s a layer below you. How, how does that work in terms of your life and how you manage something that’s running seven days. Eight to eight.

Jimmy: Yeah. Good question. I think it was a bit more challenging at first. But then, you get into a flow don’t you? And, if you have a good team and you can allocate work, you feel that the team are picking up that work and you get good feedback.

Jimmy: I think at that point you can start taking your foot off the pedal a bit. And maybe, just concentrate on the more complicated work with more complicated problem solving. I think more of the operational type aspects of the business, I would leave to other team members. Our clinical leads, for example, practise managers and so on. I think that would be where I would try to just actively take a step away and say, that’s your role? And if you have any issues and come and see me. But, essentially I’ll expect you to fulfil that role.

Jimmy: And if it’s clearly defined from the outset, and if that means you can dip in and dip out accordingly. And then, make those time for your kids and everything else, you’ve got to make time for as well. It’s just juggling time. Isn’t it really?

Payman: Yeah. So tell us about what it’s like working within a UDC environment. Like, whole PPE thing. Especially, when the virus was peaking. Did you have members of staff scared to go in and that sort of thing?

Jimmy: That’s interesting. Yeah, I think we’ve seen the whole evolution of this really. Because, from the outset we were sort of sitting with the NHS saying, this is how we think it should be delivered.

Jimmy: And, everybody didn’t have the level of sort of guidance as we have now. More documentations coming out on a weekly basis, daily basis almost. But, early on, we didn’t have that level of guidance. So, we would do things like fit testing. And then, the person that was fit tested would say, look, there’s literally no guidance in the healthcare space. Most of my guidance comes from asbestos and from solvents and so on. So, there really isn’t. So we’ve asked him a question like, how about we try this. And he’d be, oh, there isn’t any evidence for it again. So, essentially become a guinea pig. And I think, that we kind of guinea pigged our way through from the early days. From PPE testing, patient flow, everything. They created softs quite early on and they did a good job in explaining this.

Jimmy: I think that their team that created the standard operating procedure to do a good job, based on the evidence they have. And obviously, more has just flooded the market and opinions have changed over time.

Jimmy: So, where we started and where we are now is quite different, actually, I would say. A bit more clarity on what you can and can’t do.

Payman: And you were doing AGPs as well. Right?

Jimmy: We were doing AGPs from quite long time now. Yeah, we sort of embraced all of the PPE requirements, and obviously patient flow requirements. And adjusting the practise to accommodate donning and doffing areas. All that sort of stuff. We did that early on. Yeah. And we’ve been doing it for a while, so we feel quite right doing it. So, we’ve continued on. And yeah, we’re happy to share any sort of information. We’ve done that through the LTC networks. We’ve always shared any kind of learning.

Payman: Yeah. What are some tips how to manage in this new normal. In this bit? H Hopefully it’s going to change again. But, to me it seems like patient communication is an issue, right?

Jimmy: I think so. The conversation, there’s going to be an issue because of the mixed messages that they’re probably getting from the wider sphere. So, if the tell everyone they’re opening on the eighth. And they don’t give you any indication as to what to expect. And it becomes a bit of a… You almost have to work backwards. Certainly, they give you all of the information later. So we’ve had a big comms bundle that’s come from the NHS. But practises are already open. So, you’re kind of retrospectively trying to get that all out to patients. So, it’s kind of almost doing things in reverse. And that hasn’t really helped the situation. But in practises that are proactive and people are quite sort of willing to get on with it. I think that’s, we’re a pretty adaptable profession. And I think that we can adapt to whatever that gets thrown out. So, I’m not hugely downbeat about it. I think you just got to adapt to what’s there.

Payman: When I said communication, I meant actually patient-dentist communication. Under all that stuff, do they not find it difficult talking?

Jimmy: Yeah. So we’ll have a conversation with the patient prior to getting them through. So yeah, we learned quite early on that we needed to triage prior to them coming into the practise. So, trying to get conversations done and dusted. And we’ve been using things like video conferencing and things like that to at least liaise with the patient beforehand. And just kind of give them an idea. And post-treatment as well, essentially when you’ve treated them, you want them out of the door and out of the practise. So that you can start preparing the practise for the next patient and cleaning down and so on. So, we can always have a debrief post the appointment. So, using tech has been a big help and has allowed us to sort of contact patient outside of the room, sitting in the chair. I think, it is going to be a useful thing to use. I think going forward, I think the whole profession will embrace it, wouldn’t they?

Prav: I think something that keeps coming up with a lot of my dental clients and friends is it’s fallow times and how long to leave between AGP, non AGP procedures. And, what was that when you first kicked off? Has that changed and what advice can you give? And it’s different. We speak to everyone. It’s different.

Jimmy: Yeah. In the early as standard operating procedures that we’ve got from the UDC, the real first incarnation of that. At that time, it’s about 60 minutes and we used to leave about an hour and a half some for the AGPs. And about 60 minutes for anybody non-AGP. But, that was what was written down. Because, I think that, that position was evolving. And obviously again, through the LDC network, we would always ask the questions about this type of thing directly to the NHS. And sit there and wait for an answer from PHE, would eventually come down the line. Things like air conditioning, for example. We had a lot of our teams sweating away in FFP3s and their gowns. And, we’ve kept asking the question, yeah, can we use air conditioning? And then, we got the responsible for a few weeks later.

Jimmy: So, it hasn’t always been that quick, getting the response. But, obviously the PAT position is that equal position. So, I think that you have to follow that. The FGEP guidance has been very useful in my mind. I thought that was a good document. And again, some of our East [inaudible] colleagues were involved in creating that document. But, it’s not always in tune with the NHS documentation. It’s kind of explained in a slightly different way. And, I think that ultimately from what I’ve heard anyway, the NHS document has to trump that in terms of that being a legal position that you must take.

Jimmy: So, I think the final time issue is going to be something that sort of ranges on and on. Isn’t it? Especially, when we move into the sort of level three type alert status, and people start to think about going a bit more towards routine care or going a bit more back to routine practise. I think those questions will be asked a lot more about fallow time and how, how it could be potentially mitigated.

Prav: So what are the fallow times today? Are they similar, or have they changed now?

Jimmy: Well, the FGEP thing to see… I’m not an expert on this, but they tend to sort of, from my understanding of their documentation, that the non AGP, they didn’t really mention having a fallow time. And for AGP, they gave a range of mitigation for how long the fallow time should be. But the baseline is 60 minutes based on six air changes, I believe. After which we are opening a window. So, and I think they’ve taken out from hospital theatre design and air movements in the hospital sector, how they design it.

Jimmy: So whether more information will come out about mitigation, for example, air exchanges, ventilation systems, and so on. If more evidence comes up, maybe they’ll tweak that slightly. And obviously, you can use rubber down in the suction. And there some very good papers, that talk about the experiences of other countries and how they’ve tried to mitigate that sort of circumstance. I think, certainly the Germans and the South Koreans and so on have certainly released some good information about how they dealt with the issue. And what the actual risk is. I think this is an evolving thing. I think that as their profession demands, more thorough investigation, more thorough explanation of what they can and can’t do. This will only widen the debate further, I believe.

Prav: And, just excuse my ignorance here. But, am I right in understanding as an NHS practise, there’s certain things that you have to stick to. And payment, you might know this better than me. Where this is solely private practise, you can be a little bit more discretionary and go towards, let’s say the SGDP guidelines, or what the BAPD are doing. Because, I’m having conversations every day. Obviously I’m not going to mention any names. And some people are saying, look, I’m using fallow times of 10, 15, 20 minutes. And, I know those are going down the more rigid sort of 60 and longer fallow time routes. And, and is this a sort of, well, this is what independent practises do. This is what NHS guidelines, they have to stick to these. And then, there’s the conundrum of, well, if you’re a mixed practise, how does that pan out?

Jimmy: That’s a good point. I’m not a big… Essentially, people are people and patients are patients.

Prav: Of course.

Jimmy: Everybody is an NHS patient, quite frankly, because everybody pays tax. So everybody’s an NHS patient. Some people choose to have their private perk, healthcare provided privately. But, they have the option of accessing secondary care, also other things on the NHS. And we have lots of patients that maybe have a bit of both. So, I think fundamentally making that divide between NHS and private, probably isn’t going to hold well, if you get scrutinised on your prep. On the way that you decide to interpret rules and regulations. I think, I’m going to give a personal opinion there. I’m not that strong on this. But, I suppose in my opinion, if you’re dealing with a sort of that level four. It’s there for a reason and we should really be dealing with urgent care or maybe tinkering on essential care. People that are having problems that you know, will get worse. And, really sticking to more of a non AGP based model.

Jimmy: I think if you start mitigating fallow times at level four, alert level, I think, maybe in my opinion, that’s a bit premature. I think, as the alert level reduces and the outside risk reduces, then maybe there’s more scope. But again, that’s why I’ve mentioned, that there’s lots of guidance. And, I think that if the PAT position is really the legal position as far as I’m led to believe. So, I think the GDC have also acknowledged that. But, in terms of health and safety, which is essentially what this would fall into. Then, you’d have to follow a legal position in the past, been defined by the department of public health England. I think even as a private practise, I think you’d be hard pushed to defy that regulation.

Jimmy: I think the issue is whether having robust stays and if it’s challenged and so on. And, how much evidence is there to back it up. I think ultimately, you can have an opinion on these things. But my own opinion is that you probably have to follow that regulation if it was in black and white. I think you’d be hard pushed to have your own interpretation of it, unless you had some senior figures, or senior think tanks. Or, people that were in a position that they could rewrite legislation on your side.

Payman: Obviously, you’re quite a focused person. You’re obviously looking into the future and from the business perspective, what do you see happening with your contract. And what do you think you’re going to do? What are going to be your tactics going forward, your strategy going forward?

Jimmy: That’s a pretty broad question. Does anybody know? I mean, ultimately it depends on a number of things. If the GDP figures are what they are in terms of the tanking economy, that is going to be a mitigating factor. And all that will go back on what’s happened in the past. And I guess 2008, we do remember 2008. And I think that, it was when the profession took a hit. And I think that, my gut instinct is that it’s probably going to take a hit again. By how much we don’t know. I think that a furlough is probably giving a false sense of security at this stage. And then, they are going to affect cost and mitigate. And, it might be that the appetite is maybe not as great as it was. It’s a very difficult question to ask.

Jimmy: I think that the NHS side of what we do will continue because the demand will always be there. And we’re quite happy to serve those people that have issues and need dental care. We’re quite happy to do that.

Payman: Do you think the contract’s going to change?

Jimmy: This is the million dollar question, right? I mean, from everything I was reading, it seemed to hint that the contract would change. What happened in Wales, and then the CDO. Sort of reading between the lines. It seemed to hint that change was in the air and that the appetite was there. I know that they’d be piloting for 10 years since the [inaudible] report. They’ve been piloting other options. I’m unsure about the… I think the pilots have become generally unstuck too, to their financial modelling. And, I think that’s always been a hurdle that they’ve never been able to get over. And possibly, there’s an appetite in the profession to change the NHS system. But it’s, whatever… It could be appropriately costly I suppose. That’s again, my personal opinion. It’s probably something to do with…

Payman: If I were to say that you were the King of the… You were the CDO? How would you structure NHS and private?

Jimmy: Well, I think that you could look at other models. The French are quite sort of, have a huge NHS. But then, they remunerate very well for their NHS care. I think about 95% of their MTs are on the NHS. And then, certain aspects they take out of the NHS, like prosthesis, like dentures and so on. So, there are various models around Europe that people could look to. And I think that a prevention based approach has got to be the way forward. If you really, you’ve got to remunerate of prevention. You’ve got to look after kids. You’ve got to. That has to be your baseline. As a national health service, that’s what you got to do. I think at the moment, it’s been skewed towards activity. And really got to go down the prevention route. It just depends on whether they’re in the position to afford it really, I think. As that’s going to be…

Payman: I don’t think they’re going to spend any more money, are they? That seems clear. And we were talking to Ian Wilson and he was saying, look, it’s 2.5% of healthcare spending is for teeth. So, what’s the best way of spending that. And I know, by the way, it’s not even worth saying if you were King of the world, what would you do? Because you’re not. And, the world doesn’t change like that. The world changes incrementally. But it’s been sick for a long time, the system. And I think, the timeline… This is a good time to reflect on what we can change.

Payman: And by the way, also the stuff that Dominic’s been talking about where… I see you’ve really managed well in this period, right? You’ve moved quickly. And you’re the kind of guy who doesn’t complain and takes care of business, but you know, we’ve been let down overall. We’ve been let down by the regulator, we’ve been let down by, over our own defence organisations, I thought were pretty poor as well. Don’t you think it’s a time for the profession viewing the LDC system? Are you guys not having these conversations?

Jimmy: Yeah, we’ve been having these conversations a lot. That’s a part of what we do in terms of discussing these issues. But yeah, it’s a very difficult question to answer. I think that you’ve got to put people’s healthcare at the forefront, because that’s essentially why you do the job. I hope so. That’s why we do it. So, people’s health has to be at the forefront. So, any system you design has to be based around patient care and making sure that the service that we deliver is in line with the demand. What we should be doing to prevent problems going forward.

Jimmy: So, as I said, prevention has got to be the key. I would agree with you, there has been some disjointed comments from various aspects of the profession over this period of time. But, you’ve had to just sort of piece it together.

Jimmy: I think that’d be fair to the LDC network. Again, I keep going on about this, because I’m sort of part of this network. But, they’ve had to provide a lot of information for practitioners. In terms of trying to decipher through sort of a plethora of information and guidance that is coming through. Certainly, we’ve tried to sort of kick through the relevant bits of information and get them sent out to practitioners. So, our levy pays to constituents are receiving that information in a timely fashion. But it doesn’t help. If the information, as I said, it’s sometimes a bit backward. Open the practise and then tell you how to do it afterwards. I think that kind of position has been a bit tricky.

Jimmy: And also, trying to extract a position statement from a lot of organisations has taken time, as well. As I said, that starts at the UDCs. We didn’t have this guidance. We were just kind of winging it a little bit based on some guidance. But then, that was evolving. I was reading constantly reading weekly, trying to work out if anything new had come about. And do we need to change the way we practise.

Jimmy: And I think that’s the experience of most of the practitioners now. So I think the frustration maybe has come about from just having to go back to your business model constantly. And have to make adjustments because new guidance come out and then that would supersede other guidance. And then you trying to decide which one trumps, which. Because, you might get two different opinions and you’re not an expert to decide which trumps which. So you’re waiting for someone else to come out and tell you. For example, that the public health England position is the law and the other positions are not.

Jimmy: So, you needed that guidance from the GDC to actually spell that out. So then, you know that if you’re going to be scrutinised, which guidance you’ve got to follow. So, I think that this is where it’s very… It’s been a huge learning curve and a huge challenge for not only practises. But practise owners especially, but also associates and so on have had to adjust to a different style of working and so on. So, I think any kind of change often breeds fear, doesn’t it? So I think that we are fearful about these changes. But, I think the way to deal with it, it’s just to be level headed and just try to see it in and around and…

Payman: Where do you sit on the conspiracy versus incompetence kind of debate.

Jimmy: As I said, I’d like to think that I’ve gotten a bit of an idea about where I think of how is it we, want to go with dentistry. But then, everybody throws their 2 cents in. And that’s why, again, as you said, would be sort of this redesign of the whole NHS system. I thought that was on the cards. I really… My initial thought was that will never happen because it’s simply too expensive to do it. Or, it would involve additional funding. But then, you started to get trickles of the fact that obviously they were thinking about this in the background. And, there was an opportunity. As you said, everything’s up in the air and an opportunity to rethink it all. But then again, they came back with, we’re probably going to go back to activity again. So then, my hopes were dashed somewhat.

Jimmy: So basically, that letter it’s just quite generic and said, we’re going back to activity again. So, I don’t know what goes on in those conversations. I get a bit of an inkling from people that possibly are negotiating on our behalf as a profession. And giving you sort of snippets and possibly eyeballing the opposition or the other side and the negotiations. And, they can give you their thoughts. But ultimately, unless you’re in that position, sitting around that table, you haven’t really bothered how to make that decision. So, all we can do from the grass or our level, which is the ground level, is just make our opinion known. And then keep our fingers crossed that it doesn’t fall on deaf ears and that somebody does something about it.

Payman: You’ve read a book, it’s called The Shock Doctrine? There’s a new idea as well. It’s all about, when there is a crisis, that’s a good time to make a massive social change.

Payman: Again, by the way, whether it’s a pre thought out thing. Or these plans are already… Of course, there’s loads of plans in place. And there must be people saying, well, now’s a good time to put it in. I can see that happening. I thought the opening, the sudden decision to open. I think that had as much to do with Dominic Cummings’ problems as anything else. Because they announced a bunch of stuff that day on the ticker and on the class. That’s how government tends to work, the news flow management and so on. Right?

Payman: Yeah. But not conspiracy theorist are you?

Prav: No, I am not. I think know for me, I hear lots of things from lots of dentists, right? And, I’ve listened a lot to Dominic. I’ve listened a lot to Tiff. A lot of my clients as well. And they’re all saying different things. My approach has always been that everything that we do in all actions we take, we should be following guidance and law. But at the same time, I truly believe that we should be following science as well. I think that’s key for me, is when, when you look at… And I don’t know if you guys have been following stuff that Ross Hobson has been putting out. He’s been filming smoke bombs in his clinic and stuff like that to see how quickly the air clears. And I think, one of the things that’s really clear to me is one thing that we’re doing with every single patient that walks through the door is we’re doing this screening. But, we’re treating every single patient like they’re walking COVID time-bomb.

Prav: And so, while we’ve got these clean down, leaving it so long for the dust to clear and everything. While we’ve got the temperature check, we’ve got the questionnaires, we’ve got all of this. And, I am not at the front line either. So, I can say what I want, right? And I can say, well, do you know what? The fallow time should be 10 minutes. Or, I think it should be less than that. And I think personally, things will move in that direction. I think, as the evidence comes out and more and more comes out, I think things will shift over back to normality. But, I think the people who are making these decisions have also got a lot on there, a big weight on their shoulders. What if they were to make a decision tomorrow and somebody contracted COVID, that was tough.

Payman: We have been having these conversations with super people who’ve been through. President of GDC, president of BDS. None of them seem to know where the answers were, until we finally got to this point of the chief dental officer. Yeah.

Payman: So, the system’s broken and this is not the last time we’re going to have a problem. There’s going to be other types of problems, whether it’s again, one of these pandemic type. Or some sort of crash or financial crash or whatever it is. Jimmy, what are you thinking going forward? What were your plans? Are you the kind of guy who thinks 10 years ahead. Or, are you thinking of adding more than four practises? What you’re doing?

Jimmy: I don’t know. I think this has been a bit of a chance to reflect, this kind of problem. Knowing that the advice that we get is like throwing a pack of cards in the air and seeing how they fall. I haven’t got. I’m not sort of. Just get a good balance in life basically. Isn’t that, just [inaudible 00:32:17].

Payman: Just seven days a week, eight to eight.

Prav: Jimmy, can I ask you one question? Yeah. And it’s a question I’ve been asking a lot of my friends, colleagues and stuff is, what has been your biggest silver lining of COVID?

Prav: Mine has been focused around family life, appreciating the kids And getting some time and moments in life that 100% I would have missed.

Jimmy: Yeah.

Prav: And, you couldn’t have paid me any amount of money to take this time off work and do that. So, a lot of blessings there. Have you got any silver linings personally, or professionally that have come out of this that you could share with us?

Jimmy: I’m probably on your page there. I think just basically spending some time with the kids. Actually they have been off, we’d been off a little bit. So, it’s been nice to actually just be spending that quality time. Just doing mundane stuff with them was quite fun actually. And also, I think from a professional point of view, I’ve had to really look at the business. And, I’ve never looked at it that much before. And I’m talking, looking at the numbers, really focusing, crunching down those numbers and making projections.

Jimmy: And I think, sometimes we all get a bit complacent and you just kind of like talk… When it comes in, you see that there’s a margin there, you kind of just fill up the gaps, you just get a bit complacent about it. And I think, something like this makes you really focus and sit down in front of that computer screen. And keep looking at those Excel spreadsheets and just trying to work the numbers and work out what’s going on. I think that’s just been a good thing. And I think I’ll make some permanent changes within the practise. It’s definitely off the charts. I think those changes would be for the benefit factor. And when all of this sort of mess goes away, eventually, when things start to go back to normality more, I think that those will be positive changes. I think that making you focus so intensely is a good thing. It’s something that I probably wouldn’t have done.

Prav: Yeah. I agree with you there in terms of, when the train’s moving. And you’ve got this business and it’s moving, there’s always those ideas you have. One day I’ll get around to this, one day I’ll look at this, one day I’ll look at that. And all of a sudden, the train stops moving. You get off there and you’re able to walk around it and analyse what was wrong and say, I’ll change this, these systems, these processes, this, that, and the other. And then, you jump on, it starts moving. And you think, I’m so glad I’ve had that breathing space. So I think for me, definitely systems and processes. And yeah, it’s been good. It’s been good in many ways, it counteracts a lot in the negatives.

Payman: Well certainly, the family stuff. I’m enjoying working from home. It’s a nice mix. For professionally… But the reason why Jimmy’s on this podcast right now is because I called him as an enlightened centre. And said, how’s it going? And so on. And, I wasn’t doing that before. You know, those calls, from me, the CEO to my top users. I should have been doing more of those. I’ve learned that and there are some simple things like that.

Payman: Of course, there’s all the financial side. Luckily I’ve got a partner who takes care of that stuff as you know.

Prav: You too want to leash me.

Payman: Yeah. I’m more the spender. He’s more the controller.

Payman: Anyway, mate. Thanks a lot for taking the time. It’s been a real education. I think you’ve got a very bright future. I don’t know if you’re looking at the whole politics side of dentistry. But you should. Because, you’ve provided more clarity than some of the big guns that I’ve spoken to. It’s really refreshing to see that. Thank you mate.

Prav: Thanks to you actually, really appreciate it. Take care. Bye bye.

Outro Voice: 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.

Prav: Thanks for listening guys. If you’ve got this volume, 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 had to say and what our guest has had to say. Because, I’m assuming you got some value out of it.

Payman: If you did get some value out of it, think about subscribing. And if you would, share this with a friend who you think might get some value out of it too. Thank you so much for listening. Thanks. And don’t forget our six star rating.

Bertie: From when she was three years old, the joke was always, when she was three and a half, they said to her, “What are you going to do when you’re big?” And she says, “I want to be a doctor, but I want to be a real doctor, not a dentist.”

Speaker 2: 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.

Payman: It gives me great pleasure to welcome one of the people I call in dentistry the voice of reason, is the way I would characterise Bertie Napier. Someone who’s come from his native South Africa to the UK, and has got a wonderful private practise in Hertfordshire. And for me, Bertie’s not just been of massive service to his patients, but of massive service to the profession itself, culminating with being the president of the BACD and one of the founding members of the BAPD. And right now at the cutting edge of where we’re all going to go post-COVID. So, thanks for joining us, Bertie.

Bertie: Thank you. Thank you for giving the opportunity.

Payman: Bertie, give us a little quick run-down of your childhood. The 30-second version.

Bertie: Yeah. Great up on a farm in South Africa. Pretty much Afrikaans-speaking area, so having the English language meant I needed to go to a boarding school. So that’s the way I spent most of my school life, was from age six all the way through to finishing school, was at a boarding school. Yeah, and I suppose that pretty much led me to be quite independent and easy with staying away from home.

Prav: Any siblings, Bertie?

Bertie: Yep, I’m actually one of five boys.

Payman: Wow.

Bertie: The last two were twins. My mum said she always wanted girls, but when the boys started arriving in twos, she decided that’s it. Yeah, so I’ve got another brother who’s, one of the twin brothers is a dentist as well, and then the others range from motor mechanic through to panel beater, teacher. No longer a teacher. Was a headteacher, is now involved in HR in education. All in South Africa, still.

Bertie: Dad was also from farming stock. He farmed for a little while, then he was a motor mechanic. That’s where my brother got into it. And then he was a Member of Parliament for a while in South Africa. I think he served two terms in Parliament. It’s through the time that things were moving from the Apartheid era into the new democracy in South Africa. So those heavy years, that’s when my dad was in Parliament.

Payman: As a child, Bertie, what are your memories? What are your memories of the Apartheid regime?

Bertie: One of the things is, I always look at a Wimpy and I can clearly remember that we were not allowed to go into a Wimpy restaurant in South Africa. There was a little window on the side for non-whites, and if you were white, you could go into the restaurant and sit down and eat. If you were not white, you had to go to the side of the restaurant to go and get a takeaway. So that’s the one thing. Every time I see a Wimpy, I always remember that experience. I mean, it’s all changed now of course. It’s completely different. But as far as Apartheid, that’s the first memory.

Bertie: And then at university it was a friend of mine that I stayed, in a Catholic residence run by Catholic priests. And there was a French guy. We both were 19 years old. “Let’s go to the cinema,” one day. And of course, I’d never been to a cinema in my life. I grew up on a farm. I went to a boarding school in the middle of nowhere. And of course, we get there and the woman looks and says, “No, he can’t come in.” And of course both of us were dumbfounded. “Well, why not?” And she explained to us, “No, this cinema’s for whites only.” The French guy is saying, “No, we just want to watch the movie. That’s all. We’re not coming here for anything else.” And she’s saying, “No, you still can’t come in.”

Bertie: And then, of course, I suppose you’d call it the troubled times in South Africa, which was more or less when I was at university, when there was all the bombings going on, and the ANC was very active as a freedom fighting force at the time. And being told by my parents, “Don’t…” Well, it wasn’t my parents, but my uncle, actually. “Don’t get involved. You’re not there for politics. You’re there to get an education. When you’ve got your education, then you can make a difference. But while you’re there just stay out of things.” Didn’t quite work that way. You got involved. That was the end of that, I think.

Bertie: But university was, I think, Linda Greenwall was one of your guests on a previous podcast, and she mentioned that of all the universities, actually that is where things were happening as far as the politics and the anti-Apartheid side of it. And yeah, dental school of course. And I can remember what Linda said was, “You were told you’re here for dental school, you’re here to become a dentist, you’re not here for politics.” They did try and drum that into us.

Payman: She was mentioning Steve Biko was a medical student.

Bertie: Well, he was down in, I think it was Port Elizabeth area. That’s where that happened, yeah.

Payman: Which is a bit earlier, eh?

Bertie: Yeah, yeah. That was much earlier. Yeah.

Payman: So which year were you in university?

Bertie: I was at Wits from 1983 to 1988.

Payman: Okay. So right in the middle of it all.

Bertie: Right in the middle of all of it. Yeah. We had some hairy times.

Payman: So did you actually get involved in politics? Did you go and demonstrate?

Bertie: Yeah. We all did. We all demonstrated. We all ran for our lives when the police fired tear gas and rubber bullets. It was part of life. It’s what you went out and what you did. And not everyone looks at it as black and white. It wasn’t quite like that. There were lots of my friends who I still regard as very good friends, and I have a lot of respect for, who were white South Africans who were with me at uni, and amazing people, really, really good people. They don’t even realise the impact that they’ve had, some of the things they said or did. So I’m not going to mention names, but some of them will stay, the memories of the things they said and did, and when they stood up for things, will remain with me for a very long time. Yeah.

Payman: You were from a privileged background, definitely, right? Because your dad being a-

Bertie: Was I?

Payman: Well, your dad ended up as a Member of Parliament. That didn’t happen by mistake, did it?

Bertie: Well, no. Well, okay. Let’s go back.

Payman: Tell us the story. Tell us the story.

Bertie: Take a step back. Childhood memories, we didn’t own a house. We always rented. And we usually rented… Most farmers would have had one or two houses on their farm, and we usually rented a house from a farmer. And I can remember, when it rained it was exciting times, because you never knew where the rain was going to be coming through the roof. And we had a collection of buckets and bowls for the times it rained.

Bertie: I mean, my dad was a motor mechanic. He didn’t earn much. Mum was a teacher. She didn’t earn much either. Very low paid. And of course, they just couldn’t afford the deposit to buy a house. It was as simple as that. And then of course you have five children, and you got the kids at boarding school, so there’s even less money because you’re paying school fees. But for my parents it was the education that was probably the most important thing for them. I mean, my dad was always involved… I suppose that’s where I’ve got it from, is to not just sit back and let other people do things. You need to step up and get involved in your community, and get involved in your profession. My dad was a union rep as a motor mechanic. My dad was involved in lots of clubs and things, very similar to Rotary. Very involved in-

Payman: Was he a left wing politician or right wing?

Bertie: No. I suppose I’d class him as, if anything, he’d be more conservative than anything else. If you’re looking at conservative versus left wing, he’d be more conservative. But in South Africa, if you were anti the establishment, you were automatically regarded as left wing. So I guess at that time-

Payman: Everything was a bit more to the right.

Bertie: Yeah. Right wing meant you were more to maintaining Apartheid. Left wing meant you were anti-Apartheid. So slightly different to here. Left wing here is more socialist, and right wing is more capitalist. So as far as thing side of things, it would have been fairly balanced. My dad has always been someone who’s been, you need to look after everyone. There needs to be a fairness to people. It can’t be capitalism at the expense of walking all over the average person.

Payman: Was politics part of dinner conversation in your house?

Bertie: No. Strangely not. We grew up on a farm. We didn’t have electricity in the house. It was paraffin lamps. I remember when my dad wired the first house to put electric lights in the house. We had a diesel generator, and you had to go outside and start the generator when it got too dark. And then he’d run it for a certain amount of time, and then the lights would go out and we’d be back to candles, basically. So if you got up during the night, you need to reach over for the matches and light a candle.

Payman: Wow.

Bertie: Yeah.

Prav: When the interview started with, “I went to boarding school,” I didn’t imagine this conversation was coming next. So it obviously came at the sacrifice of other things?

Bertie: Oh, my parents sacrificed a lot. And I think with my mum being a teacher, that’s where education was absolutely paramount. School-wise, my mum went up to the equivalent of GCSE, and then she went and did a teacher training diploma. And it was only after I had qualified as a dentist that my mum went back and finished, because she couldn’t get above a certain pay grade without having the equivalent of A levels, which in South Africa is called matric. So she went back to school and basically did the extra night classes. Even though she’s a qualified teacher, she had to do the night classes to get that matric certificate so that she would move onto a different pay grade. In the end, she was a headteacher as well. That’s what she retired from. Yeah.

Prav: Wow.

Payman: How many years did you practise as a dentist in South Africa before you decided to move?

Bertie: So dental school was what, five and a half years? It was a six-year course that had been condensed down to five and a half years, and I practised from, qualified in June ’88 all the way through to the end of 1997. That was in South Africa. And then I started here in the UK in January ’98.

Payman: Did you have a patient base that was diverse or not?

Bertie: In South Africa?

Payman: Yeah.

Bertie: I would say not. Also, this is where I got interesting as well. I lived illegally in a white suburb in Johannesburg. It was illegal. You weren’t allowed to. I mean, it was Apartheid when I’d qualified. It only switched in ’94. So from ’88 all the way through to ’94, if you lived in a white area, it was pretty much illegal still. Or just before ’94 when they cancelled the Group Areas Act. I can’t remember the exact year. It might have been ’93 or ’94.

Prav: And it is so recent, isn’t it? ’94.

Bertie: Oh, yeah. Yeah. So worked in Kliptown, which was where the Freedom Charter was written, the ANC Freedom Charter, that’s where they wrote the Freedom Charter in South Africa was in Kliptown, which is Soweto. And obviously, I would say, 90% of our patients were black. I had two white patients who ventured into the township to come and see me, and that is only because of where I lived, and because of my friends. And that was just those people who… One was an Afrikaner lady, Sonya. I’ll never forget Sonya. What a lovely person. And she just said straight out, “I’m coming to see you and that’s it.” I said, “Oh, it’s a bit dangerous, Sonya.” She says, “I don’t care.” And she’d drive out into the middle of a black township, which is not something that a white person did in those years, and she came to me as a patient. Then a few of my other friends as well would have done the same. But yeah.

Payman: And in your year, how many whites were there and how many blacks were there at university?

Bertie: We had a quota system at university at the time.

Payman: Oh, really?

Bertie: Our class, there were 62 of us in our class, and it was very obviously quota. So we had two black ladies, two black men, both of them, I think, had been therapists or technicians, I think. Jerry is now here in the UK as well with his family. So there were two of them. They had a quota then for Muslim Indian and then for Hindu Indian. So the girls, I think there were two. Honestly, that’s the way it was done. And then even, you knew that there were a certain number of Greek girls, there were a certain number of Jewish girls. Men. They had a system which the university had to comply with, otherwise the government wouldn’t fund. The government funded it on the basis of race.

Bertie: But then, Wits eventually were the ones to kick up against it, and they stopped complying with the quota system after a while. I was the only so-called coloured person, which I suppose, yeah, would be called mixed race. And yeah, that was it. I think that was the quota, was one a year. So there was usually either just one male and one female and that was it. And we got to know each other, whichever year we were in, and supported each other. It was an eye-opener, actually, getting to Wits university, because for the first time, talking to people of different races and realising that everyone actually wanted the same thing. That we all had the same insecurities, that we all had the same dreams, that we all had the same wishes for ourselves and our families. And that we all knew absolutely nothing about each others’ struggles and the way we’d gone through things in our lives.

Prav: So fast-forwarding to coming to the UK and practise ownership, what’s the story there?

Bertie: I had got to 10 years after, qualified in ’88, by the end of ’97, I was quite disillusioned with the industry because it was mostly fixing pain and sepsis, and most people couldn’t afford it. Things like root canal treatments, you might do one in two or three months because people just couldn’t afford it. And it was a case of, just take the tooth out. And I’d got to the stage, I thought, “I’ve had enough. I need to do something. While I’m young enough, let me go and do something different.”

Bertie: Spoke to a couple of colleagues, one was an orthodontist, one was a maxillofacial surgeon that was in Durban, and the guys basically said, “Ah, so you’re registered in the UK?” And, “Yes, I am registered in the UK.” And they said, “Why don’t you get rid of your practise, go to the UK, work for a while and see if you want to actually do something else?” So off we came to the UK, and the intention was to stay for a couple of years and just try and discern where to next. So while working on the NHS to travel around a bit, and yeah. But that didn’t quite work out because my daughter was four years old at the time, and when we landed, we were told she actually needs to start school. In South Africa you started school at six. To send them to school before then was a matter of choice.

Bertie: So we’d had her in a Montessori school over there, and we thought, “Oh, we’ll just do the same here.” Then realised that she’s got to start school officially. She started school, and I was here for the two years. Came towards the end of the two years, and the guys I was working for, it was a corporate, and they said, “Do you want to stay for a bit longer?” It was a massive emotional upheaval, moving from one country to another. Probably took us about 18 months to settle down, and just starting to make friends, to enjoy being here and getting used to life, the way things worked in the UK. Then we thought, “Well, we’ve been through the tough part, let’s give ourselves another two years and actually enjoy it.”

Bertie: Which we did. And then along came a letter saying, “You may apply for permanent residency if you wish,” which we thought, “Oh, well, we might as well do that. If we go back to South Africa and we are not happy, then we can always come back again.” Within six months of the permanent residence, they said we could apply for citizenship. So that’s what we did, and became British citizens. And I’ve never really looked back. I mean, now when I look at it, and I think my kids were four and a half and two and a half when we got here, and where they are now, it’s just chalk and cheese. My children have had an absolutely amazing opportunity to grow up in the UK.

Bertie: I know we look at things and we say things that are really tough, and they are. The UK has its problems. I’m not saying that they’re not there. But I just really count ourselves as so blessed to have landed here, to have had the experience we’ve had. For the children to have grown up in a society where race is not a big deal. And in South Africa it still is, unfortunately. It’s going to be a hangover for a very long time. And they are just such well-balanced people, when I look at them.

Prav: So they’re not running around with buckets and hooking the house up to diesel generators-

Bertie: No.

Prav: … or anything like that. And I think me and Payman have spoken to each other and guests about, how do you keep it real?

Payman: Yeah.

Prav: With your kids, right? I didn’t have the most privileged of upbringings, and my kids certainly are a step up in that sense, in terms of the opportunities available to them, because we can afford it, and perhaps we’re a little bit more forward-thinking in terms of value in certain things. But there’s always that, wanting to hold back and say, “No,” whilst wanting to give them everything, because you love them, right? And finding that balance. Do you have that?

Bertie: Oh yeah. Oh yeah.

Prav: Have you had that dynamic?

Bertie: You do.

Prav: What’s your take on it?

Bertie: You do have moments where you think, “You guys haven’t had it tough enough. You need to experience what poverty is so that you can appreciate what you’ve got.” But then you look at them again, and the awareness they have for other people’s situations, and you think to yourself, “You don’t necessarily always have to go through tough times to appreciate what tough times are, and to appreciate where other people have come from and the difficulties they might have had.”

Bertie: I do have this thing that you should try to walk in other people’s shoes. You should experience what poverty looks like. When you talk about things, even the Wimpy experience, and just people will look at you and say, “You can’t come in here because of what you look like,” not how you behave, not the fact that you are-

Prav: Education or anything.

Bertie: Nothing. Nothing. It’s just they just look at you and say, “No, you can’t come in here and that’s the end of that.” Yeah. When you felt you were taking your life in your hands. I mean, South Africa, because I lived in a white area, and all my friends around me were predominantly white, when weekends came around and you went off to, there was a big lake called the… Well, the Vaal Dam. We’d call it a lake here, there we called it a dam. It was massive. I mean, it supplied the water for the whole of the Transvaal Province. And we’d go away for a weekend, and there’d be boating and all of that.

Bertie: I’ve never been to the non-white part of the Vaal Dam resort. I’d only been to the white areas. And of course, you are on tenterhooks because you are very aware that you stick out like a sore thumb. You look completely different to everyone around you. But then of course you’ve got a group of 20 people who are with you, so you’re there, but you are on edge all the way through.

Bertie: And then the same thing happened later on. I did a lot of motorcycling, so a few of us would go out on our bikes regularly, and we’d go to bike rallies. Now, if you’ve seen the typical bikers, big hairy white guys, and there I am. And I was like, “Do I take my helmet off? What do I do?” I mean, until the helmet comes off they think I’m the same as everybody else. But then the helmet would come off and nobody took a second glance, which was a real shock for me.

Payman: Bizarre.

Bertie: Nobody objected. Nobody looked at you different. They just accepted you there. It was just bizarre.

Payman: Culture shock.

Bertie: Yeah. Yeah.

Payman: Bertie, was there not an element… I understand what you said about moving to the UK and the opportunities that gave to your children and everything. But was there not an element of, at that very moment when South Africa switched, would have been an amazing time for someone of your talents to build something there?

Bertie: Do you know what, Payman? I think I was probably thinking very selfishly at the time. And very focused on what I wanted and what was not happening for me, and the unhappiness of what I was doing within my profession. What I had trained for versus what I was actually able to do. And that was the reason for moving. It had nothing to do with looking for a better opportunity for the kids. That is somebody up above who is looking down on us, and there’s a bigger plan.

Bertie: I genuinely believe that was God above looking after us. I look at my nieces and nephews, and I mean, they’re growing up in a very different South Africa to what we grew up in. And they’ve also got different opportunities and things. But my children’s relationship, or perspective, of other races, is completely different to my nieces and nephews in South Africa, because of the hangover of Apartheid. Because people live in communities based on race still. And you’ve got the more affluent areas which will be far more mixed. But the average person is going to be living really based in suburbs that are still very, very racially segregated, still, even though people are allowed to buy and move and do whatever they want to wherever they want to. The reality is that people will probably stay in the home that they’ve grown up in.

Payman: Yeah. I mean, I adored South Africa when I went there, but one thing I did notice at the time, I think probably right now as well, the pound is pretty strong there, right? At the time, the pound was pretty strong there and so we could afford to do things. So we took a helicopter over Cape Town, and what a wonderful city. But seeing the townships and the swimming pools and the tennis courts, and the geography of it from above, really showed you there’s a bunch of people having a fantastic time, and then a bunch of people not having a fantastic… You could see it from above so much more, because as tourists, you don’t dwell in the townships.

Bertie: That’s still the worry, though. That’s still the worry. For me, whenever I go, and looking and seeing that difference, and I’m sure people in other countries have the same experience where you see the big difference between the haves and the have nots. And you look and you think, “How does a country survive that in the longer term?” Because it can’t. You can’t. You just cannot. Something has got to give at some point if you think that that’s just going to keep going.

Bertie: Although you look at a country like Brazil, and it’s a very similar situation going on there. And they didn’t have the Apartheid problem. The socioeconomic problem is very much there. What is the solution? How do you fix the problem? Is it even fixable, or do we have to accept that that’s always going to be the situation?

Payman: Tell us about when you transitioned from associate to practise owner. When was it?

Bertie: 2002. Yeah. Actually, so this has happened twice for me. In South Africa as a new graduate I went and worked for someone. I worked as an associate probably from June, maybe for about a year. Let’s just see. 1990 I bought it, so a couple of years maybe worked as an associate, and then I was offered to buy into the practise, which I did. And on very, very favourable terms. A deposit, and the rest of the money I worked it off, basically. So I had a fixed salary which was a very generous salary, and whatever else I earned as my share as a one-third partner in the practise, went to the other two partners to pay off what I owed them.

Bertie: If I needed any extra money for anything they would let me have it. And I mean, honestly, you could not get a more generous way of buying into a practise.

Prav: Amazing.

Bertie: It was absolutely superb. Perhaps that’s something, I always look at that and think, “If I had a young dentist in my practise and they eventually wanted to buy into the practise, that’s what I would love to do for them, is pay a deposit and then work it off as you go.” Because that actually demonstrates that you’ve got faith in your business being a good business as well.

Bertie: So that was my first transition from associate to practise owner, and then came to the UK, so worked on the NHS from January ’98, and then in October 2002 was when we discovered this practise for sale, about three and a half, four miles in the next village from the town we were working in. And two of us, Odette and myself, decided we’re going to take the plunge.

Bertie: So two things were going to happen. One was getting away from the NHS, because as an associate coming in from South Africa, I didn’t have an NHS number and neither did… Did Odette? No, I think she didn’t have one either. So we both decided, “This is an opportunity to really just go for it.” And the practise we bought was totally private anyway. So that’s October 2002, bought into it, 300 active patients, 600 on the list. There’s about 5,000 on the list now, and I’d say about 2,500 active. Yeah.

Payman: So I remember once you told me before, I think maybe the last time we spoke on this thing, you said coming over from South Africa to the UK, that feeling the respect for dentistry over there was more than it was here.

Bertie: Oh, much, much, much higher. I think for me it starts at GDC level here. I think seriously, people will behave in the way you treat them. If you show someone respect, people will behave in a certain way, generally. When you, not belittle, but when you reduce the level of respect for a profession, so that you’re expecting a profession to behave in one way, but a simple thing like the title Doctor takes a lot away from a profession. And I know some people love the idea that it’s Mr. because it’s a surgeon, but come on, let’s not kid ourselves. The Mr. that surgeons are afforded is slightly above where we are, because they will have done a medical degree, and they’d have done a specialist degree on top of that. So there’s a slight difference in the definition of surgeon there.

Bertie: So that’s the first thing. And we have patients from Europe, for example, the Portuguese and the Spanish, dentists are called Doctor, and they treat you with so much respect. And as much as I say, “Please call me Bertie,” it’s, “No, no, you’re Dr. Napier.” And yet you see them outside in a social setting and then they will call you Bertie. But in the practise setting they insist, especially the older patients, insist on that level of respect. Now, it makes you want to behave completely differently and live up to what the people’s expectation is of you.

Payman: Tell me about the difference between the practise in South Africa, the last one that you were part owning, and the NHS practise you walked into, standards-wise.

Bertie: Oh, Lord.

Payman: Was it lower here?

Bertie: When I got here, right? And they showed me the surgery I had to work in, I think if Harry Potter had been around, I’d have thought I’d ended up in the cupboard under the stairs. I have never seen. It was a small room, and I actually thought to myself, “What the heck have I done?” I really did. I thought, “Wow. Now I’ve really gone and made a huge mistake.” But fortunately the practise had just been bought by the corporate, and they improved things fairly rapidly after that.

Bertie: But there was an experience I had where the first day, I had 52 patients for check ups.

Payman: 52.

Bertie: 52. That was my list. It was like, five minutes, five minutes, five minutes, five minutes.

Payman: How many were you seeing in South Africa?

Bertie: Much less. In South Africa it was much less. But we worked very differently there. Almost, you didn’t work during… It was very rare that you would do just a check up. Usually somebody would be coming in for something. If they came in for a check up, it was a check up and hygiene. So you would do a really quick check up, and you’d only write down what the problems were. If there was no problem, there were no notes. You just wrote, “Check up, all okay.” Done. You’ve done your oral cancer screening. You’ve done your dental check. You’ve done your perio check. You’ve done all of those things. And all the notes basically said was, you just said, “Check up done, all okay.” Finished. That was the end of that. If there were problems, then obviously you’d list the problems, and then off they went and saw the hygienist.

Bertie: Then here, the initial experience was very similar, because they had those brown envelopes, I forget what they were called, where you did your notes. And it was fairly similar. It was exam SNP. Done. That was it. You’ve done it. You didn’t have to say what you looked at or what you saw. Yeah, now it’s about five pages of A4 for a check up. So it was five minutes to do this. And if it wasn’t something glaringly obvious, that was it. And then the X-rays were… I mean, the quality of the stuff was actually really poor because it was going through a Velopex, probably the oldest Velopex that was there, that existed in the country, almost. So yeah, this old Velopex X-ray machine. So it went through. It might have come out the other end, it might not have come out the other end.

Bertie: The X-rays were either developed properly or not fixed properly, so you’d be able to see it that day. If you went back a few days later, it might have been so dark that you could hardly see what was going on. But again, a lot of that changed very, very quickly as the corporate brought their effect to bear on the way the practise was run. I remember my principal at the time, [Jerry 00:32:32], he couldn’t understand how come the turnover was so low. So I said, “I’ve got no time to do treatment.” 52 check ups in a day, you’re going to earn nothing. It was a fiver or something like that at the time so the whole day you’re turning over £250. It’s just a silly joke.

Bertie: He came in and he said, “Right, that’s it. No more of this. I don’t want you seeing any more than 15 patients a day.” And from that moment things changed in the practise, when he put his foot down that that was the way it was going to be.

Payman: When did you start looking at cosmetic dentistry?

Bertie: We bought the practise, where we are now, October 2002, and looking at growing the practise, we started looking at all sorts of things. I ended up at a seminar at the RSM, and one of the speakers was Raj Rayan, the one who always makes the joke that when people see his name they think he’s Irish, and they see him and wonder what’s going on here.

Bertie: I remember him saying about growing your practise and marketing. That’s what he was talking about. He said simple things like joining an academy. Join the American Academy of Cosmetic Dentistry. All you have to do is pay your membership and you’re allowed to say you’re a member of the American Academy of Cosmetic Dentistry. And patients will look at it and it brings some idea that you do cosmetic dentistry. So I thought, “Oh, okay, let’s have a look at this AACD thing.” Went online, looked at it and thought, “This looks pretty damn good. This is just up my alley. I like what these guys are doing. I want to learn how to do that.”

Bertie: So joined the AACD purely as one of those chequebook members, and then they sent out the conference programme. That was me hooked. First conference, Vancouver 2004, and I’ve never looked back since then. And it started off as, the cosmetic dentist side of it, the beautiful dentistry side of it, was what catches the eye, and you want to do that kind of dentistry. Looks good, it’s functional. I mean, their emphasis… Everybody looked at cosmetic dentistry in the UK at the time as a dirty word. If you did cosmetic dentistry you were one of those people who was just cutting teeth to blazes, just to put veneers on, and make teeth look nice. I’m not trying to say I’m better than anybody else, but I am so pleased that I have never, ever never, ever cut down six, or eight, or 10 healthy teeth to put veneers onto them. I’ve never done that.

Payman: Me neither. No.

Bertie: I’ve never done it. I’ve never done it. Right? So as much as I’ve loved cosmetic dentistry, I’ve always been of the opinion of pushing patients for ortho. I remember a young girl, 22 years old, came to see me in our practise, and she wanted veneers. And I said to her, “You need to have braces.” And she said, “No, no, no, I don’t want braces. I want to have veneers.” She’d been to a practise, I’m not going to mention the group in London at the time, because there are certain people connected with it, who had told her she can have 10 veneers on the front. I explained to her, “You know what? You’re going to end up with the root canal treatments and it’s going to damage the nerves of the teeth.”

Bertie: So she disappeared. Didn’t see her. She came back a year later. I did the first three endos on her anterior teeth. At that time she was 23 years old. She was a model. Saw her again probably about five years later. She’s now [inaudible] and could not afford to have the veneers redone because there’s been general recession, things have changed, and now we are stuck with a mouth that does not look very good at all. Which is really sad. Very, very sad.

Payman: Yeah.

Bertie: So yeah. And that’s the sort of stuff that we’ve seen fairly often. Most of the work that we’ve done is replacing work that’s been there 10 years or longer. So that is a lot of what I do. And tooth work cases is a lot of what I do. So yeah, yeah. And as I say, I’m not saying it to say that I’m better than anyone else, it was just something that didn’t sit easy with me, and I just… Yeah.

Payman: One thing I’ve always admired about you, Bertie, is you’ve managed to balance this diplomat, on the one side, with standing up and saying what you believe on the other side. And those time things tend to be, for me, in tension, because if I say what I really think, sometimes I’m not being a diplomat. But you manage to really do that. You carry that off very, very well. I’ve seen it many times where you feel strongly about something and you stand up and say it. But on the most contentious issue, you’re the diplomat. Where does this come from? Is this from your dad?

Bertie: I don’t know. I don’t know.

Payman: I mean, that fairness thing you were saying.

Bertie: I suppose, yeah, you do pick up values. You pick up values from your parents. It’s from, I would say, mum and dad. I’d say my grandfather on my mum’s side, who is much younger than my paternal grandfather, so was a big influence on all of us and an amazing man. Watched him, and his sense of-

Payman: Was he a farmer too?

Bertie: No, he wasn’t. He was in the Second World War. He was a sergeant major. He was in Eighth Army under Montgomery in North Africa. But he was a driver in convoys. He was at the battle of El Alamein. I remember him talking about that. Was absolutely fascinated when the first Gulf War happened because he said, “I can’t believe I’m watching war on television. I never thought I’d see anything like that.”

Bertie: But he was a manager of a dairy, it was a company that sold milk and dairy products. They got the milk in from the farmers, they processed it, they bottled it, milk, all the dairy products, cream, yoghourt, fresh fruit, all those sorts of things. It’s not a dairy product, but they did all that sort of stuff as well. And he was the manager of that. And very respectful of the boss, the owner of the business. I suppose his military side is what got him that sort of job and that he was able to handle it as well as he did.

Bertie: But the fairness, the way in which he treated the people who worked for him, black or white, was just unbelievable. You watched him, and this man was a rock solid man. Absolutely. As well, he and my dad got on extremely well. The two of them. Yeah. And my mum was very close to her father as well. So yeah, heavily influenced by all of them.

Payman: I think it’s one thing to appreciate fairness but it’s another thing to lead in that way.

Bertie: But Payman, is it something that you can teach? Is it something that you’re born with?

Payman: I don’t know.

Bertie: I look at the generation of young people today, I look at my kids, and especially my son, there’s a sense of fairness. I mean, he’s 25, but there’s a sense of fairness amongst young people that-

Payman: Yeah. Kindness.

Bertie: Yeah.

Payman: I’ve noticed that with the Millennials.

Bertie: That’s it. It’s the Millennials, isn’t it? And there’s that sense of, when something is unjust, it hits them. You can see. They take a step back and think, “But why are you doing that? Why are you treating someone like that?” And even amongst our team, that’s one thing I love about all of them, and it goes beyond the Millennials, is if they feel something’s unfair, they’ll actually speak up and say it.

Prav: Question it.

Bertie: Yeah. They will say something. Is that something that you’re just born with? Have I seen things through my growing up at boarding school that I’ve thought, “No, come on, this is not right”? I don’t know. But somewhere along the line things have influenced you. Maybe it’s through personal experience, that you’ve been unhappy the way you’ve been treated. I don’t know.

Payman: Did you send your kids to boarding school?

Bertie: I would have loved to, but my wife, no way. I was listening to when Zacky was talking about it as well. For me, boarding school wasn’t a bad experience. In the beginning, I think as a young child, it’s a tough experience. I mean, I was seven years old. My brothers were all six years old when they went to boarding school. And it was tough. But when you look back now, the level of education… Because they were Catholic schools. So the level of education was a standard higher, and it was the nuns who were teaching. So they were there because they wanted to be there. It wasn’t just a job for them. They took it to another level, which was absolutely superb.

Payman: Vocational.

Bertie: Yeah. So we got a really, really good education. So I would have wanted my children to go to boarding school. But then I spoke to the local Catholic priest here about a private school not far from us, and he said, “Why would you? You’ve got such good schools in the town. You don’t need to spend money on sending your children to a private school.” And he was right. We’re very fortunate, the town that we’re in. We’ve got some really, really good schools. And if you look at St. Mary’s, which is the local Catholic school that my kids went to, people that have come out of there become doctors. I know somebody, Dominique, my daughter’s friends who, she’s becoming a specialist and she’ll be a consultant one day, and comes from a difficult background as well. But what a lovely, lovely girl.

Bertie: And you see how people can get to different places just by the fact that somebody believes in them, that somebody has told them, “You can do it.” And nobody’s telling you that no you can’t, because you come from a particular background, you’re a particular race or whatever. There’s none of that. And that is the opportunity they’ve got here.

Bertie: But yeah, boarding school, I wanted it, because I thought it was pretty good and I thought there’s a lot of discipline and all the rest of it. Gillian also went to boarding school. I mean, we were at school together all our lives almost. She was, “No, I don’t think we should send them. We can live close to school and they can go to school from home.”

Payman: The thing about boarding school, people who’ve enjoyed it themselves want to give that opportunity to their kids-

Bertie: That’s it.

Payman: … to enjoy it too. It’s good for sport and all that, right?

Bertie: Yeah, yeah.

Payman: You know, Bertie, when I think about your practise and your situation at BACD, I can see someone like you’s a great asset to have in both of those situations. Is that a piece of advice you would give to ambitious young dentists, to get involved in these organisations and to give service back? I mean, is it for everyone?

Bertie: Okay, the word ambition I think is my problem.

Payman: Yeah.

Bertie: I can never say that I’ve been ambitious. I’ve never looked and said, “I want to do that.” When it came to the BACD, for example, it was Chris Orr, who I didn’t even know, who approached me, I don’t know why he approached me, but he approached me and said, “Do you want to consider getting involved with the board for the BACD?” It was probably because we met over at ASCD-

Payman: ASCD.

Bertie: … was the first very informal hello, and just knew each other by face and name, possibly. And then, the first BACD meeting that was here, that was the first time I saw Tif Qureshi, Tim Bradstock-Smith, Elaine Halley, David Bloom, Chris Orr, I remember Mike Zybutz. That was the first time I had met a lot of these people.

Bertie: And then both Odette and I went to every single BACD meeting from there, and it was a few years in that Chris Orr approached me and said, “Do you want to stand for board?” Which I did, and became the longest-serving board member. And then realised you need an exit strategy, and the best exit strategy was to become president and then past president and then out.

Payman: When you say you have a problem with the ambition part, are you saying that you don’t see it as an ambitious step? You see it as a service step?

Bertie: No, no, it wasn’t. When somebody approaches you and says, “Do you want to get involved?” You look at it and you think, “Actually, I can see why this is a good thing.” And what I could see the BACD doing, I thought, was probably the best thing that’s happened to dentistry in the UK. But suddenly this move to raise standards, it wasn’t purely about making smiles look pretty. That was the great part, that there was a visible side to what you were doing, but there was a lot more going on behind the scenes. The functional side of dentistry was a big thing, and Chris Orr has been one of those people that’s always pushed that.

Bertie: So ambition-wise, I wouldn’t say I did it because I saw myself as one day becoming president. I remember when I gave my little, call it an elevator speech, for the elections… It was such a small group of people at the time. There must have been only about 30 people that were the voting members of the BACD at the time. I remember saying, “I mean, I’ve got nothing to offer. I’m just a general practitioner with a huge interest in cosmetic dentistry, but I can promise you that you will get my blood, my sweat, my tears. You will get 100% commitment.”

Payman: I think I was there.

Bertie: I mean, I paraphrased Winston Churchill, I think. That was the quote that I used. And then I got elected onto the board. And what an opportunity for growth, because I’d never done anything like it. I’d been involved in dental organisations in South Africa, but very political, in uniting the whole dental community in South Africa. We had a non-white dental organisation, and then we had a white dental organisation. We got that together. So that was my experience. I was the general secretary for that, and involved in negotiations with the South African, the white dental association or what was perceived as the white dental association at the time.

Bertie: So coming onto the board at the BACD was a huge learning experience, and being asked to do a role. I think membership was the first one that I got involved in. And then each year, the board of directors would change. You had a new chairman of the board, which was the new president, and he would rearrange his cabinet, so to speak, to try and put people in different positions. And I was moved around a lot. But in the end you realise, it’s actually the best way to prepare yourself for leading an organisation, is to actually have full experience of the whole organisation, of what the membership side is like, of running… Comms was our big area, and between myself and with Andrew Chandrapal following up, and seeing how we started looking at things like budgets.

Bertie: In the beginning, I mean, money was not an object with the BACD. There was a lot of money thrown at it by a lot of people, and we were able to do a lot as far as publicity and PR and all the rest of it. And a lot of money was made from the conferences, because it was a very unique concept. And then the copycatting started, and everybody started having conferences very much like the BACD’s conference. And that starts diluting the effect, and you’re competing with other people, and of course numbers dwindle and that’s when the challenges come in. So I learned how to work with budgets, I learned how to be focused. I learned how to plan the year.

Bertie: I mean, there was so much that I learned at BACD and could take back to my practise. So where somebody might be ambitious and think they want to just rocket to the top of an organisation, I don’t think it’s the right thing. I think it’s like the practise. You should focus on doing the right things, and the other things follow. The financial reward follows in your practise, the personal reward follows at organisation level. It’s going to happen for you, but what you need to do is to do what the organisation needs you to do. That for me is key.

Payman: What a lovely speech, man. I love that. So beautiful.

Prav: Bertie, even as a practise owner, I speak to a lot of practise owners on a regular basis. It doesn’t seem like you’ve got an ambition or an exit strategy or anything like that, but it’s more like just doing the right thing for your patients and your team.

Bertie: Yeah.

Prav: Is there an overarching business goal or ambition? Do you feel like, “In five years time, I want to get out and sell this?”

Bertie: I think yeah. I think the reality is biting that you need to at some point have something that’s sellable. And of course the conversation starts happening now. I mean, my financial planning in South Africa was to retire at 55. So what’s happening at the moment is, all my endowment policies, my retirement annuities, I’m getting all these letters from South Africa saying policies have matured and suddenly I’m like, “Oh, no. This is when I was supposed to retire. Age 55 was shutdown time and go and enjoy yourself.” I just can’t imagine doing that now.

Bertie: But what I’m doing now is saying to myself, “You’ve got 10 years.” And in five years time I need to start winding down. So I need another four years of really working for myself and doing what I want to do, and then allow an extra five years of transition for whoever it is that wants to buy the practise, that I still want to be able to input and make sure that this practise is a good return on investment for the next person, and prove that it is worth what I think it’s worth.

Bertie: So, yes, the mind is starting to stray in that direction, but there’s still a lot of, just keep doing the right thing and things will just… Yeah.

Prav: So between now and the next however many years it is, have you got a plan to maximise value? Maximise turnover? Maximise profitability so you can increase that saleable value?

Bertie: Oh, absolutely.

Prav: Is there a set-out strategy for that?

Bertie: We started last year, and the first thing we thought is, “We need to start getting specialists into the practise.” We’d like to get the associate position for a full-time. So hygienists first. Five days of hygiene. We’re up to four at the moment. We need it to be five. So the only way we could do that was by extending the practise and having another surgery. So that is what we thought we would do. We have a staff room, yeah? Payman, you’ve been to the practise. The old staff room-

Payman: I like your practise. It’s beautiful.

Bertie: Whereas the old staff room would become another surgery. And we had some sheds out at the back, and we thought, “Right, the sheds will become the staff area.” And that was the plan.

Bertie: And then, we started planning and looking at building. We thought, “Well, we need to link these two buildings.” So what started out as converting a staff room into surgery number four turned into extending the building, having surgery number four, while we’re at it, do you know what? My surgery downstairs, I need a little bit of extra room. So we’ll just extend out to the back another four feet or so.

Bertie: The four feet became a 12-foot extension of another room onto the back of the practise, on the back of my surgery. So what’s happened now, we have essentially two buildings that are merged together. If we needed to, we could actually separate off the back section and it could turn into a complete residential unit on its own, if it had to. But it’s actually working very nicely as part of a bigger practise. So we’ve got lots of room now. We’ve got four surgeries.

Payman: It’s a very South African trait, to be building out and up.

Bertie: Yeah. That’s it. So we’ve got four surgeries now, and potential for a fifth one. Again, knowing that some of the corporates, when they look, they look for at least four surgeries, and plus, they’re looking for potential for expansion. And we are in a good area for private patients. So yeah, that’s what we’re looking at, is building the practise but also not over-capitalising at this stage. Which was going well until COVID came along. And that put the brakes on a lot of things. Yeah. But if we could keep going in our recovery the way we are now, then we’ll be okay.

Prav: We’ll be all right.

Bertie: Yep.

Prav: I think we’ll definitely be all right.

Payman: Tell us about the BAPD. When was the first time… You were one of the original-

Bertie: Well, so BAPD came about from two groups. There was a group, which I think Neel Jaiswal, and I think Zacky, were pretty much instrumental in this. And a lot of guys who were, I’d say, in a new mainly friendship group, so a lot of us knew each other from that, and in chatting we were already formed these groups on Facebook. There was the turbine dentist group, there was a couple of other groups. We garden and enjoy nice cars and things like that. Not necessarily our own but other people who have them and go to car shows and things. So there’s a lot of common interest outside of dentistry.

Bertie: So when this happened, there were conversations going on, and people said, “We need to do something, so let’s start sorting out…” And what was the catalyst was, 3rd of April was the webinar by the CDO, and where the question was asked, and I’ve realised it was Wayne Williams that actually asked that question, about the involvement of private practises and the CDO saying, “I don’t speak for private dentists, yeah? I only speak for NHS.”

Bertie: And the sudden realisation, “Hey, we’re in limbo, yeah? There’s nobody going to help us.” And of course, practises then being told… Well, we were told to close down on, it was 22nd of March, 23rd of March, by the BDA first. That was the first time I had heard about it. But by that time, we’d already said to our older patients, “You know what? Just stay home until we know what’s going on.” So first call to close I heard was from the BDA, and then of course the next one was the NHS basically saying, “NHS practises should close.” I think that was 24th or 25th of March, somewhere there.

Bertie: And then the first webinar from the CDO was the 3rd of April, and her saying that she didn’t speak for private. Of course, there you are, you’ve closed your practise and you don’t know what on Earth is going to happen next. So we got together, and then we started a Facebook group, and then realised there was another Facebook group that had just been started with Jason and Luke Thorley. I think Simon Thackeray was involved in that one as well. And then we decided, “Guys, rather than launching two separate organisations, let’s talk to these guys and see what we can do.”

Bertie: And of course, people get together because you’re in groups of trust. You’re with people you know and people you trust. So there’s one group of trust, which was Jason and Simon and these guys, sort of knew each other, and Luke, but I don’t think Luke knew them as well as they knew each other, but there was this group who felt they could trust each other, and then there was our group who felt we could trust each other. And then bringing the two together. So there was a bit of, I would call it, what do they call it, forming, storming and norming when it comes to any organisation. So there was the forming, “Everybody, yeah, we’re going to come together.” And then there’s the storming when you don’t know who you can trust, you don’t know people’s motivations. And then the norming where we’ve now established what we’re about, and people can see by people’s actions that these are genuine people. These are people who have dentistry at heart, and where dentistry is going at heart.

Bertie: And from not knowing people to suddenly defending people from criticism from others, because there’s a lot of social media issues where dentists look at other dentists and think, “Oh, these people just want social media fame,” and yet when you get to know people, there’s a slight, “No, actually, yes they’re social media savvy but it doesn’t mean that they’re there just for the sake of being famous.” Which is, I think, that’s the realisation, that we’ve got to know people at a deeper level now, working with people. It’s just been amazing. Yeah. So it’s been a really good experience of getting to know people at a completely different level.

Payman: So we won’t know for sure exactly when this one goes out, Bertie, but we’re at that early August. Right now, today, are we looking at fallow time? What’s the APD’s current agenda?

Bertie: We’d like to see it gone. No, seriously. And the science… I can see the argument that for the danger of what might be in the air from an infected patient, we can see that there’s an argument. We can see the argument, the point of view of the precautionary principle. And I will say this to their faces, the way PHE have gone about this is just treating us like a bunch of idiots. Because you cannot say one hour fallow time on the basis of that’s how long it takes to turn over air in a room. Excuse me? How big is the window in that room? How big is the door in that room? What is the air flow in that room?

Bertie: These are people who are highly qualified. These are dentists who, we’ve got years of studying behind us, of studying science behind us. We’ve all done physics as part of our courses. We would know how to calculate on the basis of what our rooms have. Surely, say, let’s get a scientific basis of calculating how to ensure that there’s fresh air in your room, before you allow the next person into your room. But no. We’ve just been treated like a bunch of mushrooms and told, “One hour, that’s it, you can’t mitigate for it. You can’t do this. You can’t do that.” I’m sorry, but of course people are going to kick back.

Bertie: I think it was again Churchill who said something about, the more regulations you make, the more people lose total respect for the law. So when you start throwing regulations out left, right and centre like that, with no explanation, no justification, no consultation with the profession, or consulting with people who are non-clinical and allowing them to make regulations… I mean, I looked at the stuff from the beginning. It said aerosol generating procedure, and it says what these things are, and then it says evidence. So each thing that PHE had done, they would say what the evidence was, that there was a potential for transmission of this virus.

Bertie: And, when it came to aerosol-generating procedures, evidence, none. There was nothing there. So it’s been taken from other situations and just put into, because it’s happened for, let’s just say, with EMTs and that in the emergency where they’ve been treating these patients under emergency and it’s been just transposed to dentistry, now, why is it that orthopaedic surgeons have managed to get this changed for them and yet it’s taking forever for dentistry? Where people have been presenting science and saying, “Come on, we need to look at this, we need to look at this,” and countries all over the world have been doing very similar things, and yet here we are in the UK, still trying to battle with it.

Payman: What’s the answer to that, buddy? Why?

Bertie: They’ve got to get their act together. I have no idea. I’m a cynic. I’m a cynic. I’m a cynic. So I’d rather not answer that.

Payman: Where do you sit on that balance between conspiracy and just lack of attention to detail?

Bertie: I don’t-

Payman: We can see there’s definitely some NHS angles going down. Right? We can see that.

Bertie: I think the NHS are using the opportunity. And I think because they’re using the opportunity, that has lessened the urgency. Because if the NHS had wanted to get back to work quickly, there would have been a greater urgency to get this thing sorted. 100%, that’s what I feel.

Payman: I agree with that.

Bertie: But because the NHS have decided that they will use government funding, which is my taxes and your taxes, to support NHS… I don’t want to call them NHS dentists, because I don’t believe there’s such a thing. I believe that we are all dentists, and I believe some of us are working with a system that’s funded by the NHS and some of us are working with a system that’s funded by the patient. So I don’t believe in saying it’s an NHS dentist or it’s a private dentist, because that starts conjuring up that the dentistry is different and there should only be one standard of dentistry, and that’s the end of that.

Bertie: But I think the NHS is using, or those in charge of the NHS, are not in a hurry to get rid of fallow time, but may become in a hurry now because their plans may have moved on, and they need to start seeing people get back to work. And while they’ve got the Urgent Care Centres running, supposedly picking up the emergencies… I know it’s not the case in my area, I’m seeing a lot of emergencies who are NHS patients and who want to see someone local to them. So I’m sure that’s what’s happening in the other areas.

Bertie: So while there may be claims that the Urgent Care Centres are actually working really well, the reality is probably that private practises are picking up the slack in a massive way.

Payman: Yeah. Talking to private dentists, that’s what I’m hearing, too.

Prav: Bertie, me speaking to a lot of private dentists about fallow time at the moment, many people are looking at it differently, and there’s this so-called one-hour statement that’s been made. People are treating it completely differently, and it’s a sliding scale, as I see it. Naturally, I’d never mention any names because people have spoken to me in confidence, but it’s everything from nothing, right up to the whole one-hour thing, and panicking and stressing, despite having the large windows, despite having the suction and all the rest of it. Where do you sit on that scale?

Bertie: I think where people are looking at it is looking at the FGDP. What the GDC says, basically, if you are shown to be following a body of opinion and you have done your risk assessments, and you’ve taken the precautions to make sure that you’re not going to harm patients, and you’re doing things safely, and I think it’s that body of opinion. So you don’t have to be following one particular thing.

Bertie: The PHE stuff, as far as I’m concerned, is guidance. It’s guidance. And when you read it, it does leave itself open to, because they explain what it’s about, and there’s a few more documents and things which I’ve had sight of. And you see, there’s an explanation behind how the fallow time works and the number of… It’s based on number of air changes. Now, if I can prove that the air changes are happening to a higher rate in my room, then surely, I have evidence that I’m achieving the air change. It may be taking me a lot less than an hour. Is there some argument to say that I’m not allowed to do that? Because if it’s based on an air change, then that’s what we’re doing.

Prav: How much air change does the one hour assume.

Bertie: Six.

Prav: Six. So if you did 12 in an hour, then you could drop it to half an hour, theory would dictate.

Bertie: Well, this is what the…

Prav: It’s very simple… Yeah.

Bertie: Well, no, it won’t quite work like that, because it’s like taking a cup of tea and pouring clean water into it. It’s not going to take six cups to clear out that water-

Prav: Convection.

Bertie: Yeah.

Prav: Dilution.

Bertie: It’s dilution, but how long is it going to take? It’s not saying that you can cut it to half an hour because you’re getting 12. But there is a system of calculating it, and it is out there somewhere. If you can calculate the size of your room and how many air changes it takes to change that air completely, and how quickly you’re going to do it because of extraction systems, negative air pressure, whatever it is that you’re doing, yeah. It just comes down to calculating it for your particular room.

Prav: Yeah. Yeah. The number of questions I’ve had that are mathematical, from dentists, is unreal. “I’ve got six air changes in my practise and I’ve just put a fan in that does six air changes in that thing. Does that mean I’m getting 12?” I feel like I’m doing maths with my kids.

Bertie: Do you know what? The safest is actually to get a ventilation company in and get them to actually say to you, “So if you’re installing a massive extraction system,” which some people have done. They have actually got professional companies in to come and do it.

Prav: Certify you.

Bertie: The company says, “This is the number of air changes that this is achieving and it’s going to take so much time to achieve it, based on the size of your room,” and that is the safest way to do it. Otherwise, we’re no better than the PHE, which is based on whatever non-evidence that it’s based on. But the argument comes back to, does the virus actually exist in the aerosol that we are generating?

Payman: It’s not the same aerosol as the surgeons [crosstalk]

Bertie: Exactly.

Payman: Yeah, I agree with that, I agree with that.

Bertie: Exactly.

Payman: It’s all about nuance, isn’t it? You know, that question of nuance. I heard a lovely quote, the guy was saying, “Tyranny is the deliberate removal of nuance from an argument.” The deliberate removal. The removal of nuance itself, we can see, messes stuff up. Doing it on purpose, that’s-

Bertie: Well, we have an organisation that does that on a regular basis, don’t we?

Payman: Yes. So, Bertie, when you look back on your career, are there parts of it that were dark and difficult? What was a failure in your career that you learnt from later on, that at the time seemed like a disaster, but then actually turned out to be formative?

Bertie: Wow. Okay. What seemed like a disaster was working on the NHS.

Payman: That was a disaster.

Bertie: No, it did. I really thought, “You’ve done it now.” I suppose the turning point was in attitude, and it was someone from the Pankey Institute who said, “You see the opportunity in the situation that you’re in and use it to get you to where you want to be.” Richard Branson, I always remember one of his quotes when he talks about making a mistake, and he says, “I’ve never made a wrong decision. The decisions I’ve made have always been the right decision based on the evidence or the information that I’ve had at that time.” As you’ve got more information, you may have realised that you should have made a different decision.

Bertie: So do we ever really make a wrong decision? Mistakes happen, I think, when you go against your gut instinct. And gut instinct is that amazing computer that’s your brain, that is seeing things faster than you can humanly recognise that you’re seeing these things. And then you’re going to use the logical side of your brain in ignoring the other half, and that’s when we make mistakes, because we think we’re smart.

Payman: Are you one of these guys who really trusts your instincts fully? Are you good with your instincts? Do you get sudden feelings about people that you like them or not?

Bertie: I always say to myself, you meet someone and you think to yourself, for some reason you just don’t feel comfortable. And then you get to know the person, and you think, “Oh, wow, this guy’s actually not so bad.” And then you’re proven later why your instinct was what it was. So my thing now is I always try and recognise what my first instinct is when meeting someone new, and also, when getting into a situation. I always say, “What’s your gut saying? Recognise it.”

Bertie: I can accuse myself very successfully of analysis paralysis at times, where I will sit and analyse something, and take forever to come to a decision, and then come to a decision based on the logic and the evidence and all the rest of it, and I keep saying to myself, “What was your initial reaction?” If that need to analyse is based on a gut instinct that said, “Hold on, something’s not quite right here,” then something is generally not quite right. And then just say no.

Bertie: I’ve taught myself, when somebody says, “It’s an excellent offer but it’s only available until 5:00,” I don’t wait until 5:00 to say no, I just say, “Well, the answer’s no.” Because I’m not going to put myself under pressure and make a mistake. So if somebody’s putting you under pressure, I always say, “Just say no.” An offer of a job. If somebody says, “I need to know by 5:00,” okay, if I’m not certain at that point, the answer is no.

Payman: Love that.

Bertie: You get cheekier.

Payman: So your daughter’s-

Bertie: You get cheekier as you get older though.

Payman: Yeah. Your daughter’s finished dental school now.

Bertie: Yeah. Yeah. She has done-

Payman: Did you encourage her to go to dental-

Bertie: I didn’t, actually.

Prav: Did you discourage-

Bertie: I didn’t discourage her either. From when she was three years old, the joke was always, when she was three and a half, they said to her, “What are you going to do when you’re big?” And she says, “I want to be a doctor, but I want to be a real doctor, not a dentist.” So we used to always laugh about that as she got older. And then she decided she didn’t want to do medicine, but she still wanted to be involved in the medical sciences field, and she did a biomed degree first because she wasn’t sure what she wanted to do.

Bertie: It was medicine all along. Went on a work experience at the local private hospital and got to see all the different aspects, the physio, the radiology, the pharmacy, in the operating theatres with the surgeons. Really, really enjoyed it and decided, “Medicine is not for me.” That was when she made the decision, but she still wanted to be involved in the sphere and did a biomed degree at St. George’s, and then during her final year is when she decided she wanted to do the dentistry.

Bertie: A lot of her colleagues did medicine. I think there’s one who’s doing veterinary science. Others have gone on and done a Master’s, and then she-

Payman: Secretly you were happy, then?

Bertie: I’ll tell you why I was pleased, because I thought she’s got the attributes to do it. She’s got good hands. She’s OCD. She’s meticulous about things. So yeah, I just felt she’s got all the attributes.

Payman: Good people person.

Bertie: And that’s it. And Dominique loves people. Yeah. And I actually thought, she needs to do this on her own. I didn’t encourage her. I’m happy that she’s done it. Obviously, you’re advising, “Do this now, do that now.” Looking at specialising, I’m like, “Do ortho, do ortho, do ortho.” Yeah. But the girl likes the surgery. And this is another thing. Having a daughter-

Payman: Oh, is she doing maxillo?

Bertie: Well, I think she’s done a restorative… What is it when they go into the hospital? She’s worked at year at the Royal London.

Payman: After VT?

Bertie: After VT, or after foundation year. What do they call it? What do they call it? DF1 or something like than.

Payman: I forget. DF2?

Bertie: She’s now going to be working at Whipps Cross, and she’s going to be doing surgery, I think is the field that she’s more going to be focused on. Obviously COVID has thrown a massive spoke into the restorative side of things, because she has not done as much as she would have liked to, but she’s done the sedation thing. So that’s been good as well.

Bertie: But having a daughter, and looking at the experience of women in dentistry, it opens your eyes. Actually, having a daughter first opens your eyes to realising the amount of… It’s not intentional discrimination, but people almost can’t help themselves. We go to the trade shows, for example. I remember being with a lady dentist, and both of us, we hadn’t seen each other for a while. We met on a occlusion course. Walked up to the same trade stand, and someone turns to me and starts speaking to me as a dentist, and then speaks to her as, “So are you practise manager? Or are you head nurse?” And she was absolutely livid.

Bertie: That was the first time it actually hit home, that people automatically assume that because you’re dressed very ordinary, I mean, I was dressed ordinary, I wasn’t in a suit and tie, she wasn’t in a business suit or anything like that, she was dressed ordinary. But the assumption was I was a dentist because I was male, and the assumption was that she was what’s now called DCP because she was female. And you realise, “Hold on, this is not quite right.” And this is still happening in dentistry.

Bertie: It’s like when people say, “I’m not racist.” It’s one thing to be non-racist and it’s another thing to be anti-racist. So I think the challenge is there for us now, and it’s not only because my daughter is a dentist, but the challenge is there for us now to stand with women in dentistry and actually help where we can to be aware of where these things can creep in.

Payman: We talked about this before, you were the one who pointed out to me, you said, “There should be a minimum number of speakers at your event,” at my conference, women speakers.

Bertie: Yeah. Yeah.

Payman: Do you still believe that?

Bertie: Oh, absolutely. Absolutely. There’s two arguments to this thing. There’s one where you look at it and you say, “Surely people should be getting in there on the basis of merit, and that should be it.” Now, there’s another argument that says, when it comes to your friendship groups, very often it’s easy for guys, for us as men, to socialise with each other and it’s easy for women to socialise with each other. And the reality is, even though there are more women dentists graduating today than men, and I seriously think, I’m sure there are more qualified female dentists than there are male dentists, the reality is that the male dentists are in the profession and in the profession from Day One you’re there as a dentist. You’re never leaving for a few years to go and have a family. You’re never leaving for a few years to look after your family. You’re never going part-time because of your family. Which means women are always looked at, possibly, as not going to be there all the time, whereas the male dentists are looked at as, yes, they are. They are bankers, almost.

Payman: This is true in every field, right?

Bertie: It is, it is. And it’s happening in our profession as well. But I don’t know what-

Payman: But shall we take it to there? Shall we say the next prime minister should be a woman, then the next one should be a man?

Bertie: Payman, you see, I don’t like all of that as well.

Payman: I’m not being facetious on purpose.

Bertie: Yeah, no, I hear what you’re saying and I feel the same way. I don’t like that as well. But how wonderful that you can recognise women dentists who have actually achieved and then invite them to come forward? But we also need to encourage them to show themselves. They need to show themselves. It’s no use the shouting going on from the side saying, “There are no women representatives on your organisation. Why is it all male?” Well, I know in the case of the BAPD, I can say it straight out, it happens to be all male because these are the people who stood up and made a noise.

Bertie: Yes, there were women dentists invited to get involved as well. It didn’t quite work out for various reasons. And it would be wonderful if we had women dentists with the same sort of passion and characteristics of the men who are there already saying, “Right, we’re going to fight this battle for private dentistry.” But how do you find those people? How do we encourage those people to step forward? We’ve got one or two really, really good people involved at the moment, but it would be great if there were more.

Bertie: Now, what do you do? Do you say to the male dentists who are involved in, let’s just say, various organisations, say, “Right, we need you to step down because we want a woman dentist to be in your place”? You can’t do that. It’s just wrong. So what needs to happen is looking at how things go forward, is to encourage women to step up and stand forward, put themselves forward, for example, for election on organisations, to put themselves forward for doing presentations. The opportunities are there, but it means people need to be connected, whether it’s on Facebook groups, whether it’s in organisations where the questions are being asked. Women dentists need to be there.

Payman: I think, you know Bertie, my issue with it is women definitely get a really raw deal in dentistry. But I’m not thinking of the dentists, I’m thinking of the nurses, the hygienists, those types. The stories you hear about the way some staff are treated by dentists, men and women. Terrible, terrible stories. Our profession is dominated by women if you count everyone up. Men are the absolute minority.

Payman: For me, if you want to address something, that’s the one that needs addressing. The career prospects of women in dentistry, rather than women dentists. But from that post I saw, there was quite a lot of heavy feeling about it. So I guess that needs addressing too. Prav, what’s your question?

Prav: Bertie, you’ve obviously shared a lot of your values with us today during this short time we’ve been speaking, both from your upbringing, your folks, and then passing on to your kids as well. Imagine it’s your last day on the planet and you’ve got three pieces of advice that you’re going to leave your children, the world, with. What would those three pieces of advice be? And how would you like to be remembered? What would your legacy be?

Bertie: I think the first piece of advice is always try to tell the truth, because then you don’t have to remember what the story was, you actually remember what the facts of the event were. So always try to tell the truth.

Bertie: The second one is always try to talk about people as though they are there with you. That’s a very difficult one to remember at times, because emotions can creep into things. And the third one is always do the right thing. Do the right thing as though everyone is watching you even when no one is watching you. You sleep better. The rewards follow. The rewards follow. Never chase titles. Never chase recognition. Never chase money. Just keep doing the right thing.

Bertie: What would I like to be remembered for? Gee whiz. For being a good father. For being a good father. For being a good husband. For being there for people who need me, whether it’s my colleagues, whether it’s personal things that happen. For being there for my team when they need me. For being fair to people. For just being a really good human being. I think that’s more important than anything else.

Prav: Bertie, that’s beautiful. And I think the one word that comes out of that that resonates with me is integrity. It really does resonate with me based on what we’ve discussed today.

Bertie: Yep.

Payman: It’s always such a nicest pleasure to speak with you, Bertie.

Bertie: Thank you. Thanks, guys. Yeah.

Payman: Whether it’s in the practise, or in a bar at the conference, or on-

Bertie: Pub.

Payman: … a podcast, it’s always a massive pleasure. I always finish off speaking with you feeling enriched by it.

Bertie: Thank you very much.

Payman: So thanks a lot for doing this, buddy. Thank you.

Bertie: Thanks Payman, and thanks, Prav.

Speaker 2: 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.

Prav: Thanks for listening, guys, if you got this far 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 had to say, and what our guest has had to say, because I’m assuming you got some value out of it.

Payman: If you did get some value out of it, think about subscribing, and if you would share this with a friend who you think might get some value out of it too, thank you so, so, so much for listening. Thanks.

Prav: And don’t forget our six-star rating.

Dominic: The third one is, don’t piss on my grave when I die.

Speaker 2: 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.

Prav: Oh gosh, haven’t done one of these intros in a long time. Payman’s really good at these.

Payman: It gives me great pleasure to…

Prav: Yeah. Fucking… you’ve just stolen the words out of my mouth.

Payman: Go on, bud, we haven’t got time.

Prav: It gives me great pleasure to introduce Dominic O’Hooley to the Dental Leaders Podcast. So much to talk about in so many different areas of life, be it academic, science, real home life lessons, kids, everything. I think we’re going to have a really deep conversation today because Dom said before this, “You can have anything, guys,” so let’s start from the beginning, Dom.

Dominic: Except my house.

Prav: Except his house.

Dominic: Yeah.

Prav: So, Dom, let’s start from the beginning. Your upbringing, where you were born, where you were brought up? Just a micro history of your upbringing.

Dominic: Yeah, a synopsis. I was born in Leeds, brought up in a little town called Horsforth. Two children, myself and my younger sister, Belinda. Mom and dad, Seamus and Jean. Had a very conventional upbringing, raised a Catholic, but, I’d like to say about from the age of five, but I think it was from probably the age of seven or eight, I decided I was agnostic and had a lot of conflicts with my parents about that because my dad was… to say he was religious was an understatement. I went to a Catholic primary school in Horsforth and I was an altar boy. I had to go and serve mass three times a week, Tuesdays, Thursdays, and Sundays. The high point of that was, nicking a bit of the altar wine. The low point was having to serve for a Monsignor Justice, who sounds a little bit like a Judge Dredd character and he was like that a little bit as well. He was a bit tough.

Dominic: So, moved over to Guiseley when I was ready to enter secondary school, and, then, unfortunately, my relationship with my father started to decline very much so at that point.

Prav: What do you mean by that, Dom?

Dominic: I’m afraid that my dad wasn’t an easy guy. He’s passed away. My dad weren’t an easy. He seemed to find me almost impossible to understand or deal with. You know from what I’ve said before, that I’ve now got a diagnosis of autism. But, at that time, there was no real understanding of that at all. I think the commonest expression he used and my mom used as well was, you’re just odd. Which sounds a bit corny but it wasn’t particularly funny at the time.

Prav: Did you hear that a lot growing up?

Dominic: A lot.

Prav: Constantly.

Dominic: [inaudible 00:03:25], yeah.

Prav: Yeah.

Dominic: By the time I got to do my A-Levels, it got to the point where my dad threw me out. So, I ended up doing my A-Levels living in a bedsit in Headingley.

Prav: What led to that Dom? Just take us back to that moment where you did get thrown out. Was it an argument? Was it, the whole focus around being odd, or was it you rebeling a little bit?

Dominic: Well, I was a rebellious type.

Prav: Yeah.

Dominic: One of the things that I’ve reflected a lot upon since, is that my dad was very authoritarian and I didn’t take kindly to it so I was always extremely resilient and would come back at him and report everything he said. As I got older, it became a physical thing quite a lot. He beat me up a few times. We ended up, as I got bigger… and we’re both six foot tall, we ended up fighting quite a lot in the house, which wasn’t appropriate. I think that really got to the point where I went to school one day, and when I got home that evening, my bags were on the doorstep. I was told to get in the car and they took me down to this bedsit, and that was that.

Prav: Wow.

Dominic: I’d love to tell you that was horrible, but, to be honest with you, despite been a bit of an odd bird, I’ve always been a bit of a… not a ladies man, exactly, but I’ve never had any problem whatsoever when I was a young guy talking to girls, I’ve never been embarrassed or anything like that. I’ve always thought I’m quite funny, whether they [inaudible 00:05:14]. I’ll be honest, I thought it was quite an opportunity rather than a punishment, to be living in student land in Headingley.

Payman: So, Dom, when was the first time where you became aware of, there might be a diagnosis here as opposed to I’m a bit odd. When was that?

Dominic: Well, when I was at school, I had a music teacher called Mr. Mumford, who’s a lovely guy… or was a lovely guy. Unfortunately, he passed away as well. I remember in first year of secondary school, walking around one lunchtime on this… the school had numerous playgrounds, and this was a quiet one down a bit… where there weren’t a lot of kids around. Just walking around on my own, really upset and I couldn’t tell you why but I was. He just said to me… he came over and he said, “What’s up with you?” He said it in such a way that I felt confident enough to open up and I just said, “I don’t know who I am, I don’t know what to do, I don’t know how to think.” I was only 11 at the time. He became a bit of a pal through school to be honest with you.

Dominic: Then, I started to get an inkling that there was something not quite the same about me, as there was about a lot of my compatriots. As I got older, I became very adept at masking my difference and being very good at concealing it. I think being fairly intelligent means I can usually hide it with a combination of being quite amusing, if I want, and also just being quick on the draw so I can judge what people want to say… and I can do that. But, I think as you get to know me, I think, sometimes, the cracks in my armour become very apparent, really.

Dominic: So, as I got a bit older I left school. When I met my wife, Rebecca, I think very early on she realised that I was autistic. For a number of years, we had a conversation where it was a case of, I think you possibly should get a diagnosis and, say, go forward with that, and eventually I did.

Prav: Dominic, it expresses themselves on a sliding scale for different people, doesn’t it, and manifests itself in different ways. For you, personally, how is that expressed in communication, personality, dealing with others, body posture, and then other people that you know? What does that sliding scale look like? Just for whoever’s listening to, really, get a-

Dominic: [inaudible] give you a brief understanding.

Prav: Yeah.

Dominic: My boy, Humphrey, who’s 14, he’s got… I suppose, if you’re looking at sliding scale, he’s very much towards the right side, the severe side. He’s nonverbal. He has never really been able to speak at all. He can say the odd word such as no, or yes, but he can’t say anything else, really. He has unusual behaviours such as self-harm and absconding behaviour. He likes to run free. So, for example, when he lived at home, if he was in the house, he would try and escape all the time. It’s not because he was upset, it’s just because he likes to. Then, he used to do something called garden hopping, which was quite fun, really, which is where he’d been in the backyard with me, I might turn my back for 30 seconds, he’d climb over the garden fence, and within minutes, he’s gone down about 12 houses, across the gardens and over the fences.

Dominic: So, from my point of view, looking at my own personal… I did write a blog about this, I think the way my mind works, it’s constantly going through an incredible number of complex verbal options. I keep running back to these topics and subjects that I like and I have to whack them out of my brain because otherwise, I’d want to say to you, I’ve got a very interesting fact for you, Prav. Did you know that rhodium is actually this and… I particular like metals and things like that. Enough, Dominic.

Payman: I read something where you said you’ve chosen to look at it as an advantage.

Dominic: Yeah.

Payman: The work you’ve done with the [BABD] and the Scientific Committee on… we mustn’t say, Oh, it’s because of this, but, to some extent, you’ve used it to really focus on the evidence for COVID. But in dentistry, is it an advantage? Do you find it an advantage in some ways?

Dominic: I do. It’s a double-edged sword. I think it can be intensely focused. So, if you think about the flow state that, sometimes, we get into, Prav, I’d imagine, sometimes when you’re training, you might get into-

Prav: [inaudible 00:10:22], yeah.

Dominic: [inaudible] individual. So, therefore, with me, I can find I can get into a flow state quite simply and become almost unaware of time. That’s probably the happiest I can be in my life really, when I’m like that really. I, also, I find it a challenge because… I think I said this in my little thing that I wrote for dentistry magazine. I said, I’ve chosen the worst job in the world for an autistic guy because I’ve got to meet new people all the time. That’s hard. It really is hard. Well, I suppose, it’s a case of sod it if it’s hard, I’ve got to do it. So, I get some satisfaction from that and I get some satisfaction from the fact that I’m, in some ways, able to charm my patients and have very honest conversations with them and get over my communication issues.

Dominic: On the other hand, I think it leaves me very anxious and wrung out. So, I’ll often find at the end of the day, I’m absolutely wrung out. When my son, Humphrey, had perhaps had a, we call, meltdown, because he’s just overstimulated and he just can’t cope with it any more. I suppose, I have the similar… and I used to use my bike as a way of getting around that. So, I’d have my day of patients and I’d be completely at the end of my tether, and I just get on the bike and spend an hour and 15 minutes, hammering it back home. By the time I get home, I’ll be fine. Right now, I haven’t got that anymore.

Prav: What do you use as a substitute? You just talked about your flow state, and that’s when you’re happiest, is that? Is that when you’re mentally in the zone? One of the guys who works for me, has had a diagnosis, and he finds himself… one of the smartest guys I know, and he says, once he gets in the zone, and the zone is a mental zone rather than a physical one, there’s no stopping this guy. He is super intelligent, and just thinks differently. He’ll solve a problem in 20 minutes that will take the rest of the team a week.

Dominic: I suppose, with me, it is a mental thing. When I’m reading papers, for example, and trying to solve complex problems, I do find a [inaudible] way of thinking about things that’s perhaps a little bit different. I think one of the advantages I have is, I can absorb a massive amount of information quite quickly. So, I can look through a lot of papers and I can start to pick on things that perhaps not everybody will pick up on. Then, that means I can collate a lot of information. I suppose, it’s been a geek fest for me to be able to pull papers up that I think they useful on a daily basis.

Dominic: [inaudible] though, insofar as, I have to watch myself because I can go down the rabbit hole very eager. So, if I read a paper that really interests me, then I’ll forget that, actually, I’ve got a bit of a mission that I should be out helping to educate the [inaudible] population on COVID in my little view, that I should be doing that. I go down rabbit holes and end up reading something that’s got very little to do with it.

Prav: So, if I read a paper, I’ll scribble in some notes down. Get some facts down and stuff.

Dominic: Yeah.

Prav: What’s going in your head? Is it a bit like the Matrix? You sit there and then you pull out the bits, but [inaudible 00:13:52], and then you contextualise it and make a relationship with the next paper you read and just pull it all together. Have you got a great memory? Are you able to bring facts together and then formalise them… those facts together, in what you feel is a solid argument. How does that work? Because, for me, I have to write it down.

Dominic: I’m not sure. The thing is, that I don’t look at the abstracts, I tend to go straight to the body of the paper and read the paper.

Prav: Yeah.

Dominic: I have weak points. I’ll be honest with you, at the moment, I find statistics difficult, I always have. It makes a weak point of mine. So, there’s gaps within that quality of my ability to absorb information. What I find interesting, is that I’m able to… and, sometimes, I’ve actually wanted to go back to the office and say, You haven’t seen this connection. Why aren’t you seeing it? I’ve seen it [inaudible 00:14:55]. It’s good, but, as I’ve said, there’s big negatives to it as well. I’ve actually had to catch myself. This happens with patients and it happens when I’m in chats with dentists. I catch myself and I’ve actually been rambling on about someone for 10 minutes and you can see that their eyes are like too hard boiled eggs, because they’re like, Oh, stop, please.

Payman: So, Dom, you’re 17, 18, living alone and self-motivating yourself to do A-Levels and hanging out with chicks, but where did dentistry come into? How did dentistry come into that?

Dominic: Well, dentistry came into it from the fact that I was a little bit led by… my mother kept saying to me, she says you’re so sensitive… I think she saw my oddness as sensitivity because I used to weep quite a lot. I think the weeping was, a lot, due to the fact that I just couldn’t cope with… I felt so out of it. When I was at school, I just felt like this guy was just inside a clean room looking out at everybody else. Do you know those big round circle for clear inflatable circles and you see people playing and rolling down the hills, I felt like one of them. I don’t know what you call them.

Payman: [inaudible 00:16:19].

Dominic: Yeah, that’s it. I felt like I was in one of them all the time. But, my mom took it as sensitivity and she said… I’ve always had a medical leaning. I’ve always found medical facts particularly interesting, and she put me off doing medicine. She said, “You can cope with death.” I think one of my obsessions, all my life, has been death.

Payman: What do you mean?

Dominic: She said [inaudible] talk about it a lot. I don’t think it’s for you. I don’t think you should go down that road. Because, dealing with death, potentially, on a daily basis is just not going to be something that’s good for you. So, I thought, Well, I’ll go for dentistry then.

Payman: Pulp death, instead.

Dominic: Yeah, well, it’s a combination of minutia, so I can look into the material science side, I can get involved in things like that. Secondly, I can control my interactions with patients. So, I felt very early on that I can shut the buggers up if I want because I can tell them to open their mouth and get on with the work. Will you bleep that bit? Yeah, [inaudible 00:17:33].

Dominic: Also, I think, from a fiscal point of view, I thought it’s a good living. When I was a young guy, I went and actually watched the dentist do work in Horsforth and I realised that he had a very nice 911, a red one. A 911 turbo. One of the first ones with the massive wing on it. Then, he owed a restaurant in Horsforth, [inaudible] called Johnny [inaudible 00:17:59]. At the time, I thought, well, you’re doing all right, and yet you always seem to leave five o’clock. So, from that point of view, I though, he’s got a good bang for his buck ratio. I can do good work. I can get him very interested in what I do. But, I can still be out of work at a reasonable time. It didn’t quite always work out like that.

Payman: Where did you study dentistry?

Dominic: Liverpool?

Payman: Oh, good town.

Dominic: Yeah, so I went across the Pennines, primarily, because… I don’t know, really, I just thought, I didn’t fancy Manchester, for some reason. Pay back. I wanted to be able to [inaudible 00:18:43]. It was one of the best decisions I’ve ever made. I absolutely loved it in Liverpool.

Prav: What was dental school like compared to school school, in terms of fitting in and the social side of things?

Dominic: Well, that’s interesting because I started to find the crooks. That was quite a way for me to become more fitting in and there was two sides to that. One was alcohol. So, from an alcohol point of view, I found, that if I drank quite a lot, and I became very funny in my own head. I seemed to get a real circle of friends who were also guys who liked to go out for a drink. The second aspect of it was a geeky side. I was one of these unusual students who seemed to have a friendship base among the geeks and also among the real rogues as well. So, I ended up actually being quite a popular student, really. I know that’s hard to believe, but I did.

Dominic: I think the third aspect was that I decided… I got very fit when I was at home and I decided I was going to go for a selection into an airborne territorial army regiment, so I did that as well. So, I ended up being one of the fittest heavy drinkers in dental school.

Prav: [inaudible 00:20:04].

Dominic: Yeah, so I had a lot on my plate. I was actually doing selection for an airborne TA regiment as I was going towards finals. I’ve always been a bit like that. I love having tongues on my plate.

Prav: Just putting the pressure on. Do you to perform better under pressure? Do you feel like… Yeah.

Dominic: Yeah, I love it.

Prav: Are you a grafter that puts in loads and loads and loads of hours into lots of different things or, no? It just comes naturally to you. You mentioned the fitness as well. I remember speaking to you separately on this point about fitness. I think the words you said to me is, I’ve just got a decent engine on me, I’m just pretty good at it. But, is it something that just came naturally to you?

Dominic: Well, it’s a funny one, because when I was a young boy, my mom was a bit of a feeder, and so I was very restricted with my diet when I was a young lad. That’s not unusual among autistic people. Then, I seemed to find things that I liked and, then, when I was about 11, 12, I got a bit overweight. That was due to big meals and I had my dad making me finishing everything on my plate. Absolutely had to finish everything on my plate. So, I became a little bit… not diet obsessed but became obsessed with aspects of physical health. As we’ve talked about offline, [inaudible 00:21:29], we’ve talked about longevity, the health span of human beings and things like that, I’ve found all that very interesting over the years. When I talk about having a good engine, I think it was that once I discovered cardiovascular exercise, so running, I started getting into running in the fells.

Dominic: So, I used to like fell running. For somebody who’s a bit of a loner, a lot of the time, there’s nothing better really. You’re out in the fells on your own. Beautiful views. Can be very, very arduous, it can be bad weather, you can feel very close to nature, really. Also, there’s an element of fear there, sometimes, because I used to do a lot of very long fell races. Something called a super long races. You’d be really a long way from civilization from [inaudible 00:22:21]. If you broke your leg, you’d be in trouble. So, that appealed to me. I just discovered, I seemed to have very good cardiovascular fitness. I think that’s just a genetic thing.

Payman: Yeah.

Dominic: Funnily enough, since I’ve had my accident, I’ve discovered I’ve actually got bicuspid aortic valve. So, I’ve got an unusual aortic valve where [inaudible 00:22:44]. That was an incidental finding.

Payman: Tell us about your accident, Dom?

Dominic: Yeah, just very briefly, I was going into cycling a lot as well, and I found, as I’ve reflected briefly earlier… I said, I used cycling as a way to deal with being a bit overstimulated. So, it’s a good way for me, at the time, to calm down after a bad day work or get prepared for a day at work. I think getting tired before I start work sometimes helps me mentally. So, anyway, one day in 2018, Friday the 13th of July, beautiful summer’s day, I set off to go to Huddersfield for one of my practises where I place implants, and I got to about halfway on the journey, riding a bike I built up… a beautiful bike. Then, I went through a junction called Hellfire Corner. It’s called that because of the amount of accidents that happen at it. I went through a set of lights at green, and a guy was driving an extended VW craft van, over, up the other direction and he turned right into me. The combined impact speed was about 48 miles an hour.

Payman: Jesus.

Prav: If you take yourself back to that moment, can you visualise it happening in slow motion? Or, is it all a complete blank?

Dominic: I say it’s a blank, I’ve got retrograde amnesia. What that means is, that because I have a moderate to severe head injury, I’ve no memory from about five minutes before it to about three days after it.

Prav: Wow.

Dominic: So, I had two different bleeds on my brain. One of them was towards the posterior part of my brain and the other was in the upper right anterior frontal lobe. I also had something called a diffuse axonal injury, which is a deceleration type injury. So, it’s remarkable that I’ve still got some good cognitive function really. I’m really pleased about that because, I suppose, from a self-worth point of view, being fairly bright… One of the ways I gauge myself is with self-esteem, I think. I think if I’d really lost that or aspects of that, I’d have found that incredibly challenging. I don’t know how I would have found it. Yeah, so I have a memory of going past the school, five minutes before the crash, and then nothing until about three days later, when I’m in hospital.

Prav: Somebody, obviously, mapped out what happened in that 5, 10 minute window, or whatever it was, at that time, and then what happened since. So, what happened? Who came to the scene?

Dominic: Well, the craft van had two different cams on it. He had a frontal cam, and it actually shows me [inaudible] them. I’m wearing the brightest orange top you’ve ever seen in your life with black and white Chevron’s across the chest. You can see it from a mile off, so you think, you can’t be looking, mate, because I’m really obvious. A lot like an angry wasp coming down the road. Then, actually, the second dash cam is actually of the driver. When you see him, you actually see him jump at least three inches off his seat and you see the whole cab… and that’s me hitting the cab.

Payman: Oh, Jesus.

Dominic: Then, you see him start off and he parks around the corner. Then, you see him get out of the cab. An abiding memory of that, is the amount of builders cleavage he was showing as he climbed out of the cab. Half his backside are running out. Always remember that, for some reason. But anyway, what happened is, the air ambulance came from Leeds Major Trauma Centre, so the Archer Air ambulance. One of the people on board was a consultant in emergency medicine. So, she obviously assessed me at the time. She picked up my bike helmet, took my bike helmet off and it hadn’t cracked. It was very flat on the front, which she made the assessment that I didn’t have a severe injury at that time.

Dominic: I was giving ketamine because I was in acute pain because I’d had the [inaudible] forearm. So, my right forearm had [inaudible 00:27:11]. I think it was a partial [inaudible] glove and it was still attached. I had multiple compound fractures in my right forearm. My right index finger was almost amputated in an open fracture dislocation. My left wrist had an explosive compound fracture of several bones. I had a C7-T1 fracture in my neck. Had an orbital ethmoidal fracture of my left orbit which had allowed air into my [inaudible] cranial vault.

Payman: Wow.

Dominic: So yeah, and a bit of facial trauma as well, which is improved me.

Prav: So, fast forward to the point where you come around three days later, or whatever it is, when did you come to realisation of the enormity of what had happened? That alone, obviously, you mentioned that, out of everything you want to hold on to your faculties upstairs, right. That’s more important to you than anything else.

Dominic: Oh, yeah.

Prav: But, for someone who’s an athlete, who gets their buzz off… Look, I’m far from an athlete, but back injuries, wrist injuries, just the tiniest little injuries set me off mentally. How did you compute all that, and what was going through your mind at that point?

Dominic: Well, it was a funny one because I’d had an atypical reaction to ketamine. It was a combination of that and something called… it was almost a form of delirium due to my head injury so I became very agitated. So, they gave me something called an atypical anti-psychotic medication called olanzapine. So, I had some unusual symptoms from that. So, went I came around, I was rocking back and forth all the time. I didn’t know I was doing it.

Dominic: So, Rebecca, my wife, was looking at me and… I think another side effect of it was, that I was exceptionally happy. I felt fantastic. I think a combination of opiate analgesia and that, meant that I felt on top of the world, to be honest. I felt very relaxed. I felt almost transcendental in some ways. I felt like I’d escaped death and I was amused by the fact that I had this thing called a vac pack on my right arm where they were using negative pressure to stop the separation and everything. I felt amused by it all.

Dominic: So, it’ll be very wrong to say, that when I came around, I was devastated, I wasn’t. I almost felt like, Wow, I’ve got a really good excuse not to train. I can’t train. So, there’s no point worrying about it because I can’t train. There’s no way I can think I’m going to do it.

Prav: Is that because you were high and dosed up, or even when you came off that, was your mind set, that’s how you felt afterwards? That, actually, I’m just accepting what’s happened, and I’m going to say the positives from it.

Dominic: A bit. I think that the whole time in hospital everybody was so nice to me. My health anxiety, which is another side effect of my autism, hadn’t kicked in. So, the cardiologists, for example, didn’t come and see me when I was in hospital and say, Oh, by the way, when we looked at your full body CT, your aorta is slightly enlarged and we think you might have a bicuspid valve. They didn’t say that to me, so I wasn’t worried about that. The healing seemed to be happening quite quickly and I thought, well, it’s unlikely I’m never going to do dentistry again here. Because, one, I can’t move left hand at all, two, I can’t feel my left hand at all. So, [inaudible 00:31:09].

Dominic: It was only once I came out of hospital, and it was only when I got home, that it hit me like a tonne of bricks, and I just felt devastated. I had something called atypical PTSD which is where you don’t have flashbacks to the event because I can’t remember anything. But, I have very unusual night terrors, and I used to wake up… I had something called Early Morning Awakening syndrome so I used to wake up every morning at about half one, and that was it, I couldn’t go back to sleep. After a few weeks of that, you start getting a bit… it’s hard to explain how low I felt really.

Payman: Dom, did you go in to, Dom mode, and fully research everything and try-

Dominic: Oh, yeah.

Payman: Yeah.

Dominic: I did. I’ve done that on so many different… unfortunately, it became very unhealthy. So, one of the things I did is, I did discover I had a congenital heart issue. I must have spent about six hours a day researching aortic dilation, bicuspid aortic valves, all the rest of it, long-term sequelae of it. [inaudible 00:32:32]. Then, I became the absolute expert on it, there’s no doubt. I could have a very detailed conversation with any cardiologist you want and I can discuss papers with them at great length. However, that’s not good. That’s not good at all.

Prav: Does it help your health anxiety a bit?

Dominic: Not at all. But, I suppose, I think, in a way, because I’ve become a little bit more accepting [inaudible 00:33:00]. I felt almost immortal before this happened. I felt like I’m doing everything I can to live forever. I’m going to have the longest health span of anybody because I take supplements hardly anybody bugger knows about. Secondly, I trained so well. Thirdly, my diets fantastic. And, fourthly, I sleep well. All these things. So, I’m really optimising everything here. Then, I got smashed to bits. I realised, it don’t matter what you do, because it can just happen around the corner. [inaudible] all taken out of your hands. That sense of being immortal is gone and I’m trying to, a little bit, more, these days, thinking, every day has got to have a better meaning for me.

Prav: Dom, this has been a common theme throughout this conversation, which is the topic of death. So, you mentioned it very early on in the conversation when you mentioned your mom, and she said you can’t cope with it, with medicine. Then, you’ve talked about being immortal. Then, you’ve talked about escaping death. Is there a theme there in terms of this been throughout your life, in terms of mortality or wanting to live forever? And, that’s why you invest in these supplements and all the rest of it. What’s the theme there?

Dominic: Well, I think from a scientific point of view, we’re almost on the cusp of proper health span elongation.

Prav: Yeah.

Dominic: I think that we’re near there. I think that, perhaps, we’re a little early, or, perhaps, our generation will benefit. It’s hard to know. But, I think we’re close to it.

Prav: Yeah.

Dominic: So, from my exciting scientific point of view, I feel like if I can persevere for a bit longer, I might benefit from that. Secondly, I think on a… not a sadder note, but it is sad, quite oddly, I was the person who was holding both my parents when they died. So, when my mom died of recurrent breast cancer, for example, in Cookridge Cancer Hospital, as it was called at the time, I was at the foot of a bed and then I just noticed her breathing changed and went and cuddled her. She died in my arms. Then, only 2017, my father who I’ve had such an awful relationship with, I was in his final room in hospital in Bradford, and he died in my arms, again, as well.

Dominic: And, being from an Irish Catholic family, uncles who died, we did something called awake, which meant that the corpse was presented to the family and we used to sit around all night. So, the dead body is not something that bothers me in the slightest and the transition from life to death is something that I’ve become a bit obsessed about from a young age. I don’t know, I think it’s an obsession with not conquering the fear of death, exactly, but just… I don’t know, it’s hard to say. I just think about it a lot. [crosstalk 00:36:21]-

Payman: You said you were agnostic, but do you have any spiritual belief about life after death?

Dominic: Well, I’ve gone through phases in my life of being agnostic when I was a young boy and then becoming a very strong atheist and becoming quite combative with people. I’m sure, you’re probably aware, I’ve done that on Facebook and the rest of it. I’ve been combative with people who’ve got faith. I’ve almost had, in some ways… I’ve wanted to get an argument going because I want to try and convince people and I want to try and… But lately, I’ve started to become, in the last few years, agnostic. The limits of human understanding is such, that how dare I say I’m an atheist. Do you know what I mean? It’s like a priest his atheist. Well, what the hell’s it got to do with anything.

Dominic: So, I think it’s a more pragmatic view, but who knows? Will we ever be able to comprehend what’s really happening? Who knows? Will we use artificial intelligence to augment what we’ve got, to allow us to have the cognitive function to comprehend things we just have no ability to at the moment. So, I think it’s fascinating but I also think, at the same time, I’ve tried to soften my outlook towards other people who have got faith because I think it was remarkably, almost, unemphatic of me. It’s almost the psychopathic side of autism where your empathy switches off and you’re just very black and white, and you don’t really appreciate the feelings involved in other people’s thoughts. You just say it how it is. I think I’ve come a cropper with that a lot in my life.

Prav: Has that changed post-accident, Dom? Was that a turning point for you in terms of the way you looked at things, in terms of both being combative, and religion?

Dominic: Not religion. I think the agnosticism had been happening for years before the accident, and nothing’s really changed there. But, I think that the accident did allow me to reflect on my own persona and my own shortcomings. I think one of the things that I did notice was, I saw the best in the very worst of people after my accident, and, by far, the majority was the best. All these friends of mine who just stepped up and just did [inaudible 00:39:00]. Going to my practises and finishing my cases and doing it for no price and just labs doing the work for nothing. All those people were my medical indemnity… not medical indemnity, [inaudible] helped me out.

Dominic: I just realised, [inaudible 00:39:23], why do we deserve that? What have you done to deserve this amazing outpouring of love? Then, I, also, in some cases… I won’t go into this, but I saw the very worst of people as well. I don’t know, it’s hard to explain. I started to think, Well, I’ve got to be a bit more forgiving of myself. Because, sometimes, I think that it’s my own incredibly high standards that I’ve got for myself, and my, really, almost pathological perfectionism that comes across in such a negative way to other people and I judge them by my standards, and it’s disgusting, really. So, I decided, the best thing to do, is to stop being like that. And, start trying to take a breath a bit more. Take a breath and not be such a-

Payman: A lot of times in life, your biggest strength ends up becoming your Achilles Heel as well.

Dominic: Yeah.

Payman: It’s being aware of it, I guess, is the clue for that. [crosstalk 00:40:26]… Go ahead.

Dominic: No, I was just going to say, you’re very right there. I think it’s the awareness of it that’s become better since my accident. I don’t know whether my autistic brain has been slightly rewired and I’m more self-aware than I was. Perhaps.

Prav: Tell us about… its Humphrey, isn’t it?

Dominic: Yes.

Prav: So, from the day he was born right up to now, not living at home. Is that right?

Dominic: No. Humphrey born, second to last child. Jemima’s my youngest child.

Prav: Mm-hmm (affirmative)-

Dominic: Humphrey was born, he was very small for [inaudible 00:41:05], but then he caught up very quickly. When he was born, he was only five pounds. A little lad. He had a couple of physical issues at birth. Something called Hypospadias, which is a congenital abnormality of the ureter. He had to have that fixed when he was a toddler, young lad, now he’s a little boy. But, even from the age of about three, we started to know that he was different. They say, in autism, sometimes, they reach their milestones, then they seem to regress, and that happened with him. When his speech started to go and he didn’t gesture. We call it the blank face of autism where he had a neutral expression all the time.

Dominic: You’ll often say, old artistic people are not wrinkled much because they [inaudible] but I do. But, it’s weird. But, anyway, as he got older… it’s been the greatest thing in my life and my wife, Rebecca’s, life without a doubt, but also the hardest thing in our life without a doubt as well, because a combination of different things. I think, the degree of his disabilities, his hyperactivity, severe learning difficulties and nonverbal autism, and this predilection for self-harm and very disturbed sleep, very difficult for him and also for us. When he started, then, becoming quite violent towards his siblings and to his mom, it became harder.

Dominic: Then, we’ve had a bit of misfortune with the fact Rebecca was also diagnosed with a pituitary tumour [inaudible 00:43:02]. For years, before that, she’d been having something called atypical migraine [inaudible] atypical migraine. But, actually, we think now that they were tumour headaches from a growing macroadenoma of the anterior pituitary glands. So, we had a lot on our plate, really. Then, when Humphrey started, before he was just getting to puberty… he’s a big boy, and his self-harm and his aggression to his family got to the point where the best idea for him, really, was to go into a residential school. So, he’s been there three years, down in South Yorkshire.

Dominic: What happens is, before lockdown, we went to visit him every week and, just in the last year, he was starting to come back and visit us as well for day visits. We haven’t had an overnight one yet. [inaudible] so hard, I can’t tell you. Taking down on the 18th of December for the first time… I took him down with my son, Gabriel, who’s 21. We took him down in the car. That was the hardest thing in my life, that.

Dominic: Then, I went to visit him. Rebecca was very ill with a migraine, one of these atypical migraines on Christmas Day. He’d been down a week and I went to visit him on my own. So I drove down, visited him and, I always remember, he was absolutely full of cold and he;d obviously got a cold meeting new people. I sat there with him and he ate his Christmas dinner with me. I’ll be honest with you, I think, when I left there, it’s the one time in the life, rather than just be obsessed with death, I actually had proper suicidal ideation and pulled up and thought, I’m going to top myself, I can’t bare with it. I [inaudible] obviously. It got to eight o’clock that night and got a call from where he was and he’d absconded, and he’d managed to escape.

Prav: Gone garden hopping.

Dominic: Yeah. It’s really quite difficult. It’s beautiful grounds, very tall fences and he’d escaped and he was going [inaudible] in the dark, middle of the countryside. They had to get dog teams out and police helicopters to get him. That was the same night, Christmas night.

Prav: That you were having those thoughts.

Dominic: A tough time.

Prav: Yeah.

Dominic: Well, I’ll be honest, let’s look at the bright side, his school there is 10 yards from his front door. We don’t have any more of the problems we used to have where he used to have a different bus driver taking him to the special school where we live. If he had a different driver and they hadn’t been told, that was the whole day ruined. He’d be completely utterly bereft and these little things such as that, where it was a different bus driver or he didn’t have his teacher at school, same one, or even such stupid little things to me or to anybody else… the bus driver’s shoes were different, they’d bother him. They’d bother him so much that, he’d not only have a bad day at school, but when he’d get home, he’d very aggressive and self-harm as well. Hard times.

Payman: Did you find you had to balance Humphrey’s interests with your other kids interests?

Dominic: Well, this is it, very much so, because a big boy and he did hurt his older brothers a couple of times quite badly. Particularly, Rufus once. Threw a boot at him and hit him right in the face with it really hard. Things like that are not… it didn’t break his nose but it could have broken his nose. Then, he went for his little sister a few times. It got to the point where I had to physically restrain him and he was almost impossible to restrain. He was a young boy, but I called him a bag of snakes. He was so strong. It got to the point where… he didn’t feel physical pain like we do, perhaps, because one of his self-harms was biting his nails off and then he’d laugh. So, he’d bite a nail off, and he’d laugh and just smile. Mentally, it’s a very tough thing. So, it got to the point where that was the best decision for everybody.

Dominic: One of my ambitions in my life, after all the accident and everything, I can do what I was going to do before the accident, which is move to a bigger place, with the grounds enough for me to have an annex built, that eventually, hopefully, that Humphrey can come over and have an annex, and we can have him back home. Whether that happens or not, I’m not sure. Well, it’s an ambition. So, let’s hope.

Prav: What’s the communication like at the moment? Is there any, at the moment, during lockdown or anything?

Dominic: Well, he don’t like telephone so he won’t [inaudible] on the phone. So, he’s got used to Skype a little bit now. So, the first Skype call was about eight seconds. The second one was about 30 seconds. Now, he’ll do about five minutes, and it’s great.

Prav: It’s progress, isn’t it?

Dominic: It certainly is. It’s actually exponential progress if you think about it. We’re allowed to go down and see him again now. So, there was a spell during lockdown when we couldn’t. So, we go down and see him now. We have to wear PPE, and he thinks that’s very amusing, which is a good thing. He finds it funny so that’s great. If he found it distressing, that would be a problem. What he doesn’t like, is that we can’t go in his house anymore. We just got to stay outside. So, he finds that difficult. So, the visits are a little bit shorter at the moment. We drive down, it’s good a 70 mile. Then, the first visit was only 15 minutes because he wanted to go inside and when he does, he wants to go in and we can’t. Not with that. But, it’s still 15 minutes. But, the last one was a good hour, and it’s fantastic.

Dominic: Well, it’ll get all right again. I’m full of hope for that. The main thing is, that he’s found lockdown not too difficult at all. It’s been a very same existence. Every day is very similar-

Prav: It’s what he needs.

Dominic: It’s perfect.

Prav: Yeah.

Dominic: Perfect. So, who’s to argue with that?

Prav: Yeah. So, going back to just health optimization and life extension, Dom, I’m sure, loads people are interested in it. What are your five top tips to push people towards living forever? What five things would you say… look, I’ve done my research, I’ve geeked out on all this stuff, whether it’s supplementation, lifestyle adjustment, diets, whatever it is. If you could just give five bits of advice, what would they be?

Dominic: One, I’m going to do few that aren’t chemical at first. So, one, to have a good circle of friends.

Prav: Mm-hmm (affirmative)-

Dominic: I think it’s really important. I think that from a psychological and from certain physical points of view, having friends, throughout your life, is important. Doing physical exercise. I think doing physical exercise tailored to your age. So, I think, that trying to be a marathon runner, when you’re 49, for the first time, is probably not a good idea. Also, look at your lifetime exercise total, as if it’s a bucket full of sand, and you’ve done a lot of exercise and you’re filling that bucket up. Once it’s full, and you’ve done 19 marathons or something, don’t just keep doing it because you’ll just get atrial fibrillation. It’s because you’ve basically got micro fibrosis in your heart muscle because you’ve [crosstalk] exactly, you’ve just overdone it too much.

Dominic: I think from a dietary point of view, don’t do what my dad told me. [inaudible 00:52:01], don’t finish your plate, even if you full. It’s a bad idea. I think, leave the table slightly… I won’t say hungry, but leave it with the ability to eat more. But, at the same time, don’t be a complete disciple of a very limited diet. I’m not saying that because you’re here.

Payman: No.

Dominic: I’m not. I’m saying it because I think a little bit of what you fancy, does you good as well.

Payman: Of course, it does.

Dominic: I think it’s important to keep that in mind, because I think that if you lose the pleasure from eating, you can tend to find that you can lose the value of eating as well. So, I think that it’s important. I think, believe it or not, micronutrients that you get from a wide variety of foods, it’s surprising. One of the things I have changed is, that I really believe that supplements are great and I still do, but I think that what you get from whole foods are very important as well. I think that there’s things that we don’t know yet and it’s the combination of the different chemicals within the whole food, that’s providing us with a sum of its parts that we’re not getting from supplements. So, I think that’s important.

Dominic: Another one is sleep, I can’t overestimate it. I think if you can just try and get into good sleep hygiene pattern. I wouldn’t use sleep apps. The reason I won’t use them is, because I think they make you anxious. I think a sleep app can be a double-edged sword. For people who like to quantify every behavioural parameter in their life, it can be a nice thing. But, if you get anxious and you find that your parameters are not where you want them to be, that can then be a self-fulfilling prophecy where you start going down a spiral of insomnia. So, it’s important to try and do that. On the sleep thing, try not to eat after about six o’clock or nine if you can, maybe seven. Just don’t be scoffing food before you go to bed.

Dominic: The last one is, for me, I think, if you want a good life, get a pet. Go cuddle your dog. [inaudible] coming through. It’s not just about cuddling your wife and kids and everything, we [inaudible] get those [inaudible] microdosing, going as many times as you can a day. What do you reckon?

Prav: Good advice. Loads of great advice there. I think, although, you started off with saying, I’m going to start with some non-chemical ones, I truly believe they’re all chemical.

Dominic: Well, they are.

Prav: In one way, shape or form, having a great group of friends around you and being happy is firing all sorts of chemicals off.

Payman: I think I’m breaking every one of those rules apart from the friends one. Let’s hope the friends one’s the most important one.

Dominic: If you looking at chemicals, perhaps BCQ and [inaudible] mononucleotide, are two that I’d consider quite seriously if you’re trying to life extend.

Prav: They’re expensive. They’re bloody expensive. Dom’s cost me a fortune with his advice.

Payman: How much is your monthly supplement bill?

Dominic: Oh, I’m not telling you.

Payman: Prav?

Prav: I don’t add it up, mate, deliberately. Dom’s seen my cupboard.

Payman: Is that what you call it?

Prav: Sometimes you’re shoving this stuff down you and you don’t know what it’s doing. But, I was just speaking to Payman about this. We talk about, you need the break and you need to enjoy yourself and all the rest of it, and exercising age appropriately. Every bit of advice you’ve just dished out, Dom, I’ve just broke. So, I was going hell for leather on my thingy bike… what’s it called, Airdyne.

Dominic: Oh, yeah.

Prav: Doing a flip into batter on there, trying to murder myself on it, came off it screaming. My legs was so full of blood, I’d rather chop them off. Then, I had this incredible knee pain. Then, I’m hobbling around. This is six, eight weeks ago or something like that, right. I’ve torn my sartorius. Hobbling around, gone for an MRI, confirmed it had been torn. A tiny tear in my meniscus.

Dominic: Ouch.

Prav: Yeah, ouch. Then, started feeling really sorry for myself. So, I thought, fuck this, I’m going to stop training. Even though I could do upper body stuff and that. I just thought bollocks to it. So, I stopped training. I still ate fairly well, but I stopped taking my supplements as well. It’s funny, your mindset… the tablets are all in one of these right? Okay. When you’re going to take them. I just couldn’t be assed. I thought bollocks to it, I can’t be bothered. I carried on with a diet because my wife sorts that out for me. I’m quite lucky, in that sense, so I don’t need to worry about that. I’ve put 10 kilos on, right. 10 kilos on. My foot pain has started coming back, I don’t feel as mentally sharp, I definitely don’t feel like Superman anymore.

Prav: That’s made me realise a few things. One of them is, probably, the pills that I was taking, were having a good effect, anti-inflammatory and all the rest of it. But the other thing is, I think, my mindset, really, in terms of the way I look at it, you either turn around and say bollocks to it, I can’t be assed anymore and you go into self-destruct mode, which is what I’ve been in for about six weeks. Or, you say, let’s have it, I’m going to stay positive, screw you all. Yeah. Come at me, I’m going to win. I flipped between those two modes. There’s no half measures for me. I’m either, all the one direction or the other.

Prav: But, the one thing that has come out of this is, the Domino’s Pizza that I had was awesome when I had the break from it all, but more importantly, actually, the supplements I’ve been taken, I do feel that they’ve been having a positive… and starting taking them again. I don’t think it’s placebo. I do think they do have a profound effect on well-being and the way you feel.

Dominic: Yeah, I think you’re a little bit like me in some way, insofar, as you, not bipolar, but you’re bipolar with regard to you all or nothing, with regard to your training profiles. But, I think you might be like me, insofar as, if you do let yourself go, you’re almost excited about the fact you’ve got to come back.

Prav: Do it properly.

Dominic: So, you got to do it properly. So, it’s almost like it’s a mission. It’s the fact you’ve got this mission, that you [inaudible] again.

Prav: What’s more detrimental is, because you know you can come back, you let yourself go a little bit further and it’s a bit of arrogance. Do you understand where I’m coming from?

Dominic: Oh, yeah.

Prav: That, itself, is-

Dominic: Then, you just [inaudible 00:59:15]. So, I’m suddenly getting more injuries than I used to get. So, I’m getting things like grown strains, and then I’ve got a calf strain. I’m thinking, I can come back, I’m a glutton for punishment, I’ll run this mountain, I’ll run till I’m blue in the face.

Prav: Yeah.

Dominic: Then, I’ve got this calf strain at the moment, and I can’t. So, I’ve got into cowbells at the moment. I’m using that as a way of trying to [crosstalk 00:59:43]. Yeah, I’ve forgotten how hard kettlebells are, actually. [inaudible 00:59:48].

Payman: Dom, we’ve been asking everyone about their clinical errors, in the hope that we can all learn from them.

Dominic: Yeah.

Payman: Can you think of a clinical error that you want to share with us?

Dominic: Absolutely. Yeah. First implant ever placed. I placed it on a young female doctor. I left it four millimetres super crustal because I bottled it. I didn’t screw it in enough. So, that was a combination of hubris, insofar, as I thought I was better than I was, even though it was my the first implant I’ve ever placed. Two, it was not being aware of the fact that when I was in the middle of the surgery, that I’d get deep fear that would come from nowhere. Thirdly, I wasn’t able to control the ability to take a breath and relax into the surgery and get into the flow.

Dominic: For me, one of the biggest lessons I’ve ever learned in surgery is, going slower than you think you need to. So, rather than thinking, right, this is the surgery, I need to get it done, I need to get it finished. No, this is the surgery and I need to enjoy every little bit of it. Obviously, I don’t want to cause excess morbidity of my patient by taking too long. But, I definitely want to reflect twice on everything I do. That’s a lesson that I didn’t learn in that case and it stuck with me for the rest of my implant career. Because, I was very lucky. The patient has good biotype and never shown any issues with that, and has got no problems. But, I think it might be to do with… it was an Austrian plant and they do keep the bone well as well. So, the fact that the super crustals [inaudible] or there. But, on the other hand, that could have been a nightmare around the beginning of my implant career.

Payman: How long ago was that when you put your first implant in? How many years were you into dentistry?

Dominic: About 13 years ago now. Yeah.

Payman: So, you’d qualified a good 10 years or something?

Dominic: 13, the number that follows it. No, I’ve been qualified 27 years. [crosstalk 01:01:55]. [inaudible] that I’m 50, but I am nearly 51.

Payman: So, you’re not going to be working under Boris’s new scheme? You’re going to be one of the over 50s who’s going to stay at home?

Dominic: Well, I’m not because I’ve got the biological age of a 21 year old athlete. [inaudible 01:02:17]. He can come and try and stop me if he wants and then [inaudible 01:02:22]. The old aggressive Dom might come out again then.

Payman: Dom, you know that reading your stuff…

Dominic: Yes.

Payman: The English is superb. Where did that come from? Was that that Catholic school? Or is it that you read a lot?

Dominic: I started reading very young. I read a lot. I’ve got, I suppose, not an obsession, but it’s one of the things I do love is, language. I think language is a beautiful thing. Words, themselves, are beautiful things. Just big vocabulary. I think that, sometimes, it’s wrong to dumb stuff down. So, the fact that we live in a generation where it’s all WhatsApp and Twitter feeds and all the rest of it, and we’ve gutteralized our language a little bit, doesn’t mean that you should do that when you’re writing. For me, I think you should write and I think you should challenge your readership to… if they don’t know a word, go and bloody [crosstalk 01:03:22].

Dominic: Don’t change your style if you can. I suppose I’m a verbose person with regards to my writing. So, my style is a little bit verbose as well. I do try and reflect on it and think, I don’t want to come across as a total smart ass here as well, just using the big words, because I know one. But, at the same time, sometimes they just seem to fit the moment. So, that’s what I’ll use.

Payman: Is your style of writing… does it just flow? Like you said, you’re in that flow state. Would you consider it-

Dominic: I can write 1000 words of pro’s in three hours and just do it. Sometimes, I don’t need to change it, hardly, at all afterwards. It’s easy. It’s almost edited as I go.

Payman: There’s definitely a novel in you somewhere or a book in you somewhere. Have you ever thought about that?

Dominic: I’m 60,000 words into a [inaudible 01:04:19]-

Payman: Oh, are you?

Dominic: Yeah.

Payman: Oh, I didn’t know that.

Dominic: Originally, the title was going to be Orange is the New Black because of my orange top that I had. Also, because Orange is the New Black was on Netflix at the time. My cycling [inaudible 01:04:35]. I’ve changed the title, I won’t tell you what it is at the moment. But, I’m 60,000 words in. It’s a combination of the year since my accident and reflections on everything from my upbringing. A lot of what we’ve talked about here. I’ve had a few people read it including a couple of people who… one person is quite a big publisher in London and she says it’s wonderful. I’m hopeful something will come from it. But, I stopped writing it at the beginning of lockdown and I started reading the papers. So, I just started writing a little bit of it again.

Dominic: I think it will be… to use a phrase from Chris Sparrow, it’s a bit marmite. [inaudible] it. It’s very, very candid. Very candid, indeed. But, the style will either grab you or it won’t. I think it’s the style I use in my writing generally. There’s a lot of shorter sentences… Quite a lot of descriptive [inaudible 01:05:42]. There’s things that will stay with you hopefully. Not, perhaps, always for the right reasons.

Prav: I think what you wrote in dentistry about the accident, the way it was written, it was almost as though we you could visualise it. I could relive that moment on your bike with you. It was that well written, do you know what I mean? It just sucked me right in.

Payman: [inaudible] really well.

Prav: Also, the feelings about… that surrounded the individuals who were there for you, and those that weren’t.

Dominic: Yeah.

Prav: And, how that… it was just so beautiful, Dom. It was so well written. It was really nice.

Dominic: [inaudible 01:06:29]. To be honest, I was please with it myself. Normally, I’m all right with stuff, I read it and I thought, that’s pretty good.

Payman: Dom, when lockdown happened, we were all asking ourselves questions about the virus and aerosol and then you really took that on and we’ve kind of talked about some of that. But, as the biggest expert we know in this area, how do you see things panning out? Do you see a second peak? How do you see the aerosol question panning out?

Dominic: Yeah, when you look at aerosol infectivity, I think you’ve got to be a lot more detailed in the way that you look about-

Payman: The nuance, yeah.

Dominic: And, think about this virus is a bit of a rascal, really. In very individual circumstances, it can be infective in an aerosolized form, in my opinion. However, those occasions are remarkably prescriptive. So, in the vast majority of the aerosols that we create on a breath by breath basis, I don’t feel it is a primary effective factor in the slightest. So, I think that, where we’ve got to be careful, and we see this with super spreader events, is things such as choir practises. So, where people are, perhaps, not quite as social distanced as they should be and where they’re vocalising loudly, for an extended period of time, usually inside, perhaps with unusually static air flows in quiet buildings, things like that. Perhaps, where you’re in a meat processing plant, for example, where you’re standing with your colleagues in front of a conveyor belt in a very cold, humid environment. You probably turning and chatting to them and shouting over the noise of the machine or in the background, things like that.

Dominic: With regard to a second wave, I don’t believe there is a second wave at all at the moment. I think we never really escaped from a first wave with regard to certain parts of the geography of the UK. I think there was a certain number of cases, it never really went away there. So, I don’t think we’re seeing that. I think we’re seeing a complex political situation where, perhaps… I hope I’m wrong here, but I think that perhaps, because we’re in a fixed-term Parliament act and the government are thinking, well, it’s coming up, well, we’re going to have to get voted in or out again, the very obvious fact that, with hindsight, we can pick bits out of the way that the government have responded to this incredible crisis, means that they’re now using, perhaps, a politicised way to try and take our eye off that ball. So, I think that, in a way… maybe, I’m being cynical here, I think the second wave thing is slightly… I’m not convinced at the moment about that.

Payman: Are you not convinced about the other countries? Spain, and all of that.

Dominic: I think that there’s a few things happening. One is, it’s a slightly different demographic. So, I think it’s a younger, more healthy demographic. I think that the level of death rates compared to infectivity is different than it was in the first wave. I think, secondly, the more testing you do, and this isn’t to quote Donald Trump… the more testing you do, the more cases you find, but that’s true as well. I know that it’s not a static relationship between the two. I think you can’t just describe the death rate being lower, as due to better treatment. I think that that’s wrong to say that. I think it’s because it’s a different demographic of people who are getting it now. I think there’s a level of cross-immunity between SARS-CoV to another coronavirus. Colds and things like that. Perhaps, it’s those individuals now.

Dominic: So, for me, I’m not as worried as I was at all and I could be very wrong. I also think the virus could still attenuate and I’m not convinced it hasn’t slightly attenuated even now. That could be a reason where we’re seeing infectivity, but we’re not seeing as much morbidity and mortality.

Payman: So, you’re quite optimistic, it sounds like?

Dominic: Yeah, I am.

Payman: That’s good. That’s good news. I know what you were doing over lockdown, but, did anything happen to you as far as you’re going to live differently going forward because of what you learned in lockdown?

Dominic: No, not really well.

Payman: Oh, I like that. The first time I’ve heard that.

Dominic: I think the accident had made me change things in my life before lockdown, but the lockdown, itself, wasn’t this fundamental existential self-evaluation exercise where I’ve decided I’m going to now be a disciple of veganism or anything like that. I’ll be honest, nah.

Payman: The last time me and you spoke privately, I asked you, do you feel the weight of it? Did you ever feel the weight of it because, in a way, everyone was looking to Dom for a while there? Did you ever feel responsibility?

Dominic: A bit, yeah. [crosstalk] background. Yeah, for several reasons. I think one of them is that I’m a general dentist with no form of neurology training whatsoever. So, my absolute formal scientific qualifications to be any form of arbiter of advice are very spurious. Two, I think that I am able to captivate people with my scientific utterances. So, people think, oh, he seems to be on the ball, on the money. So, therefore, there’s a responsibility there to be actually sure you are actually on the money. You don’t want to be saying things that are a load of rubbish. So therefore, there was an element of that, is that you set the bar high for yourself. I think I had because my first webinar… I’ll be honest with you, I’m quite proud of that because some of the stuff then was way ahead of this game. I think, Wow, you did well there. You really picked up on some stuff very early on then.

Dominic: When you set the bar high, on one level, you have to keep up with your research to a very high level. But secondly, you have to be open to criticism as well. That’s something that I, in a previous life, I would have found very difficult. So, getting challenged, I used to find it really difficult. I used to think, What the hell do you know? [inaudible 01:13:27]. Well, now, [inaudible 01:13:35]. [inaudible 01:13:35], let’s debate it, let’s discuss it, and let’s try and come to an outcome that’s even better.

Dominic: At the end of the day, we’re still very early doors with this thing, we really don’t know. It’s thrown some real curve balls at us. We’ve gone from this thing where we thought, let’s just ventilate everybody and build a million ventilators, to realising that, actually, ventilating the majority of these patients in the way we were ventilating them was probably killing them. Because, we were high flow ventilating them and we were actually creating a situation where they were ending up far more ill than they would have been.

Dominic: So, like anything else, we’ve become so much more nuanced over the month. So, going back to your question, yeah, I did feel a responsibility. It’s been nice to not feel quite as much of that at the moment. So, I’m glad there hasn’t been Dom’s 19th COVID webinar.

Payman: Then, you wrote that other piece about how, as a profession, we’ve been let down.

Dominic: Yeah.

Payman: It got quite a lot of support. I remember talking to you to about it at the time. It was right about the time that that practises opened again, and you were saying, the momentum’s gone because people are so focused on going back to work now.

Dominic: Yeah.

Payman: Where do we sit with that?

Dominic: Yeah, that was [inaudible 01:14:49]. I remember writing that.

Payman: Yeah.

Dominic: I remember writing it. It took me about 10 minutes to write that. I was furious when I wrote that. I think that property comes across a little bit in it, really. I thought, we’re at a crux here. We’re at a crux point. Almost, like a pivot point where we’ll do what we always did before, which is that we’ll have all these voices and all this anger and all the rest of it. It’s like when the RF went up to nearly a grand, everybody was, [inaudible 01:15:22]. Then, the next minute, we’re all back at work, and we’re just bending over and accepting it like we did before.

Dominic: So, I was furious because I thought, we’re all just going to go back to work and we’re all going to be bothered about the day-to-day, and we’re all going to end up getting basically taken advantage of by quangoites, managers, people who don’t have a clue how difficult dentistry is on a clinical basis, people who have accepted this liability culture of the norm and [inaudible] for everything not. That’s somehow, civilizationally, a step forward. For me, it’s one of the greatest retrograde steps of being civilised that we could have. That we’ve gone from a thing where we can have a good relationship with a patient after a problem, to one where you end up in litigation and vicarious liability, all the rest of it, and it’s just hard.

Dominic: So, there was a lot of anger when I wrote that little piece, and it did appear to trigger a few reactions, mainly positive ones. But, I still feel anger. I feel anger towards the GDC. I feel anger towards the way that they’re dealing with my freedom of information request. I feel that, the fact that they’ve got one standard for us, which is a very high standard indeed, and they’ve got, it appears, a different standards for themselves with regard to their duty of candour. So, for me-

Payman: Yeah, for someone who doesn’t know about the freedom of information request-

Dominic: Yeah.

Payman: Could you summarise what that was about?

Dominic: Yeah, well, there’s a few of them. One of them was about the minutes of the council meeting where they had, basically, decided not to revisit the ARF. So, the annual retention fee. They decided not to revisit that, unanimously, as council members. Despite the fact that, obviously, the profession, as a whole, was in lockdown, our income was massively devastated. Many of us were thinking that our dental practises may not even survive. Yet, they weren’t even willing to revisit the ARF with regard to doing a direct debit option. So that-

Payman: Their reason for not releasing the minutes of that meeting, was that it was a closed meeting.

Dominic: Yeah, so they basically wanted the freedom of information request… I wanted to know what the written communications between the council members and the Board were, where this decision was made, and they basically have said, to divulge that information to me would inhibit the council members from being free to discuss these things in the future. So, the duty for public disclosure was outweighed by the fact that they had to feel free and uninhibited to speak candidly with regard to these topics. I was almost gobsmacked with that, to be honest.

Dominic: So then, I went on and did a second freedom of information request regarding their second [inaudible] which was in Birmingham, where they’ve now got a very prestigious office in the most… well, the most prestigious office block in the middle of Birmingham. I’ve tried to find out some information about that as well, and I’ve, so far, received very little accurate data, so I’m taking that one further as well. It just makes me a little bit cross that they’ve ended up in such a prestigious office building when they’re not willing to revisit our ARF, and, as a profession, we’re struggling at the moment, financially. I think it sets a precedent, which means that we’re even more… in some ways, perhaps, there were the slightest green shoots showing that the GDC might be listening to us again, and all that appears to have been entirely devastated in recent weeks by what they’re doing there.

Dominic: So, to me, they’ve a lot of hard work to do. I hope that if I do end up having a fitness to practise case for my candour… I’m not going to say anymore, I’m digging a hole here. I can see I’m digging a hole.

Payman: Our time’s nearly over, guys. I’ve got one more question for Dom and then Prav has one more question. My last question, Dom, is, what would you have been if you weren’t a dentist?

Dominic: A philosopher. I think I would have liked to have been a philosopher, with hindsight. A lot of time thinking, writing, being on my own, and irritating a lot of people with my writing. That would have a nice job. Perhaps, the education side of that as well, because, I think, I have got some great benefit from the educational side of my knowledge that I didn’t think I was going to get and I have got that. Okay.

Prav: So, Dom, my final question for you… You know what’s coming next.

Dominic: I don’t.

Payman: He’s never listened.

Prav: Oh, right, fair enough. Listen, mate, you’re 251 years old, and it’s your final day on the planet. You’ve got your kids by your side, and two things-

Dominic: Are they in their coffins because they don’t have longevity like me.

Prav: No, because you’ve given them the supplements, mate.

Dominic: Fair enough.

Prav: You’ve been funding them in this massive estate that you created that’s part of the ambition, remember.

Dominic: Yeah.

Prav: So, you’re 251 years old, they’re all next to you, and there’s three pieces of advice that you can leave them to stroke the world with. The next question is, how would you like to be remembered?

Dominic: All right, so the first one is the three pieces of advice.

Prav: Yeah.

Dominic: Male or female, any age, if somebody bullies you, punch them in the face. Okay.

Prav: Yeah.

Dominic: Especially when you’re young and at school. Don’t take it. Don’t hurt them, insofar as, when they’re down, do something, but punch them in the face. Then, whatever repercussion you’ll get, it’ll be worth it.

Prav: Love it.

Dominic: For various reasons, that will enable you in a lot of ways in your life. Two, [inaudible 01:22:09], get a pet, look after it, and be kind to it. Remember that many pets are more sensitive than you think. So, treat them with love and affection. The third one is, don’t piss on my grave when a die. You don’t have to put flowers on it because I’m not half-fussed about that.

Dominic: And, how I want to be remembered. Perhaps as, who was that COVID geek? He used to be a right asshole, him, but he was all right when he got a bit older. At the end of the day, when I met him, I realised he was actually quite kind. That’ll be good.

Prav: Lovely. Beautiful. It’s really nice, Dom. It’s been a great conversation, mate.

Dominic: I hope so. Thank you very much.

Prav: It’s been brilliant, mate. Thanks for sharing a lot of that depth that you did with us. It can’t have been easy. But, it’s pretty powerful stuff.

Payman: Thank you so much, Dom. I really enjoyed it.

Dominic: I really enjoy speaking to you both. So, I hope it’s onwards and upwards now with the rest of your conversations today.

Payman: We look forward to the book.

Dominic: Oh yeah, well, if you want, I can always send it to you, as long as you don’t facilitate it anywhere. I’ll send you a little preview if you want.

Payman: Yeah, for sure.

Prav: Love to.

Payman: Thank you very much, buddy.

Dominic: All right.

Payman: Thank you.

Prav: Thank you.

Speaker 2: 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.

Prav: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. Just a huge thank you, both, from and Pay for, actually, sticking through and listening to what we had to say and what our guest has had to say, because. I’m assuming, you got some value out of it.

Payman: If you did get some value out of it, think about subscribing, and if you would share this with a friend who you think might get some value out of it, too. Thank you so much for listening. Thanks.

Prav: And, don’t forget our six star rating.

Nik: Long story short, started making websites for people, expanded into different industries and bigger clients. And now we’re fortunate enough to be-

Payman Langroud…: All along you were a dental student, you were doing this as a dental student?

Nik: Yeah.

Payman Langroud…: In Hungary?

Nik: In Hungary, yeah.

Saeed: Dentistry must have been really easy in Hungary. Had the time to [crosstalk 00:00:19].

Speaker 4: 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.

Prav Solanki: Welcome to the dental leaders podcast, and today we’ve got the pleasure of Nikunj and Saeed from the Wise 360 group. Just want to start things off by just asking you guys really how you both got into business together, how you first connected, heard about each other, and then how this all started. So could you just tell us your backstory, please?

Saeed: This is actually a very funny story. So I came up with an idea of doing an award ceremony for dental students and young dentists, because the whole idea was to bring the fun back into dentistry. And I thought my idea was unique and nobody else had told about this idea. So I had [inaudible] some time back and say, “This is the idea, what do you think?” I said, “Well, it’s a good idea. It’s always good to contribute in the education of dental students and young dentists.” And before I even had any chance of doing any preparation, somebody else somewhere else launched a project called Dental Student Awards at the time. And it seemed really interesting actually, Payman sent me a message saying, “Mate, the idea you had, somebody else has already done it.

Saeed: So I saw a picture of Nikunj in some Instagram post, and I had already spoken to Nikunj before about another project, so I knew of him. So I thought, you know what, he’s a great guy. I’m sure he’s going to do a good job. But let me contact him, see how things are going. So I contacted him. And we had couple of meetings, and we actually decided to do it together, which actually turned out really well. And for those of you that know, it’s been a great success last year, and we are holding the next one this year in October.

Nik: Yeah. And I think since the future of dentistry awards was the first thing that kicked things off, and then as we’ve grown both as people and in work in things, we’ve just allowed that relationship to mature and doesn’t get involved into more other businesses, and expand it accordingly.

Prav Solanki: So I think that was a really interesting exchange there, because other people may see that as competition. Other people might see that as a rival and think, there’s someone out there who’s stolen my idea, or beat me to it. I need to work even harder now. But you took a different approach. Can you talk us through that initial exchange of contact, what it was like, what that initial … Was it a phone call or a meeting?

Saeed: For me, dentistry in the UK, or business in the UK, there’s so many different opportunities. You don’t really need to be saddened by the fact that somebody else launched something sooner than you. You can always do something else. There are great ideas and as long as you can execute something properly, you can just move into something else. So first of all, there is no hard feelings if somebody started something before you, you still have to try. And then the second thing is I had so much passion about this, I wasn’t thinking of doing this for money, which is not a profitable organisation. I had passion for it, so I thought if somebody else has passion for it, there must be some common ground here so if anything, I should connect with this person.

Saeed: And it was quite simple. If you’re living in a technological world, their Facebook message was quite sufficient to attract Nik’s attention.

Nik: Yeah. And also, I think having complementary skills as well was very helpful, because there are things that I’m very good at, and there were things that Saeed was good at. And we were essentially quite a good fit because my weaknesses were covered by Saeed anyway. And one of the [inaudible] I’ve always had in businesses like, always do somewhat take more of a collaborative approach rather than a competitive one. Because you’ll kind of go stuck in a rat race with competition, never find satisfaction, fueling your insecurities and collaboration allows you to not go down that way.

Payman Langroud…: So I was at that first awards, and it was a fun night. But more interesting than that was how big it was, for the first time of doing something like that. Because I remember telling you that, “Look, forget the first year you’re going … just work for the second and third,” but it was a huge number of people. How many people turned up?

Saeed: We had an excess of 400 people. Actually, we had to stop people coming. Well, a few people couldn’t actually join because we were overflown to be honest with you with the venue. The venue has a capacity of 400 people and we were definitely above 400.

Payman Langroud…: And with all the cynicism around awards, did you get any bad vibes from people about that as well that you starting awards at the student level?

Saeed: Obviously we did our homework very well. We spoke to quite a few people with more experience in dentistry, including yourself and we wanted to come up with a project where it was actually genuine, and we didn’t want to approach it commercially at all. And most importantly, we didn’t want to get into clinical aspect of dentistry. We are celebrating other achievements of dental students and young dentists. We leave the clinical dentistry to the universities. They are best place to assess individuals on clinical dentistry. We are assessing individuals on other great experiences and achievements they have which otherwise is not seen, because everybody gets stuck into the bubble of dentistry.

Saeed: So that’s the reason we don’t get any heat because we’ve got the best sports man, the best sports woman of the Year. I mean, nobody, people usually care about that, but you would be surprised to find out some of the dental students are in Olympics and they do other amazing things. That is a contribution to dentistry because that tells you who they are as an individual, not necessarily whether their occlusal composite is the best.

Payman Langroud…: And what are the some of the other categories? Have you got CSR … well, charity?

Saeed: We’ve got contribution to charity, we’ve got ethical students. So that is for a student to be able to demonstrate what measures they’ve taken to be able to develop in an ethical manner and provide ethical dentistry. We do have the audit of the year but that is something that is selected by the deanery. We don’t have any judging over that. So we are very careful not to impinge on something that we are not an expert on.

Prav Solanki: And so what was the selection/submission judging criteria and who was involved in all of that? How did you go about setting all that up?

Nik: Yeah, so the first thing that we wanted to do was to make sure that [inaudible] organisers of the event were essentially very hands off of all of that process. So we scouted around and found judges and spoke to a variety of people who are basically everyone from deans of universities, to actual clinicians in practises. And so people who would have had quite a multidisciplinary skill set with them, and not just all clinical and also with business or other skills. And so after creating this judging panel, then we allowed them to come up with a criteria and we provide … basically just passed on the applications to them. And the applications got judged by them and they did a rank, schooling system. And essentially the top scoring individuals were the ones who were the winners.

Payman Langroud…: So now your new project, Wise 360, talk us through that. What’s that all about?

Saeed: Sure. So Wise 360 is at the heart of what I was just saying with collaboration over competition. So Wise 360 group is basically our main parent company that essentially houses tooth wise, medical wise, which are our different brands that we advertise, tooth wise being in dentistry. And so with Wise 360, we are creating an educational platform where people can basically discover courses to go on to, to learn about medicine, dentistry, or whichever field that they’re in. And the whole point of this is for them to actually find courses which are suitable for them to make better decisions, and then also have a more powerful platform because a lot of learning is now becoming digitalized.

Saeed: So we’re helping these course organisers to actually take time away from the admin. And we’ll manage the admin side with the platform and with technology, and then instead they can actually focus their time on the clinical teaching of itself.

Payman Langroud…: The problem you’re solving with it is that … I don’t know what courses are available, firstly. All right?

Saeed: Yeah.

Payman Langroud…: And then with the CPD bits and all that? [inaudible 00:09:12]?

Nik: Yeah. So there’s a part of automating the CPD certificates and things like that. So imagine, for example, the best way to describe it is booking.com, Airbnb. So the same way you would go into one of these websites to find a hotel for you, you would go onto our website and just search a course. So let’s say you want to composite course, you would just go ahead and search that. And then there’s filtering options, so if you want to filter it based on certain criteria, so price, location, if there’s verified or non verified CPD, if it’s a online or in person course, things like that. Or even reviews and the star rating.

Nik: And so then that way, you’re able to tailor your search based on what you want. And then we’ve already started including the things necessarily to be able to use AI so that you will able to actually guess the course for them before they’ve even thought about it themselves, stay tuned.

Saeed: Before Nick gets into algorithms and AI and everything that you don’t understand, he is very technical. For my point, I did dentistry in London and been a dentist almost 10 years now. I used to ask as a student to older generation, “Which course do you think I should go for? What should I do? And whether it is good or bad.” Nowadays there is this drive in dentistry. As soon as you qualify from dental school, you think that you should do further courses to even get better. And so I get asked this question very often, said, “What do you think? Which course should I do? Which one is the best one for me?”

Saeed: I think this platform will enable people to make their own decisions by being able to see the reviews of the courses, to make comparisons to understand where they are located, how much they cost, and create a long term career pathway for themselves. And that will be their decision. Alternatively, you’re going to have to ask 10 people, but if you have the opportunity of seeing all the courses in the UK and also abroad, you know that it is a golden opportunity for you to plan for your career.

Payman Langroud…: And it doesn’t cost anymore, the user doesn’t cost me any more to go through the platform?

Saeed: No, it’s absolutely free. Doesn’t cost you anything. You don’t even have to sign up to search the courses. But of course, if you want to book it makes sense that you need to sign up, but it doesn’t cost them anything.

Payman Langroud…: And so the business model is that you take from the course organisers?

Saeed: Yeah, we think that’s fair. We are going to also help course organisers to fill the seats that they wouldn’t otherwise fill, because they are welcome to do their own marketing by all means, if we are just an additional help. And yes, they will cover the cost of booking but we know that the average transaction fee whether you use PayPal, Stripe or any other measure is already about 5% anyway, and we charge something just above that, so it’s a no brainer. If you are a course organiser, you don’t get a booking from us, you don’t get charged, you get a booking, you get charged. There is no lacking in contract. You join and leave whenever you want.

Payman Langroud…: Then what if a particular course organiser doesn’t want to join it? Then that detracts from the service in terms of you’re not going to have as many … you’re going to have all the courses on, let’s say this six composite courses, and any three of them sign up.

Saeed: I think as I said, it’s a no brainer. Why wouldn’t you? If you’ve got pride in your course, and you think you’re doing a great job, you think your delegates are really happy with you, this is an opportunity for you to actually get on a platform where you can show off how great you are, get reviews from users. If you don’t want to join then, by all means, then you can go direct. But in our opinion that wouldn’t be a very smart move.

Payman Langroud…: So I see as a no brainer as a course provider and pay you, you’re on courses as well, let’s say so a little over 5%. As a course provider, would you give a 5% discount to a delegate who is ready to book a new course?

Prav Solanki: Of course you would. So you’re providing that booking at that rate you would normally give a discount for anyway. So that’s-

Saeed: That’s absolutely right. I mean, 5% is I think very, very generous. I know people that-

Prav Solanki: Give much, much more.

Saeed: … more than that.

Prav Solanki: Yeah, of course.

Saeed: We’ve done our homework very well. We’ve been working on this project for the past two years. This is not something we’ve come up last month, and we’ve already done extensive market research. I personally spoke to close to 50 course organisers across the UK, and understand to see whether this was something that would help them. And I would say 90% of them said they are on board, they are happy to get on board. We have had a couple of one or two people say “Well, my courses are already fully booked. Why do I need further bookings?” And the simple answer to that question is one, you can expand, just do more courses, get more tutors on your course and expand.

Saeed: And the second question is, if you’re really passionate about dentistry, you’re reaching people that are within your close proximity. You’re not reaching people from outside the UK, you’re not reaching people from other cities. And if you’re really passionate about dentistry, why would you want them to be disadvantaged? Reach them as well.

Prav Solanki: I see two big challenges for this project. So I’m sure you guys have overcome those. And I’d just like to hear how you have approached them. And the first one is, how do you reach the audience of dentists to make the booking? So one is lead gen. And the other one is probably for you, Nikunj is the technical challenges of building that platform must be immense. How do you overcome those challenges, and the bug, and all the techie programming side of things?

Nik: Yeah. So to answer the first question in regards to essentially what we [inaudible] this will in marketplace end of the day, and there’s two ends to a marketplace. One is the supply and the other is the demand. So the demand is where from the consumers and the supplier is from the actual course organisers. And so like any good shop, you have to have both of these things there. So, we’ve been building tooth wise for the past two years in terms of a social media plan and creating lots of content and really making sure that we have both that online and physical presence. Things like running the awards, which has been a fantastic success has also been a firsthand experience for us, as a company to understand from a cost organisers point of view what it’s like to run event.

Nik: This is a very larger scale event, but it still helps. And on top of that, so I always had that expertise where he’s organised multiple courses and events himself as well as listening to people. So, through that, building that initial brand, we will be using that and using those techniques, as well as doing a collaborative approach with the course organisers. So by providing them with a tool, which essentially allows them to fill delegates into our portal, we’re able to then provide different offerings, which creates a positive feedback cycle, which allows those people who have signed up to go ahead and discover more courses. So essentially we’ll kind of snowball our user-ship on them.

Prav Solanki: So if somebody registers for, let’s say, my course, and then they take that course, they become a contact in your database, essentially?

Nik: Exactly, yeah.

Prav Solanki: Which allows you guys to maybe make them aware of what courses are coming up next month or in a year’s time?

Nik: Exactly, yeah. And we would understand as well, their occupation, subspecialty and interests. And once we have this data, and we understand this data, we’re able to recommend better courses as well for them.

Prav Solanki: Okay, so playing devil’s advocate, I run a mini smile makeover course. And the only course I want anyone to do is my composite course. And so somebody books through your platform and my anxiety there is, they’re going to go and do my competitors course. What would your play off be to that? What would your response be to that?

Nik: Yeah. So for example, one of the biggest key decision factors is word of mouth. And what word of mouth actually brings to people is credibility on a course. Reviews is basically the modern day version of word of mouth. So it becomes a very black and white system where if you’ve got a composite provider A and composite provider B, and you’ve got … one’s got 400 reviews at 4.7 stars, and the other one has got 700 reviews at two stars, it’s kind of a no brainer to realise which one is the better course to go to. And so you’ve [inaudible] that’s what we’re doing is, we’re giving people the ability to transparently provide the views and give their opinions about courses so that they can be shared with other delegates just like themselves to then go on to the course.

Nik: So to answer your question, the question is, keep running better courses and encourage better reviews, period.

Payman Langroud…: What about the second part of his question regarding the actual building of the thing, and the startup world that I guess you guys are now in? What have you got? A group of developers? How much runway do you have? Are you raising finance? What’s-

Nik: Yeah, no. So my background, as you know applies all, and mostly being in the startup world and tech and things. So with the technology, and to answer the question, with the technology stack that we’re running, it’s a very versatile thing where we’re using Facebook’s React Native platform, which has recently been released a few years ago. And now that’s open source. And what that’s allowed us to do is be ready for mobile, when we’re ready to create actual mobile apps and things for the future. At the same time, you’ll realise … I’m sure you’ve done it with your own software’s that you developed or the dentists’ listing when they go and make a website.

Nik: A lot of the pricing in technology is done on an hourly basis. So the more you can reduce the hours, the cheaper the product that is going to be. So we have a mentality called lean in our minds, which is basically, running everything in a streamline and as efficient way possible, where we create the minimal possible version of basically a platform that’s going to achieve the goal. So long story short, we’ve got a team of developers, which is with my own agency, based in Hungary and the Ukraine, which are developing very hard and well for us.

Payman Langroud…: So how long will it be before it’s ready?

Nik: A few weeks.

Payman Langroud…: A few weeks? Wow!

Nik: The platform is actually ready to go. We are creating the supply on that now.

Prav Solanki: Just to give us an idea in terms of, to get your MVP or your minimal viable product out, which is I’m assuming going to be your initial beta version, that you’re going to improve on and add features to how, many developer hours has gone into that?

Saeed: To answer that question, actually, that is a very interesting question with regards to the MVP. Whatever project we do, we set quite a high standard. You would have seen that from future dentist [inaudible] like Payman was explaining. First year one of the best awards that anywhere ever seen in the UK. With the courses booking platform, we started with the MVP idea, but we wanted to make it so perfect. I’m not actually sure even if it is an MVP anymore, it’s probably a fully blown platform. So, for an MVP, it is pretty developed.

Nik: Yeah. So to answer the question, it’s let’s say a couple of thousands.

Prav Solanki: And that’s how many developers working on that at the same time?

Nik: So we’ve got six developers or a team of six in total, including a project manager, excluding myself and the designer.

Prav Solanki: Wow! Whilst developing that, have you come across any major challenges? I know we’ve developed software in the past, and sometimes we make some technical decisions that throw us completely off than anything, “Oh geez, if only I’d have done it this way or that way.” Or have you circumvented that by planning and mistakes that you’ve made in the past?

Nik: Yeah, it has been a lot to do with the planning in my experience with things, with the previous projects I’ve worked on and other clients and things. I think the biggest challenge that we faced with this is probably the payment side of things. And ensuring that the entire platform is so secure, especially with that payment. And one of the things that we wanted to actually overcome was end of the day, when you’re course organiser, they want money in their bank ASAP, right? And that helps their cash flow, it helps a variety of things. And so we were able to thankfully create a system and partner with a fairly big payment provider to actually be able to facilitate that for them. So that, as soon as a transaction is done by a delegate, we will get our commission and it automatically goes straight to the course organiser.

Nik: So it reduces that time delay for them. And the end of the day cash is king, right? So, yeah.

Prav Solanki: That’s pretty impressive. So we’ve worked with payment processors or in the past, and as you probably well know, more so than we do is that they hold on to your money for five to seven days or maybe even longer, and then pass it on. And you’ve developed a system that allows people to get paid same day?

Nik: So we work with whatever the payment provider’s rules and regulations are. There is obviously always going to be that delay when you transfer money from one place to a bank account.

Prav Solanki: Sure.

Nik: There’s always going to be that delay. But in terms of other platforms and things, for example, what they would do is the payment provider or whoever the platform is, for instance, they would actually only pay out at the end of every month or so. So we’ve been able to actually go out to them.

Saeed: What we’re basically been trying to do is to keep things the same for the course organiser. The course organiser currently, those that claim online bookings, they already take payment over their website. We’ve just tried to keep the time the same. So nothing is disturbed for them with regards to payment.

Nik: So there’s no disadvantage to them.

Saeed: Exactly. That’s the whole idea.

Prav Solanki: Let’s talk about reviews. This comes up in conversation for me loads, so practises come and go. I’ve got a negative Google review, somebody’s left. And then other practises say their competition are getting people to leave fake reviews. Just talk to us about your review system and how you’ve developed that so that it’s watertight and verified.

Saeed: Obviously, with regards to that, the reviews environment is a very vibrant environment and that needs to mature over time. So we have to see what the user behaviour is. Do we even have that problem? We hope not. With the people joining, with their registration number we know individuals, they are not random people. But we have already discussed this. This is very important for us. And Google is so big now that they either don’t care or they don’t have time to look at a single review anymore. But, before we get to that stage, there will be a few years. So in the initial instance, we are going to make sure that their reviews are genuine, because there are big platforms like for example, Amazon have systems in place where the reviews are actually genuine. They can check. Google isn’t one of them.

Saeed: But that is the approach we are taking to ensure that nobody can come and badmouth someone that they haven’t been to their course.

Payman Langroud…: Just to clarify, if I was to book on the say, mini smile makeover course or say [inaudible] ABB course, in order for me to leave a review for that you will be able to verify that I had taken that course or registered on your platform in order to do that?

Saeed: That is one of the routes, because there is also the argument that you may have had been to the course two years ago. You still have a right to write a review. The course is the same course. So as I said, that’s something that we have to look at the environment and make a decision according to that. However, being a practise owner myself, and having had multiple bad reviews sometimes left on multiple clinics-

Payman Langroud…: You know the pain.

Saeed: I feel that. I know the pain. So I definitely make sure that doesn’t happen to anyone else.

Payman Langroud…: Brilliant.

Nik: And we have a reporting system as well. So people, including the course organisers or other delegates, or people who’re just visiting the site can actually go ahead and review the course, I mean report to review. So then once that review is reported, then our team will then find out and then they will take the necessary steps. So the first thing that we will do is ask them for proof, “Have you been on this course?” If they went three years ago, for example. And if they haven’t then that review is obviously taken down and their star rating and things are restored back to what it was.

Saeed: Which is very fair. You work really hard for your brand and the last thing you would want us to leave yourself on the role.

Nik: Yeah.

Payman Langroud…: Is the plan to then scale it up to medical and international? What are you studying, dental in the UK?

Nik: So initially dental and medicine is the plan. So we will be-

Saeed: That’s the plan.

Nik: Yeah, absolutely. So medicine is a huge market as well. And there’s a great demand. Very interestingly, I’ve got friends studying in medicine and he had to do a course in hospital. And they asked him, “Could you pay for this course?” And they asked him for a piece of paper to put their card details on. And he was shocked. And he was, “I’m not doing this at all.” And he called up the admin person and gave the card details through the phone. But it tells you, the paperwork that we’re dealing with, but let’s put GDPR aside, let alone anything other like security, right? So-

Saeed: Well, the question sometimes we ask ourselves is, why are we launching in dentistry where medical business is much bigger and much bigger market? And the simple answer to that question is because we have passion for dentistry, because I’m a dentist and they used to be a dental student. That’s the only reason that dentistry industry is going to benefit from this first than medicine, just because the creators are kind of dentists.

Payman Langroud…: Yeah, good to start somewhere where you know what’s going on more, for sure. So let’s go to the past. Nikunj, you’ve done a lot of interesting things tooth wise, with some of your partners, right?

Nik: Yes. So tooth wise is something that I had initially started by myself-

Payman Langroud…: As a dental student?

Nik: As a dental student, finally … tooth wise has a very long journey. I was a very keen bean student in my first year, like most, [inaudible] that fades away, I guess sometimes. But I was very keen, and I wanted to essentially be very smart at dentistry, and I got really into learning and reading every single other magazine here and there. And so I wanted to create a platform that brings all of these resources and everything together. Just what resources? I wasn’t sure. And then further working with people Saeed and things and actually listening and talking to a lot of people and studying what the dental market is, we realised that the course’s platform is the best thing to do.

Nik: And so we’re fortunate to have been able to create a content driven brand up until now. And tooth wise, we wanted it to be very engaging, because I’m sure you guys know with social media views are one thing, engagement is a far bigger thing. And so when we created content we wanted to create content that was relatable and emotionally driven for people. The best way to describe it is we have this mentality of being the BuzzFeed of dentistry. So we’ll create 10 problems that dentists have, and then [inaudible] a funny caption with that. And it’s great because I’ll be, “Saeed, you’re number four, and this is hilarious.”

Nik: And the great thing that fuels though is that I am then commenting in Facebook and social and sharing that with people, so not only is my audience seeing it, than Saeed’s audience is seeing. And that creates a snowballing effect in terms of the engagement and the reach that your content has. So I think that’s why we’re able to be quite fortunate enough to be able to get about 450,000 unique visitors on our social every single week, because purely we’re creating great content, period.

Payman Langroud…: And also, as you were studying you started this marketing company as well.

Nik: Yeah, well, it was a tech … well, I say tech agency. It wasn’t even a tech agency at that point. It was just me making websites for people.

Payman Langroud…: How did that even start?

Nik: Okay, so that’s quite an interesting story. So I was in my first year, and I was studying in Hungary. I had a lease and I was studying in Hungary. It was probably because I messed about a bit too much in my school, honestly speaking, and then I met a great dentist called Sameer Patel. He runs Elleven Dental. And I shadowed him for a few days and I fell in love, because he showed me both the business and the dental side of things, and I absolutely loved what he did. And he’s treating all these celebrities and looked really cool. So this sounds quite good and I became very passionate. And then I realised … I looked at my results cards for A-levels and I was like, “I don’t even have biology or physics or half the sciences I need even study dentistry.”

Nik: So then I did a one year intensive A-level course, and thankfully I got straight A’s and all that stuff. So then gone … I’m conditioned off to go ahead and study in Hungary. And then so once I was in my first year of dental school over there, I basically left home for reasons I’ll probably not go into right now, but circumstances caused me to essentially leave home, and I was faced with position where okay, I have to make ends meet. What the hell do I do? And so I had to learn a business in the past which I basically exited to make money for university and then I restarted another major, started making websites for people.

Nik: Long story short, started making websites for people, expanded into different industries and bigger clients. And now we’re fortunate enough to be-

Payman Langroud…: All along you were a dental student? You’re doing this as a dental student?

Nik: Yeah.

Payman Langroud…: In Hungary?

Nik: In Hungary, yeah.

Saeed: Dentistry must have been really easy in Hungary. [crosstalk 00:31:30].

Prav Solanki: Your story really resonates with me because I’m my brother, right? So when we were at uni, I was ordering in 20 kilos sacks of whey protein from New Zealand, separating into one kilo sacks and selling it on eBay. My brother was building computers and business was ingrained through our blood, through my dad driving taxis and us working in the corner shop. Is there anything about your childhood that was influential in you being what seems to be like you have an entrepreneurial spirit?

Nik: It’s probably to do with the fact that, as people, we’re quite innately wanting to be providers for the loved ones and the people around us. And so, trying to like fulfil that for people, we want friends and family around us to be proud of us. And then we also want them to have the most comfortable life possible in both wealth and health. So I think that is the thing that really pushed me forward, was, I had my brother and my grandma and my girlfriend, everyone who’s around me, and just wanting to be able to deliver for them was probably one of the biggest driving factors. And then realising that business is probably one of the most efficient ways in a way, when those are the riskiest but then you look at the risk with the reward as well, and it’s basically, you’re taking cumulative risk for the award. So you’re hoping that the reward’s going to grow.

Prav Solanki: And so what you say there is completely selfless, right? You’re talking about you doing something for the benefit of others, in order … when people go into business it’s like, “I’m going to be rich. I’m going to make loads of money,” and you’ve just said that, actually, I’m looking at my loved ones, the closest people around me on wanting to do the best for them.

Saeed: Yeah, it’s very interesting, actually. I asked that question to Nik about two weeks ago, just before we had a business meeting. I said, “Well, Nik, you’re doing very well. You’ve got a team of so many people working and you’ve got enough money. If you make more money you’re not going get any happier than you are now. You know that perfectly fine. So what is the reason that you want to set off so many other projects?” And the answer to that question is because that is a way of life. You enjoy doing what you’re doing. He loves business. He’s selfless. He can provide for his family already. There’s no further need for business. And I keep telling that to him all the time because I’m a bit older. But when you do something well, and you enjoy doing it, I think that’s the reason you probably do it at our level rather than any sort of financial way.

Nik: Yeah, definitely, because end of the day once you get over that hurdle, because having been through it firsthand as well you get to a point where, okay, it’s all about meeting the demand, demand, demand. And then you’ve met demand, and then what do you do after? And then you realise that way, I’m actually happy doing what I do. And once you realise that, okay, this is something I’m very content with, don’t get me wrong, I absolutely love dentistry, but it got to a point where I had to make a decision when I left school was that which one was I more happier doing end of the day, and which one would be a better use of my time? And I found that technology and business was the thing that filled me, so I took the plunge.

Nik: It was a very risky move, very difficult to explain to people because especially Asian parents and stuff like that-

Prav Solanki: Totally mate, totally. You’re right.

Nik: Yeah, they don’t understand startups and they’ll just throw the dice, the whole statistic like one in three businesses only succeed and all that stuff. And yeah, so that was a difficult conversation to have. But I think being very passionate and happiness driven is the thing that really fuels both side and life forward.

Prav Solanki: And what is it about your mindset and your makeup that makes you say, you know what? Against all these odds, I’m going to do it. Have you been on any mindset coaching journeys or are you spiritual in any way? What is it about you that makes you say, “Do you know what? All these people think I’m going fail. One in three fail. I’m not going down the traditional Asian parent; doctor, lawyer, dentist, medicine, whatever. What is it about you that’s different?

Nik: I think one, it comes from having people like Saeed next to me who really fuel that. Because when you’re a leader essentially, [inaudible 00:36:12], your team will sometimes not actually believe in your business and your thing as much or as passionately as you. And so having a team which is able to actually really fuel the passion and the drive that you have, and actually say, “You know what? This is actually bloody possible,” despite whatever the odds of them that may be. Then that’s also very reassuring to have. And then a lot of it comes down from you’re essentially just weighing down inside, what are the facts, what are the data and what are the strengths that we have and how can we build on it? Now, I like to take it from a very OCD logical way of thinking.

Prav Solanki: You sound like a programmer.

Nik: Yeah.

Prav Solanki: What are the facts? What are the data? What is it [inaudible] my risk profile? Boom! I’m going to go.

Nik: Absolutely, yeah.

Prav Solanki: And having worked with lots of developers, you literally sound like such a logic minded guy that just weighs his risk [inaudible 00:37:10].

Nik: It’s a blessing and a curse at the same time.

Payman Langroud…: What about the work on the Brushlink?

Nik: Yeah, so Brushlink was exciting. So first year, I started Oxo, my agency. Second year, I co-founded Brushlink with the team, so that was very exciting. So I had the opportunity to basically take care of the technology for Brushlink. So for those who don’t know what Brushlink is, it’s a small device that attaches to the handle of a toothbrush, and then monitors the way people brush their teeth, and it connects to a mobile phone app. And so we recently completed a survey, so in our survey research study that was done by Liz Kay. And what we found was that brushing helped reduce pluck by 70%, which was a phenomenal thing and with the study basically there was another part of it which was just without Brushlink and that was only all the health instruction and that reduced pluck by 30%.

Nik: So to see that Brushlink reduced pluck by like a massive amount like that was insanely phenomenal. And that was a very interesting journey for me because that was to create a product and I have no idea how to make a product at the time. I knew tech, I knew software at most. I had no clue about manufacturing [inaudible 00:38:33].

Payman Langroud…: You did that as a dental student too.

Nik: Yeah, second year was the hardest. But pilot, you know in second year, in Hungary, okay, no joke. I don’t mean to-

Payman Langroud…: [inaudible] agreeing with Saeed about your dental [inaudible 00:38:49].

Nik: So that was just about-

Payman Langroud…: Too much for your time.

Nik: So that what was about to say, I don’t mean to bad mouth the Hungarian universities and things, but the dropout rate in second year 40% passed, period. Like, that’s it. 40% of students passed. It was immensely tough to actually get through.

Saeed: That’s what I heard. Very, very few people actually finish Hungarian dental courses in the normal time period.

Nik: Yeah. In second year you have anatomy, physiology. I was learning anatomy of the polonium and the legs, and constantly asking my teachers, “Why do I need to know this as a dentist? But yeah, it was tough, but I think just again, realising that like wow, this could be such a phenomenal, amazing product, really drove me to create something like Brushlink. And it was great because I’m waking up in the morning, having conversations with China, trying to take care of manufacturing between lectures talking to [inaudible] else, talking to developers and things every single … I remember being between [inaudible] had glasses at times. It was just responding to emails, being told off by the teacher to put my phone away and then came back at it.

Saeed: Don’t set bad example to the [inaudible 00:40:16].

Nik: Yeah, don’t do that, kids. Don’t drop out of school.

Saeed: Don’t try that at home.

Payman Langroud…: To say, your past also very interesting. I mean, to make a dentist, charity to the foundation, that came about because of the work you were doing as a dental student as well?

Saeed: That’s right. Yes.

Payman Langroud…: So what were you doing?

Saeed: We were-

Payman Langroud…: I was not doing this stuff when I was a dentist student. God ahead.

Prav Solanki: I’m just wondering why I was just weighing whey protein. [crosstalk 00:40:43].

Nik: Whey protein.

Payman Langroud…: Go ahead, Saeed.

Saeed: I think what you do in the next 10 years of your life is sometimes a reflection of what happened in the past 10 years of your life. I went to a state college in Ladbroke Grove called St. Charles Catholic College. Some of you might know that from the adulthood film. Before I actually started college, the headmaster of the school was stabbed outside the college. I went to an absolute gangster college. And I studied really hard for two years and it was, great because the library was always empty. I had that library to myself. And they were amazing to me. They were really supportive and I was the only student actually got into any sort of dentistry medicine from my dental school.

Saeed: It was such a big achievement for them that there is actually a massive picture of me on the entrance of the dental school. I was one of the successful students, so quite proud of that. So when I went to dental school I always had this thing that if people, if they are held, they can do amazing things. Because it’s people helped me and I could make some good life out for myself. And I always wanted to go back and help the students. The first ever project I set actually was to go back to the dental school and help the students to get into medicine and dentistry.

Saeed: And after a year of work we actually managed to get seven students into medical school, which was amazing. I mean, these students are people that came from really rough backgrounds and they had no idea what it means to sit down and study. I had no clue, but after the second year of working with them, they were sitting in the library for 12,13 hours studying for medicine. And having that background of wanting to help people for potentially also for my personal pleasure just to give something back, I had a conversation with Prof. [inaudible 00:42:35], which was the dean of Boston London at the time. A great lady, and she said, “Saeed, you did all this stuff in the UK, but how about doing something in Africa?”

Saeed: I said, “Well, what do you mean?” She said, “I’m from Zimbabwe, and is there anything you can do?” I said, “Yeah, of course, they may have a thing.” So I had a thing, and emailed her then the same evening, I said, “Yeah, I’m going to do something for Zimbabwe because people there definitely need the help much more than a lot of other people in Europe.” And we set up this project called Make a Dentist, and the idea was we would help the education of dental students in Africa. And it was very simple, we were collecting stuff that people didn’t want to use here anymore, recycling educational resources.

Saeed: And every year we were shipping tonnes of stuff to Zimbabwe. That was amazing for them. And that was books, scrubs, instruments. There’s so much money sometimes being wasted here in the European system where an instrument is a bit blunt, they don’t want to use it anymore. They put it in the bin. So we said, “Don’t put in the bin, give it to us. We’ll send it.” We send it off. And obviously to raise money to be able to ship those goods we had to set up events. And there was nothing better than setting up conferences. We set up conferences for, again, education of dental students in this country.

Saeed: So we were helping the education of students here and in Africa and also holding some social events for young dental students to bring the fun back into dentistry, because we don’t like the whole negativity in dentistry in our group anyway. And that’s how Make a Dentist started 2009.

Payman Langroud…: Before that you were putting out this booklet on how to buy a practise with [inaudible 00:44:10], but you hadn’t bought a practise yourself yet. It was really interesting notion. It was this detailed booklet, wasn’t it?

Saeed: Yeah, I had to send it to-

Payman Langroud…: What was it called?

Saeed: [inaudible] assessment. It’s actually been downloaded by over 1000 people. It’s quite-

Payman Langroud…: And you were just giving it out for free?

Saeed: This is really interesting because I got tired of working for someone else, as much as I love my boss. He’s an amazing guy and he helped me so much.

Payman Langroud…: Who was that?

Saeed: Mansur Kanji, very nice guy and I’m still in contact with him. But I told, “You know what? I want to run my own clinic.” So first option was to buy a dental clinic. So we started with Sanny, every single weekend, Saturday, Sunday planning, because we didn’t want to just buy a clinic. We wanted to buy a clinic and make it the best clinic in the UK. That was the plan, always be the best. And as a result, you will be surprised that we went and looked at 80 clinics. I think we went a bit over the top. We enjoyed doing it. We were just learning from all these businesses all the good and bad things because they tell you. But the funny thing is, we couldn’t buy any of them. Not because we didn’t have money, there was always something not quite right when we wanted to actually proceed.

Saeed: And as a result, we came up with a criteria, which was a set of questions we would ask when we went to the viewings. And once we went to the bank, we were going to buy this clinic in Milton Keynes 1.6 million pounds. I don’t own a clinic and I’m only an associate for three years. And I put this question in front of this lady, the general manager of healthcare in Metro Bank. And she said, “This is amazing. Where did you get this from?” So well, these are the questions we are asked when we go to look at the clinics. She said, “This is I mean. This is a business plan, it’s really good.” So we thought, actually, you know what? These questions could become like a booklet, like a questionnaire, like a business due diligence tool.

Saeed: And we always worked more on it. And we provided it for free, because for me … Okay, we could have sold it for five [inaudible 00:46:01], people probably would have bought it. But for me, it’s very important I think the young dentists to have the opportunity to buy and set up dental clinics. I don’t like the fact that you qualify, and then you’re going to have to go and work for someone else or corporates for the rest of your life. I just don’t like it. I don’t think that creates competition in the UK. I don’t think that helps with the quality of provision of dentistry. And I think that destroys a lot of young dentists’ dreams.

Saeed: It’s a majority of people’s dream to own their own clinic, and we just wanted to help them. And I think we’ve helped a lot of people because majority of the bank managers you go tell them about filing system, they’ve seen it, they know it, and that is a brilliant business plan that you can offer. That’s how I could afford 1.6 million being a dental associate for three years. But the funny thing is eventually I ended up setting up my own clinic actually. I didn’t actually buy a clinic. And I have bought a clinic since. We do have the experience in that as well. But yeah-

Payman Langroud…: What’s your top tip for someone who’s looking to have their own practise? Download them.

Saeed: Download the assessment. Make sense, download as is free. Well, the top tips are planning ahead. Don’t expect to jump in and be successful. It doesn’t work like that. Don’t work full time as an associate, work three, four days. I made more money working four days a week, compared to working five days a week. Because I was burning myself out working five days my brain wasn’t actually functioning. When I dropped my days, some of my friends told me I couldn’t believe my income actually went up. You can’t work four days a week as a dentist, you got three days left. You can either go and have fun, which is by all means really good. If you’ve got the financial, do that, I didn’t. Or you can plan. Plan ahead, keep your expenses low.

Saeed: Don’t go and buy a Porsche 911 second year out of the dental school, because by the time you pay for the finance of that and by the time you pay for a mortgage, you’re not going to be financial well place to be able to either set up or buy a dental clinic. You need to plan financially before hand as well.

Prav Solanki: Saeed, just offline you mentioned to me earlier that you’re now helping new practise owners. So what started as writing a booklet you’re now actually giving services and active advice, and helping younger, old dentists set up their practises and almost handhold them, right?

Saeed: That’s right, just to mentor them.

Prav Solanki: Can you just tell us a little bit more about that, how it works, how people get involved, and maybe two or three of your key top tips to somebody looking to sell their own squat?

Saeed: Sure. When I started with Dr. Sandy [inaudible 00:48:44], my business partner, when I started with him our plan was to open and buy 50 clinics before we stopped, okay. And then after three clinics, we stopped that for a variety of reasons. I didn’t want to get into the corporate model which I was always against from the start. And then we came up with this idea that we are such experts in actually setting our mind and our clinics, because the third dental clinic I set up, it broke even in the second week. Now, for those people that know, an average business in the UK takes 18 months to break even. So to break even in the second week is something completely unheard of. It is the most successful squat clinic in the UK.

Saeed: And if we can do that we thought, you know what? We always had the passion of helping and helping ourselves also in the same time helping young dentists set up clinics. So let’s just set up a practise incubator programme where we will partner with an individual who’s got the passion, but they don’t know how to go about it and set up clinic with them. Our first project just started in [inaudible] and it’s going to be an amazing project. We are working with an amazing dentist who is very passionate, very good clinically, but he just didn’t know where to start.

Saeed: And I went and asked people when I wanted to open my first clinic, I went to people like James Goolnik, like Seema Sharma, to people who I taught were successful in the business of dentistry. And that it was funny that they offered … well, Seema Sharma certainty did. She offered us money, and she said, “You know what? I’ll invest in you guys, you are smart, but I’m not going to invest any time.” Well, I didn’t need the money, the bank would have given the money anywhere. I needed the expertise. I searched for this, nobody would offer it at the time when I started. So we are offering something that we searched for, we couldn’t find it. There are other people searching out there.

Saeed: It’s a brilliant experience, because my business partner … well, your likelihood of becoming very successful is much higher, rather than doing it on your own.

Prav Solanki: Yeah. And I think what you’re doing is you’re accelerating people, maybe 18 months, if not just 12 months ahead of where they would be. It’s such a short period of time, it’s a great idea.

Saeed: It certainly is. I think it’s a good idea. But again, going back to the same thing that I said, the most important thing is I like doing it, because I’m really good at doing that. That’s the reason I’m doing it. I’m not doing it for money. Between me and Sanny and Nik, we probably run about eight businesses. There’s going to be another after finance year. We just like to do something that will keep up our reputation. I don’t want to do a project that I’m not successful. I want to only do things that is going to be greatly successful.

Payman Langroud…: I mean, it’s well and good, right, you want to do only things that are going to be successful, but projects do fail all the time, yeah? All the time. And maybe you kill them before they get to a point of being called the project.

Saeed: Yeah, sure.

Payman Langroud…: But we’ve all had it.

Nik: Yeah.

Payman Langroud…: Product projects. For me, if something is not failing along the way, I’m not trying enough things. But you are trying lots of things, it’s true. Why don’t you two just stick to being dentists?

Saeed: I am the dentist. I am practising as a dentist.

Payman Langroud…: So why do you stick to being a dentist? I mean, what is it about you that … Hell, I didn’t stick to being a dentist either, but what is it about you?

Saeed: I think it goes back to Prav’s first question to Nik, what’s your background? My family been in business for 100 years. My granddad was a banker. My father was a banker, he’s retired now. And not the banker in the sense of in this country, so they were in the exchange of currency business. And I grew up in meetings in our living room, there was always meeting and a variety of people coming and going and asking questions about business and doing business. I have a passion for that. I definitely have a passion for business. And I love dentistry, I’ve got so much respect for dentistry. Dentistry has given me so much than any other occupation wouldn’t have given me otherwise.

Saeed: And I wouldn’t for a second say I would stop being a dentist. I love doing dentistry, but I like to do dentistry while I’m enjoying it. I like to have financial freedom. I like to go to the clinic, do the treatment just because I enjoy doing that, not because I’m dependent on the money that is going to make from that treatment. Not everybody have had luxury. And it hasn’t been easy for me. I’ve been working seven days a week for the past 15 years to achieve that. I’ve recently cut down on my days.

Prav Solanki: You can tell he’s a grafter because he says work four days a week and then you’ve got another three days of week to work.

Payman Langroud…: But, be honest, if I gave you a billion tomorrow, would you still drill teeth?

Saeed: I would. And I tell you why. One of my cousins is actually a son of a billionaire family in Iran, and he’s a dentist. He’s one of the reasons I actually do dentistry. He does still practise, and they own over 50 factories, he still practise. And I saw one of his patients recently in London, because he would only send his patient to me because they moved to London. And my hands were shaking just not to make a mistake. I had to do a very deep feeling. So, yes, because it’s not about the money. I definitely know, from my background, I know more money does not bring you happiness 100%. It just doesn’t. If I do have a family, I’ve got kids, I would never ever work seven days and I don’t recommend anybody doing that. But in the same time, everybody’s different.

Saeed: I’m just not going to sit there every night watching Netflix until I fall asleep. It’s not my character. Some people like that and they might do that. Nothing wrong with it, everyone is different.

Prav Solanki: Guys, you’re too young to ask this question, both of you, but I’m going to ask you anyway. If you could turn the clock back and do it all again, what would you both do differently?

Nik: That’s a very good question. What would I do differently if I could turn the clock back? Probably study a bit harder during my A levels. I would probably … When I was in university, I would have probably taken more time to myself. I was really working my ass off during that time, to a level where, I can probably openly talk about when I was coming close to burning out, and it wasn’t healthy. So, I think taking that time and now I’ve obviously developed these techniques and figured out how to do this, but being able to get to a point where you’re able to balance the life a bit better, because it’s all great having all this passion and work, but it’s a hard game and it’s not easy.

Nik: You’re taking meetings and there’s people shouting down the phone and things like that, when things aren’t going right. And a lot of the times, things aren’t going right, and that is always more painful than any of the successes that we can talk about now. So I would probably just say, taking better care of myself when I was younger.

Payman Langroud…: But you’re still very, very young [inaudible 00:55:50].

Prav Solanki: How old are you?

Nik: I turned 27 last month.

Saeed: So when he says, “When I was young,” he’s talking about when he was 12. I definitely will second that. I did work seven days a week for a very long time. If I could turn the clock back I probably wouldn’t have done that. But it is easy to say now that-

Nik: It’s what made you, right?

Saeed: Exactly, it’s easy to say now, but what is very important for at least people in dentistry profession to know, because we’re talking about business at the end of the day, and startup [inaudible 00:56:28]. But it is definitely not a sprint. You definitely need to take your time. It’s a marathon. You don’t want to burn yourself out, because you’re going to be there for a long time. Spend more time with your family. That’s probably what I would have done. I’m definitely guilty of that. And have more hobbies and do more things that you enjoy outside. I think my problem or also Nik’s problem is that we’ve got caught in the crossfire between dentistry and business in the same time, trying to do two things in the same time and run out of time. Probably concentrate on one thing, and leave the other three days a week that you’ve got free to enjoy life rather than mourning.

Prav Solanki: Guys, it’s been an absolute pleasure. Thank you so much for your time today. And it’s amazing. I always find it’s amazing that you sit down with people who you’ve met as acquaintances at parties and events, and you learn so much in an hour.

Nik: Thank you.

Payman Langroud…: Thanks a lot, guys.

Nik: Thank you.

Saeed: Thank you very much, guys.

Speaker 4: 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.

Prav Solanki: Thank you for tuning in guys to the Dental Leaders Podcast. Just got a little request to make. If you’ve got a suggestion of somebody else who we should be interviewing or somebody who’s got a really strong story, powerful story to share with us, please send us a message and help us connect with that individual so we can bring their stories to the surface.

Payman Langroud…: Thank you so much for taking the time, guys. If you got some value out of it, think about sharing it with your friends and subscribing to the channel. Thank you guys.

Prav Solanki: Don’t forget that six star review.